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English Language Page The legislative base accounting for the rights and freedoms of individuals afflicted with mental conditions in modern Russia has made an enormous progress within a short period of time and is of a very good quality. First and foremost this has to do with the legislative acts pertaining to the medical law that were passed in 1993. Contemporary Russian legislation pertaining to psychiatric care largely complies with international standards. Therefore problematic is first of all the law-enforcement practice which shapes and strengthens the legal mentality of all the parties participating in this process. Unfortunately these practice and mentality are pre-“Milestones,” i.e., characterized by the tradition of a nihilistic attitude towards the law not only among the people and intelligentsia, but also among representatives of authorities. The latter once actively began to apply the law using an exclusively utilitarian approach, i.e., they began to substitute the rule of law with the rule by laws. The return in these conditions to the realization of the fundamental role of legal regulation, the inevitability of further development through such regulation, i.e., the idea proclaimed by Bogdan Kistyakovsky in “Milestones” (1909), Pitirim Sorokin in 1918—1920, À. Yesenin-Volpin in early 60s, and all our contemporary leading law scientists, for example by S. Alexeyev in his 2001 monograph “Ascent to the law,” coincide with the global trends of the development in this area and confirm the profound validity of such choice of further development. Human rights are such a fundamental category for the psychiatry that without them it could have never established itself as a scientific discipline. Only the removal of chains from mental patients and the policing authority from the director of the psychiatric facility turns the latter into a health care institution. In Moscow it happened 160 years ago, in 1832. And it was not until the abolition of slavery in 1864 and the subsequent transfer of psychiatric institutions to the authority of local self-government bodies that the Russian psychiatry managed to achieve its outstanding successes. One may say that the nature of the attitude towards mental patients and the way they were treated by the society during a certain historical epoch — is already a sociotherapy or something quite contrary to it. But both are the same aspect, the same dimension. Sociotherapy is in fact the most ancient and natural method of therapy. When it stems from the needs of the mental patient it is the therapy in the universally acknowledged humanistic sense of the word. When it stems however from the needs of the society and even more so from those of the state it is the sanation or, speaking in terms of the modern Russian language, the “cleansing” of the society with a view of disembarrassing it from mental patients, and together with them — from firebrands, dissidents, and even “black sheep” — deviants of all sorts — by way of their internment, isolation, or stigmatization by means, for example, of their registration, or more radically, by their termination in order to “cleanse” and “sanitize” the autochthonal nationality. One should not forget how radically changes the notion of sociotherapy depending on the priorities of the society. Such description departing from the opposite much more clearly conveys the meaning of the subject of the description and enables one to see it in a new light, more freshly and comprehensively. What is called the “police tradition in psychiatry” is the protection of the society from psychiatric patients as its main goal. Its anti-humanistic nature is not always discerned in its “mild forms.” Unfortunately it just happens to be our domestic Russian tradition which has been justified on the basis of an enormous body of historic materials by such prominent scientists as V. Vernadsky (1914) and O. Yudin (1951). Still it would be more adequate to say that the domestic tradition has from the very outset been a controversial unity of the police tradition and a steady struggle against it by the best and significant part of the professional community of psychiatrists and founding fathers — Sabler — Balinsky — Korsakov, who practically embodied the main principles of non-restraint during the first stage up until the qualitatively new and already quite a modern level of understanding of the essence of the “police tradition” by Yakobiy (1898, 1900) during the second stage. During the third stage, starting from the 1980s, it was a transition from paternalism towards partnership which had grown out of the Yaspers’ understanding of communication between the psychiatrist and the patient. Not only does it imply an unconditional respect for the patient’s personality, but it also acknowledges his right and consequently his freedom in choosing the new path of life because the illness as a marginal situation can — alongside with everything that is negative about it — break the patterns and lead the human being towards a principally new understanding of the world and oneself in it. The business of the psychiatrist is to protect the patient from destructive and self-destructive actions and