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Universal-MigrationHRlaw-PG-no-6-Publications-PractitionersGuide-2014-eng

Universal-MigrationHRlaw-PG-no-6-Publications-PractitionersGuide-2014-eng

204 | PRACTITIONERS

204 | PRACTITIONERS GUIDE No. 6c) Access to healthcareInadequate healthcare or access to essential medicines for detaineesmay also violate the freedom from inhuman or degrading treatment,either on its own or in conjunction with other factors. Although thereis no general obligation to release detainees on health grounds, thereis an obligation to protect their physical and mental wellbeing whilein detention, by providing medical care and medicines appropriateto the health condition of a detainee. 769 For example, failure to providemedical supervision and drugs necessary to detainees with HIV,or with severe epilepsy, leading to exacerbation of their conditions,can undermine the dignity of the detainee, and cause anguish andhardship beyond that normally inherent in detention, in violation ofArticle 3 ECHR. 770 Such a violation may occur even in the absence ofdemonstrated deterioration of the health condition of a detainee. 771The Inter-American Court has found that lack of adequate medicalassistance in detention could constitute a violation of Article 5 ACHR“depending on the specific circumstances of the person, the type ofdisease or ailment, the time spent without medical attention and itscumulative effects.” 772CPT standards set out the principle that medical care available in detentionshould be of an equivalent standard to that available to the generalpublic. 773 Guideline 10 (v) of the UNHCR revised guidelines on detentionof asylum seekers provides that detained asylum seekers should havethe opportunity to receive appropriate medical treatment, and psychologicalcounselling where appropriate. Other international standards,including the Standard Minimum rules for the Treatment of Prisoners(Rules 22 to 25) Body of Principles for the Protection of All Persons underAny Form of Detention or Imprisonment (Principles 22 to 26), theUnited Nations Rules for the Protection of Juveniles Deprived of their769 Hurtado v. Switzerland, ECtHR, Application No. 17549/90, Judgment of 28 January 1994;Mouisel v. France, ECtHR, Application No. 67263/01, Judgment of 14 November 2002,para. 40; Keenan v. United Kingdom, ECtHR, Application No. 27229/95, Judgment of 3 April2001, para. 111; Aleksanyan v. Russia, ECtHR, Application No. 46468/06, Judgment of22 December 2008, para. 137.770 Kaprykowski v. Poland, ECtHR, Application No. 23052/05, Judgment of 3 February 2009;Kotsaftis v. Greece, ECtHR, Application No. 39780/06, Judgment of 12 June 2008. See also,Mouisel v. France, ECtHR, op. cit., fn. 769, paras. 40–42.771 Kotsaftis v. Greece, ECtHR, op. cit., fn. 770.772 Montero-Aranguren et al (Detention Center of Catia) v. Venezuela, IACtHR, op. cit., fn. 761,para. 103. See also, Vélez Loor v. Panama, IACtHR, op. cit., fn. 536, paras. 220, 225, 227.773 CPT Standards, op. cit., fn. 629, Extract from the 3 rd General Report [CPT/Inf (93) 12], p. 27,para. 31. Although the European Court of Human Rights has sometimes accepted a lowerstandard of healthcare for prisoners than that available in the community, this has been inregard to convicted prisoners only, and the Court has expressly drawn a distinction betweenconvicted prisoners and other detainees in this regard: Aleksanyan v. Russia, ECtHR, op. cit.,fn. 769, para. 139.

MIGRATION AND INTERNATIONAL HUMAN RIGHTS LAW | 205Liberty (Section H), and the United Nations Rules for the Treatment ofWomen Prisoners and Non-custodial Measures for Women Offenders(the Bangkok Rules) set out detailed guidelines regarding appropriatemedical care in detention.Security measures applied during medical treatment must also be designedso far as possible to respect the dignity of the detainee. Issuesin this regard may be raised by the use of handcuffs or the impositionof other restraints during treatment. 774It should also be borne in mind that, as will be discussed in more detailin Chapter 5, under international law and standards enshrining the rightto health, all persons, irrespective of their nationality, residency or immigrationstatus, are entitled to primary and emergency health care, aright which also applies in the context of detention. 7753. Conditions of detention of particular groupsa) Mentally ill detaineesDetainees who are mentally ill or who are disturbed as a result oftraumatic experiences require particular consideration where they areheld in immigration detention. Their detention raises questions as to(a) whether the person should be detained at all or whether more suitablealternatives can be found (see, Section 6); and, if detention is warranted,(b) the appropriate form of detention, conditions of detention,and provision of medical care.Where the mental health condition of a detainee is caused or exacerbatedby his or her detention, and where the authorities are awareof such conditions, continued detention may amount to cruel, inhumanor degrading treatment. In C. v. Australia, the Human RightsCommittee found a violation of Article 7 ICCPR as a result of theprolonged detention of a person with serious psychiatric illness whichthe authorities knew had come about as the result of his detentionand which by the time of his eventual release, was so serious as tobe irreversible. 776Even where the detention of a mentally ill person is justifiable, considerationshould be given to the appropriate place of detention: whetherthe person should be held in a specialist psychiatric facility; or whether774 Henaf v. France, ECtHR, Application No. 65436/01, Judgment of 27 November 2003,paras. 49–60.775 CESCR, General Comment No. 14, op. cit., fn. 37, para. 34: “In particular, States are underthe obligation to respect the right to health by, inter alia, refraining from denying or limitingequal access for all persons, including prisoners or detainees, minorities, asylum seekersand illegal immigrants, to preventive, curative and palliative health services.”776 C. v. Australia, CCPR, op. cit., fn. 350, para. 8.4.

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    ISBN 978-92-9037-151-X

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