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European Court of Human Rights

In: European Journal of Health Law
Authors:
Joseph Dute Emeritus Professor of Health Law, Faculty of Law, Radboud University Nijmegen The Netherlands

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https://orcid.org/0000-0003-1536-1725
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Tom Goffin Professor of Health Law, Faculty of Medicine and Health Sciences, University of Ghent Ghent Belgium

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Open Access

These summaries are based on the provisional text of the judgements of the European Court of Human Rights. These judgments are still subject to editorial revision before their reproduction in Reports of Judgments and Decisions. For the full provisional text, see: http://www.echr.coe.int.

ECHR 2022/1 Case of M.B. v. Poland, 14 October 2021, no. 60157/15 (First Section)

1 The Facts

On 13 January 2014 the applicant, born in 1985, attacked his parents with a knife. Criminal proceedings were instituted, in which the domestic courts established that he had committed the offence of causing bodily harm. On 17 January and 3 February 2014, the applicant underwent psychiatric examinations, as a consequence of which expert psychiatrists concluded that he was suffering from paranoid schizophrenia. On account of his mental condition the applicant was found not to be criminally liable and instead it was decided that he should be placed in a closed psychiatric facility. The decision ordering the applicant’s confinement was given by the district court on 19 January 2015 and was upheld on 11 May 2015. He was subsequently admitted to the hospital on 4 August 2015. In the meantime, he underwent voluntary treatment in a hostel, a therapeutic inpatient centre for young people suffering from mental health conditions.

On 30 October 2015, at the court’s request, two doctors from the hospital submitted information about the applicant’s state of health. Furthermore, on 4 February 2016, psychiatrists from the hospital submitted an opinion on the applicant’s condition. On 12 April 2016, in the context of a periodic review, the District Court extended the applicant’s detention. He was released from the hospital on 29 November 2016.

2 The Law

2.1 Alleged Violation of Article 5 Para. 1 of the Convention

The applicant complained under Article 5 para. 1 (e) of the Convention, which protects the right to liberty and security of person, that his detention in a psychiatric hospital had been unlawful in that it had not been based on recent medical evidence.

The Court reiterates that pursuant to the Winterwerp criteria, the existence of a mental disorder warranting compulsory confinement must be reliably shown at the date of detention and throughout the detention, especially given the marked tendency of mental disorders to develop over time. The Court further reiterates that the medical assessment must be based on the actual state of mental health of the person concerned and not solely on past events. A medical opinion cannot be seen as sufficient to justify deprivation of liberty if a significant period has elapsed. At the same time, as is apparent from the Court’s well-established case-law, the question whether medical expertise was sufficiently recent is not answered by the Court in a static way but depends on the specific circumstances of the case before it. In this connection the Court also notes that Polish law does not provide for an obligation to carry out every six months a periodic review of the need to continue a person’s involuntary treatment in a closed facility.

2.1.1 The Applicant’s Confinement between 4 August 2015 and 12 April 2016

After the psychiatric examination on 3 February 2014, and until the adoption of the final decision, no other medical examinations had been ordered by the domestic courts. The applicant submitted that following his voluntary treatment in the hostel his confinement in a closed facility was no longer necessary. In support of his submissions the applicant provided certificates from the hostel dated July and August 2014, confirming that his condition had improved. Nevertheless, the domestic courts disregarded that evidence and based their decisions on medical reports dating back to January and February 2014. Consequently, the applicant was admitted to the hospital on 4 August 2015, based on medical reports issued a year and six months earlier without any attempt to resolve contradictions between the opinions of the experts and the hostel’s certificates. The Court finds in the circumstances of the present case that that delay was excessive and that at the time of the applicant’s detention on 4 August 2015 it had not been “reliably shown” that his mental condition necessitated his confinement. However, the Court is satisfied that on 12 April 2016, at the time of the review proceedings, a clear diagnosis of a true mental disorder in the applicant’s case was established before the competent domestic court on the basis of medical expertise. The Court thus concludes that the applicant’s hospitalisation between 4 August 2015 and 12 April 2016 was not “lawful” within the meaning of Article 5 para. 1 (e) of the Conventions.

2.1.2 The Applicant’s Confinement from 12 April 2016

The Court observes that, following the applicant’s placement in a psychiatric hospital, the District Court ordered his examination by expert psychiatrists. The expert evidence confirming the need to continue the applicant’s confinement was submitted to the court on 30 October 2015, and again on 4 February 2016. Subsequently, on 12 April 2016, the District Court confirmed that the applicant was suffering from a mental disorder which justified placing him in a psychiatric hospital. Although the applicant criticised the experts’ reports, the Court sees no reason to doubt that the experts were fully qualified and had based their conclusions on their best professional judgment.

The Court further notes that, during the period after 12 April 2016 until his release, the applicant was examined by expert psychiatrists at six-monthly intervals and that the results of the psychiatric examinations served as the basis for a fresh judicial decision. In addition, the domestic court took into consideration the evolution of the applicant’s mental health, as following an improvement in his condition it was decided to release him from the hospital.

In view of the above the Court is satisfied that the applicant’s deprivation of liberty between 12 April 2016 and 29 November 2016 was lawful within the meaning of Article 5 para. 1 (e) of the Convention.

For these reasons, the court, unanimously, holds that there has been a violation of Article 5 para. 1 (e) of the Convention in respect of the applicant’s hospitalisation between 4 August 2015 and 12 April 2016; no violation of Article 5 para. 1 (e) of the Convention in respect of the applicant’s hospitalisation between 12 April and 29 November 2016.

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