decisions. The Soviet epoch — is a grandiose in scale and radicalism social experiment to which the entire population of the country was subjected, an attempt to liquidate social instincts of freedom and private property, as well as the social institutes of family and religion. The psychiatric care adjusted itself to the totalitarian regime and achieved significant successes albeit largely at the expense of what in fact was the rightless status of patients, including the wide utilization of psychiatry with political purposes. The leading scientific schools in psychiatry changed depending on the current political course. It was the Soviet psychiatric practice, most large-scaled and widely publicized, that triggered the anti-psychiatric movement as a counter-reaction. Its precursor and ideologist, Michel Foucault, centered and absolutized the relationship between the power and psychiatry, the utilitarian, manipulative utilization of psychiatry by the power. For a totalitarian power it is indeed in one form or other a quite natural thing to do. Therefore one may say that the attitude towards mental patients and their treatment by the society is the face of the society, it is its very sensitive indicator, and it is the criterion used to measure its totalitarity at the level of the everyday mentality. Psychiatric patients are one of the most legally vulnerable categories of the population. It is most natural to expect that the legislation regulating this sphere should be thought-through to the utmost and most legitimate in the eyes of the society and first and foremost in the eyes of former mental patients and their relatives. And that — should one count situational reactions and all the marginal psychiatry and narcology — is the overwhelming majority of the country’s population. The new epoch that began under the pressure of the international community yet during the Soviet regime, in 1988, was a traditional for Russia “revolution from top-downwards.” Remaining politicized the psychiatry is getting rid of the ideology, of the gap between itself and the global science, is returning to methods of diagnostics comparable with those used in other countries, and is making its way down the path of legal regulation. Albeit, only in the form and level of development in which this legal regulation is currently available in Russia. The tendencies with respect to human rights in the sphere of psychiatric health can be identified on the basis of several characteristics. We shall choose only several most expressive of them from the context of events. It is the attitude towards the past, the independent expertise, and the public control. I. To begin with, in order to move forward it is necessary, as it is known, to know the path, the direction of the movement, what to stem from and what to strive for. In early 1990s the Director of the State Center named after Serbsky, T. B. Dmitriyeva, delivered the then required words of penitence for the unprecedented in scale utilization of psychiatry with political purposes in the Soviet Union to discredit, threaten, and repress the human rights movement, exercised first and foremost within this organization. This was broadly publicized abroad and very narrowly — within the country, in the St. Petersburg newspaper Chas Pik. However it was already in 1996 that the anniversary of the Center was celebrated triumphantly and in her 2001 book Alliance of Law and Mercy Dmitriyeva wrote that there had been no abuses in psychiatry and even if there had been any they could not be considered to be of greater magnitude than those encountered in the lauded western countries. That same year, at a gathering dedicated to yet another anniversary of the Serbsky Center, the audience, in response to the exhortation of the first Deputy Minister of Health Care, Vyalkov, offered a stand-up greeting to academician G. Morozov, thus rehabilitating him despite an international boycott as the chief executor of the shameful practice of rendering political dissidents as psychiatric patients. In addition, in the aforementioned book Dmitriyeva reproaches the old and new domestic intelligentsia by saying that Professor V. Serbsky et al. should have cooperated with the police department because if they had there would not have been either the revolution or bloodshed… and that the modern intelligentsia should not oppose the authorities. She went even further by stating that the Universal Declaration of Human Rights lacks charity. Thus, Dmitriyeva returns to the not unsuccessful political gimmicks of Soviet diplomats in the UN to dissolve the fundamental human rights in the socio-economic and later in collective and solidarity rights, i.e., rights of the “second” and “third” generations. By doing so she crosses out the cornerstone democratic thesis of Milton Friedman: “The society that puts equality (in the sense of equality of results) above freedom will lose as a result both equality and freedom.” What the charity is like when it is juxtaposed to the fundamental human rights to security, freedom and dignity, we know from how the majority of psychiatric institutions is funded, when the board of patients is twice as worse than that of prisoners. So, in the assessment of the past and the attitude