CEDH · CASELAW;CLIN;ENG — 11 juillet 2024

.s3ABFC313 { font-size:10pt } .sD4B5322E { margin-top:12pt; margin-bottom:12pt; text-align:justify } .sBB9EE52A { font-family:Arial } .sA241FE93 { margin-top:0pt; margin-bottom:18pt; text-align:justify; page-break-after:avoid; border-bottom:0.75pt solid #000000; padding-bottom:1pt } .s2EF62ED2 { margin-top:0pt; margin-bottom:0pt; font-size:12pt } .s4DDA3AA3 { font-family:Arial; font-weight:bold; font-style:italic } .s29100277 { font-family:Arial; font-weight:bold } .s32563E28 { margin-top:0pt; margin-bottom:0pt } .s8F2B0B1B { margin-top:12pt; margin-bottom:12pt; page-break-after:avoid; font-size:12pt } .s97EB40D9 { margin-top:12pt; margin-bottom:14pt; page-break-after:avoid } .sA36B60A1 { font-family:Arial; font-style:italic } .s5F48796F { margin-top:12pt; margin-bottom:0pt; text-align:justify } .s7ED160F0 { text-decoration:none } .s3DC36BA9 { font-family:Arial; text-decoration:underline; color:#0069d6 } .s8B6C6D43 { margin-top:0pt; margin-bottom:0pt; border-bottom:1pt solid #000000; padding-bottom:1pt } .sDF790F1E { margin-top:12pt; margin-bottom:0pt; text-align:center } Legal summary July 2024 Sahraoui and Others v. France - 35402/20 Judgment 11.7.2024 [Section V] Article 2 Positive obligations Death of prisoner suffering from drug addiction from overdose of various medications, some of which had not been prescribed by medical authorities: no violation Facts – The applicants’ relative (their husband and father), an opioid addict, was transferred from one prison to another on 17 March 2009; he was subsequently found dead in his cell on 30 April 2009. According to the inquiry reports, the prisoner, who had been in poor health, had died as a result of an overdose, caused by consuming a methadone substitution treatment and other medication prescribed by the relevant medical authorities to treat his opioid addiction and mental-health issues alongside other non-prescribed medication, which had probably been stolen from his cellmate or procured for him by that person. The deceased’s family applied to the administrative court, requesting that the State be ordered to pay compensation for the damage they had sustained. Their application was dismissed. In the domestic court’s view, the death could not be shown to be linked to a negligent lack of monitoring or care on the part of the relevant authorities. Law – Article   2: In addition to his drug addiction and mental-health issues, the deceased prisoner (“S.T.”) had also suffered from other health conditions, which had contributed to the deterioration in his state, and about which the relevant medical authorities had not been fully aware. In those circumstances, the Court examined whether the State, having regard to the manner in which S.T.’s health, and his vulnerable condition, had been managed, had failed in its positive obligation to take all measures necessary to safeguard his life. Only where it could be shown that the authorities had not done all that could reasonably be expected of them to avoid a real and immediate risk to life could a possible violation of a positive obligation on their part be envisaged. In reaching its finding, the Court took the following factors into consideration. First, when S.T. arrived at the second prison, information concerning his drug addiction and medical treatment had been transmitted by the first prison. In addition, a doctor had been appointed to take charge of the treatment for his drug addiction, and this treatment was put in place with the care team of the Outpatient Consultation and Treatment Unit ( unité de consultation et de soins ambulatoires – “the UCSA”). S.T. had undergone an assessment, at which his opioid addiction was noted and it had been suggested that the substitution treatment be continued, at a dose comparable with that which the State authorities had undertaken to provide for the population as a whole, together with the other medication associated with this treatment. A few days after his arrival, his situation had been reviewed by the doctor and assessed by a multi-disciplinary committee, including nurses from the UCSA; it was not considered that he was at risk or that he needed to be more closely monitored. The UCSA played a key role in monitoring and administering the treatment, given its specific risks, the comorbidities associated with addiction and the need to respect medical confidentiality. Secondly, it appeared from the toxicology report drawn up during the inquiry that the prescription and dispensing instructions had been complied with in the week leading up to the day before S.T.’s death. No adverse effects on S.T.’s health from taking the substitution treatment and the medication prescribed by the medical service had been observed. He had been in daily contact with health professionals, enabling them to assess his state of health and stability, and any side effects of the medication prescribed. There was no evidence before the Court that there had been a failure to monitor S.T.’s adherence to the treatment plan or that his medical care had at any time appeared inappropriate or to have required adjustment and a more in-depth clinical assessment of his situation. S.T.’s death had resulted from a polydrug overdose, caused in part by his having consumed medication other than that prescribed to him by the doctors, apparently obtained through an exchange with or theft from his cellmate. In consequence, the Court examined whether, having regard to the strength of the drug treatment that S.T. had been prescribed, the known risks of taking methadone with other substances and the constraints of the prison environment, the authorities had failed in their duty of care by not providing for more stringent monitoring. In that regard, and although trafficking in medication between prisoners was a long-standing and always concerning practice, the Court was well aware that any obligation on the domestic authorities in this sphere could only be an obligation of means, not one of result. It was incumbent on the authorities to pay particular attention to the possibility that prisoners suffering from addiction might consume non-prescribed medication, given their vulnerability, the extent of their psychiatric comorbidities and the anxiety-inducing effects of imprisonment, and accordingly to conduct, if necessary, more thorough medical examinations or other adjustments in the provision of care or management of detention. In the present case, according to the domestic courts, the investigation had shown that there was nothing to indicate that the prison authorities, in consultation with the medical service, should have exercised their powers under the internal regulations to organise differently the dispensing of medication and to prevent S.T. from being in possession of medication other than that prescribed to him. Above all, it had been only six weeks since S.T. had been transferred to the second prison, and in that time there had been no evidence of trafficking of medication between him and his cellmate. Lastly, a decision had been taken, albeit regrettably at a late stage, to move the cellmate elsewhere on account of his complaints about S.T.’s drug addictions. Thus, although the role of the non-prescribed medication consumed had been considered a possible additional decisive factor when establishing the cause of death, the Court considered that the authorities had not failed in their positive obligation to ensure, in so far as possible, that S.T. received the proper treatment in accordance with the doctor’s instructions. Lastly, the Court examined the treatment received by S.T. on the day he died. The fact that the doctor – who had noted that S.T. was nervous and anxious – had adjusted his medication on the previous day was not mentioned in the toxicology report as a possible contributing factor in the rapid deterioration in his health. S.T. had, moreover, gone to the medical centre to take his substitution treatment. Finally, it was clear from the inquiry and the concurring reasoning of the domestic courts that S.T. had received appropriate and diligent care when, initially, he had been found “conscious”, “a bit slow” and in “his usual state” – in other words, in a state that all those involved had considered to be hardly surprising – and that the vital-signs checks carried out by the nurses had appeared to be good, before he was later discovered dead. In the light of all these considerations, the Court concluded that S.T. had been treated and monitored appropriately while in prison and that it was not possible to establish a causal link between the omissions alleged by the applicants and his death. There was therefore no reason to depart from the domestic courts’ finding that S.T.’s death could not be shown to be linked to a negligent lack of monitoring or diligence on the part of the relevant authorities. Conclusion : no violation (unanimously). (See also Wenner v.   Germany , 62303/13, 1   September 2016, Legal Summary ; Abdyusheva and Others v.   Russia , 58502/11 et al., 26   November 2019, Legal Summary )   © Council of Europe/European Court of Human Rights This summary by the Registry does not bind the Court. To access legal summaries in English or French click here . For non-official translations into other languages click here .