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Resolution 2082 (2015)
The fate of critically ill detainees in Europe
1. The Parliamentary Assembly considers
that nobody should die in detention. All member States should ensure
that each detainee is afforded the basic human dignity of dying
outside of prison.
2. In this vein, the Assembly is concerned about legal and practical
barriers to detainees’ access to critical medical care and to the
compassionate release of elderly or terminally ill detainees.
3. Despite international standards stating that a detainee must
enjoy the same right of access to health care as any other member
of society, the Assembly is concerned that the prison health-care
system does not always provide for timely access to vital medical
treatment, particularly for critically ill detainees.
4. Practical barriers, such as the unavailability of trained
medical staff, the lack of prompt and efficient communication between
prison staff and medical staff, the failure to transfer detainees
to a public hospital, and the disproportionate physical restraint
of detainees, create obstacles to a detainee’s ability to obtain
adequate medical care, especially in instances in which the detainee’s
condition is so severe that he or she must seek care at an off-site
hospital.
5. The Assembly is also worried about reports regarding the inappropriate
use of handcuffs on immobile, comatose, dying or even dead detainees,
which draw attention to the alarming practices in some member States
that insist on the use of means of restraint even when it is obvious
that a detainee is physically incapable of escaping or harming those
nearby.
6. The Assembly also expresses concern about restrictive practices
for granting compassionate release. These are often based on undetermined
and subjective criteria or on recommendations from medical professionals
who are not independent from the prison system or the executive.
Moreover, the final decision sometimes rests with a government official,
without the possibility of judicial review.
7. The ageing trend in society is mirrored in the prison population.
As the population of detainees grows older, the need for appropriate
medical care and compassionate early release becomes critical for humanitarian
reasons.
8. People in detention tend to age prematurely and are often
subject to more health concerns than people living in freedom. The
resulting need for geriatric-friendly facilities in detention centres
should be taken into account in the construction and renovation
of premises.
9. The lack of end-of-life or palliative care plans in many detention
centres, or their misuse or poor implementation where they do exist,
leads to situations in which detainees suffer undignified and painful deaths,
often still in a cell or prison hospital and without the presence
of family or friends.
10. The Assembly therefore urges the Council of Europe member
States to:
10.1. bring their domestic
law and practice into line with international standards that guarantee
the right to equal access to health care for detainees;
10.2. ensure that processes exist by which seriously ill detainees
can apply for temporary compassionate release in order to receive
specialised medical attention, for which the approval or refusal
is subject to review by an independent judicial body;
10.3. ensure that processes exist by which elderly or terminally
ill detainees can apply for permanent compassionate release in order
to die with dignity, for which the approval or refusal is subject
to review by an independent judicial body;
10.4. ensure that the relevant authorities:
10.4.1. authorise
treatment and efficiently provide transport in the event that a
sick detainee requires special medical care at an outside facility,
including when a woman goes into labour;
10.4.2. undertake a risk assessment to determine the necessary
level of restraint, if any, when a detainee requires treatment at
an outside facility, considering primarily the detainee’s state
of health and how it is changing;
10.4.3. expedite decision making with respect to applications
for temporary or permanent compassionate release, keeping in mind
the medical urgency of the situation;
10.4.4. set up geriatric, palliative and end-of-life care plans
that address the specific needs of an elderly detainee population
and terminally and seriously ill detainees, in order to provide
the most humane and comfortable environment possible until a detainee’s
release.
11. In addition to the above, the Assembly invites:
11.1. Turkey to:
11.1.1. adopt
a national policy stipulating that the use of restraints on detainees
in medical settings must be exceptional and at all times proportionate
to the security risks that the person can realistically pose;
11.1.2. entrust the responsibility for transporting detainees
to outside hospitals to a body other than the gendarmerie, and take
all necessary measures to safeguard the detainee’s dignity prior to
and during such transfers, in particular by making sure that they
take place without undue or arbitrary delays and by avoiding any
ill-treatment of detainees during the transfers;
11.1.3. amend its legislation on suspension of prison sentences
for medical reasons in such a way as to ensure that:
11.1.3.1. decisions
on granting or revoking the suspension of a prison sentence are taken
by an independent authority established by law, other than the public
prosecutor’s office, in order to avoid any risk of conflict of interest
or political bias;
11.1.3.2. a petitioner’s eligibility for compassionate release is
evaluated based on medical reports from doctors who are independent
from the prison administration and the executive branch of government;
11.1.3.3. the eligibility criterion that the person to be released
does not pose a threat to public security is not applied in a discriminatory
manner, so that all prisoners who are eligible for release on medical
grounds are released, while imposing whatever conditions may be
needed to avoid reoffending;
11.1.3.4. national law and practice is compliant with the case law
of the European Court of Human Rights on whole-life prison sentences,
by providing the possibility for prisoners serving an aggravated
life sentence to apply for conditional release as well as for suspension
of a sentence for medical reasons;
11.2. Romania to:
11.2.1. increase the number of medical
staff in places of detention, including by creating incentives for
qualified medical staff to work in prison establishments;
11.2.2. significantly increase the daily food allowance for detainees
and ensure that they are provided with nutritious food;
11.2.3. redouble its efforts to combat overcrowding in prisons
and guarantee conditions of detention conducive to good health and
recovery from illness;
11.3. Montenegro to undertake to further increase the number
of medical staff in its prisons, and enhance co-operation with medical
services outside the prison system, especially as concerns psychological
care and treatment for mental illness.
12. Lastly, the Assembly notes that the situation of people in
detention with severe disabilities raises similar concerns as those
outlined above and considers that these should be explored separately.