CEDH · CASELAW;JUDGMENTS;CHAMBER;ENG — 24 juin 2021

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margin-bottom:6pt; text-indent:-17.05pt; text-align:justify; page-break-inside:avoid; page-break-after:avoid; font-size:10pt } .s7AE800C3 { width:4.28pt; font:7pt 'Times New Roman'; display:inline-block } .s37072F3C { margin-top:14pt; margin-left:15pt; margin-bottom:12pt; page-break-inside:avoid; page-break-after:avoid; padding-left:2.85pt; font-family:Arial; text-transform:uppercase } .s9A177BD5 { margin-top:14pt; margin-left:17.85pt; margin-bottom:12pt; page-break-inside:avoid; page-break-after:avoid; font-family:Arial; text-transform:uppercase } .sD11CFAB7 { margin-top:14pt; margin-left:15.01pt; margin-bottom:3pt; text-align:justify; padding-left:1.99pt; font-family:Arial } .sFBC99493 { font-style:italic } .s51DFF5CF { margin-top:0pt; margin-left:34pt; margin-bottom:0pt; text-indent:-17pt; text-align:justify } .sE5BF05B1 { width:2.33pt; font:7pt 'Times New Roman'; display:inline-block } .s7CB9076 { margin-top:36pt; margin-bottom:0pt; page-break-inside:avoid; page-break-after:avoid } .sF920FE69 { font-family:Arial; color:#f8f8f8 } .s69DCC830 { margin-top:36pt; margin-bottom:0pt } .s867F9C1B { width:175.28pt; display:inline-block } .s7602FED2 { width:18.21pt; display:inline-block } .sC1AC44A4 { width:228.11pt; display:inline-block }   FIRST SECTION CASE OF KHACHATUROV v. ARMENIA (Application no. 59687/17)     JUDGMENT   Art 3 • Extradition (Russia) • Decision to extradite applicant unfit for travel, even with medical supervision, due to severe health condition • Extradition without proper assessment of transfer risks would entail a breach • Receiving State’s assurances insufficient, since limited to availability of medical supervision during transfer • Requirement of a case-by-case examination of individual’s medical condition, at a particular point in time, and of substantiated specific medical risks in light of conditions of a particular transfer • Lack of relevant domestic legal safeguards and procedures   STRASBOURG 24 June 2021   FINAL   24/09/2021   This judgment has become final under Article 44 § 2 of the Convention. It may be subject to editorial revision. In the case of Khachaturov v. Armenia, The European Court of Human Rights (First Section), sitting as a Chamber composed of:   Krzysztof Wojtyczek, President,   Tim Eicke,   Aleš Pejchal,   Armen Harutyunyan,   Pauliine Koskelo,   Raffaele Sabato,   Linos-Alexandre Sicilianos, judges, and Renata Degener, Section Registrar , Having regard to: the application (no. 59687/17) against the Republic of Armenia lodged with the Court under Article 34 of the Convention for the Protection of Human Rights and Fundamental Freedoms (“the Convention”) by a Russian national, Mr Suren Khachaturov (“the applicant”), on 18 August 2017; the decision to give notice of the application to the Armenian Government (“the Government”); the decision to indicate interim measure to the respondent Government under Rule 39 of the Rules of Court and the fact that this interim measure has been complied with; the decision not to notify the Russian Federation of the application (see I   v. Sweden , no. 61204/09, §§ 42-46, 5 September 2013); the parties’ observations; Having deliberated in private on 25 May 2021, Delivers the following judgment, which was adopted on that date: INTRODUCTION 1.     The application, lodged under Articles 2 and 3 of the Convention, concerns the applicant’s allegation that his transfer, if the decision to extradite him to Russia were implemented, would expose him to risks to his life and physical well-being, considering his state of health. THE FACTS 2.     The applicant was born in 1974 and lives in Yerevan. The applicant was represented by Mr T. Yegoryan and Mr N. Baghdasaryan, lawyers practising in Yerevan. 3.     The Government were represented by their Agent, Mr G. Kostanyan, and subsequently by Mr Y. Kirakosyan, Representative of the Republic of Armenia to the European Court of Human Rights. 4.     The facts of the case, as submitted by the parties, may be summarised as follows. 5.     The applicant, who is ethnic Armenian, lived and worked in Russia prior to his return to Armenia on an unspecified date in June 2015. He was first deputy director of one of the State budgetary establishments of the City of Moscow. Criminal proceedings against the applicant in Russia 6.     On 27 May 2015 the investigative department of the north administrative district of Moscow instituted criminal proceedings against the applicant on suspicion of attempted bribe-taking. 7.     On 1 June 2015 the applicant undertook to appear when summoned by the investigative authority and to inform the investigator immediately of any change of place of residence or registration. 8.     On 10 June 2015 the applicant was charged with attempted bribe-taking. 9.     On the same date the applicant was admitted to accident and emergency in a hospital in Moscow with transient cerebral ischaemia. He was discharged on 14 June 2015. 10.     On 16 June 2015 the investigator declared the applicant a fugitive, including him in the federal wanted list. 11.     On 8 July 2015 the applicant was declared an international fugitive. 12.     