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A (des)proteção do doente mental
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Os transtornos mentais são uma das principais causas de incapacidade, com elevados custos humanos, sociais e económicos. Em Portugal, afetam quase um quarto da população, um dos índices mais altos da Europa. Enquanto o preconceito em torno destes transtornos dissuade os doentes de procurar o apoio necessário, o sofrimento que lhes é inerente leva a que muitas vidas sejam tragicamente perdidas por suicídio. Deste modo, o tratamento involuntário é uma medida essencial para proteger a saúde das pessoas com transtornos mentais, inclusive para salvar vidas. No entanto, persistem violações de DH nas instituições psiquiátricas, tornando urgente a implementação de legislações que equilibrem a proteção dos direitos fundamentais. Esta dissertação examina a proteção dos direitos das PSM em Portugal, abordando o quadro legal e as diretrizes internacionais que
influenciam a regulamentação do internamento involuntário, com especial atenção à recente revisão da LSM. Através de uma abordagem comparativa e interpretativa, utilizando o DSM-5 para caracterizar as condições clínicas dos transtornos em questão, e realizando uma análise crítica das legislações nacional (Portugal), europeia (CEDH e CDHB) e internacional (CDPD). A pesquisa explora as diferentes interpretações dessas normas pelos tribunais e comités internacionais, com enfoque nas divergências entre cada ordenamento e na adequação dessas normas às necessidades específicas das pessoas com transtornos mentais. A análise evidencia que o Direito português e a CEDH reconhecem a importância do internamento involuntário, aplicando salvaguardas específicas para proteger direitos individuais, enquanto o ComDPD propõe a abolição total do internamento involuntário, baseando-se numa interpretação mais estrita da capacidade jurídica. Essa posição do ComDPD, de eliminar o internamento involuntário e outras medidas substitutivas, desconsidera o sofrimento e limita o acesso dessas pessoas a cuidados de saúde essenciais, comprometendo a sua proteção jurídica e de saúde. Dado que a jurisprudência europeia permite uma interpretação mais adaptada à realidade psiquiátrica, sugere-se que a legislação portuguesa se afaste da visão radical do ComDPD, promovendo a integração dos novos direitos da CDPD, como à reabilitação e vida independente, que podem complementar a proteção já existente.
Mental disorders are one of the main causes of disability, with high human, social and economic costs. In Portugal, they affect almost a quarter of the population, one of the highest rates in Europe. While the prejudice surrounding these disorders dissuade patients from seeking the necessary support, the suffering inherent in them means that many lives are tragically lost to suicide. Involuntary treatment is therefore an essential measure to protect the health of people with mental disorders, including to save lives. However, HR violations persist in psychiatric institutions, making it urgent to implement legislation that balances the protection of fundamental rights. This dissertation examines the protection of the rights of PSM in Portugal, addressing the legal framework and international guidelines that influence the regulation of involuntary hospitalization, with special attention to the recent revision of the LSM. Through a comparative and interpretative approach, using the DSM-5 to characterize the clinical conditions of the disorders in question, and carrying out a critical analysis of national (Portugal), European (ECHR and CDHB) and international (CDPD) legislation. The research explores the different interpretations of these norms by international courts and committees, focusing on the divergences between each legal framework and the suitability of these norms to the specific needs of people with mental disorders. The analysis shows that Portuguese law and the ECHR recognize the importance of involuntary internment, applying specific safeguards to protect individual rights, while the ComDPD proposes the total abolition of involuntary internment, based on a stricter interpretation of legal capacity. The ComDPD's position of eliminating involuntary hospitalization and other substitute measures disregards suffering and limits these people's access to essential health care, undermining their legal and health protection. Given that European case law allows for an interpretation that is more adapted to the psychiatric reality, it is suggested that Portuguese legislation should move away from the radical vision of the ComDPD, promoting the integration of the new rights of the CRPD, such as rehabilitation and independent living, which can complement the protection that already exists.
Mental disorders are one of the main causes of disability, with high human, social and economic costs. In Portugal, they affect almost a quarter of the population, one of the highest rates in Europe. While the prejudice surrounding these disorders dissuade patients from seeking the necessary support, the suffering inherent in them means that many lives are tragically lost to suicide. Involuntary treatment is therefore an essential measure to protect the health of people with mental disorders, including to save lives. However, HR violations persist in psychiatric institutions, making it urgent to implement legislation that balances the protection of fundamental rights. This dissertation examines the protection of the rights of PSM in Portugal, addressing the legal framework and international guidelines that influence the regulation of involuntary hospitalization, with special attention to the recent revision of the LSM. Through a comparative and interpretative approach, using the DSM-5 to characterize the clinical conditions of the disorders in question, and carrying out a critical analysis of national (Portugal), European (ECHR and CDHB) and international (CDPD) legislation. The research explores the different interpretations of these norms by international courts and committees, focusing on the divergences between each legal framework and the suitability of these norms to the specific needs of people with mental disorders. The analysis shows that Portuguese law and the ECHR recognize the importance of involuntary internment, applying specific safeguards to protect individual rights, while the ComDPD proposes the total abolition of involuntary internment, based on a stricter interpretation of legal capacity. The ComDPD's position of eliminating involuntary hospitalization and other substitute measures disregards suffering and limits these people's access to essential health care, undermining their legal and health protection. Given that European case law allows for an interpretation that is more adapted to the psychiatric reality, it is suggested that Portuguese legislation should move away from the radical vision of the ComDPD, promoting the integration of the new rights of the CRPD, such as rehabilitation and independent living, which can complement the protection that already exists.
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Palavras-chave
transtorno mental internamento involuntário legislação Conselho da Europa Direito Internacional mental disorder involuntary internment legislation Council of Europe International Law