Restrictions of freedom
It gives me great pleasure to present the Dementia in Europe Yearbook 2011.
In addition to the Annual Report of Alzheimer Europe for 2010, it contains our work on the legal provisions relating to the restriction of the freedom of move- ment of people with dementia. The main topics addressed are involuntary internment, the use of coercive measures and restrictions relating to driving licences.
Involuntary internment is the term used to describe the situation whereby a person is obliged by law to reside in some form of institution. Usually, the grounds for this restriction of liberty are that the person has a mental disor- der and is considered as a danger to him/herself or others. National laws are often ill-suited to the needs of people with dementia. In some countries, it only concerns internment in a psychiatric institution or ward which is not the ideal place to provide appropriate care and support for people with dementia.
The term “coercive measures” denotes methods that are used to restrain a person which involve restraint, force or threat. Examples would include bed rails, chair and bed belts, threatening behaviour or words, various electronic devices and the use of tranquilis- ers. Sometimes, coercive measures can be quite subtle such as forcing people to wear sleeping attire thereby making many people feel unable to leave the building. The use of coercive measures can sometimes be justified (e.g. to prevent a person from harm- ing him/herself or others, or to enable medical staff to administer necessary medication or treatment).
However, these measures infringe on people’s personal liberty which is a fundamental human right. Consequently, their use must be closely monitored. In the case of people with dementia, many of whom are older and frail, many forms of coercion are increasingly considered as abusive and to be avoided if at all possible. There is even evidence that the use of certain forms of restraint can increase the likelihood of falls or harm.
The withdrawal of one’s driving licence (or limitations on its use) is also perceived as a restriction of freedom of movement by many people with dementia. No longer having the opportunity to drive often entails a gradual restriction of one’s activities and social contacts. In the sections on driving, we look at the legal regulations and processes gov- erning the renewal and withdrawal of driving licences.
Dedicated lawyers and legal experts throughout Europe contributed their expertise and time to the drafting of a separate report for each country. This made it possible to pub- lish a report on the legal issues relating to the restriction of liberty of people with dementia in 32 different countries. We would like to thank all the lawyers and legal experts for their work and for making this possible. You will find a list of all those who helped in this way and to whom we are deeply grateful at the end of this report in section 3. I would also like to thank Dianne Gove, Information Officer of Alzheimer Europe, for having prepared the reports for the countries in which we had no legal expert and for organising the compilation of this year’s Lawnet report.
W have made every possible effort to ensure that the information in this report is accurate. However, amendments and new laws are continuously been passed and existing laws repealed. We would therefore be pleased to be informed of any relevant developments in the period following publication of this report.
We hope that this publication will be of interest to policy makers, researchers, people with dementia and anyone with an interest in the legal protection and rights of people with dementia. An overview and comparison of the legal provisions in different countries may be helpful in highlighting areas where the rights and protection of people with dementia are lacking or inadequate, or on the contrary, countries in which the legal provisions provide an appropriate response to the protection and rights of people with dementia.
Last Updated: mercredi 14 mars 2012