On 14 July 2015 the Savelevskiy District Court of Moscow allowed the investigator’s application seeking the applicant’s detention. In doing so, it dismissed the applicant’s lawyer’s arguments concerning the applicant’s poor state of health and the fact that that he had received inpatient medical treatment in Yerevan of which the investigator had been informed. The court found, inter alia , that the applicant had knowingly chosen not to receive medical treatment in Russia and had left the country despite the criminal proceedings pending against him. Extradition proceedings in Armenia and the applicant’s state of health 13.     On 11 April 2017 the applicant was arrested in Yerevan. He was then detained pending determination of the question of his extradition to Russia. 14.     On 14 April 2017 the Office of the Prosecutor General of Armenia submitted an application to the Kentron and Nork-Marash District Court of Yerevan (“the District Court”) seeking to detain the applicant for a period of forty days pending determination of the question of his extradition to Russia. 15.     On the same date the District Court authorised the applicant’s detention for a period of forty days counting from 11 April 2017. 16.     On 19 April 2017 the applicant lodged an appeal against the District Court’s decision of 14 April 2017, arguing that he should be considered an Armenian citizen, which would be legal grounds preventing his extradition. The applicant submitted a number of documents such as his birth certificate, old passports, documents concerning his military conscription in Armenia, and so forth to substantiate that he satisfied the requirements of section 10 of the Nationality Act and he should therefore be recognised an Armenian citizen. 17.     On 30 May 2017 the Criminal Court of Appeal (“the Court of Appeal”) dismissed the applicant’s appeal. In particular, having examined the documents submitted by the prosecution in support of the argument that the applicant had received Russian nationality before 13 July 1995, the date of entry into force of the Constitution – one of the requirements of section 10 of the Nationality Act – the Court of Appeal found that the applicant’s detention for the purpose of his extradition to a foreign country would be in breach of his rights since the question of his nationality was disputed. At the same time, the Court of Appeal found that the applicant’s detention pending receipt of the criminal case against him for the purpose of his prosecution in Armenia was lawful under Articles 478.2 and 478.3 of the Code of Criminal Procedure. 18.     On 12 May 2017 the Prosecutor General of Russia requested the applicant’s extradition under the 1993 Minsk Convention on Legal Assistance and Legal Relations in Civil, Family and Criminal Matters. That request also stated that the applicant would not be subjected to torture, inhuman and degrading treatment or punishment. 19.     On 14 May 2017 the Office of the Prosecutor General of Armenia lodged an application with the District Court, seeking the applicant’s detention for two months for the purpose of carrying out his extradition. 20.     On 19 May 2017 the District Court authorised the applicant’s detention for a period of two months. 21 .     On 16 June 2017 the applicant was transferred from the Nubarashen detention facility to the Central Prison Hospital with the following diagnosis: “Heart ischaemic disease; arterial hypertension progressing to a critical state”. 22.     In a decision of 23 June 2017 the Prosecutor General of Armenia granted the extradition request, instructing the police and the Central Prison Hospital, where the applicant was detained, to ensure his extradition to Russia after the decision had become final. It was stated in the decision that according to the documents provided by the Office of the Prosecutor General of Russia the applicant had received Russian nationality on 26 July 1994 and that he was still a Russian citizen. Hence, there were no legal impediments to his extradition. 23 .     On 3 July 2017 the deputy head of the Central Prison Hospital issued a certificate in respect of the applicant’s state of health. It stated that he was suffering from a post-stroke condition with severe vestibulopathy and eye ‑ movement impairment; remnants of the stroke in the area of the left middle artery of the brain with right-sided reflector hemiparesis; walking difficulty as a result of hemiparesis; 2nd degree atherosclerotic encephalopathy; 1st degree arterial hypertension; a 15% risk of developing cardiovascular complications. 24.     On 6 July 2017 the applicant appealed against the extradition decision of 23 June 2017 to the Court of Appeal. He argued that, considering his state of health, his transfer to Russia could cause irreparable harm to his health or put his life in danger. In support of his appeal, the applicant relied on the medical certificate of 3 July 2017. 25.     In a letter of 12 July 2017 the Office of the Prosecutor General of Russia asked the Office of the Prosecutor General of Armenia to inform it of the planned date for the applicant’s transfer, guaranteeing that during the applicant’s detention and, in the event of his conviction, during the serving of his sentence the staff of the Armenian consulate in Russia would have access to him. In addition, during the same periods, in case of necessity, the applicant would be provided with the requisite medical assistance. 26 .     On the same date the chief neurologist of the Ministry of Health of Armenia issued a medical certificate which stated that the applicant was suffering from the consequences of an ischaemic stroke indicating severe disorders of the cardiovascular and nervous systems. Considering those risks, it could not be ruled out that the applicant’s transfer to Russia by air or land could result in a further stroke or a heart attack. 