towards human rights we see an open return to the Soviet course which in turn was a consistent movement from the debasement of human rights as an “abstract,” “bourgeois” category legitimate only with respect to the proletariat and the poorest population strata that are in fact deprived of private property as the foundation of independence, towards the debasement of human rights as a one-sided centration of a “purely western” value, and, finally, towards the aforementioned dissolution and devaluation of the fundamental human rights in socio-economic and other rights. II. A logical consequence and confirmation of that was the return since 1995 of the technologies developed and polished with respect to political dissidents that are now used against “non-traditional” religious organizations only three years after these technologies had been publicly exposed in the case of General P. Grigorenko. During the last seven years multiple court proceedings have been underway that are supervised by a special group of Professor F. Kondratyev that was put together in 1996 in the Serbsky Center that studies destructive effects of new religious formations. The whole business amounted to lawsuits based in fact on accusations in witchcraft. When formulations of the initial lawsuits, “for causing severe damage to mental health and deformation of personality,” was proven to be invalid they were replaced with the following formulations “for illegal infliction of the state of hypnosis” and “damage caused by hypnotic trance,” and later still — “for unobservable production of impact at the level of unconsciousness,” and even with texts calling for giving up the consumption of alcohol and narcotics. The interest in unorthodox religions was perceived not as an acceptable natural feeling but as a consequence of a secretive evil technology. This is how the self-projection of the lingering totalitarian mentality identified itself, for which everything is controllable, governable, and its own practice of such kind represents itself as universal. The widely used term “totalitarian sects” is not only illiterate from the theological standpoint; it is in itself a product of totalitarian consciousness. In other notorious prefabricated lawsuits one is struck with the utmost unceremoniousness and presumptuousness, as well as gross violation of elementary professional principles and proprieties. Scenarios of such lawsuits are clearly written beforehand. The most notorious of the dutifully litigated prefabricated cases — the case of Colonel Budanov — has become the Dreifus case for the modern Russia as far as its societal meaning is concerned . The Serbsky State Center attempted over the past three years to defend the positions of our “hawks” in defiance of all the facts, all professional principles and criteria, in defiance of an absolutely simple and clear for the entire country state of affairs. The lawsuit on the abduction, rape, and murder of an 18-year old Chechen girl by a drunken colonel was in litigation for three years. The rape and the state of alcohol intoxication were excluded from the litigation right from the start on the basis of manipulation of witnesses and their testimonies. Initially it was considered that at the moment of murder the defendant was in a twilight condition, whereas after the confutation — that he was afflicted with a psychoorganic syndrome, i.e., a chronic pathological mental condition, and after this diagnosis was overturned he was thought again to have been in a twilight condition at the moment of murder. Each time the interpretation was totally arbitrary based on the testimony of the defendant himself. The atmosphere of pressure was so gross that it was almost impossible to find anyone who would be willing to act as an expert on the side of the plaintiff. We see a form of the public protest in this. On the first television channel our position was labeled by Dmitriyeva as “paid-for by the CIA.” The Budanov case, despite its all notoriety and an enormous public resonance was not reviewed either in the Serbsky Center, or at any of the meetings of the Russian Society of Psychiatrists. The state psychiatry totally ignored it and kept its mouth tightly shut. Only the “Independent psychiatric journal” in four of its issues (2002 #2, 3; 2003 #1, 3) presented initial materials of this case accompanied with a detailed discussion. But for the state court psychiatry the Budanov case did not serve as a lesson; no practical conclusions were drawn from it. In the meantime these conclusions invite themselves: a truly independent court-psychiatric expertise is necessary. It is not confined to personal independence of the members of the expert commission, although even this requirement accounted for by Federal Law “On the State Expert Activity” was not complied with. Members of the expert commission in the last two examinations undertaken within the framework of the Budanov case were representatives of an expert institution whose leader was interested in confirming the conclusion of the previous expert commission of the Serbsky Center which was rendered untenable. In addition, contrary to the common sense and generally understandable logic the two key positions for the expert commission that