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Romania

Restrictions of freedom

Involuntary internment

Involuntary internment is covered by the Law on Mental Health and Protection of People with Mental Disorders (No. 487) which was adopted by the Senate on 27 June 2002. The procedure for involuntary internment is only applied when all attempts to admit the person on a voluntary basis have failed. If applied, the person can only be admitted involuntarily to a psychiatric hospital that is equipped to provide professional/specialist care in specific conditions.

The conditions for involuntary internment

A person can be involuntarily admitted if a competent psychiatrist decides that s/he is suffering from a mental disorder and considers that because of that mental disorder there is an imminent danger of the person harming him/herself or other people. Another justifiable reason for involuntary internment is that a person may have a severe mental disorder and impaired judgement, and that failure to admit or detain that person is likely to lead to a serious deterioration of his/her condition or would hinder the administration of appropriate treatment (article 45).

The procedure for involuntary internment

The people who can request the involuntary internment of a person with a mental disorder are:

  • The family doctor providing healthcare for the person concerned
  • The psychiatric specialist providing healthcare for the person concerned
  • The person’s family
  • Representatives of the competent local public administration services
  • Representatives of the police, the gendarmerie, the prosecutor’s office or the fire brigade.

The person making the request must provide reasons, sign the declaration, provide details of his/her identity, explain the circumstances surrounding the request and provide details of the identity and medical history of the person concerned (article 47).

The person is usually transported to the psychiatric hospital by the ambulance services. If the person seems to be quite dangerous, the assistance of the police, the gendarmerie or firemen may be requested. During this process, all possible safety measures must be taken to ensure that the physical integrity and dignity of the person are respected (article 48).

The person is then examined by a psychiatrist with the aim of determining whether involuntary admission is necessary. The person must be informed immediately of any decision to submit him/her for psychiatric treatment and his/her personal or legal representative must be informed within 72 hours (article 49). If it is not known whether the person has a personal or legal representative or their address is not known, the doctor[1] must notify the guardianship authorities (article 50). If s/he considers that there is no justification for the involuntary internment of the person, s/he will not detain the person and will register this decision, along with the reasons for it, in the medical records (article 51).

Once the doctor (psychiatrist?) has made a decision to involuntary intern a person, this decision must be confirmed within 72 hours by a commission made up of 3 members appointed by the director of the hospital, namely 2 psychiatrists (preferably other than the one who admitted the person for the initial examination) and a doctor of another specialty or a representative of civil society. This commission is responsible for examining the person within 15 days and whenever the doctor responsible for their care requests it. The commission must notify the patient and his/her personal or legal representative of their decision and record it in the person’s medical file (article 52).

Within 24 hours of making a decision to involuntarily intern the person, the commission must inform the prosecutor’s office which then reviews the decision. In order to do this, the commission must provide the prosecutor’s office with the person’s medical file and relevant documents. If the prosecutor’s office is of the opinion that the internment is unjustified, it will order a new psychiatric examination to be carried out by another medical-judicial commission (article 53).

The duration of involuntary internment

There is no mention in the law about an initial duration of the involuntary internment. It is simply state in article 56 that when the conditions leading to the decision to admit a person involuntarily are no longer met, and this is confirmed by the psychiatrist taking care of the person, the commission reviewing the procedure will, after having examined the person, release him/her. The patient can then either leave the institution immediately of if s/he so wishes can request the continuation of treatment based on his/her written consent (article 56).

The right to appeal

The person or his/her personal or legal representative can appeal to a competent judicial body against a decision for involuntary internment. During the process, the judge hears the person (provided that the person’s condition permits this). If this is not possible, the judge will visit the person in the unit where s/he is being detained in order to conduct the hearing. The case will be dealt with urgently (article 54).

Patient advisors

The personal advisor mentioned several times in connection with the process of involuntary internment is defined in the Law on Mental Health and Protection of People with Mental Disorders of 2002 as a person, other than the legal representative, nominated by a person with mental disorder, who agrees to represent the interests of the person concerned.