27 .     By further letter of 14 July 2017 the Office of the Prosecutor General of Russia gave assurances that a doctor with the relevant specialisation would travel with a special convoy to provide the applicant with medical assistance if necessary during his transfer. 28 .     On 19 July 2017 the Court of Appeal rejected the applicant’s appeal. It referred to the assurances provided by the Office of the Prosecutor General of Russia regarding the presence of a medical specialist during the applicant’s transfer to Russia and during his detention and, if convicted, while serving his sentence. 29.     On 26 July 2017 the applicant lodged an appeal on points of law against the decision of 19 July 2017, arguing that the translator appointed for him had failed to appear at the hearing and that a copy in Russian of the judgment had not been provided to him. In addition, the applicant had not been able to effectively participate in the proceedings since he had neither been properly given a chance to make arguments nor had he been informed of his rights. Lastly, the applicant argued that the Court of Appeal had failed to verify his state of health as far as the risks during his transfer were concerned. 30 .     In the certificate of 28 July 2017 Dr A.K., the head of the neurological department of a hospital in Yerevan, confirmed the applicant’s diagnosis as set out in the medical certificate of 12 July 2017 (see paragraph   26 above). It was further noted that the applicant had developed cephalic disorder accompanied with photophobia and phonophobia, which required treatment and preferably supervision by a neurologist. On the basis of those conditions and risk factors, it was concluded that the applicant should not be allowed to be transferred by air or land as that might cause further heart and brain problems. 31 .     Between 14 August and 1 September 2017 the applicant underwent inpatient medical examination and treatment in a civilian hospital. His discharge diagnosis stated the following: “Arterial hypertension, progressing to a critical state, high risk with chronic insufficiency of blood circulation and frequent transient ischaemic attacks in vertebra-basilar pool. Discirculatory angio-encephalopathy of the 3rd degree with ischaemic strokes in the vertebra-basilar pool and the pool of the left-middle cerebral artery accompanied with post-stroke cysts in the midbrain, the bridge and the brainstem; with leukoaraiosis with stable residual phenomena in the form of the right-sided moderate hemiparesis; vestibulopathy; moderate disorder of walking function; hypertensive syndrome manifested with frequent cephalgia. Ischaemic heart disease, stable angina pectoris ... ” 32.     On 21 August 2017 the Court of Cassation quashed the decision of 19 July 2017 and remitted the case for a new examination on the grounds that the Court of Appeal had failed to ensure that the applicant had understood the language of the proceedings and that he had been aware of his rights. 33 .     On 13 September 2017 Dr A.K. provided a further medical opinion concerning the applicant’s state of health based on his discharge diagnosis (see paragraph 31 above). She stated, in particular, the following: “[T]he applicant’s [condition] is serious and unpredictable, considering the strong probability of future attacks in the form of hypertonic crises and transient ischaemic attacks, the two previous ischaemic strokes in the vertebra-basilar pool and the pool of the left-middle cerebral artery. A person suffering from those conditions cannot participate in court hearings, because any emotional tension might lead to the development of new potential complications.” 34 .     At the hearing of 25 October 2017 during the fresh examination of the applicant’s appeal against the extradition decision of 23 June 2017, his lawyer lodged an application with the Court of Appeal, seeking the appointment of an expert to assess his state of health. The prosecutor objected to the application, stating that there were insufficient grounds to conclude that the applicant’s transfer to Russia would pose any risks to his health or life. She reasoned that during the examination of the request for the applicant’s extradition the Prosecutor General of Armenia had not been in possession of any medical documents concerning the applicant’s health. Moreover, the prosecutor expressed doubts about the applicant’s medical condition, referring to a letter from the detention facility dated 13 July 2017 which stated that he was fit to participate in court proceedings. 35 .     On the same date the Court of Appeal rejected the applicant’s appeal finding that there were no circumstances preventing the applicant’s extradition. In particular, the applicant was a Russian national and assurances about securing his rights within the framework of the criminal proceedings against him had been provided by the Russian authorities. The Court of Appeal affirmed the decision of the Prosecutor General of Armenia on extraditing the applicant to Russia, relying on the supplementary assurances of the Russian authorities that the applicant’s medical supervision during and after his transfer to Russia would be ensured. In the meantime, it also rejected the applicant’s request to appoint a forensic medical expert on the grounds that the assignment of a forensic medical examination during extradition proceedings was not prescribed under domestic law. 36.     