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Welcome to the EuroPris Knowledge Management System. The table below shows questions and responses from European National Agencies. Select a question for more information or use the filters on the left to narrow down questions based on Agency or Category.
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Introduction: Given that in Montenegro on July 17th 2015 was adopted a new Law reagrding a prison system of Montenegro, that is in line with international standards and procedures, it would beneficial to us before making the new Rulebook on health protection of prisoners and detainees, to have some knowledge of the procedure from other prison systems on the topic of fixation / isolation of prisoners and detainees in prisons
If in inmate act as he needs to be taken in solitary confinement he/she shall be examined by a physician to exclude that the behaviour is caused be a severe mental illness. Persons in solitary confinement should be examined by a physician every month.
Who from health professionals in the prison should give an order for human bonding of a patient?Force for medical/psychiatric reasons are not allowed in prison. Human bonding can only be ordered by a prison officer.
Do you have specific procedures in the event of a hunger strike?Yes. If the person loses his/her consciousness he/she could be taken to hospital for i.v substitution
Do you have a procedure of fixation in a prison?Not applicable as there is no provision to hold prisoners in solitary confinement in Irish prisons nor is it the policy of the Irish Prison Service to hold prisoners under such conditions.
Who from health professionals in the prison should give an order for human bonding of a patient?Not applicable, as there is no provision for such a measure in Irish prisons.
Do you have specific procedures in the event of a hunger strike?Yes, the Irish Prison Service have a protocol / management document covering such circumstances.
Do you have a procedure of fixation in a prison?This question is unclear and therefore I am not in a position to provide an answer.
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Prison doctor does not give an opinion about the convict's ability to stay in solitary confinement as disciplinary sanction; he does not write ''capable of isolation''. We had such practices in the past but under changed laws the responsibility of doctor is defined in different way - he now cares for prisoner's state of health.
Who from health professionals in the prison should give an order for human bonding of a patient?In any case only a doctor could give an order for human bonding. In case doctor collaborating with prison could not be reached doctor who is replacing that one must be found.
Do you have specific procedures in the event of a hunger strike?There are internal guidelines for prison system about hunger strike where procedures in such cases are defined.
Do you have a procedure of fixation in a prison?We do not have any such procedure in place.
Yes, a psychiatrist or other physician gives his/her professional opinion about the patient`s ability to stay in solitary confinement.
Who from health professionals in the prison should give an order for human bonding of a patient?The order is given by the prison governor, proposed by the psychiatrist or other physician, prepared medical reference, completed Protocol approved psychiatric standard for temporarily limiting the movements of a patient with psycho-motor agitation, and shall be reflected: her/his name, № ( history of the disease), time, reason, monitor and record vital indicators 15 min., check breathing, heartbeat, blood pressure and pulse in the limbs. Fixation is not more than two hours under continuous direct observation.
Do you have specific procedures in the event of a hunger strike?The prisoner is registered, a medical examination is performed and patent`s status is described in medical reference, explains in plain and simple language to face the danger to her/his health and life, clarifies claims and the reasons of deprivation of liberty and seek lawful way to solving them. Daily respected algorithm, ensuring that reflects weight, vital signs, blood sugar levels, ketones in the urine. Upon agreement of him flowing water saline, glucose, amino acids, protein solutions and is powered by liquid and liquid mushy food.
Do you have a procedure of fixation in a prison?Yes, under our Law on execution of sentences and remand in custody and Decree № 2 from 22th of March this year to terms and conditions for medical treatment in places of imprisonment.
According to the Law on the Enforcement of the Prison Sentence, before application of disciplinary measure of sending prisoner to a solitary confinement, medical examination is obligatory. During enforcement of this disciplinary measure supervision of medical doctor is obligatory at least once in 24 hours. Findings and remarks of medical doctor and of other authorized officials are marked in the Register of enforcement of disciplinary measures. Cited Law does not prescribe that doctor must give opinion about the patient's ability to stay in solitary confinement. This kind of opinion is foreseen only in case of application of special measure of maintaining order and security – placement in a specially secured cell without dangerous objects.
Who from health professionals in the prison should give an order for human bonding of a patient?Special measures of maintaining order and security are stipulated in the Law on the Enforcement of the Prison Sentence and they can be ordered by the prison director or person authorized by him/her. Among these measures, tying by handcuffs and placement in a specially secured cell without dangerous objects can be classified as restraining. Placement in a specially secured cell without dangerous objects is always combined with other special measure of maintaining order and security – enhanced surveillance and during application of this measure it is obligatory for the prisoner to be monitored by a medical doctor. Prisoners with serious mental disorders serve their sentence in the Prison Hospital in Zagreb which employs psychiatrists and has prescribed procedure of fixing patients, according to the Law on the Protection of Persons with Mental Disorders (see previous answers). In other correctional institutions, in case of a prisoner who is threatening to seriously and directly jeopardize his own life, health or security or life, health or security of other persons and his behaviour has characteristics of serious mental disturbance, he is immediately transferred to Prison Hospital in Zagreb or to nearest Psychiatric hospital (civil hospital). Then the psychiatrist will make a decision on applying measures of force regulated by the Law on the Protection of Persons with Mental Disorders and by the Regulation on types and manner of application of measures of force to a person with serious mental disturbances. One of the measures of force is restraining (fixing) which can be applied as physical restraining or as chemical restraining, for example by applying fast tranquilization or sedation.
