Malacu and others v Romania (the Poiana Mare Hospital case)

Forum: European Court of Human Rights
INTERIGHTS' role: Adviser to counsel
Keywords: Disability, health, inhuman and degrading treatment, right to life

On Friday 11 December 2009, the Center for Legal Resources and advisers of record INTERIGHTS filed an application (Malacu and others v Romania, 55093/09) with the European Court of Human Rights on behalf of five patients who died at the Poiana Mare Psychiatric Hospital in the period January to February 2004. The hospital has a sad reputation for its record of human rights abuses perpetrated against its residents. Over the two years 2002-2003, 155 patients died at the hospital, with a further 28 people dying during the first five months of 2004, with many of these deaths taking place during winter time. The applicants are four women and a man who suffered from various mental health problems and spent long periods, in some cases their whole lives, in social care institutions.  The applicants died from a combination of poor care and inadequate treatment, as well as extremely substandard living conditions, including insufficient food and heating.

The case raises issues of access to justice for people with disabilities as well as shedding light on the failure of authorities to prevent the numerous abuses perpetrated against people with disabilities inside social care institutions and psychiatric hospitals. The Center for Legal Resources and INTERIGHTS hope that a positive decision from the Court will strengthen further the case against long-stay residential institutions and in favour of community living for people with disabilities.

The applicants are asking the European Court of Human Rights to adapt its requirements on standing and victim status in order to permit the Center for Legal Resources to file this application on the applicants’ behalf. Current standing rules, which state that applicants who are deceased may only be represented by their family, are symptomatic of the sort of procedural barriers that people with disabilities have to face in their access to justice throughout Europe. The NGOs argue that the application on behalf of the patients is justified on the basis that they have no next of kin, that no alternative source of representation is available, and that the highest Romanian court has already recognised the Center for Legal Resources standing to act on the applicants’ behalf (Decision in file no. 4948/1/2006, High Court of Cassation and Justice, 15 June 2006). The NGOs also maintain that it is in the best interest of the realisation of human rights for the Court to hear this complaint.

The case emphasises the plight of individuals who are often termed “social cases” by the authorities – socially marginalised individuals who may, or may not, have mental health issues before entering an institution. Their social status is due mainly to the absence of family or other community-based support, possibly in combination with other factors such as lack of a home, income, or a substance abuse problem. Instead of providing them with the requisite community-based support, authorities are driving vulnerable individuals into social care institutions where they have few procedural safeguards ensuring their right to liberty, and where they spend lengthy periods of time, frequently the remainder of their lives.

The case paints a comprehensive picture of the range of unchecked abuses taking place in social care institutions, as well as the entrenched discrimination towards people with disabilities by those in authority, including medical professionals and other hospital staff, their own communities, and the wider public. Perpetrators of these abuses are very rarely prosecuted despite the existence of laws meant to protect vulnerable people with mental and physical disabilities. Although the Prosecutor’s Office initiated criminal investigations in relation to each of the deaths occurring during the period 2002-2004, in no case was any individual found criminally responsible.

Poiana Mare Psychiatric Hospital is in an isolated countryside location in south-eastern Romania, on an extensive 26-hectare site which formerly housed military barracks. The hospital is also notorious as a place of detention for political dissidents during the Communist regime. Since 1989 the hospital has been used as a place of detention for many categories of patients including patients hospitalised in the context of criminal proceedings, persons with mental health problems or intellectual disabilities and persons suffering from tuberculosis.  The establishment has been visited by the Committee for the Prevention of Torture on three occasions in 1995, 1999 and 2004. Each time the Committee has released a very critical report regarding the conditions at the hospital, requesting the Romanian authorities to take urgent action to remedy the situation. Despite the Committee’s exhortations, the situation at the Poiana Mare Hospital has remained more or less unchanged

In a parallel development a complaint raising similar issues was filed with the European Court of Human Rights. The complaint concerns the tragic death of an intellectually-disabled HIV-positive teenager after he had been transferred abusively to the Poiana Mare Hospital and where he only spent one week and was filed with the European Court of Human Rights in April 2009. That application raises similar admissibility issues as this case.

INTERIGHTS acts in the case as adviser to counsel, the Romanian non governmental organisation Center for Legal Resources, which pursued proceedings on the applicants’ behalf at the domestic level.

Click here to read an overview of challenges related to the standing requirements imposed by the Court in the cases Campeanu v Romania and Malacu and others v Romania.

INTERIGHTS contact: Constantin Cojocariu, Lawyer, Europe Programme, ccojocariu@interights.org

Documents and related further information:

Application to the European Court of Human Rights

Reports from the Committee for the Prevention of Torture from 1995, 1999 and 2004 (in French)

Amnesty International report (2005)

'Institutions remain dumping grounds for forgotten people' - investigation of living conditions in residential institutions for people with disabilities in Bulgaria, Romania and Serbia by Yana Buhrer Tavanier, 2009

Human Rights Comment by the Council of Europe Human Rights Commissioner, Thomas Hammarberg: 'Inhuman treatment of persons with disabilities in Institutions', 21 October 2010

Constantin Cojocariu, 'Handicapping Rules: The Overly Restrictive Application of Admissibility Criteria by the European Court of Human Rights to Complaints Concerning Disabled People,' first published by Sweet & Maxwell in [2011] E.H.R.L.R. 686