The applicant lodged an appeal on points of law complaining of lack of a public hearing and adversarial trial before the Court of Appeal. He also reiterated his arguments about the medical risks of his transfer. 37.     On 23 November 2017 the Court of Cassation declared the appeal inadmissible for lack of merit. Accordingly, the decision of the Prosecutor General of Armenia to extradite the applicant to Russia became final. 38 .     On 30 November 2017 the decision of 23 November 2017 was served on the applicant’s lawyer. Indication of an interim measure under Rule 39 of the Rules of Court 39.     On 18 August 2017 the applicant asked the Court, under Rule 39 of the Rules of the Court, to indicate to the Government to stay his extradition to Russia until the Court had examined the merits of his complaints. 40.     On 30 November 2017 the applicant informed the Court that the domestic courts had reached a final decision to extradite him to Russia. 41 .     On the same date the Court (the duty judge) decided to indicate to the Government, under Rule 39 of the Rules of Court, that the applicant should not be extradited until further notice. In the meantime, the Court (duty judge) decided, under Rule 54 § 2 (a) of the Rules of Court, to ask the Government to respond to the following questions by 15 December 2017: “1. What practical steps, if any, have been taken for the applicant’s effective transfer to the Russian Federation? 2. If steps have been taken, when and how will the applicant be transferred (by air, land)? 3. Will the applicant be provided with medical assistance during the journey? If so, please provide details. 4. Is there a medical protocol for handing over the applicant to the Russian authorities upon arrival?” 42 .     In their reply the Government submitted that the applicant had speculatively tried to hinder his extradition first by providing misleading information to substantiate that he was an Armenian national and then by producing medical documents about a drastic deterioration of his state of health. Furthermore, the applicant had already been suffering from the diseases mentioned in the medical note of 12 July 2017 when he had travelled to Armenia by plane in June 2015. The Government relied on the letters of 12 and 14 July (see paragraphs   26 and 27 above) and 14 December 2017 (see paragraph 49 below) which contained assurances by the Russian authorities that the applicant would be provided with the requisite medical assistance during his transfer to Russia and, if convicted, while serving his sentence. They submitted that according to the established practice, a person’s extradition from Armenia was performed only if a medical document proving his or her fitness to be transferred had been issued by the Central Prison Hospital. 43 .     In reply to the Government’s submissions, the applicant maintained that he had had health issues since at least 1994, when he had been exempted from mandatory military service on health grounds. However, it had only been since 2015 that his health had sharply deteriorated as a result of the stress and anxiety caused by his prosecution. Owing to his poor state of health he had been kept in the Central Prison Hospital during his detention and transferred to civilian hospitals by the authorities to receive specialist care. Furthermore, the Government had never ordered an assessment of his state of his health in order to verify whether he had been fit to be extradited. In addition, the Court of Appeal had dismissed his application to be examined by a forensic medical expert. The applicant argued that the general assurances obtained from the Russian authorities were insufficient for the discontinuation of the measure indicated by the Court, considering the seriousness of his illnesses as attested to by various medical professionals. He also relied on the medical advice that he should not be transferred to Russia either by air or land given the potential risks of such transfer indicated by doctors. 44.     On 6 February 2018 the Court (the duty judge) decided to maintain the interim measure indicated on 30 November 2017. Parallel and subsequent developments 45.     On 27 September 2017 the applicant submitted a request for asylum to the State Migration Service. 46 .     In a decision of 14 November 2017 the State Migration Service refused the applicant’s request for asylum. 47.     On 11 December 2017 the applicant was released from detention as the maximum period of his detention pending extradition had expired. 48.     On the same date he was admitted to the neurology department of a civilian hospital for examination and treatment. 49 .     By letter of 14 December 2017 the Office of the Prosecutor General of Russia, with reference to a letter from the Russian Federal Service for Execution of Sentences, informed the Prosecutor General of Armenia that the special convoy accompanying the applicant would include a medical specialist ready to provide medical assistance to him in accordance with his state of health. Furthermore, the medication and medical equipment necessary to provide assistance in the event of cardiovascular problems would be at the disposal of the doctor accompanying the applicant during his transfer. The letter also stressed that, before signing the applicant’s act of transfer, it would be necessary for the accompanying doctor to examine his medical records with a view to verifying the absence of contraindications for his transfer by air transport. Lastly, it was stated that the applicant would undergo medical examinations and consultations upon arrival at the detention facility with a view to planning outpatient supervision of his chronic illnesses. 