Do you have specific procedures in the event of a hunger strike?Procedures in the event of a hunger strike are prescribed by the Head Office in June 2015. These procedures are based on the WHO's Declaration of Malta on Hunger Strikers and they describe doctors' procedure which comprehends: - Obligation of ethical treatment - Respecting autonomy of a person - Concept of "benefaction" - Balancing double loyalty - Confidentiality and gaining trust - Assessment of psychical capacity of a hunger striker - Instructions which are given in advance - Getting detailed information about health condition of a hunger striker - Detailed examination of a hunger striker - Keeping detailed records - Artificial feeding - Forced feeding - Appeal of conscience
Do you have a procedure of fixation in a prison?In April 2015 director of the Prison Hospital in Zagreb gave an order on Procedure in case of applying measures of force to persons with serious mental disturbances and physical limitation of freedom of movement of persons hospitalized for medical reasons to harmonize this procedure with the Law on the Protection of Persons with Mental Disorders and Ombudsman's recommendations. Measures of force and means of physical limitation of freedom of movement are applied exceptionally if this is the only way to prevent person from jeopardizing his own life, health or security or life, health or security of other persons. Decision can be made by a psychiatrist or other medical doctor or by nurse in case of emergency, but then psychiatrist must be informed about it promptly. Restraining is applied by medical belts, always on big joints. Medical doctor is regularly checking the patient, fulfilling the protocol of application of measures of force, controlling mental and physical state of the patient, writing time of checking the patient and date and time of termination of application of measures of force. Nurse is continuously checking the patient, controlling his vital functions and personal hygiene, fulfilling the list of applied interventions and writing nurses remarks. Application of measures of force is never used as punishment. Since July 2015 in Prison Hospital in Zagreb restrained (fixed) prisoner is supervised 24 hours a day by a video-camera intended for enhanced surveillance of prisoners with acute psychical decompensation.
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Medical professionals and psychologists are entitled to call for the cancellation or omission of solitary confinement for medical reasons or if the (mental) health of a prisoner justifies it.
Who from health professionals in the prison should give an order for human bonding of a patient?Psychologists are required to monitor prisoners under solitary confinement and may call for the cancellation of the disciplinary measure in order to avert threats to security such as suicidal intent etc.
Do you have specific procedures in the event of a hunger strike?Refusing food or meals unless certain self-designated conditions are met is regarded as a disciplinary offense. The medical professional of the institution will examine the person in question and may call for his or her hospitalization if parenteral nutrition is required. No consent is required from the prisoner if he or she is in a critical condition.
Do you have a procedure of fixation in a prison?n.a.
Part 6. of the Prison Healthcare Directions 2011 state: —(1) On being informed by the Governor under Rule 96(3)(a) of the Prison Rules that the Governor proposes to make an order under Rule 96(2), a medical practitioner must advise the Governor whether or not it would be appropriate, on health and welfare grounds, to place a prisoner under a restraint in order to prevent self-harm. (2) On being informed by the Governor under Rule 96(3)(b) of the Prison Rules that the Governor has made an order under Rule 96(2), a medical practitioner must advise the Governor whether or not it would be appropriate, on health and welfare grounds, to remove the prisoner from the restraint. (3) A medical practitioner must examine a prisoner who is placed under a restraint immediately following— (a) the placing of the restraint; (b) its removal; and (c) regularly while under restraint, as clinically required.
Who from health professionals in the prison should give an order for human bonding of a patient?The responsibility for the delivery of health care services in prisons in Scotland transferred to National Health Service (NHS) Health Boards in November 2011. The Health Board would determine who is responsible in the absence of the Doctor.
Do you have specific procedures in the event of a hunger strike?NHS Health Boards are responsible for the monitoring of the health condition of any prisoner on hunger strike. The Scottish Prison Service will monitor and record the individual’s food intake and report to the NHS Health Board.
It is not necessary.
Who from health professionals in the prison should give an order for human bonding of a patient?Each of penitentiary institution, which has a room with a fixation bed, has procedure /regulation approved by the director of the institution. This measure is applied only by specially trained officers. The decision to apply the fixation can be made by a doctor or psychiatrist only in prison hospital.
Do you have specific procedures in the event of a hunger strike?Yes, specific instructions are provided for the event of hunger strike which are complied with
Do you have a procedure of fixation in a prison?Yes.
No. The doctor is due to examine every prisoner immediately after his placement in isolation and on a daily basis during the measure, and he must report to the prison governor as soon as he assesses a deterioration of the prisoner's state of health due to the isolation. This procedure is in conformity with CPT standards.
Who from health professionals in the prison should give an order for human bonding of a patient?N/A
Do you have specific procedures in the event of a hunger strike?No. Hunger-striking prisoners are dealt with on a case-by-case basis in the respect of medical deontology.
