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Greece

Restrictions of freedom

Involuntary internment

According to Lecca Marcati [1] , people who have been diagnosed as having Alzheimer's disease are not admitted to psychiatric hospitals as none of the Greek psychiatric hospitals accept patients with this disorder. However, some may be committed in the early stages of the disease due to a misdiagnosis, but they are released when a diagnosis of Alzheimer's disease can be made. The following provisions for involuntary commitment (insofar as this relates to people with dementia) are therefore only applicable in cases of emergency.

The conditions for involuntary internment

The Hospital Law of 1992 (N° 2071) together with the more recent N.2447/96 on the involuntary commitment of people suffering from mental diseases are the relevant laws in this case (Despos 1 ). A person can be interned against his/her will (whether or not s/he is subject to judicial assistance) for either of the following reasons:

  1. The patient is incapable of judgement concerning his/her health, and lack of hospitalisation would render treatment impossible or would lead to a further deterioration of his/her health or
  2. The hospitalisation of the patient is necessary in order to avoid acts of violence against him/herself or others.

The law restricts those who can apply to the Public Prosecutor for involuntary commitment of the patient to the wife or husband, relatives (without restriction in a straight line for blood relatives and up to a second degree for others) and to the carer or judicial assistant.

The procedure for internment

Despos [2] describes the procedure for involuntary commitment and the conditions of internment as follows:

The application should be accompanied by two recommendations from two recognised psychiatrists. If an application is made to the court without these two recommendations, the Public Prosecutor is obliged to take care of this matter. If the procedure is exercised ex officio by the Public Prosecutor, or the application clearly states that the examination of the patient by doctors was impossible due to his/her refusal to comply, the court orders the examination and assessment in a public psychiatric ward. However, the admission of the patient to the ward should be done in accordance with the law, that is under circumstances which ensure the respect of his/her personality and dignity. The admission to the ward for the purpose of assessment cannot be for longer than 48 hours. It should be noted that according to the new article 1687 of the Civil Code, the Public Prosecutor alone cannot order this admission, but is obliged to ask the court to decide.

The patient has the right to be present in court to represent him/herself. However, in practice, the patient is not usually present. Even if absent, s/he can take legal measures against the decision of the court.

Concerning the procedure itself, if the court judges that the recommendations of the two psychiatrists differ, or considers them inadequate, it can appoint a third psychiatrist, preferably the scientific director of a public health care facility.

What are the conditions and duration of involuntary commitment?

The conditions of the involuntary commitment should serve the needs of therapy. The necessary restrictive measures should not preclude therapeutic efforts, for example permission for a day off, organised excursions, or living in supervised hostels outside the ward. The conditions of internment and the organisation of the therapy are determined by the Ministry of Public Health and Care. Particular emphasis is placed on the respect of the personality of each patient during hospitalisation. Also, it is stressed that restrictions imposed on the personal freedom of the patient should serve his/her health and the aim of the hospitalisation.

Finally, the duration of hospitalisation cannot be longer than 6 months. After the first three months, the scientific director of the facility plus a second psychiatrist of the section of mental health, submit a report to the Public Prosecutor on the state of health of the patient. The Public Prosecutor has the right to send this report to the court, asking for the termination or continuation of hospitalisation. It should be noted here, that the law fails to determine a time limit within which the report should be submitted by the Public Prosecutor to the court.

Compulsory removal from the home

Compulsory removal from the home is allowed for safety reasons. The consent of a social worker appointed by the court and the district attorney is necessary. This measure is particularly relevant in cases where the person lives alone. S/he is always removed to a residential home or hospital but never to a psychiatric hospital (Lecca Marcati [3] )

Coercive measures

In the Greek Constitution (article 7, par. 2), it is stated that it is prohibited and a crime punishable by law to engage in torture, any kind of bodily ill-treatment or injury to health, or to resort to the use of psychological pressure or any other offence against human dignity.

Respect of the person's dignity by medical professionals is addressed in article 1 of the Rules of Medical Ethics and Deontology (RMED). Concerning abuse, article 18 states that doctors must never use their knowledge, abilities or experience for the purposes of cruel, inhuman or degrading actions, regardless of the reasons for such treatment.

Driving

According to article 13 of the Highway Code, a person who is deprived of his/her required physical and mental ability is not in a fit state to drive. Moreover, this article 13 gives transport authorities the right to demand a reappraisal of any driver in case of doubt concerning his/her ability to drive and to demand a medical reappraisal in case of doubt regarding the person's physical or mental state. 

In Greece, there are certain measures which help limit the consequences of the withdrawal of a driving licence. For example, all mentally disabled people under the age of 65 are entitled to purchase a car for private use (up to 1600cc) without paying the import tax, which amounts to about 40% of the cost price. The car can be driven by one family member other than the person with dementia. In addition, all people suffering from a mental disorder are entitled to holiday bonuses, as well as reduced fares (of up to 50%) on all forms of public transport (Lecca Marcati [4] ).

[1] Information provided in connection with the Lawnet conference on 11 May 1999

[2] Information provided in connection with the Lawnet conference on 11 May 1999

[3] Information provided in connection with the Lawnet conference on 11 May 1999

[4] Information provided in connection with the Lawnet conference on 11 May 1999

 

 
 

Last Updated: mercredi 14 mars 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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