50.     On 18 December 2017 the applicant lodged a claim with the Administrative Court seeking judicial review of the decision of the State Migration Service dated 14 November 2017 (see paragraph 46 above). 51.     On 21 December 2017 the Administrative Court admitted the applicant’s claim for examination. The outcome of those proceedings was not communicated to the Court. 52.     On 26 December 2017 the applicant qualified for disability. 53 .     On 28 December 2017 the applicant was discharged from hospital with the following diagnosis: “Arterial hypertension, progressing to a critical state, high risk with chronic insufficiency of blood circulation and frequent transient ischaemic attacks in the vertebra-basilar pool. Third degree discirculatory angio-encephalopathy with ischaemic strokes in the vertebra-basilar pool and the pool of the left-middle cerebral artery with the existence of post ‑ stroke cysts in the midbrain, the bridge and the brainstem, with leukoaraiosis with stable residual phenomena in the form of the right–sided moderate hemiparesis, vestibulopathy, moderate disorder of walking function, with hypertensive syndrome, and frequent cephalgia. Ischaemic heart disease, angina pectoris class 2, class 1 heart failure (NYHA classification). Multi-level degenerative-dystrophic changes of the spine, osteochondrosis of the 4th degree with hernias at C4-C5, C5-C6, C6-C7 levels, hydromyelia. Recommendation: constant supervision by a neurologist. At the moment, he is not fit to travel. Constant administration of hypotensive and antiplatelet medication”. Events after NOTICE of the application being given to the respondent Government 54 .     On 9 January 2019 the Government informed the Court that they had ordered an additional impartial medical evaluation of the potential risks associated with the applicant’s transfer to Russia based on the evidence presented by the applicant regarding his state of health. 55 .     On 11 January 2019 a neurologist examined the applicant and confirmed the diagnoses set out in the conclusion of 28 December 2017 (see paragraph 53 above). In addition, the neurologist noted the following: “... at the moment, transfer by air or land is contraindicative, as any change in pressure (take-off, landing, being in a confined space for a long time, oxygen scarcity, motion sickness, any sudden and quick movements) can worsen the state of the disease, which threatens not only the patient’s health, but also his life.” 56 .     In a letter of 31 January 2019 the Government Agent asked the Minister of Health to form a medical panel which would provide professional medical opinion on the following questions: “Considering [the applicant’s] diagnosis as stated in the medical documents submitted to the [European Court of Human Rights], would his transfer to the Russian Federation by air or land expose him to risks to his life and physical well-being? If [the applicant’s] transfer exposed him to risks to his life and physical well-being, would the presence of an accompanying doctor (specifically with what type of specialisation) during the transfer eliminate or minimise such risks?” 57.     On 12 February 2019 the Minister of Health submitted the opinion of the medical panel which had been convened on 11 February 2019. The medical panel answered the questions as formulated in the Government Agent’s letter of 31 January 2019 (see paragraph 56 above) as follows: “Question 1: Yes, the high risks associated with [the applicant’s] transfer to the Russian Federation by air or land are linked to the chronic diseases reflected in ... his medical documents and their possible unpredictable aggravation. Question 2: No, since in the event of aggravation [of the chronic diseases] emergency medical care in a specialist medical institution may become necessary.” 58 .     The opinion of the medical panel convened on 11 February 2019 was provided to the Court on 2 May 2019 by the applicant, who had received it in response to an enquiry sent to the Ministry of Health in April 2019. 59 .     The parties have not provided any further information with regard to developments in the applicant’s state of health. RELEVANT LEGAL FRAMEWORK Relevant domestic law Constitution (with the amendments introduced on 6 December 2015, in force as of 22 December 2015) Article 55: Prohibition of expulsion or extradition “1. No one may be expelled or extradited to a foreign State if there is a real danger that the given person may be subjected to the death penalty, torture, inhuman or degrading treatment or punishment in that country. 2. A citizen of the Republic of Armenia may not be extradited to a foreign State, except for the cases provided for by the international treaties ratified by the Republic of Armenia.” Code of Criminal Procedure 60.     Article 478.2 § 1 states that individuals who have committed a crime outside the territory of Armenia and have been arrested in the territory of that State can be placed in temporary detention for a maximum of forty days or another time-period as provided in an international treaty with the purpose of receiving an extradition request and verifying the existence of circumstances excluding extradition. 