Page 67 - Reduction of coercive measures

an overlap between various categories, with the experts regarding the category of “Restricting a person’s freedom to determine his own life” as a bucket category. As they see it, this category includes situations where patients are not allowed to choose what they eat or drink, or to choose who they live with. The experts recognise that more attention needs to be paid to rights of self-determination, but doubt whether the current wording of the definition and categories allow this, given, for example, the lack of clarity caused by the use of differing terminology for involuntary care(and various forms of this).
The legislator believes, however, that further specification will obstruct current developments in the field (Parliamentary Papers II, 2015/16, 32399, No. 25). A similar discussion is on-going in the UK, where the definition of deprivation of liberty remains unclear. Results from studies concerning the DOLS illustrate that a clear definition is important for implementation. In a study on the use of vignettes, Cairns et al. (2011) find only minor agreement between professionals on what constitutes deprivation of liberty. Despite the impact of the recent Cheshire West decision in the UK, Blamires et al. (2016) still question the current legal system in the UK concerning DOLS. They think that a major revision is needed. At this moment, opportunities to identify the best form of support and the least restrictive options are (still) missing.
The experts also referred to certain forms of care that, in view of their invasiveness, should always be regarded as involuntary, regardless of whether the client resists. Examples of such forms of care include the administration of fluids, food or medication, and the imposition of restraint, seclusion or separation. These forms of care are covered by some of the nine categories for which the legislator has set standards that are to be applied in the event of resistance by a client or his representative. The experts did not mention forms of involuntary care that, at first sight, may appear less significant, such as situations involving use of surveillance technologies, and restrictions on clients’ freedom of choice, but which the Care and Coercion Act also requires to be included in the new reporting system in the event of resistance.
Reporting coercive measures
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