CAT/OP/27/2 III. Medical treatment of persons deprived of liberty and informed consent 12. Informed consent is a decision made voluntarily on the basis of comprehensible and sufficient information regarding potential effects and side effects of treatment and the likely results of refraining from treatment. Informed consent is fundamental to respecting an individual’s autonomy, self-determination and human dignity. 13. Every person deprived of liberty who requires medical treatment should be fully informed about the diagnostic reasons for recommending a particular medical treatment and about existing alternatives, and given the opportunity to decline or receive the suggested treatment or other form of intervention. 14. Exceptionally, it may be necessary to medically treat a person deprived of liberty without her or his consent if the person concerned is not able to: (a) Understand the information given concerning the characteristics of the threat to her or his life or personal integrity, or its consequences; (b) Understand the information about the medical treatment proposed, including its purpose, its means, its direct effects and its possible side effects; (c) Communicate effectively with others. 15. In such a situation, the withholding of medical treatment would constitute inappropriate practice and could amount to a form of cruel, inhuman or degrading treatment or punishment. It may also constitute a form of discrimination. The measure must be a last resort to avoid irreparable damage to the life, integrity or health of the person concerned, and must be mandated by a competent authority within a strict framework that sets out the criteria and duration for the treatment and review and supervision mechanisms. 16. Medical treatment without informed consent should be subject to review before an independent authority and/or a complaint mechanism as soon as this is practicable. It must never be used for the convenience of staff, next of kin or others. Further, the administration of any medication without informed consent must be precisely recorded and subject to administrative accountability and judicial review. 17. Only in situations of emergency care may a decision about any necessary intervention be made by the medical professional alone. 18. An expert decision regarding psychiatric disease cannot in itself override the right to refuse medical treatment. 19. A person deprived of liberty who has been subjected to treatment without informed consent and to restraints must be debriefed by a medical doctor as soon as her or his condition permits it; she or he must have access to the medical record and must be informed of complaint mechanisms and means of redress. IV. Duties of States parties 20. States parties are encouraged to review their mental health legislation and public policies with respect to the legality of involuntary interventions for persons with mental disabilities, with the following objectives: (a) Developing restrictive criteria for the use of involuntary interventions, which must make explicit that the use of such interventions is limited to cases in which less 3

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