5. Congress of the European Network of (ex-)Users and Survivors of Psychiatry
(A joined congress of ENUSP and the World Network of Users and Survivors of Psychiatry – WNUSP):

"Networking for our Human Rights and Dignity"

July 17 – 21, 2004 in Vejle (Denmark), Idrætshøjskole

back to Workshop Index

Report of Workshop 8:
Human Rights / What is coercion in psychiatry and how to fight against it?

Facilitator: Gábor Gombos, Hungary

The Committee of Ministers (CoM) of Council of Europe (CoE), at their last meeting, was expexcted to adopt a new Recommendation concerning the protection of the human rights and dignity of persons with mental disorder. The CoM decided to postpone this agenda item until their next meeting in September. As the bulk of the document (both in volume and in substance) is about involuntary placement, involuntary treatment and other coercive measures, and because of the necesity for an urgent response from the European (ex-)user/survivor movement, the workshop focussed on this particular document. The so-called 'Draft Recommendation' is available online at: http://www.coe.int/T/E/Legal_Affairs/Legal_co-operation/Bioethics/Activities/Psychiatry_and_human_rights/INF_2004_5e%20psychiatrie%20projet%20rec%20&%20ER.pdf

The workshop was attended by about ten people, mostly from CoE Member States. Copies of the Draft Recommendation were made available for participants.

In the first part of the session background information was provided on Council of Europe, on the status of CoE Recommendations and on the long prehistory of the present document, including ENUSP and WNUSP participation in the public consultation in 2000 and ENUSP attempts, and failure, to make the proceedings comply with the UN Standard Rules guidelines on the involvement of persons with disabilites and their organisations in all levels of policy making. More information on the history of the present Draft Recommendation, including ENUSP's statements, activism, is available at http://www.enusp.org (navigation: Documents & Reports / Declarations and Other Documents / White Paper)

In the second part, workshop participants analysed some of the Articles of the Draft Recommendation. Article 30 was selected as one of the examples to illustrate the sophisticated language used by the document.

The mere fact that a person has a mental disorder should not constitute a justification for permanent infringement of his or her capacity to procreate. (Article 30 of the Draft Recommendation)

Workhsop participants were asked to analyse and then tell the group what messages are involved in this single sentence and if they could agree with them. Some of the "hidden" messages, uncovered by the group members, include: ·

  • Having a mental disorder alone does not justify forced sterilization, however, in the presence of some, nowhere in the text specified, additional factors, it does justify the intervention.
    • ·
  • Having a mental disorder itself can justify non-permanent infringement of the person's capacity to procreate.

Participants could not agree with this proposal, they felt that this Article is discriminatory and lowers already existing standards in internationally recognized medical, ethical and human rights guidelines.

Criteria for involuntary placement and involuntary treatment as given in Articles 17 and 18 of the Draft Recommendation were also discussed. In this debate workshop members wanted to have a vote if there were people who could accept forced measures at all. None of the present people could endorse the idea of legalising coercion. The workshop recommended to support no-force approaches.

Outcome of the workshop: The workshop raised concerns as follows: ·

  • Procedural concern: Internationally recognized standards on the involvement of the stakeholders (e.g. UN Standard Rules) have been overlooked in the process of drafting, finalising and submitting the document for adoption.
    • ·
  • Disability rights legislative environmental concern: Since the last and only public consultation on the first version of the Draft, the UN General Assembly has adopted a Resolution (GAOR 56/168, 19/12/2001) on mandating an Ad Hoc Committee to work on an integrative, comprehensive human rights treaty to protect and promote the human rights and dignity of people with disabilities. The new human rights treaty has been drafted and is expected to be ready for adoption by the UN General Assembly in 2005. The CoE Draft Recommendation was developed without any co-ordination with the UN drafting process. If the CoM of CoE will adopt the Draft Recommendation as it is, very soon the UN treaty will likely overrule many of its provisions. Then, CoE will need to mandate a new working group to develop a new recommendation, what would be an unjustified waste of time, human and financial resources.
    • ·
  • Concern on the standards adopted: Several of the Articles employ human rights standards that are lower than the ones adopted in already existing professional and human rights guidelines and in the recent case-law at the European Court for Human Rights.
    • ·
  • Proportionality concern: While mental health professionals and expert lawyers claim that coercive measures are necessary in a very small percentage of cases, and also the present document adopts that such measures should be justified only under exceptional circumstances, the bulk of the Draft deals with these very exceptional, rare cases and has no innovative provisions to protect human rights and dignity of persons with mental problems in the vast majority of cases.

The workshop concluded with a recommendation:

In the Council of Europe Member States lobbying for the UN disability rights treaty should be combined with lobbying against the adoption of the Council of Europe Draft Recommendation. Instead, Council of Europe shall make sure that a guidelines for human rights protection of persons with mental problems will be developed in accordance with the standards adopted by the coming UN treaty. (Recommendation from the workshop.)