Page 70 - Reduction of coercive measures

Chapter 3
Conclusion
Our review of the literature demonstrates that external reporting of involuntary care has not yet become properly established, either in the Netherlands or elsewhere such as in the UK. The experts in this study fully endorse the importance of standardized, real-time external reporting. However, they do not believe that this objective will be achieved if the Dutch legislator continues to adhere to the wording as currently used in the text of the Care and Coercion Act. The meeting with experts also illustrates that a lot of factors remain unclear, which is in line with the on-going discussion about the system of DOLS in the UK. The primary question posed to a group of experts in the care of people with an intellectual disability was: Which forms of involuntary care should be externally reported and how is this external reporting influenced by environmental and other factors? For the purposes of this study, reporting was taken to mean an external reporting system that can be accessed at any time by the Health Care Inspectorate. Although the experts’ answers to this question were not unequivocal, they indicated that a client’s resistance to involuntary care must in any event be reported, while the administration of fluids, food or medication, as well as the imposition of restraint, separation or seclusion, should also always be reported, regardless of whether the measure is resisted. These findings reiterate the need for more concrete definitions of involuntary care and the legislator’s nine categories, if uniform and reliable reporting of involuntary care is to be achieved in a manner that will help protect clients’ legal position. The challenge is to ensure that the beneficial effects of the protective function of reporting involuntary care are not diminished by the inevitable bureaucratic elements of the reporting system.
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