61.     Article 478.3 § 5 provides that the person can be detained for the purpose of his or her extradition for a period of two months. Detention for the purpose of extradition cannot exceed eight months. 62.   Article 479 § 1 (1) provides that it is the Prosecutor General of Armenia who adopts decisions to grant or refuse extradition requests if the case is at the pre-trial stage. The Prosecutor General’s relevant decision is subject to appeal to the Criminal Court of Appeal within ten days of its receipt while the decisions of the appellate court are subject to appeal to the Court of Cassation within five days of their receipt. The Court of Appeal and the Court of Cassation must examine the case and adopt a decision within five days of the date of receipt of the appeal (Article 479 § 3). If a person’s, including an Armenian citizen’s, extradition is refused, but there are sufficient grounds to prosecute him or her for the offence in relation to which a foreign country requested his or her extradition, the Prosecutor General of Armenia initiates that person’s criminal prosecution (Article 479 § 9). 63.     In accordance with Article 488 § 1 (3) an extradition request submitted by the competent authorities of a foreign State must be refused if the request concerns the extradition of an Armenian citizen. Nationality Act (enacted on 6 November 1995) 64.     Pursuant to section 10(1), former USSR nationals who permanently reside in the territory of the Republic of Armenia and who did not obtain the nationality of another State before the entry into force of the Constitution (13 July 1995) or who renounced it within a period of one year of the date of the entry into force of the present Act (28 November 1995), are recognised as nationals of the Republic of Armenia. Relevant international law 1993 Minsk Convention 65.     The Convention on Legal Assistance and Legal Relations in Civil, Family and Criminal Matters (signed in Minsk on 22 January 1993 – hereinafter “the Minsk Convention”), to which both Armenia and Russia are parties, provides as follows: Article 56. Obligation of extradition “1. The Contracting Parties shall ... at each other’s request, extradite persons who find themselves in their territory for criminal prosecution or to serve a sentence. 2. Extradition for criminal prosecution shall extend to offences which are criminally punishable under the laws of the requesting and requested Contracting Parties, and which entail at least one year’s imprisonment or a heavier sentence.” Article 60. Detention for extradition “Upon receipt of an extradition request, the requested Contracting Party shall immediately take measures to detain the person whose extradition is sought, except in cases where no extradition is possible.” Article 61. Arrest or detention before the receipt of an extradition request “1. The person whose extradition is sought may also be arrested before receipt of an extradition request, if there is a related petition. The petition shall contain a reference to a detention order or a final conviction and shall indicate that an extradition request will follow ...” Article 62. Release of the person arrested or detained “1. A person arrested under Article 61 § 1 ... shall be released ... if no request for extradition is received by the requested Contracting Party within forty days of the arrest ...” European Convention on Extradition 66.     The European Convention on Extradition (signed in Paris on 13   December 1957) which entered into force in respect of Armenia on 25   April 2002, provides as follows: Article 1 – Obligation to extradite “The Contracting Parties undertake to surrender to each other, subject to the provisions and conditions laid down in this Convention, all persons against whom the competent authorities of the requesting Party are proceeding for an offence or who are wanted by the said authorities for the carrying out of a sentence or detention order.” 67.     The instrument of ratification deposited by the Armenian Government on 25 January 2002 contained the following reservation: “In respect of Article 1 of the Convention, the Republic of Armenia reserves the right to refuse to grant extradition: ... b. if there are sufficient grounds to suppose that in result of the person’s state of health and age her [or] his extradition will be injurious to her [or] his health or threaten her [or] his life; ...” THE LAW ALLEGED VIOLATION OF ARTICLEs 2 and 3 OF THE CONVENTION 68.     The applicant alleged that his extradition to Russia would be contrary to the requirements of Articles 2 and 3 of the Convention, considering the medical evidence in respect of the risks of his transfer. Those Articles provide, in so far as relevant, as follows:   Article 2 “1.   Everyone’s right to life shall be protected byone shall be deprived of his life intentionally save in the execution of a sentence of a court following his conviction of a crime for which this penalty is provided by law. ...” Article 3 “No one shall be subjected to torture or to inhuman or degrading treatment or punishment.” Admissibility 69.     