in fact predetermine its decision were filled in the last expert commission but one by representatives of the Serbsky Center again — it is the physician-reporter who prepares an extract from the 42 volumes of the case and has an opportunity to willingly or unwillingly, consciously or unconsciously emphasize or obscure various details, i.e., to manipulate the initial information; and the composer of the expert commission who has the opportunity to put together a commission consisting of hyperdiagnosticians or hypodiagnosticians of schizophrenia or the psychoorganic syndrome thus predetermining the commission’s decision. This director disguised by the amorphous formulation of the “RF Ministry of Health Care” was the very same director of the Serbsky Center, Dmitriyeva. The requirement to put together an expert commission consisting of lay experts and no individuals occupying high-rank positions and thus bound by a variety of interdependencies was not complied with either. On the contrary, the commission was put together of heads of all primary centers of state psychiatry: director of the Moscow Psychiatric Research Institute of the RF Ministry of Health Care, director of the All-Russian Center of Psychiatric Health of the Russian Academy of Medical Sciences, director and psychiatry chair of the Narcology Institute named after Korsakov (the most respected in the country traditionally) and even academician Morozov who had been director of the Serbsky State Center for 32 years who is boycotted by the world professional community. It was only for the next, sixth expert examination that one managed to compose an expert commission consisting of experts nominated by all the interested parties, i.e., on the basis of the principle ensuring competition. This was not easy to do for the court because the new law on the state expert activity had been created to provide for the monopoly of the state expert institution and its head totally ignoring the fundamental principle of competition. As a result, the last examination took place in the court room. Although Federal Law “On the State Court-Expert Activity in the Russian Federation” adopted in May 2001 allows for a non-state expertise it makes it in fact impossible since the certificate of a court expert is only issued to employees of state expert institutions. And judges do require such certificates, the absolute monopolist on issuing which is the only in the country chair of court psychiatry within the system of the Russian Medical Academy which operates on the basis of the Serbsky Center and is headed by its director, the very same Dmitriyeva. Thus, the figure of a non-state expert is factually ousted in this outwardly legitimate way, the court-expert service is rendered state-regulated, and the monopoly of the Serbsky Center becomes absolute. Never in the past years during the Soviet period did this odious institution command such unlimited possibilities of state psychiatry. During the first “thawing” the Committee of the Supreme Party Control of the Central Committee of the Communist Party of the Soviet Union put together a commission consisting of the leading domestic psychiatrists headed by Professor V. Gilyarovsky that was to audit the activities of the Serbsky Center, which was then known as the Central Psychiatric Research Institute named after Serbsky, that recommended in its conclusion to disband this institution in view of the fact that it was estranged from the general psychiatry, strove for monopoly, fabricated cases, and treated individuals undergoing examinations in a rough manner. Being disbanded however ended up that very commission as the time of the thawing was over. Today the situation is even more dramatic. The constructive experience of participation of members of the Independent Psychiatric Association of Russia in expert commissions of the Serbsky Center was put an end to in 1997 when the director of this institution became the Minister of Health Care. Since then the Center stopped to even comply with decisions of courts while actively working on legitimizing its monopoly. This monopoly resounds in the directive formulations of expert conclusions — “should be considered as non compos mentis (or compos mentis)” which although legally illiterate have become and example to follow. The expert’s right to independent position and special opinion accounted for by the law remains as much of a declaration as it was during the Soviet times. The only such case that occurred in the Institute of Court Psychiatry named after Serbsky over the past 25 years ended up in a specialist being induced to quit his job. The not ungrounded fear has been retained by many, even by the author of the well known monograph, “Diagnostic errors of the court-psychiatric practice (on the example of the Institute of Court Psychiatry named after Serbsky), N. Shumsky. Independent expertise is promoted by the Independent Psychiatric Association of Russia whose members understand it first and foremost as a competitive expertise. A report on this subject was presented in 2001 at the annual Kerbikov readings on court psychiatry and was highly esteemed in the final speech of the chairman, Professor B. Shostakovich. That year Professor Shostakovich retired