The UN Committee against Torture condemns the use of cage beds against people with disabilities in Slovakia

Lucia Černáková is a woman with an intellectual disability and autistic spectrum disorder. In 2006, faced with a lack of support to take care of her daughter at home, her mother had no choice but to accept that Lucia is placed in a Social Care Facility. Lucia is a person who needs individual attention and support, but the Facility could not give this to her. Instead, the staff of the institution dehumanized her by injecting her with sedatives against her will and denying her right to go home. Understandably these measures hurt and upset Lucia deeply, but an institution is not the place to express any emotion; here submission is the only possibility. Lucia’s upset was met with even harsher sanctions: the nurses restrained her in a cage-bed where she received repeated doses of sedatives. To add insult to injury, the staff did not keep any record of the amount of time they kept Lucia in the cage bed. 

The international community has long condemned psychiatric hospitals for the use of cage beds to restrain people with disabilities who exhibit ‘challenging’ or ‘difficult’ behaviour. Cage beds deny people with disabilities even their most basic human rights and represent a severe form of ill treatment. Even so, the Slovak authorities chose to look the other way. The prosecutors did not investigate any of the allegations presented by Lucia and her mother and the national courts accepted this without criticism, even though the evidence established beyond any doubt that the staff restrained Lucia in a cage bed and forcibly medicated her. What is more, cage beds are prohibited in Slovakia but the authorities continue to use legal loopholes to evade accountability. 

In these circumstances, Lucia and her mother, with the help of Forum for Human Rights and Validity Foundation filed a petition to the United Nations Committee against Torture – the leading UN body in this field. In a groundbreaking decision, the Committee condemned Slovakia for multiple violations of the Convention against Torture. 

The Committee clearly established that restraining a person in a cage bed represents ill treatment and it is a violation of the UN Convention against Torture. The Committee also condemned Slovakia for not taking any action to address what has happened to Lucia to prevent its recurrence. It found that the authorities should have carried out an effective criminal investigation and recognised that a civil remedy would not have been effective for Lucia, in particular because there were no reasonable and procedural accommodations for her to prove a civil claim. The Committee criticized the Slovak laws as inadequate because they allow for suspending the proceedings without investigating and punishing the perpetrators.

Moreover, the Committee held that the state is responsible for the acts of staff in private facilities providing public services. It also determined that  Lucia’s right to redress for the ill-treatment was violated because she did not receive any compensation, rehabilitation or satisfaction (recognition) of the physical and moral harm she suffered by placement in a netted cage-bed; and because the state did not take any steps to prevent the use of cage-beds against her and other women with disabilities in the future. It ordered the state to provide her with these remedies and to prevent the use of unlawful or prohibited forms of restraints.

After this decision, Slovakia should take steps to amend its national laws: 

“Changing the legislation is the minimum necessary,” says Maroš Matiaško, the family’s attorney. “It is essential to ensure that there is no recurrence. That’s why the Government should focus on a deeper systematic transformation of institutional care – both social and psychiatric – and the development of an ample amount of community-based, quality services for people with autism, fully in line with the UN Convention on the Rights of Persons with Disabilities.”

It is all too often that state authorities do not take ill treatment seriously. In Lucia’s case, this can be seen at all levels of the investigation. Not only did the authorities suspend her criminal complaint without identification of the perpetrators; they did not take any further step to ensure that other persons with disabilities will not be mistreated in the same way. 

Ann Campbell, Co-Executive Director of Validity Foundation noted: 

“This is a groundbreaking victory for persons with disabilities. But it is also a recognition that states need to take structural measures if we are to truly adhere to the UN Convention on the Rights of Persons with Disabilities. Developing appropriate support systems for persons with disabilities to enable their participation in community life is the only way forward. Time and again we have demonstrated that institutional settings are a breeding ground for horrendous practices, and this is yet another example. People with disabilities are advocating for support in the community and not for institutions; this is what authorities all over the world need to implement.”

Forum for Human Rights and Validity have long been involved in the fight against institutionalisation of persons with disabilities. Lucia’s case is yet another regrettable example of the consequences of institutionalisation for persons with disabilities. An institution which should have ‘helped’ her became an active perpetrator of inhumane acts and used its position to claim impunity for any human rights violations. It is hard to imagine how people with disabilities can be full members of the community as long as institutional culture persists. This most recent decision of the Committee Against Torture is one step closer towards changing from institutional care to support in the community for persons with disabilities. With adequate help, Lucia’s mother could have supported her daughter and all the trauma she went through would have been avoided.