Coercive measures

Restriction of personal liberty

The illegal deprivation of a person’s freedom shall be punished by a prison sentence of between 3 and 10 years (article 201 (1) of the Criminal Code).

According to the Law on Mental Health and Protection of People with Mental Disorders of 2002,

“The care and treatment of people with mental disorders must be carried out in the least restrictive environment, with the least restrictive procedures that respect, to the extent possible, the person’s physical and psychical integrity and meet, at the same time, his or her health needs, as well as the necessity of ensuring the physical safety of others.” (article 26)

Restraint and other coercive measures

According to article 210 (1) of the Criminal Code a person who threatens someone else with the commission of an offence or a damaging act will be imprisoned for 6 months to 1 year or fined if the threat is considered to have alarmed the latter. The sanction cannot, however, exceed that which would have been applied had the offence or damage been committed.

Blackmail is covered by article 211 (1) of the Criminal Code which states that the coercion of a person by violence or threat to give, do, not do or suffer something, if the act is committed in order to obtain an unlawful benefit shall be punished by a prison sentence of between 1 and 5 years. If the blackmail is linked to a real or imagined act, which if revealed would compromise the person, the sentence would be between 2 and 7 years (article 211 (2).

Mistreatment/abuse

Article 26 of the Law on Mental Health and protection of people with disabilities of 2002 states that a person suffering from mental disability has to be protected from harm caused by the unjustified administration of medicines or certain diagnostic or treatment procedures, against ill treatment caused by other patients, by personnel or other persons or any other actions causing physical or mental suffering.

The issue of neglect is covered in the Criminal Code. Article 198 states that the act of abandoning, sending away or leaving helpless a child or a person who is unable to look after themselves by a person who is responsible for their supervision or care thereby placing that person’s life, health or corporal integrity in imminent danger, shall be punished by a prison sentence of between 1 and 3 years or a fine. If, however, the person responsible for the other person’s care or supervision voluntarily resumes such care or supervision after the incident of neglect has occurred, s/he shall not be punished.

Article 200 foresees a sentence of between 1 and 6 months or a fine for failure to notify the authorities about a person who has been abandoned or is lost, who needs help, whose life, health or corporal integrity is in jeopardy and who lacks the power to save him/herself.

Chapter III of the Criminal Code contains several articles on the topic of violence and neglect. Article 185 states that hitting or any other act of violence causing physical suffering shall be punished by imprisonment of between 1 month and 3 months or a fine. This is followed by a series of articles which describe to what extent this punishment is increased in line with the severity of the possible resulting injury (e.g. resulting in the need for medical care for up to 20 days, up to 60 days or more than 60 days) and based on whether the act was committed by a family member.

Article 189 states that with the exception of grievous bodily harm and acts resulting in a person’s death, acts resulting in the need for between 10 and 60 days’ medical care, which were committed by negligence, shall be punish be imprisonment of 1 to 3 months or by a fine.

Driving

Romanians over the age of 65 must have a health check every year in order to keep their driving licences. Every month, doctors must inform the police of all new diagnoses of mental disorder thus creating a dilemma for doctors who must choose between the desire to protect the general public from accidents caused by people with mental disorders and their ethical obligation to respect confidentiality (Tãtaru, 2008).

Reference

Tãtaru, N. (2008), Practice of competence assessment in dementia: Romania. Ed. Gabriela Stoppe (2008),Competence assessment in dementia,Springer Wien New York.

[1] The person referred to in the English translation of the law is “the doctor” but it seems from the context that this means the psychiatrist who examines the person to determine whether or not to involuntarily intern him/her.

 

 
 

Last Updated: Mittwoch, 14. März 2012

 

 
  • Acknowledgements

    The above information was published in the 2011 Dementia in Europe Yearbook as part of Alzheimer Europe's 2011 Work Plan which received funding from the European Union in the framework of the Health Programme. AE also gratefully acknowledges the support it received from Fondation Médéric Alzheimer for its project on restrictions of freedom and for the publication of its Yearbook.
  • European Union
  • Fondation Médéric Alzheimer
 
 

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