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Night-time confinement is an unacceptable hospital practice

  • George Szmukler (a1)
Summary

Night-time confinement, currently imposed as a blanket restriction on all patients on wards in UK high secure hospitals, constitutes an arbitrary restriction of liberty, not being based on any therapeutic purpose for those so restricted, nor serving a need for the protection of others. Its imposition constitutes a form of ‘degrading’ treatment as well as an unjustified restriction of ‘residual’ liberty. Persons who are vulnerable, especially those who are involuntarily detained as in this case, are particularly at risk of suffering human rights abuses. A compelling case can be made, based on ethics, law and accepted practice standards, for ruling out night-time confinement as an acceptable measure.

Declaration of interest

None.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Corresponding author
Correspondence to George Szmukler (george.szmukler@kcl.ac.uk)
References
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1Waldron, J. Inhuman and degrading treatment: the words themselves (The Coxford Lecture). Can J Law Jurisprud 2010; 23: 269–86.
2Council of Europe. European Convention on Human Rights 1950 (https://www.echr.coe.int/Documents/Convention_ENG.pdf).
3Equality and Human Rights Commission. Article 3: Freedom from Torture and Inhuman or Degrading Treatment (https://www.equalityhumanrights.com/en/human-rights-act/article-3-freedom-torture-and-inhuman-or-degrading-treatment).
4Herzczegefalvy v Austria (1992) 10533/83 ECHR 58.
5Burke, R (on the application of) v The General Medical Council Rev 1 [2004] EWHC 1879.
6Chu, S, McNeill, K, Wright, KM, Hague, A, Wilkins, T. The impact of a night confinement policy on patients in a UK high secure inpatient mental health service. J Forensic Pract 2015; 17: 2130.
7Munjaz v UK (2012) 2913/06 ECHR 1704.
8Department of Health. Mental Health Act 1983: Code of Practice. TSO, 2015.
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BJPsych Bulletin
  • ISSN: 2056-4694
  • EISSN: 2056-4708
  • URL: /core/journals/bjpsych-bulletin
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Night-time confinement is an unacceptable hospital practice

  • George Szmukler (a1)
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