and no invitation followed. In addition, the RF Ministry of Justice demanded that the Independent Psychiatric Association of Russia should remove independent expertise from its charter as a form of licensed activity having threatened to revoke its registration despite the fact that it had registered this very charter at some point earlier. It is indicative that our press conference in Moscow, “Ministry of Justice against independent expertise,” took place one hour before the press conference “Ministry of Justice registers Nazis” dedicated to the legal registration of a nationalist party despite its openly Nazism-oriented activities and in defiance of public protests. All this was happening during the time of the Civil Forum at which the President demonstrated a good understanding of the situation and gave encouraging assurances with respect to which representatives of the Ministry of Justice would cool our passion: “We had a different directive; the number of public organizations will be significantly reduced.” As the recent events show their information turned out to be more reliable. Nevertheless the Independent Psychiatric Association of Russia filed a lawsuit against the RF Ministry of Justice since its demand could not be justified by the current legislation. And indeed, although the court of first instance took sides with the Ministry of Justice, it is already 10 months that it has not been in the position to formulate a justified rejection and forward it to the IPA depriving it of the opportunity to appeal it in the order prescribed by law. Despite numerous examples of high effectiveness in many, including notorious, cases the business of independent (competitive) expertise has not only stuck but it also has gone back to its initial positions. Although it would be more adequate to say “thanks to” rather than “despite.” Current power structures prefer domesticated, pet-like, trained, obedient expertise; they want to manipulate ignoring all realities. Therefore the monopoly of the pocket Serbsky Center is convenient; therefore the figure of the state expert-vane who regards the instantaneous political conjuncture as the only governing value and follows it unconditionally, prevails. What this leads to has been shown by the colonel Budanov case. Never before had the prestige and reputation of the psychiatric expertise fallen so low. But the authorities receive a questionable profit. Because it is obtained at the expense of losing the capability of receiving adequate feedback from the reality and that of degradation of professionalism. The stylistics of these cases and technologies rapidly becomes part of the wide circle of routine daily cases, first and foremost, apartment-related, which replenish the army of homeless and vanished people. Very characteristic is the evolution of the attitude towards the name “independent” be that expertise, association, position in a discussion, etc. — “independent from whom and what?!” If in the early 1990s the indignant speeches of such type had the intonation of “You think we are dependent?,” at the end of the decade the intonation became aggressive-denouncing, in manner of that which resounds in auditoriums filled with proselytes: “What do you believe in?!” with the following subtext: if you are a non-believer then you have nothing sacred about you. This offensive position is a method of impervious camouflage of the acute problem of double loyalty which requires thorough openness. An expert must be independent of everything save professional values, and this means that he must be independent of the administrative elevation, of his own biases, and of any other considerations: ideological, political, etc. III. Not less characteristic is the evolution of the attitude towards the law “On psychiatric care and guarantees of the rights of citizens in therapy.” Adopted with an 80-year delay following the first draft of 1911 it placed the domestic psychiatry at the forefront right away but — as yet another “revolution from top-downwards” — fell on an unprepared soil having not matured in a natural way. As a result, it took a lot of time and painful efforts to enter life unevenly and partially. Several years into the non-enforcement of the law physicians were required to undergo attestation taking tests which included questions targeted at determining their knowledge of the law. Commissions of the RF Ministry of Health Care which verified compliance with the law identified falsification of patients’ signatures indicating voluntary submission to institutionalization because the signatures were given as a rule in the condition when the patients were unable to comprehend the reality. They signed their records while being pressured against in a variety of fashions without even looking at them. Physicians took pains to minimize court procedures perceiving them as an unnecessary job. This is how various methods of imitating the compliance with the law emerged. Despite a virtually total lack of guarantees of its enforcement the law nevertheless began to work in a number of country’s regions. This law is the main democratic achievement of the domestic psychiatry during the past decade. Its adoption enriched the theretofore purely administrative regulation