Do you have a procedure of fixation in a prison?No
Yes, we do take into account the health condition of the inmate before placing him/her in a cell. This is being regulated according with the Regulations No.800 of Cabinet of Ministers of November 27, 2007 “Internal Rules of Investigation Prison” and with the Regulations No.423 of Cabinet of Ministers of May 30, 2006 “Internal Rules of Penitentiary Institution”. (According with the Regulations No.800 of Cabinet of Ministers of November 27, 2007 “Internal Rules of Investigation Prison”: Section 13 – if the sanitary processing and health check of the arrested person has not been carried out, he/she is placed in a solitary cell. In this case, the health check and sanitary processing of the arrested person is carried out no later than on the third day after being admitted to the investigation prison. Section 18 – an arrested person is placed in a common cell only with the permission of a doctor or doctor assistant. According with the Regulations No.423 of Cabinet of Ministers of May 30, 2006 “Internal Rules of Penitentiary Institution”: Section 11 – the Admission department of the place of imprisonment carries out the medical examination and sanitary processing of the convicted person. Section 13 – the inmate placement commission, established based on the order of the head of the place of imprisonment, decides in which department, unit and cell will the inmate be placed (they take into account the free places in the cells, psychological compatibility, level of education and health condition of the inmates). Section 44.7. – according with the instructions of the Administration of the place of imprisonment the inmate has the duty to comply with the necessary medical examination and vaccination. Section 44.8. – according with the instructions of the Administration of the place of imprisonment the inmate has the duty to take the medicine immediately after receiving it in the presence of a staff member of the place of imprisonment.)
Who from health professionals in the prison should give an order for human bonding of a patient?The medical professionals of the Medical Department in the place of imprisonment do not decide whether or not to use restraints on an inmate. According with the Regulations No.283 of Cabinet of Ministers of June 9, 2015 “Procedures by which the Official of Latvian Prison Administration Uses Special Means” the medical professional carries out the state of health examination of the inmate after the use of special means. (Section 2 – an officer is allowed to use the following special means: restraints; handcuffs; hand and leg cuffs; (..). Section 8 – the form of the special means and the intensity with which it will be used is determined by an officer after having ascertained the specific situation, possible threat, consequences, individual characteristics of the inmate or other person, possible harm of the special mean. A special mean is used on other person is used only to detain that person. Section 10 – restraints, handcuffs, hand and leg cuffs are used if it is necessary to bind inmate’s or other person’s hands or legs, or both hands and legs at the same time in order to prevent the inmate’s or other person’s physical resistance. Section 16 – an officer after having evaluated the requirements noted in the Section 8 of these regulations, decides, while in transit to health facility to receive treatment outside of the place of imprisonment, to bind inmate’s hands with restraints or hand cuffs with hands in front or behind the back, or not to bind hands with restraints or handcuffs. Section 18 – When guarding an inmate in a health facility while receiving treatment outside of the place of imprisonment, an officer binds inmate’s hands with handcuffs with hands in front or behind the back, or binds inmate’s hands with handcuffs to the bed, if: Section 18.1. the inmate is not cooperating with the legitimate demands of the officer or medical personnel of the health facility; Section 18.2. the inmate is physically resisting the officer or medical personnel of the health facility; Section 18.3. there is reason to believe that the inmate may cause harm to themselves or to another person, may attack the officer, medical personnel of the health facility or another person, or may try to escape. Section 20 – Hand and leg cuffs are used when an inmate with life sentence is being transferred to a health facility outside the place of imprisonment to receive treatment, if there is reason to believe that the inmate may attack an officer, medical personnel of the health facility or another person, or may try to escape. Hand and leg cuffs are not taken off during the whole transfer of the inmate as well as during all of the time while the inmate is guarded in the health facility. Section 34 – Restraints are used, if it is necessary to interfere with inmate’s movements by using special devices to fire nets, ropes, adhesive substances or foams.)
Do you have specific procedures in the event of a hunger strike?No, but every day after the third day of hunger strike a medical specialist of the prison Medical department observes and carries out the state of health examination of the inmate.
Do you have a procedure of fixation in a prison?The procedure for fixation in a prison is stated in the Regulations No.283 of Cabinet of Ministers of June 9, 2015 “Procedures by which the Official of Latvian Prison Administration Uses Special Means”.
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The regulatory texts don't stipulate only that a consultative opinion from a medic on the placement in isolation of a detained person. The medic visits regularly.
Who from health professionals in the prison should give an order for human bonding of a patient?In the absence of a chief medic, a psychiatrist can actually ask the prison director to take a measure of isolation for a detainee.
Do you have specific procedures in the event of a hunger strike?The person who makes official his/her will to hunger strike, by mail post addressed to the prison director, is isolated. The meals are offered systematically. The medic appreciates the opportunity of hospitalisation or not.
Do you have a procedure of fixation in a prison?There are isolation procedures well framed by the regulations. The placement in isolation as a security measure can be made at the request of the detainee or at the demand of the prison director or his representative.