CEDH · CASELAW;JUDGMENTS;CHAMBER;ENG — 22 novembre 2012

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THE CZECH REPUBLIC   (Application no. 23419/07)               JUDGMENT       STRASBOURG   22 November 2012   FINAL   22/02/2013   This judgment has become final under Article 44 § 2 of the Convention. It may be subject to editorial revision. In the case of Sýkora v. the Czech Republic, The European Court of Human Rights (Fifth Section), sitting as a Chamber composed of:   Dean Spielmann, President,   Mark Villiger,   Karel Jungwiert,   Boštjan M. Zupančič,   Angelika Nußberger,   André Potocki,   Paul Lemmens, judges, and Stephen Phillips, Deputy Section Registrar, Having deliberated in private on 23 October 2012, Delivers the following judgment, which was adopted on that date: PROCEDURE 1.     The case originated in an application (no. 23419/07) against the Czech Republic lodged with the Court under Article 34 of the Convention for the Protection of Human Rights and Fundamental Freedoms (“the Convention”) by a Czech national, Mr Milan Sýkora (“the applicant”), on 30 May 2007. 2.     The applicant was represented by Mr D. Zahumenský, Ms   B.   Bukovská, and Mr J. Fiala, lawyers from the Mental Disability Advocacy Center in Brno. The Czech Government (“the Government”) were represented by their Agent, Mr Vít A. Schorm, of the Ministry of Justice. 3.     The applicant alleged, in particular, that his right to liberty and private life had been violated on account of the removal of legal capacity from him and his subsequent detention in a psychiatric hospital. 4.     On 29 June 2010 the application was communicated to the Government. 5.     The applicant and the Government each submitted observations on the admissibility and merits. In addition, third-party comments were received from the Harvard Law School Project on Disability, which had been granted leave by the President of the Chamber to intervene in the written procedure (Article 36 § 2 of the Convention and Rule 44 § 2). THE FACTS I.     THE CIRCUMSTANCES OF THE CASE 6.     The applicant was born in 1949 and lives in Brno. He is a person with a psycho-social disability. He has been treated in psychiatric hospitals in the past, most recently in 1995. He has not taken any medication for many years, because he considers that it has an adverse impact on his eyesight, and has used other methods to cope with his illness. A.     Proceedings concerning the removal of the applicant’s legal capacity 7.     In a judgment of 15 November 2000 the Brno Municipal Court ( městský soud ) deprived the applicant of his legal capacity at the request of the City of Brno, which maintained that the applicant had not collected his pension since 1996 because he did not have an identity card. The court based its decision on an expert report by Dr. H., who had concluded in 1998 that the applicant was suffering from paranoid schizophrenia. The applicant, although aware of the proceedings, was not summoned to appear before the court and the decision was not served on him, the court referring to an opinion of Dr. H., who was heard by the court and did not recommend that this be done. The applicant was represented by Ms. M., an employee of the court, who had never met him, did not participate at the hearing and took no substantive part in the proceedings. The judgment became final on 21   December 2000. 8.     On an unspecified date the applicant became aware of the court’s judgment and appealed. On 27 August 2001 the Brno Regional Court ( krajský soud ) quashed the first-instance decision and remitted the case to the Municipal Court which, in a judgment of 24 November 2004, again deprived the applicant of his legal capacity and appointed the City of Brno as his guardian. 9.     It based its decision on a new expert report drawn up by Dr. H. on 20   May 2004 who, however, had not been able to examine the applicant because of his refusal to have any medical examinations. She concluded that there had been no improvement in the applicant’s mental health since the first report. She reiterated her findings in the 1998 report that the applicant was unable to care for himself or to manage any property, and that he was dependent on others even for daily needs. The report further stated that the applicant’s presence at the hearing would not be appropriate, because he did not understand the purpose of the proceedings and was denying his mental illness, but a court judgment could be sent to him. At a hearing, the expert stated that the notification of the court judgment to the applicant would not worsen his health, but he would not understand. She thus recommended that the judgment not be sent to the applicant. 10.     The court did not hear the applicant, who continued to be formally represented by a court employee. The judgment was not served on him and became final on 1 January 2005. 11.     The applicant became aware of the judgment on 20 June 2006 and appealed on 4 July 2006. He stated that the court had not notified him about the institution and outcome of the incapacitation proceedings and that Dr. H had drawn up her expert opinion without examining him. The applicant was represented by a lawyer from the Mental Disability Advocacy Center (“the MDAC”). 12.     