SCIE Practice guide 09: Dignity in care

Promoting dignity within the law: Relevant articles in the Convention of the Human Rights Act

Article 3: the right not to be subjected to torture, inhuman or degrading treatment

Inhuman and degrading treatment can arise as a result of failure to assess an individual’s need for services and a failure to provide necessary services in a timely manner and at an appropriate level. Article 3 could be relevant to failures by public services to protect vulnerable adults from abuse or neglect. In social or healthcare settings practices such as tying residents of a care home into chairs would almost certainly be inhuman, and it could be argued that failure to prevent and treat bedsores could be a breach of Article 3.

Under the National Health Service and Community Care Act 1990, local authorities have a duty to provide information, a duty to assess (section 47) and a duty to promote equality under the Race Relations Amendment Act 2000.

The threshold for breach of the Article is high, and not all treatment that we might consider being undignified would breach the Article. So, for instance, neither of the following was considered to breach Article 3:

• the restraint of a prisoner, including the use of handcuffs, during medical treatment and the presence of security officers during medical consultations and treatments, as any interference was proportionate to the risk the prisoner posed [R. (on the application of Botmeh) v GSL UK Ltd (2007)].
• the strip-searching of the mother and half-brother of a prisoner awaiting trial for drugs offences, given the suspicions with regard to the prisoner and the fact that there was an endemic drugs problem in the prison. However, it was noted that the procedures were lax and had been conducted with a regrettable lack of courtesy. Also, the strip-searching was found to be a breach of Article 8 rights, because the interference was not proportionate to the legitimate aim [Wainwright v United Kingdom (2006)].

Despite the high threshold it is important to understand that its purpose is to ensure that everyone is treated with dignity, and the approach of a good service ought to be aimed at preserving dignity, rather than on what level of indignity the law is prepared to tolerate. The focus should be on the dignity of people using services. Dignity means treating each person as an individual and with the same respect as we would want for ourselves or members of our own family. (For more on the meaning of dignity, see What is dignity? on the homepage of this guide.)

Practice points

• Local authorities have a responsibility to ensure that any care home in which they place residents has adult protection or safeguarding services that will help practitioners, families and friends as well as residents take up their concerns about inhuman and degrading treatment.
• Every local authority and healthcare organisation should have policies and procedures in place to protect vulnerable adults from abuse or neglect and to provide redress should abuse occur. Relevant to this would be a robust complaints procedure and a whistle-blowing procedure.
• Staff’s rights to whistle-blowing may be important to remember when they feel that they are witnessing inhuman or degrading treatment. See Whistleblowing section of this guide.
• Local policies about adult protection or safeguarding give details of local contacts.

Further information

For more detailed guidance on aspects of dignity linked to abuse, see the Abuse section in this guide.

The Mental Capacity Act 2005 offers another route to challenge wilful neglect and mistreatment because it made these criminal offences when looking after a person who lacks mental capacity.

See also the Information booklets on the Mental Capacity Act available on the Office of the Public Guardian website.

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