In their further observations submitted in reply to the applicant’s observations, the Government argued that the applicant’s representative had used offensive language. In particular, the applicant’s representative had labelled the Government’s observations as “irrelevant”, asserted that the Government were trying to misinterpret the facts and were “in pursuit of covert and unclear goals”, among other things. Furthermore, the observations mentioned that the Government had “overstepped the permissible limits of formal judicial communication and legal ethics” and had “blamed” and “shamed” the applicant. The Government considered this to amount to an abuse of the right of application within the meaning of Article 35 § 3 of the Convention and asked the Court to declare the application inadmissible on those grounds. 70.     The Court reiterates that the implementation of Article 35 § 3 (a), which allows it to declare inadmissible any individual application that it considers to be “an abuse of the right of individual application”, is an “exceptional procedural measure” and that the concept of “abuse” refers to its ordinary meaning, namely   the harmful exercise of a right by its holder in a manner that is inconsistent with the purpose for which such right is granted (see S.A.S. v. France [GC], no. 43835/11, § 66, ECHR 2014 (extracts), and Miroļubovs and Others v. Latvia , no. 798/05, § 62, 15   September 2009). 71.     The use of particularly vexatious, insulting, threatening or provocative language by the applicant – whether this is directed against the respondent State or the Court itself – may be considered an abuse of the right of petition (see Apinis v. Latvia (dec.), no. 46549/06, 20 September 2011, and Miroļubovs and Others v. Latvia , cited above, § 64). At the same time, the applicant’s language must exceed “the bounds of normal, civil and legitimate criticism” in order to be regarded as abusive (see Di Salvo v. Italy (dec.), no. 16098/05, 11 January 2007, and Apinis , cited above). 72 .     Turning to the present case, the Court observes that in his submissions the applicant’s lawyer justified his impugned statements by the fact that in their previous correspondence as regards the applicant’s request under Rule 39 of the Rules of Court and in their observations on the admissibility and merits of the application the Government had expressed doubts as to whether the applicant had been genuinely in poor health, despite the medical evidence and the authorities’ own refusal to appoint an expert to assess his medical condition (see paragraph 42 above). Furthermore, according to him, the Government had then omitted to disclose such a crucial piece of evidence – unfavourable to them – as the conclusions of the medical panel of 11 February 2019 formed by the Ministry of Health following a request by the Government themselves. It had only been owing to his enquiries that the applicant had found out about the medical conclusion in question and had been able to provide it to the Court. 73.     The Court underlines that the only issue it is called to determine in this respect is whether the relevant statements of the applicant’s lawyer went beyond “the bounds of normal, civil and legitimate criticism” as understood in its above-cited case-law. 74.     Having regard to the material in its possession and the relevant facts (see paragraphs 56-58 above), the Court considers that the statements at issue were an emotional manifestation of the applicant’s representative’s frustration about the fact that the Government, despite being in possession of a medical opinion directly supporting the applicant’s grievances, had not submitted it in the proceedings before the Court. As to their form, those statements did not contain personal characterisations or offensive language. Although they could be described as being rather sharp and polemical, in the eyes of the Court they were not “insulting or provocative” (see Aleksanyan v. Russia , no. 46468/06, § 118, 22 December 2008; and contrast Di Salvo , cited above, and Řehák v. the Czech Republic (dec.), no.   67208/01). 75 .     In the light of the foregoing, the Court does not consider that the statements of the applicant’s representative referred to by the Government amounted to an abuse of the right of petition. Accordingly, the Government’s objection must be dismissed. 76.     The Court notes that the application is neither manifestly ill-founded nor inadmissible on any other grounds listed in Article   35 of the Convention. It must therefore be declared admissible. Merits The parties’ submissions 77.     The applicant submitted that he had experienced health problems, albeit of lesser seriousness, starting from at least 1994. On 10 June 2015 he had been hospitalised in Moscow with an ischaemic stroke. His condition had subsequently deteriorated because of the mental stress caused by his prosecution. He was under constant medical supervision, undergoing checks and taking medication regularly. 78.     The applicant maintained that there was ample medical evidence, including the medical opinion ordered by the Government, that his transfer, if the decision to extradite him were implemented, would expose him to real risk of serious and irreparable harm. In particular, the medical opinion of 11 February 2019 (see paragraph 57 above) provided straightforward and unequivocal answers to the questions raised in his application, rendering the Government’s reliance on the assurances of the Russian authorities meaningless. The applicant argued that those assurances were highly formalistic and superficial considering that the Russian authorities had not been provided with specific information concerning his state of health. 79 .     