European Court of Human Rights

Information Note on the Court’s case-law No. 154

July 2012

X v. Finland - 34806/04

Judgment 3.7.2012 [Section IV] See: [2012] ECHR 1371

Article 8

Article 8-1

Respect for private life

Forced administration of therapeutic drugs in mental institution: violation

 

Article 5

Article 5-1-e

Persons of unsound mind

Forced confinement in a mental institution: violation

 

Facts - The applicant, a paediatrician, was arrested in October 2004 in connection with criminal proceedings that had been brought against her after she allegedly helped a mother remove her daughter from public care. The court ordered the applicant’s transfer to a mental institution, where a doctor concluded after examining her over a two-month period that she suffered from a delusional disorder and met the criteria for involuntary confinement. In February 2005 the Board for Forensic Psychiatry of the National Authority for Medico-Legal Affairs ordered the applicant’s involuntary treatment on the basis of the doctor’s report. The hospital then started injecting the applicant with medication which she had refused to take orally. She was not released from hospital until January 2006 and her treatment officially ended in June of that year. The applicant unsuccessfully challenged her confinement and involuntary treatment before the domestic authorities.

Law - Article 5 § 1: The initial decision to place the applicant in involuntary hospital care had been taken by an independent administrative body with legal and medical expertise and had been based on a thorough psychiatric examination carried out in a mental institution by a doctor who had not participated in the decision to place her. The decision-making process had followed the domestic legal procedures at all times and the Mental Health Act was sufficiently clear and foreseeable in that respect. However, domestic law also had to protect individuals from arbitrary deprivation of their liberty and security. While there had been no problem with the applicant’s initial confinement, as it had been ordered by an independent specialised authority following a psychiatric examination and had been subject to judicial review, the safeguards against arbitrariness had been inadequate as regards the continuation of the applicant’s involuntary confinement after that period. In particular, there had been no independent psychiatric opinion, as the two doctors who had decided on the prolongation of the confinement were from the hospital where she was detained. In addition, under Finnish law the applicant herself could not bring proceedings for review of the need for her continued confinement, as such periodic review could only take place every six months at the initiative of the relevant domestic authorities. The procedure prescribed by national law had thus not provided adequate safeguards against arbitrariness.

Conclusion: violation (unanimously).

Article 8: Medical intervention in defiance of the individual’s will normally constituted interference with his or her private life, and in particular with his or her personal integrity. Such interference was justified if it was in accordance with the law, pursued a legitimate aim and was proportionate. The accessibility and foreseeability of the law at issue in the applicant’s case did not give rise to any problems. However, Article 8 also required that the law in question be compatible with the rule of law, which in the specific area of forced medication meant that the domestic law had to provide some kind of protection to the individual against arbitrary interference. Under the Mental Health Act, doctors attending a patient could decide on the treatment to be given, regardless of the patient’s wishes, and their decisions were not subject to appeal. However, given the seriousness of the forced administration of medication, the Court considered that the law on which such treatment was based had to guarantee proper safeguards against arbitrariness. In the applicant’s case such safeguards had been missing: the decision to confine the applicant involuntarily had included automatic authorisation for the forced administration of medication if she refused treatment. The decision-making had been solely in the hands of the treating doctors and was not subject to any kind of judicial scrutiny. The applicant had not had any remedy by which she could ask the courts to rule on the lawfulness or the proportionality of the measure or discontinue it. Accordingly, the interference in question had not been “in accordance with the law”.

Conclusion: violation (unanimously).

Article 41: EUR 10,000 in respect of non-pecuniary damage; claim in respect of pecuniary damage dismissed.

(See also Herczegfalvy v. Austria, no. 10533/83, 24 September 1992)

 

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