On 25 October 2006 the Regional Court again quashed the Municipal Court’s judgment and sent the case back to it, disputing the relevance of the expert opinion which had been drawn up without the applicant being examined. It suggested that the Municipal Court should appoint a new expert. 13.     On 19 September 2007 the Municipal Court decided not to deprive the applicant of his legal capacity, basing its decision on an expert report by Dr. B., who had concluded on 11 May 2007 that the applicant was mentally ill but did not show signs of schizophrenia, was not dangerous or aggressive and was fully capable of making legal assessments. The court heard the expert, the applicant, who was legally represented, and his guardian. The judgment became final on 23 November 2007. 14.     In total the applicant was deprived of legal capacity from 21   December 2000 to 27 August 2001 and from 1 January 2005 to 25   October 2006, that is for two years and six months. B.     Proceedings for damages against the State 15.     On 15 January 2008, in two separate documents, the applicant requested the Ministry of Justice to award him non-pecuniary damages for the unreasonable length of incapacitation proceedings and violations of other procedural rights. 16.     The Ministry joined the two requests of the applicant and on 1   September 2008 awarded him 102,000 Czech korunas (CZK, 4,602 euros (EUR)) in damages for the unreasonable length of proceedings. Regarding the rest of the applicant’s claims, the Ministry accepted that the judgments had not been served on the applicant and that his rights had therefore been violated. It stated, however, that a   finding of a violation constituted in itself sufficient satisfaction for any non-pecuniary damage he might have sustained. 17.     The applicant brought proceedings for damages at the Prague 2 District Court ( obvodní soud ), claiming violations of his procedural rights in the incapacitation proceedings. 18.     On 12 November 2008 the District Court rejected the applicant’s action. On the basis of established case-law it held that the alleged shortcomings in the incapacitation proceedings could not constitute irregular official conduct for which the State could be held responsible, because there had been a decision. The applicant could have claimed damages only for a decision that became final but was later quashed as illegal. That situation however did not arise in the present case. 19.     On 10 December 2009 the Municipal Court upheld the judgment of the lower court. 20.     On 16 February 2012 the Constitutional Court ( Ústavní soud ) dismissed a constitutional appeal by the applicant as manifestly ill-founded. It held that the legal opinion of the ordinary courts was not unconstitutional. It noted that by claiming damages for irregular official conduct the applicant had been trying to circumvent the fact that he had not met the conditions for claiming damages for an unlawful decision. Furthermore, the decisions for which the applicant was claiming damages had never become final and so could not have interfered with his rights. C.     The applicant’s detention in the Brno-Černovice Psychiatric Hospital and the ensuing proceedings 21.     On 9 November 2005 the applicant had a verbal, non-violent argument with his partner, Ms J., who called the police and an ambulance. Although the police found no signs of violence and the applicant’s partner confirmed that the applicant had not been aggressive, the ambulance doctor decided to take the applicant to a psychiatric hospital. The applicant disagreed but did not resist. 22.     At his admission to the Brno-Černovice Psychiatric Hospital, the applicant was subjected to two specialist medical examinations. They both concluded that the applicant suffered from schizophrenia. The applicant insisted at the examinations that there were no reasons for his detention. Despite his warning that neuroleptic psychiatric medication had a negative effect on his eyesight, he was nevertheless ordered to take the medication, and when he refused it was administered by injection. As a result, according to the applicant, his eyesight deteriorated. 23.     On 10 November 2005 the applicant complained about his treatment in a letter to the director of the hospital, but his letter was retained by the staff; he was informed of this on 14 November 2005. He has never received any reply from the director. 24.     On 11 November 2005 the hospital notified the Municipal Court of the applicant’s involuntary admission so that the court could start to review its lawfulness under Article 191a of the Code of Civil Procedure. On an unspecified date the hospital contacted the applicant’s guardian (the City of Brno) which, on 14 November 2005, consented to his detention. The employee who signed the consent had never met the applicant and did not inform him that consent had been given. 25.     On an unspecified date the applicant was moved to a department with a more lenient regime, but was still not allowed to leave. 26.     On 14 November 2005 he contacted the MDAC. On the same day, an MDAC lawyer stated to the Municipal Court that the applicant’s involuntary detention was unlawful, and requested his release. 27.     