Penitentiary servicemen are directly
involved in the organization of medical care for persons deprived of liberty; they
are aware of the medicines and the required doses, and have access to records
containing medical secrets.
Hence, almost the entire
administration of the penitentiary institution is aware of the illness of the persons
deprived of their liberty, and what medications they are receiving; there are
even cases when they are aware of what doses are indicated.
The organization of "Methadone
Replacement therapy" is carried out through the direct participation of
penitentiary servicemen. In the evening, antipsychotic medications are provided
to the persons deprived of their liberty in the presence of security servicemen.
One of the main concerns is that the
admission and placement of persons deprived of their liberty in the Hospital for
Convicts penitentiary institutions is carried out on the instructions of the
security servicemen of the penitentiary institution, chiefly based on security
issues. That is why a large number of patients are kept out of the departments
where they are registered.
In this case, difficulties arise not
only in the organization of effective medical care for the patient by the
doctor and medical staff but also in the implementation of medication-assisted
treatment and other medical interventions. For example, in addition to patients
registered in the therapeutic department, persons deprived of their liberty,
who are registered in the psychiatric department are also kept there.
This situation is simply intolerable.
Of course, the security in the penitentiary institutions is of paramount
importance, but medical issues regarding the admission and placement of
convicts in the hospital cannot be ignored.
The preliminary medical examination,
along with a search, is carried out in the penitentiary institution by the
medical staff on duty, in the presence of the officer on duty and the serviceman
of the security department. When a person is escorted by Police servicemen, the
latter is also present at the medical examination.
The medical examination is sometimes
implemented in a group setting: it is simultaneously carried out against
several persons deprived of their liberty.
There are cases when the medical
staff does not examine the persons deprived of their liberty. Instead, the
penitentiary servicemen ask if they have any injury or complaints during the
search.
The treatment of persons deprived of
their liberty and certain medical interventions are carried out without their
written consent. That is, they receive treatment, medical examinations, and other
interventions without informed consent. The only exceptions are the persons
deprived of their liberty who have HIV and those receiving inpatient treatment
registered in a psychiatric department.
The description of the injuries of
the persons deprived of their liberty remains a serious problem, as it is not
carried out properly. For example, the column "Existence of bodily
injuries" in the relevant register is usually filled with one word - "yes"
or "no", but there are also cases when the results of the medical
examination are not available at all.
Moreover, when an injury is recorded
in a person deprived of liberty, it does not include a complete picture of objective
medical examination results. No other criteria describing the exact anatomical
location, color, and the area of the injury are described.
There were cases when the medical
records did not even contain the doctor's conclusion on the objective
description of the injury together with the combination of the statement of the
person deprived of liberty on that matter.
Gross violations regarding the
management of the medical records were reported.
The medical history records lacked
justifications for prescribing medication and descriptions of the dynamics of
the health condition ․ There are many deletions and omissions.
There are no procedures for storing
and archiving medical records.
The medical history records of the patients
who have been discharged from the above-mentioned departments are stored in the
departments themselves, either in multiple cabinets or on the floor.
The existence of expired medicines was
registered during the monitoring visit.
There are serious problems regarding
medical waste getting dumped with household waste, which is simply unacceptable.
Restraints are applied with gross
violations, which will be discussed in more detail separately.
These are only some of the issues concerning
medical care.
Most of recorded issues have already
been sent to the Ministry of Justice by the Human Rights Defender with relevant
proposals and requests for clarifications.
These violations clearly degrade
human dignity and are considered inhuman treatment.
The situation is intolerable and the
issues remain unresolved. All these assessments are based on concrete facts.
The Human Rights Defender is ready
to provide the necessary assistance in solving the recorded issues.
Հայերեն
