On 26 March the European Court of Human Rights (ECtHR) ruled that Moldova had breached Article 3 (prohibition of inhuman or degrading treatment) and Article 14 (prohibition of discrimination) of the European Convention on Human Rights (ECHR).
The case involved an orphan who was believed to have an intellectual disability. After the death of his parents, the applicant was in the care of his aunt, but at the end of 2012, the applicant was made a ward of the mayor of Ciutești and was placed in a boarding school. At the end of the 2013/14 school year, the school requested that he be placed somewhere for the summer. After the request was made, a doctor, without ever having met the applicant, referred him for treatment in a psychiatric hospital, and the Nisporeni Committee for the Protection of Children and Risk agreed. The applicant was told that he would be going to summer camp but was instead taken to a psychiatric hospital. At the end of July that year, the hospital administration requested that the mayor of Ciutești have the applicant collected as they wished to discharge him, but this never happened despite repeated requests.
Eventually, the hospital sought an intervention from the local Nisporeni council but when this yielded no results, they contacted the Ombudsman and the Centre for Human Rights. The Nisporeni Psycho-pedagogical Assistance Service was then sent to evaluate the applicant and concluded that he did not actually have an intellectual disability. At the beginning of November 2014, the applicant was discharged into the care of his cousin, and she was appointed as his guardian. In early 2015 the applicant challenged his diagnosis and his treatment. He argued that the authorities had essentially abandoned him in the hospital and that he had been forced to take unnecessary medications which had, by the time he was released given him neuroleptic malignant syndrome, which is a potentially fatal side effect of the use of anti-psychotics. Throughout his stay in the psychiatric hospital, records show that the applicant was forcibly given a tranquiliser (diazepam and diphenhydramine), neuroleptics (risperidone, levopromazine, and chlorpromazine), anti-convulsives (valproic acid), nootropics (vinpocetine), anti-tranquiliser overdose medications (diethylamide of nicotinic acid), and heart medication (beta-blockers).
The mayor of Ciutești was subsequently charged with negligence and the case went to trial, but in 2017 the Supreme Court ultimately declared that the mayor was not guilty. Another investigation into charges of torture and ill-treatment in respect of V.I.’s allegations of being forced to take neuroleptics never amounted to charges being pressed as the prosecutor concluded that there was no evidence he had suffered psychological trauma or that he had been subject to violence or intimidation. All attempts to challenge this decision were unsuccessful.
On Appeal to the ECtHR, the Court unanimously concluded that there had been a violation of Articles 3 and 14 of the ECHR. In relation to Article 3 (prohibition of inhuman or degrading treatment), the court noted that despite the applicant’s allegations being at least partially proven by the various investigations conducted it had been concluded that the allegations were “unfounded”. The Court did not accept the reasons provided for these dismissals; that the commitment had been legitimised by a doctor, that he sustained no quantifiable traumatic consequences, and that there had there been no direct intent by the perpetrators, as the Moldovan authorities had failed to investigate several key aspects. Namely, the circumstances that led to him being placed in the hospital and whether the placement had even been necessary at all. The Court pointed out that the doctor who had initially suggested institutionalisation had not been interviewed. The ECtHR also noted that there had been no attempt to determine whether the forcible taking of anti-psychotics had impacted him, or if it had been medically necessary. Thus the court found that there had been a violation of Article 3. The court also found that the legal framework itself also violated Article 3. Specifically, the framework surrounding consent for under 18s and forced chemical restraint amounted to a violation of Article 3.
The ECtHR also held that Moldova had violated Article 14 (prohibition of discrimination) when read in conjunction with Article 3. In his application to the ECtHR, the applicant alleged that the failure to properly investigate his claims was done not out of mismanagement or incompetence but instead was due to the “general stereotypes and the discriminatory nature of the Moldovan authorities towards people with psychosocial disabilities”. The ECtHR noted that the UN’s Special Rapporteurs consistently report that Moldova systematically discriminates against children with intellectual disabilities by forcibly institutionalising them.
In conjunction with the clear pattern demonstrated by the UN’s Special Rapporteurs in the case of the applicant, every single official who owed him a duty of care failed in their duty when they institutionalised because it was not medically necessary. This was clear as the paperwork that admitted him to the hospital listed his supposed intellectual disability as the reason for the institutionalisation. All of these factors together led the ECtHR to conclude that there had been a clear violation of the prohibition of discrimination.
Mental health and intellectual disability stigma and thus discrimination has historically been a global problem. However, in recent years countries have faced pressure for change as the general public’s view of both mental health issues and intellectual disability has evolved. This ECtHR ruling is undoubtedly a victory for those with intellectual disabilities and mental health problems, not only in Moldova but for all ECHR signatory countries; however, the systemic discrimination and resulting abuses will likely take many years to fully unravel.
Click here for links to the press release and judgment in V.I. v the Republic of Moldova.