On 29 November 2005 the applicant was released from the hospital. He stated that he suffered from impaired vision and mental health for almost a year as a consequence of the treatment he received in the hospital. 28.     On an unspecified date a judge of the Municipal Court informed the MDAC lawyer that the applicant had been deprived of legal capacity and that a power of attorney therefore had to be signed by his guardian. Due to the applicant’s poor health after his release from the hospital, the applicant was able to visit his guardian in an office of the City of Brno only on 8   November 2006. The employee of the City of Brno he approached refused however to sign the power of attorney. On the same day, the applicant himself asked the Municipal Court for a further review of the lawfulness of his involuntary admission to the psychiatric hospital. On 24   November 2006 he was told in a letter that no proceedings in that regard had been instituted. 29 .     On 2 January 2007 the applicant complained to the President of the Municipal Court about delays in the proceedings. On 5   March 2007 he received a reply that no such proceedings had been instituted because his guardian had consented to his detention. 30.     On 31 January 2007 the applicant lodged a constitutional appeal ( ústavní stížnost ) alleging a violation of his rights to liberty, fair hearing, respect for private life and non-discrimination due to his involuntary hospitalisation and removal of his legal capacity. 31.     On 8 January 2009 the Constitutional Court dismissed his constitutional appeal for non-exhaustion of ordinary remedies. Regarding the proceedings on the review of the lawfulness of his involuntary hospitalisation, the court held that the applicant had not lodged a complaint under section 174a of the Act on Courts and Judges (no. 6/2002) requesting the court to set a date for action. Regarding the incapacitation proceedings, it held that at the time the constitutional appeal was lodged those proceedings were pending before the Municipal Court. 32.     On 6 February 2009 the applicant lodged a new complaint of delays in the proceedings on the review of the lawfulness of his involuntary admission to the psychiatric hospital, and requested the court to set a date for action. On 13 March 2009 the Regional Court refused his request on the grounds that since the applicant was no longer detained no proceedings on lawfulness of his detention had been held, so there were no proceedings in which any delays could be found and which could be expedited. 33.     On 21 May 2009 the applicant lodged a constitutional appeal, claiming that his psychiatric detention had never been reviewed by a court. 34.     On 11 January 2012 the Constitutional Court dismissed his constitutional appeal as unsubstantiated, holding that the courts had rightly not instituted proceedings to review the applicant’s detention, because his guardian had consented to it, and moreover when the applicant had requested the continuation of the proceedings he was no longer detained, which was another reason why the proceedings had had to be abandoned. It added that the applicant could institute civil proceedings for damages against the hospital, in which the lawfulness of its actions could be reviewed. II.     RELEVANT DOMESTIC LAW A.     Civil Code (Act no. 40/1964) in force at the material time 35.     Under Article 10 § 1, if a natural person, because of a mental disorder which is not temporary, is totally unable to make legal decisions, the court will deprive him of legal capacity. 36.     Under Article 26, if natural persons are legally incapacitated, their guardians act in their name. B.     Code of Civil Procedure (Act no. 99/1963) 37.     Under Article 191a a hospital which admits a patient against his or her will must inform an appropriate court within twenty-four hours; the court will review the lawfulness of the person’s involuntary admission to the hospital. C.     The Public Health Care Act (Act no. 20/1966) in force at the material time 38.     Under section 23(4)(b) a person may be compulsorily medically treated and even hospitalised if he appears to show signs of a mental illness and endangers himself or his surroundings. D.     Act no. 82/1998 on State liability for damage caused in the exercise of public authority by an irregularity in a decision or the conduct of proceedings 39.     Under sections 7 and 8 individuals who suffer loss because of a final unlawful decision that is later quashed or changed are entitled to claim just satisfaction. 40.     Section 13 provides that the State is also liable for damage caused by an irregularity in the conduct of proceedings, including non-compliance with the obligation to perform an act or to give a decision within the statutory time-limit. III.     RELEVANT INTERNATIONAL INSTRUMENTS A.     Convention on the Rights of Persons with Disabilities, adopted by the United Nations General Assembly on 13   December 2006 (Resolution A/RES/61/106) 41.     This Convention entered into force on 3 May 2008. It was ratified by the Czech Republic on 28 September 2009. The relevant parts of the Convention provide: Article 12 Equal recognition before the law “1.     States Parties reaffirm that persons with disabilities have the right to recognition everywhere as persons before the law. 2.     