In their observations filed on 11 February 2019 the Government submitted that during the examination of the extradition request in respect of the applicant the Office of the Prosecutor General had not been in possession of any medical documents concerning the applicant’s state of health which would have given sufficient basis to conclude that his extradition might pose a risk to his life and health. Furthermore, when arrested in April 2017 the applicant’s health had been satisfactory. He had not complained of health issues during his temporary detention and court hearings and had actively tried to substantiate his Armenian citizenship as the basis for refusal of extradition. The applicant referred to his poor state of health as grounds excluding his transfer only after his application to the Passport and Visa Department of the police with a view to being considered an Armenian national was denied. Hence, some doubts had arisen as to the credibility of the medical documents submitted by the applicant. Nevertheless, after the applicant had relied on his medical condition in July 2017 during the proceedings before the Court of Appeal, the Office of the Prosecutor General had received assurances on the availability of medical care and additional assurances to the effect that the applicant’s transfer would be organised by a special convoy of the Federal Prison Service of Russia which would include a medical practitioner with the relevant specialisation (see paragraphs 26 and 27 above). Most importantly, in a letter of 14 December 2017 the Office of the Prosecutor General of Russia had provided further assurances that the medication and medical equipment required for the treatment of possible cardiovascular problems would be available during the applicant’s transfer. Furthermore, before signing the act of transfer it would be necessary for the accompanying doctor to examine the applicant’s medical records to verify the absence of contraindications for his transfer by air (see paragraph 49 above). The Government submitted that the applicant had not provided any medical evidence which would have addressed the possibility of his transfer in the light of the additional assurances provided by the Russian authorities. They argued that the applicant’s condition was not critical while the decision to extradite would not be final until the accompanying doctor had examined him and confirmed that he was fit to travel. 80 .     In their further observations filed on 23 August 2019 the Government submitted, inter alia , that the domestic courts had upheld the Prosecutor General’s decision to extradite the applicant without having in their possession an impartial and unbiased medical opinion concerning the potential risks of the applicant’s transfer provided that constant medical supervision was ensured. Instead, the courts had referred to the assurances of the Russian authorities concerning the availability of medical supervision during and after the applicant’s transfer. The Government averred that all the relevant and necessary information concerning the applicant’s state of health had been provided to the Russian authorities and expressed readiness to present relevant documentary proof should the Court consider it necessary. The Court’s assessment (a)    General principles 81 .     Article 3 of the Convention enshrines one of the most fundamental values of democratic societies. Indeed, the prohibition of torture and inhuman or degrading treatment or punishment is a value of civilisation closely bound up with respect for human dignity. Unlike most of the substantive clauses of the Convention, Article 3 makes no provision for exceptions, and no derogation from it is permissible under Article 15 § 2, even in the event of a public emergency threatening the life of the nation. Even in the most difficult circumstances, such as the fight against terrorism and organised crime, the Convention prohibits in absolute terms torture and inhuman or degrading treatment or punishment, irrespective of the conduct of the person concerned (see Bouyid v. Belgium [GC], no. 23380/09, § 81, ECHR 2015, with further references). 82 .     Nevertheless, according to the Court’s   well-established case-law, ill-treatment must attain a minimum level of severity if it is to fall within the scope of Article 3. The assessment of this minimum is relative; it depends on all the circumstances of the case, such as the duration of the treatment, its physical and mental effects and, in some cases, the sex, age and state of health of the victim (see, among other authorities, Khlaifia and Others v.   Italy [GC], no. 16483/12, § 159, 15 December 2016, and Kudła v. Poland [GC], no. 30210/96, § 91, ECHR 2000 ‑ XI). In order to determine whether the threshold of severity has been reached, the Court may also take other factors into consideration, in particular: the purpose for which the ill-treatment was inflicted, together with the intention or motivation behind it, although the absence of an intention to humiliate or debase the victim cannot conclusively rule out a finding of a violation of Article 3; the context in which the ill-treatment was inflicted, such as an atmosphere of heightened tension and emotions; and whether the victim was in a vulnerable situation (see Nicolae Virgiliu Tănase v.   Romania [GC], no.   41720/13, § 117, 25 June 2019). 83 .     The Court has held that the suffering which flows from naturally occurring illness may be covered by Article 3, where it is, or risks being, exacer