by way of departmental instructions and orders with a higher form — legal regulation. Despite its all inconsistencies it is the most universal and effective form of regulation. Two novelties of the law became something qualitatively new and principal for the Russian psychiatry. First, it is the obligatory court procedure that must precede all involuntary measures: examination, hospitalization, and therapy (Part 4 of Article 4, Parts 4, 5 of Article 11, and Articles 23, 29). This is a giant, principally decisive step in the direction of the effective assertion of the right of the individual to freedom and personal immunity in case of psychiatric interference. The psychiatrist who in the former times — and this was considered decent enough — could examine a person in the official or unofficial setting secretively without introducing himself must now name himself. And it is the right of everyone to concede or not to concede to such examination, agree to undergo an examination administered by a different physician, choose a different form of assistance, or a certain method of therapy. Previously medical practice was marked with a one-sided position of traditional paternalism: fatherly caring, directing, and governing. But it also implied one’s obedient following directions, i.e., unconditional trust and submission. In fact it was a relationship between a parent and a silly child who not only needs but has to be guided. But psychiatry as an anthropological discipline in the most clearly defined form, i.e., a form not confined to what is bodily, biological in the human being, but treating him as an integral personality, inevitably goes beyond the narrow professional framework usual for other medical disciplines. The psychiatrist invades the freedom of likes and dislikes of the human being, in the freedom of his choice, in the mode of his life and activity. Naturally, in all of that each person must be able to retain their independent rights. The paternalist consciousness with its absolutization of professionalism in a totalitarian society considered the direct opposite to be quite natural: the doctor acted in fact as a patient’s guardian. In the conditions of high ethics, thorough transparency, a workload allowing for optimal volume and tempo necessary for individualization of efforts, this was the personification of the humanity of medicine. In the changed circumstances however, and first and foremost in the conditions of massiveness, time deficit, exacerbating formalization and one-dimensionality of the dominating consciousness, absolutization by everyone of their particular aspect of expertise, a new principle and mechanism was required in order for medicine, and first and foremost psychiatry, to preserve its humane spirit. It is the principle of partnership and informed consent. The profound philosophical justification of the partnership principle was provided by K. Yaspers using the very example of communication between the psychiatrist and his patient. Yaspers discovered a whole microcosm within this communication, having broadened both the horizon of the philosophical thinking as well as its very form. The doctrine of informed consent implies involvement of the patient in conscious cooperation in the process of therapy and independent choice of a certain method of therapeutic tactics from among several alternatives. The second principally new for the domestic psychiatry democratic achievement of the law was the declaration of the total equality of rights and freedoms of individuals afflicted by psychiatric conditions and all other citizens. The law clearly provides that “limitation of rights and freedoms of individuals suffering from mental conditions solely on the basis of the psychiatric diagnosis and the fact of their undergoing outpatient or resident therapy in a psychiatric institution or neuro-psychiatric facility for social security or educational purposes shall be forbidden. Officials committing such violations shall be held liable in accordance with the legislation of the Russian Federation and republics that are subjects of the Russian Federation” (Article 5). In compliance with this provision the law forbids solicitation of information on the state of one’s mental health, their application for and examination and treatment by psychiatrists if this is not provided for by Russian Federation laws (Article 8). Especially considering that all this information constitutes the medical secret protected by the law (Article 9). The aforementioned provisions of the law were designed to put an end to the widely pervasive and firmly rooted practice of requiring “a certificate from a neuro-psychiatric dispensary” when admitting to an institution of learning, hiring for work, arranging for an overseas travel, issuing driver’s licenses, exchanging property, etc. These habitual requirements which had accompanied lives of millions of people were rendered illegal on January 1, 1993, but their inertia is still to be felt 10 years later on a wide scale. The procedure of obtaining such certificates however has been decisively changed. While previously this was a certificate proving that someone was “not registered at a neuro-psychiatric dispensary” issued by such a dispensary in