States Parties shall recognize that persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life. 3.     States Parties shall take appropriate measures to provide access by persons with disabilities to the support they may require in exercising their legal capacity. 4.     States Parties shall ensure that all measures that relate to the exercise of legal capacity provide for appropriate and effective safeguards to prevent abuse in accordance with international human rights law. Such safeguards shall ensure that measures relating to the exercise of legal capacity respect the rights, will and preferences of the person, are free of conflict of interest and undue influence, are proportional and tailored to the person’s circumstances, apply for the shortest time possible and are subject to regular review by a competent, independent and impartial authority or judicial body. The safeguards shall be proportional to the degree to which such measures affect the person’s rights and interests. ...” Article 14 Liberty and security of person “1.     States Parties shall ensure that persons with disabilities, on an equal basis with others: ( a )     Enjoy the right to liberty and security of person; ( b )     Are not deprived of their liberty unlawfully or arbitrarily, and that any deprivation of liberty is in conformity with the law, and that the existence of a disability shall in no case justify a deprivation of liberty. 2.     States Parties shall ensure that if persons with disabilities are deprived of their liberty through any process, they are, on an equal basis with others, entitled to guarantees in accordance with international human rights law and shall be treated in compliance with the objectives and principles of the present Convention, including by provision of reasonable accommodation.” B.     Recommendation No. R (99) 4 of the Committee of Ministers of the Council of Europe on principles concerning the legal protection of incapable adults (adopted on 23 February 1999) 42 .     The relevant parts of this Recommendation read as follows: Principle 3 – Maximum reservation of capacity “1.     The legislative framework should, so far as possible, recognise that different degrees of incapacity may exist and that incapacity may vary from time to time. Accordingly, a measure of protection should not result automatically in a complete removal of legal capacity. However, a restriction of legal capacity should be possible where it is shown to be necessary for the protection of the person concerned. 2.     In particular, a measure of protection should not automatically deprive the person concerned of the right to vote, or to make a will, or to consent or refuse consent to any intervention in the health field, or to make other decisions of a personal character at any time when his or her capacity permits him or her to do so. ...” Principle 6 – Proportionality “1.     Where a measure of protection is necessary it should be proportional to the degree of capacity of the person concerned and tailored to the individual circumstances and needs of the person concerned. 2.     The measure of protection should interfere with the legal capacity, rights and freedoms of the person concerned to the minimum extent which is consistent with achieving the purpose of the intervention. ...” Principle 9 – Respect for wishes and feeling of the person concerned “3. [This principle] also implies that a person representing or assisting an incapable adult should give him or her adequate information, whenever this is possible and appropriate, in particular concerning any major decision affecting him or her, so that he or she may express a view.” Principle 13 – Right to be heard in person “The person concerned should have the right to be heard in person in any proceedings which could affect his or her legal capacity.” Principle 14 – Duration, review and appeal “1.     Measures of protection should, whenever possible and appropriate, be of limited duration. Consideration should be given to the institution of periodical reviews ... 3.     There should be adequate rights of appeal. ...” Principle 16 – Adequate control “There should be adequate control of the operation of measures of protection and of the acts and decisions of representatives.” Principle 19 – Limitation of powers of representatives “1.     It is for national law to determine which juridical acts are of such a highly personal nature that they can not be done by a representative. 2.     It is also for national law to determine whether decisions by a representative on certain serious matters should require the specific approval of a court or other body...” Principle 22 – Consent “1.     Where an adult, even if subject to a measure of protection, is in fact capable of giving free and informed consent to a given intervention in the health field, the intervention may only be carried out with his or her consent. The consent should be solicited by the person empowered to intervene. 2.     Where an adult is not in fact capable of giving free and informed consent to a given intervention, the intervention may, nonetheless, be carried out provided that:     - it is for his or her direct benefit, and     authorisation has been given by his or her representative or by an authority or a person or body provided for by law. 3.     ... Consideration should also be given to the need to provide for the authorisation of a court or other competent body in the case of certain serious types of intervention.” C.     Report to the Czech Government on the visit to the Czech Republic carried out by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) from 27 March to 7 April 2006 and from 21 to 24 June 2006 43.     In this report the CPT also assessed the guardianship regime in the Czech Republic in connection with the admission of incapacitated persons to social care institutions and psychiatric hospitals. It noted that guardians have far-reaching powers with respect to their wards, and criticised the fact that they may also decide on the question of admission to a psychiatric hospital or a social care home (§ 149). It recommended that the Czech authorities consider incorporating the Council of Europe’s Principles Concerning the Legal Protection of Incapable Adults and, in particular, Principle 19 (2), into the legal norms governing guardianship in the Czech Republic (§ 154). D.     Concluding Observations of the Human Rights Committee on the Czech Republic, 25 July 2007 44 .     The Committee expressed concern that confinement in psychiatric hospitals can be based on mere “signs of mental illness”. It regretted that court reviews of admissions to psychiatric institutions do not sufficiently ensure respect for the views of the patient, and that guardianship is sometimes assigned to attorneys who do not meet the patient. It concluded: “The State party should ensure that no medically unnecessary psychiatric confinement takes place, that all persons without full legal capacity are placed under guardianship that genuinely represents and defends the wishes and interest of those persons, and that an effective judicial review of the lawfulness of the admission and detention of such person in health institutions takes place in each case.” E.     Report of the UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Paul Hunt, Doc. no. E/CN.4/2005/51, 11 February 2005 45.     In his report the Special Rapporteur emphasised that human rights must be supported by a system of accountability, and called for the introduction of appropriate safeguards against abuse of the rights of people with mental disabilities. He advocated that an independent review body must be made accessible to individuals with mental disabilities to periodically review cases of involuntary admission and treatment (§ 71). He was further concerned by the fact that guardianship had been overused and abused in the medical, as well as other, contexts, including at the most extreme level the compulsory admission of individuals with learning disabilities in psychiatric institutions (§ 79). THE LAW I.     ALLEGED VIOLATION OF ARTICLE 5 § 1 OF THE CONVENTION 46.     The applicant complained that his admission and detention in the Brno-Černovice Psychiatric Hospital violated his right to liberty. He relied on Article 5 § 1 of the Convention, the relevant part of which reads: “1.     Everyone has the right to liberty and security of person. No one shall be deprived of his liberty save in the following cases and in accordance with a procedure prescribed by law: ... (e)     the lawful detention of persons for the prevention of the spreading of infectious diseases, of persons of unsound mind, alcoholics or drug addicts or vagrants; A.     Admissibility 47.     The Court first notes that the applicant was confined to a psychiatric hospital from 9 November 2005 to 29 November 2005, that is a total of twenty days, without his consent. While his confinement was confirmed after five days by the guardian this does not alter the fact that the applicant was deprived of his liberty involuntarily and that his continued hospitalisation against his will constituted a deprivation of liberty within the meaning of that provision (see Stanev v. Bulgaria [GC], no. 36760/06, §§   122-123, ECHR 2012; D.D. v. Lithuania , no. 13469/06, § 122, 14   February 2012; and Shtukaturov v. Russia , no. 44009/05, § 109, ECHR 2008). 48 .     The Government maintained that the applicant had lost his status as a victim after the Ministry of Justice had acknowledged that incorrect official procedure had taken place both as a result of delays in the proceedings and as a result of failure to serve courts’ decisions on the applicant, and had awarded him CZK 102,000 (see paragraph 16 above). Even though the acknowledgement concerned the proceedings on legal capacity, this must be viewed in the context of the narrow inter-connection of these proceedings and the admission of the applicant to the hospital with the consent of his guardian. 49.     The applicant disagreed, arguing that his right to liberty was not an issue in those proceedings, which concerned only his incapacitation. 50 .     The Court observes that while compensating the applicant for the unreasonable length of the incapacitation proceedings, the Ministry did not acknowledge a violation of the applicant’s right to liberty. It cannot therefore be said that the authorities have acknowledged the breach of Article 5 of the Convention and afforded redress for it. As a result, the Government’s objection must be dismissed. 