Caring accommodation
The welfare imperious accommodation is an official measure of adult protection for the treatment or care in an inpatient facility ( psychiatric hospital , nursing home ) in Switzerland . On January 1, 2013, she replaced the welfare deprivation of liberty .
Legal development until December 31, 2012
Legal regulation
The welfare deprivation of liberty (abbreviated FFE) was until December 31, 2012 a form of deprivation of liberty with which a person could be admitted to a “suitable institution” against his will.
According to the law , the prerequisite for a welfare deprivation of liberty was mental illness , mental weakness, drunkenness , other addictions or severe neglect, if the necessary personal care cannot otherwise be shown to the person and they should therefore be placed in a suitable institution or withheld. As a rule, the FFE was ordered and revoked by the guardianship authority at the patient's place of residence or residence.
With the federal law of October 6, 1978 on welfare deprivation of liberty , Articles 397a – 397f were added to the civil code with effect from January 1, 1981 . The aim was to adapt Swiss law to the requirements of Article 5 of the European Convention on Human Rights (ECHR).
After a new regulation had been discussed at expert level since 1993, the government introduced a new regulation to parliament on June 28, 2006.
«A person who suffers from a mental disorder or mental handicap or is severely neglected may be accommodated in a suitable facility if the necessary treatment or care cannot be provided otherwise. The burden and protection of relatives and third parties must be taken into account. The person concerned will be released as soon as the requirements for placement are no longer met. The person concerned or someone close to them can request dismissal at any time. A decision on this request is to be made without delay. "
The term “welfare deprivation of liberty” was replaced by adult protection law on January 1, 2013, with the term “welfare accommodation” (abbreviated to FU). The legal institution was thus not regulated in terms of the requirements, but with regard to certain procedural rights of the persons concerned.
Procedures of welfare deprivation of liberty
In practice, the police often informed the guardianship authority, as this was the case with z. B. unsuccessful suicide attempts or attacks of mental confusion is first on the spot. The authorities also called in a doctor, if possible the family doctor of the person concerned. In cases of neglect, the authorities often became aware of the situation through neighbors.
The admission - usually in a psychiatric institution - was often a mixture of pressure and voluntariness. At the end of the acute danger, attempts were made to persuade the inmate to voluntary therapy if necessary.
Since deprivation of liberty in all constitutional states is primarily only permitted in connection with criminal offenses, the FFE was clearly regulated. However, the rules could be slightly different from one canton to another. In some places the existence of the danger to others or to oneself had to be diagnosed by a psychiatrist , in other cantons an emergency doctor could order a hospital admission. If there was imminent danger, every doctor licensed to practice was responsible. The FFE had to be lifted as soon as the condition of the consignee allowed it. He or his relatives had the right to lodge a complaint with the competent court within 10 days of the notification of an FFE or the rejection of a request for dismissal.
Nevertheless, an FFE remained a massive restriction of personal rights and could also have a lasting effect on the patient's subsequent therapy.
From a legal point of view, the FFE meant an administrative intervention in the otherwise largely private-autonomous processes of civil law : the persons concerned could be restricted in their freedom rights through administrative compulsion, if necessary with the involvement of the police. Any public interest (described in ZGB 397a as “a burden on their surroundings”) must also be taken into account, as well as the well-being of the people affected by the FFE.
For every FFE a “state of weakness” was mandatory (e.g. mental illness, alcoholism). In addition, “self-endangerment” was imperative (e.g. acute suicidality, psychotic episode). Anyone who was only “dangerous to others” was not allowed to be hospitalized using FFE (e.g. violent spouses in a domestic dispute).
Relocation required a new decision by the guardianship authority, which was made with the involvement of the expert commission / guardianship authority .
If parental care has not been withdrawn, the parents' right of residence applies to young people. Adolescents often did not consent to inpatient psychiatric treatment, but parents support it. The young person came to the clinic against his will, but without the FFE.
Consent to treatment is a highly personal right and cannot be delegated to one of the parents if there is sufficient judgment.
criticism
Fundamental criticism of any kind of "forced psychiatry" is exercised by the Zurich lawyers' collective and the Psychex association founded in 1987 .
Adult protection law
The caring placement of adults for treatment or care due to a mental disorder or intellectual disability (Art. 426-439 ZGB) is to be distinguished from the caring placement of minors as an encroachment on parental care in the interests of the child's best interests (Art. 307-312 ZGB) . If a child is placed in a closed facility or in a psychiatric clinic, however, the provisions of adult protection on welfare placement apply mutatis mutandis (Art. 314b ZGB).
The adult protection of the Civil Code is supplemented by implementing legislation of the cantons.
Responsibility and procedures of the FU are regulated in Art. 430 ZGB. The accommodated person can name any person capable of acting as a person of trust (Art. 432 ZGB) who has the right to visit, the right to inspect files and information from the staff of the facility and who can participate in the preparation of the treatment plan. Art. 439, 450 ZGB grant a right of appeal against FU decisions of the adult protection authority. The cantons must designate the competent court.
The estimated accommodation rate for Switzerland in 2004 is 977 per 100,000 inhabitants. This put Switzerland behind Germany and Austria, but ahead of many other countries in a European comparison.
An improvement in the protection of fundamental rights has only partially succeeded with the expansion of legal protection in adult protection law due to the continued numerous forced admissions.
Web links
- Caring accommodation on the Pro Infirmis website
- Eric Bonvin: Caring placement in the new adult protection law: framework and challenges for the doctor involved in the decision. In: Swiss Medical Forum, 2012, pp. 725–727.
- D. Schuler, A. Tuch, C. Peter: Caring placement in Swiss psychiatric hospitals. Swiss Health Observatory (Obsan) Bulletin 02/2018
- BGE 127 I 6 - Basel compulsory medication for compulsory drug treatment in a psychiatric clinic during care deprivation of liberty
Individual evidence
- ↑ Christof Bernhart: Handbook of caring accommodation and psychiatric treatment. Publishing house Helbing & Lichtenhahn, Basel 2010.
- ↑ Edmund Schönenberger: Fundamentalkritik der Zwangspsychiatrie 2012, rev. 2015.
- ↑ Hugo Stamm: Psychex uses the courtroom as a propaganda stage. In: Tages-Anzeiger . September 27, 2012.
- ↑ Andres Büchi: Psychiatry: Psychex sees conspiracy. In: Observer . October 23, 2012.
- ↑ Albert Guler: The most important innovations in child and adult protection law November 8, 2012.
- ↑ Pro Infirmis : Welfare accommodation ( Memento of the original from March 20, 2017 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Retrieved March 19, 2017.
- ↑ Margot Michel: Welfare accommodation ( Memento of the original from March 20, 2017 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. University of Zurich, 2014, pp. 4–6.
- ↑ Forced admissions to psychiatry from a fundamental rights perspective. In: humanrights.ch. February 17, 2014, accessed March 19, 2017 .