accordance with its existing card index, now that almost two million people were removed from psychiatric registration in 1989-1990, it is a certificate indicating “absence of limitations caused by the state of psychiatric health on engagement in one type of activity or another” in accordance with the list approved by the RF Government. Thus the previous impersonal pattern-conveyor system was replaced by an individual approach: the certificate is issued only by physician. Unfortunately, upon completion of the work of the commission that developed the law, its legal expertise in 1992 illegally impaired it : ministries and departments were given the right to pass legal (not only normative) acts on psychiatric care, while psychiatric institutions were denied the right to represent the rights and legal interests of patients. In 1998 a commission was put together under the RF Ministry of Health Care to develop draft legislation “On amendments and additions to Federal Law “On Psychiatric Care…” which has consistently up until now been gradually impairing the law turning the wheel of time for the domestic psychiatry backwards. In 1999 this commission made an attempt to radically broaden the framework of the article that authorizes immediate involuntary hospitalization. In the formulation concerning patients that represent an “immediate danger” for themselves and the others it was suggested to remove the attribute “immediate” which made the article rubber-like. It is important for us here to emphasize not as much the policing meaning of the sentence as the fact that it was supported by the majority of the members of the commission that consisted of our best professional psychiatrists (I. Gurovich, V. Kotov, V. Rothstein, V. Tikhonenko). To our objections that this contradicts the Constitution an all-explaining response followed: “The Constitution can be rewritten!” An open letter of protest submitted by the Independent Association of Psychiatrists of Russia supported by lawyers resulted in the removal of this amendment. However, in the course of the review of other articles the same dilemma would emerge: which priority one has to take sides with — that of the human being or the state? The majority of the commission members were in favor of the priority of the state, and the most active of them represented the Serbsky State Center. This predetermined the fact that the draft legislation “On amendments and additions to Federal Law “On Psychiatric Care…” digressed from many a democratic achievement. The draft law significantly restricts the court procedure that accompanies application of involuntary measures, removes the necessity of physician’s authorization of involuntary measures, lifts the ban on testing new pharmaceuticals and therapy methods on mental patients with severe conditions, limits the authority of public organizations, etc. Since 2001 it has been suggested in the couloirs that the financial guarantees provided by the state to the psychiatric care should be drastically reduced which would undoubtedly worsen the situation still should such modifications be adopted. Instead of fulfilling its obligations accounted for by the law the authorities significantly reduce them by taking advantage of an obedient commission. IV. As far as the public control of psychiatric facilities is concerned, here we see the same tendencies as the ones that generally pervade the sphere of closed institutions (penitentiary, children’s, social security, etc.), as well as the areas of mental health (levels of suicides, drug abuse, etc.), environment, etc. This is a process of ongoing attempts to hustle away, abrupt, and ignore. Similar to the elimination of the public advocate figure in court proceedings a real threat is impending of a dramatic reduction of possibilities of public organizations in the sphere of the psychiatric care. On the other hand a piece of draft legislation has been developed “On public control…” and the section “Psychiatry and the human rights” has been put together within the Expert Council under the office of the RF Human Rights Ombudsman. Results of the monitoring of the situation with observation of human rights of mental patients presented in this book are the first experience of a wide-scale attempt at executing public control in the sphere of psychiatry. Thus, we see a tense and ambivalent situation in every development aspect. It is necessary to bear in mind the initial inequality of forces. Democratic aspirations are opposed by a 400-hundred-year-old tradition which has even raised an opposition to itself in its own spirit: the so called “bolshevism the other way around.” This expression however implies a significant portion of provocativeness. It nourishes an empty illusion that “bolshevism” must be opposed by a “mature democracy”, whereas the latter is simply impossible in a country with the neighbors and history that Russia has without a joint evolution of both members of this pair of opposites. Summing up one can say that Russia with its unprecedented social experiments on its own people has proven the invincibility of the nature’s diversity, the ever-present potency of pluralism, and the weakness of simple schemes. |
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