51 .     The Government further argued that the applicant had failed to exhaust domestic remedies, pointing out that his first constitutional appeal had been dismissed for non-compliance with procedural requirements. Moreover, the applicant should have instituted proceedings for damages against the State on the basis that the Brno Municipal Court had failed to decide on the lawfulness of his involuntary admission to the hospital. 52.     The applicant disagreed, maintaining that he could not claim compensation from the State for unlawful detention given that his detention had been based on the national law. 53.     Regarding the dismissal of the applicant’s first constitutional appeal for formal reasons, the Court notes that, subsequently, the applicant’s second constitutional appeal was dismissed on the merits (see paragraph 33 above). It cannot therefore be said that the applicant failed to exhaust this remedy in compliance with the procedural requirements. 54.     As regards the possibility of bringing an action for damages against the State, the Court recalls that the Constitutional Court, in its decision of 11   January 2012, found the approach of the courts in the applicant’s case to have been lawful and constitutional. Moreover, the Government have failed to submit any example of a decision in which an action for damages in comparable circumstances was successful. The Court therefore concludes that an action for damages was not a remedy which the applicant was required to exhaust, and dismisses the Government’s objection of non-exhaustion of domestic remedies. 55 .     Lastly, the Government requested the Court to apply the admissibility criterion under Article 35 § 3 (b) of the Convention, maintaining that the applicant had suffered no significant disadvantage. 56.     The Court does not accept that questions going to the lawfulness of a   deprivation of liberty which lasted twenty days could constitute an “insignificant” disadvantage. It accordingly dismisses this objection. 57.     The Court notes that this complaint is not manifestly ill-founded within the meaning of Article 35 § 3 (a) of the Convention. It further notes that it is not inadmissible on any other grounds. It must therefore be declared admissible. B.     Merits 1.     Submissions of the parties and third-party intervener 58.     The applicant complained that his detention could not have been justified under Article 5 § 1 (e) of the Convention because he was not a   person of unsound mind of a kind or degree warranting compulsory confinement. He stated that his detention had been neither lawful nor in accordance with a procedure prescribed by law. He had been detained on the basis of retrospective consent given by his guardian, who had never met him and had showed no interest in his hospitalisation. In his view, the Convention did not allow guardians to decide on questions of such fundamental importance without court approval and thus his detention could not be lawful as there had been no safeguards against his detention. The guardian’s powers were total and unchecked. 59.     The Government maintained that the applicant had a serious and long term mental disorder. He had been taken to the health care institution as a result of an emergency call by Ms J., who had reported that the applicant was being aggressive and that she had felt threatened by him. It can therefore be assumed that from the perspective of the medical specialists at the time of the confinement, the applicant’s disorder had required hospitalisation, even though the aggressive behaviour had not been confirmed and Ms J. later described it as fabricated. 60.     They added that the applicant’s hospitalisation had been in compliance with the domestic law. As far as compliance with the procedural criteria in the light of the requirements of the Convention was concerned, the Government left that assessment to the Court’s discretion. 61.     The Harvard Law School Project on Disability, as third party to the proceedings, referred in their submissions to the Convention on the Rights of Persons with Disabilities, which the Court should, in their view, take into account in interpreting the Convention. 2.     The Court’s assessment 62.     The Court reiterates that in order to comply with Article 5 § 1, the detention in issue must first of all be “lawful”, including the observance of a procedure prescribed by law; in this respect the Convention refers back essentially to national law and lays down the obligation to conform to the substantive and procedural rules thereof. Moreover, any deprivation of liberty should be consistent with the purpose of Article 5, namely to protect individuals from arbitrariness. Furthermore, the detention of an individual is such a serious measure that it is only justified where other, less severe measures have been considered and found to be insufficient to safeguard the individual or public interest which might require that the person concerned be detained. That means that it does not suffice that the deprivation of liberty is in conformity with national law; it must also be necessary in the circumstances (see Stanev , cited above, § 143). The Court has outlined three minimum conditions for the lawful detention of an individual on the basis of unsoundness of mind under Article 5 § 1 (e) of the Convention: he must reliably be shown to be of unsound mind, that is, a true mental disorder must be established before a competent authority on the basis of objective medical expertise; the mental disorder must be of a kind or degree warranting compulsory confinement; and the validity of continued confinement must depend upon the persistence of such a disorder (see Winterwerp v. the Netherlands , 24 October 1979, §   39, Series A no. 33; and Stanev , cited above, § 145). 