2011: Restrictions of freedom
Chapter 5 of the Law of Health of 1 January 2005 (last amendment 14.06.2011) deals with mental health (referred to as psychic health in the English translation). According to article 145, the state, the municipalities and non-governmental organisations are responsible for protecting the mental health of certain risk groups, including the elderly. People with mental disorders, in need of special health care, are defined in article 146 and include people with vascular and senile dementia. This chapter covers the restriction of personal freedom and compulsory accommodation and treatment (referred to hereafter as involuntary internment).
The conditions for involuntary internment
People with dementia can be involuntarily interned if, due to the disease, they may commit a crime that constitutes a danger to other people and/or represent a serious threat to their own health (art. 155).
The procedure for involuntary internment
The district court, according to the current address of the person for whom the measure is intended, is responsible for the procedure for involuntary internment (art. 155 to art. 164). In case of emergency, the district court at the location of the medical establishment is responsible for the process. The involuntary internment can be requested by the prosecutor or in emergencies by the chief of the medical establishment (art. 154 /3/).
The court sends copies of the request for involuntary internment to the person concerned who then has seven days to object to the proposed measure and to provide evidence (art. 158 /1/). Within 14 days of the request, the court examines the case in an open session in the presence of the person concerned as s/he must be consulted personally. If necessary, s/he can be brought to court by force. The participation of a psychiatrist, a defender and a prosecutor is obligatory (art. 158 /4/).
After hearing the psychiatrist’s opinion concerning the existence of a mental disorder, the court obtains a judicial-psychiatric expertise in order to ensure that the conditions for involuntary internment are fulfilled. This expertise may take not more than 14 days and the following court session must take place no longer than 48 hours after the end of the expertise (art. 159).
If it is found that the person does not have a mental disorder or that the conditions for involuntary internment are not fulfilled, the court terminates the case (art. 159 /4/). If the conditions for involuntary internment are fulfilled, the court pronounces its decision on the basis of the evidence collected after having heard the person’s reaction to the findings of the judicial-psychiatric expertise (art. 162).
The court pronounces a decision on the need for involuntary internment and its duration designates the medical establishment where this will take place and states whether the person lacks the ability to express informed consent. If necessary, it also appoints one of the person’s relatives to express informed consent to treatment on behalf of the person to be involuntarily interned (art. 162 /2/).
The duration of involuntary internment
The duration of the involuntary interment is decided by the court (art. 162 /2/).
The right to appeal
The decision of the court can be appealed by the interested parties within seven days. Seven days later, the regional court pronounces the decision which is not subject to appeal (art. 163). The compulsory treatment is terminated once the time for which it was established has passed or on the decision of the district court at the location of the medical establishment (art. 164).
Article 150 of the Law of Health of 1 January 2005 states that patients with established mental disorders who are a direct and immediate danger to their own health or life, or that of other people, can be subjected to temporary physical restriction, subject to the following conditions:
- The measures must be applied solely to create the conditions for giving treatment and not as a substitute for active treatment;
- The application of physical restraint must be ordered by a doctor who defines the kind of measure to be used and its duration (which must not be longer than six hours);
- Such measures must be implemented by staff who have been trained in the use of restraint;
- Certain information must be entered into the medical file and a special book of the medical establishment. This includes the kind of restrictive measure used, the reasons for its use, its duration, the name of the doctor who ordered it and details of the medical treatment.
- The person who is subjected to physical restraint must be under the constant observation of a doctor or nurse.
Physical abuse is covered by Art. 128 – Art. 134 of the Penal Code which deals with severe, medium and minor bodily harm, as follows:
(1) A person who inflicts on another severe bodily injury shall be punished by deprivation of liberty for three to ten years.
(1) A person who inflicts on another medium bodily injury shall be punished by deprivation of liberty for up to five years.
(1) A person who inflicts on another impairment of health apart from the cases under Articles 128 and 129, shall be punished for trivial bodily injury by deprivation of liberty for up to two years or by corrective labour.
Exposure to danger is covered by Art. 137 – Art. 139 of the Penal Code:
A person who exposes a person, deprived of the possibility to defend him/herself because of minority, advanced old age, sickness or in general because of his/her helplessness, in such a way that his/her life may be endangered, and being aware of this does not render assistance thereto, shall be punished by deprivation of liberty for up to three years.
A person who consciously does not render help, in case s/he was able to do so, to a person for who s/he was obliged to take care and who was in danger of his/her life and had no possibility to protect him/herself because of minority, advanced old age, sickness or in general because of his/her helplessness, shall be punished by deprivation of liberty for up to one year or by corrective labour.
A person who in the case of immediate danger for the life of another, does not run to his/her rescue which s/he was able to do without endangering him/herself or another, shall be punished by probation for up to six months or a fine from BGN one hundred to three hundred.
The requirements for special training and personal skills of the drivers of motor vehicles of various categories and sub-categories are set out in Ordinance № 39 of 29.01. 2004.
According to Art. 2 of this Ordinance, drivers must have the necessary knowledge, skills and behaviour to enable them:
1. to observe the laws on road traffic and in particular those aimed at preventing accidents and ensure the flow of traffic;
2. to anticipate and recognise dangerous situations in traffic and assess their seriousness;
3. to control the vehicle so as to avoid dangerous situations and to respond effectively when they occur;
4.to detect technical malfunctions that threaten the safety of traffic and take appropriate measures;
5. to comply with all the factors that affect the driver’s behaviour, so as to ensure at any given time maximum security conditions when driving;
6. not to endanger the safety of road users and to be careful and cautious with regard to vulnerable people such as pedestrians and drivers of two-wheeled vehicles.
People with dementia and other people under guardianship who do not meet the above conditions are not permitted to drive according to Bulgarian legislation.
Last Updated: Wednesday 14 March 2012