63.   Moreover, a detention cannot be considered “lawful” within the meaning of Article 5 § 1 if the domestic procedure does not provide sufficient guarantees against arbitrariness (see H.L. v. the United Kingdom , no. 45508/99, § 124, ECHR 2004 ‑ IX; Shtukaturov , cited above, § 113; and L.M. v. Latvia , no. 26000/02, § 54, 19 July 2011). In addition, deprivations of liberty must be subject to thorough scrutiny by the domestic authorities ( Ťupa v. the Czech Republic , no. 39822/07, §§ 37 and 61, 26 May 2011). 64 .     In the H.L. v. the United Kingdom case the Court found that the detention had not been lawful because of the absence of safeguards, understood both in the sense of procedural safeguards and of substantive guarantees to prevent arbitrariness (§ 120). 65.     Turning to the present case, the Court first observes that the applicant was admitted to the psychiatric hospital as an emergency case, the doctors acting on the belief that he had been aggressive to his partner. He underwent two independent medical examinations on his admission and both doctors concluded that the applicant suffered from a mental disorder. Therefore, his detention was initially based on an objective medical expertise. However, before deciding whether also the other above mentioned Winterwerp criteria were complied with in the present case, the Court must establish whether the applicant’s detention was “lawful”, in particular whether the domestic procedure provided sufficient guarantees against arbitrariness (see L.M. v. Latvia , cited above, § 45). 66.     The Court notes that no domestic court reviewed the lawfulness of the applicant’s detention as would be the normal procedure in cases of involuntary hospitalisations (see § 37 above). The reason was that since the guardian gave consent to the applicant’s detention the applicant was considered, as a matter of domestic law, to be in the psychiatric hospital voluntarily. As a result, he was deprived of his liberty for twenty days solely on the basis of the consent of his guardian. The requirements for involuntary hospitalisation, both substantive in section 23(4)(b) of the Public Health Care Act and procedural in the Code of Civil Procedure, did not apply. 67.     The Court observes that the opinions and reports issued by the various international bodies indicate a trend in international standards to require that detentions of incapacitated persons be accompanied by requisite procedural safeguards, namely by way of judicial review (see Principles 3, 16, 19 and 22 in paragraph 42 above; the views of the international bodies in paragraphs 42-44 above; and also Ťupa v. the Czech Republic , cited above, §§ 37 and 61). Judicial review, instituted automatically or brought about by the ward or some other suitable person, of a guardian’s consent to deprivation of liberty of their ward could provide, in view of the Court, a relevant safeguard against arbitrariness. The trend towards such judicial review has not yet found full implementation in most Council of Europe Member States (see the Comparative Law part in Stanev , cited above, §§   91-95), and it is not available in the Czech Republic in circumstances like the present case. 68.     The Court observes that the only possible safeguard against arbitrariness in respect of the applicant’s detention was the requirement that his guardian, which was the City of Brno, consent to the detention. However, the guardian consented to the applicant’s detention without ever meeting or even consulting the applicant. Moreover, it has never been explained why it would have been impossible or inappropriate for the guardian to consult the applicant before taking this decision, as referred to in the relevant international standards (see Principle 9 in paragraph 42 above). Accordingly, the guardian’s consent did not constitute a sufficient safeguard against arbitrariness. 69.     There were no other substantive safeguards protecting the applicant from detention than the guardian’s consent, which was not sufficient as found above. Even the protection of section 23(4)(b) of the Public Health Care Act was inapplicable once the guardian gave his consent. 70 .     The Court considers that, even after the applicant’s detention became voluntary under domestic law, it was not lawful as it was not accompanied by sufficient guarantees against arbitrariness. It is thus not necessary to consider the other arguments of the applicant. 71.     There has accordingly been a violation of Article 5 § 1 of the Convention. II.     ALLEGED VIOLATION OF ARTICLE 5 § 4 OF THE CONVENTION 72.     The applicant further complained that he did not have any opportunity to seek a judicial review of his detention. He relied on Article 5 § 4 of the Convention: “Everyone who is deprived of his liberty by arrest or detention shall be entitled to take proceedings by which the lawfulness of his detention shall be decided speedily by a court and his release ordered if the detention is not lawful.” A.     Admissibility 73.     The Government repeated their objection of inadmissibility already raised under Article 5 § 1 (see paragraphs 48, 51 and 55 above). They further maintained that Article 5 § 4 of the Convention was applicable only when a person was in detention, and that therefore this complaint as far as it concerned proceedings after 29 November 2005 was incompatible ratione materiae with the Convention. 74.     The applicant disagreed. He challenged the accuracy of the Government’s objection ratione materiae , and maintained furthermore that it was irrelevant, as his complaint concerned the absence of any opportunity to seek judicial review of his detention. 75.     The Court has already rejected the Government’s objection as to the victim status of the applicant above (see paragraph 50 above). As to their view that any disadvantage to the applicant was insignificant, the Court does not accept that the absence of an opportunity for the applicant to seek judicial review of his detention, which goes to the essence of Article 5 § 4 of the Convention, can constitute an insignificant disadvantage and, accordingly, dismisses the Government’s objection. 76.     The Court further agrees with the applicant that the question whether Article 5 § 4 applied to any proceedings after the applicant’s release is not relevant to the present complaint. 77.     It finally considers that the Government’s objection of non-exhaustion of domestic remedies must be joined to the examination of the merits of the complaint (see Rashed v. the Czech Republic , no. 298/07, § 46, 27 November 2008). 78.     The Court notes that this complaint is not manifestly ill-founded within the meaning of Article 35 § 3 of the Convention. It further notes that it is not inadmissible on any other grounds. It must therefore be declared admissible. B.     Merits 79.     The applicant complained that having been deprived of his legal capacity he had had no access to any judicial proceedings for a review of the lawfulness of his detention. He argued that Article 5 § 4 guaranteed this right to everyone, and therefore the consent of his guardian could not forfeit this right on his behalf without any safeguards. If that were the case the whole purpose of Article 5, which was to prevent arbitrary detentions, would be compromised. 80.     The Government pointed out that under the domestic law the applicant had been admitted to the psychiatric hospital with the consent of his guardian. Moreover, his detention had not been particularly lengthy. Had it been a long-term detention the situation would have been different, as after the quashing of the Municipal Court’s judgment depriving the applicant of his legal capacity, the applicant would no longer have been considered a patient detained by consent, and remedies in respect of his detention would have been available to him. 81.     Article 5 § 4 of the Convention deals only with those remedies which must be made available during a person’s detention with a view to that person obtaining speedy judicial review of the lawfulness of the detention leading, where appropriate, to his or her release ( Slivenko v.   Latvia [GC], no. 48321/99, § 158, ECHR 2003 ‑ X). 82.     As to the substantive content of the provision, the Court has recently considered the requirements of Article 5 § 4 of the Convention in the case of Stanev (cited above). It recalled that Article 5 § 4 entitles detained persons to institute proceedings for a review of compliance with the procedural and substantive conditions which are essential for the “lawfulness” of their deprivation of liberty (§ 168). The remedy must be accessible to the detained person and must afford the possibility of reviewing compliance with the conditions to be satisfied if the detention of a person of unsound mind is to be regarded as “lawful” for the purposes of Article 5 § 1 (e). The Convention requirement for an act of deprivation of liberty to be amenable to independent judicial scrutiny is of fundamental importance in the context of the underlying purpose of Article 5 of the Convention to provide safeguards against arbitrariness; in the case of mental illness, special procedural safeguards may be called for in order to protect the interests of persons who, on account of their mental illness, are not fully capable of acting for themselves (§ 170, with further references). In the case of Shtukaturov (cited above), the Court found that a remedy which could only be initiated through the applicant’s mother – who was opposed to his release – did not satisfy the requirements of Article 5 § 4 (§ 124). 83.     Turning to the present case, the Court notes that the applicant’s detention lasted twenty days, which cannot be considered too short to initiate judicial review (compare for example, a contrario , Slivenko , cited above, § 158 and Fox, Campbell and Hartley v. the United Kingdom , 30   August 19