A court order is required for the prolonged physical restraint of psychiatric patients, Germany's top court ruled on Tuesday.

The Federal Constitutional Court in Karlsruhe ruled in favor of two patients who sued the states of Bavaria and Baden-Württemberg, claiming they had been illegally restrained for long periods of time against their will.

Judges declared portions of Baden-Württemberg's laws regarding the issue unconstitutional. Bavaria has no laws regulating the restraint of patients. Judges ordered the states to comply with new federal guidelines by June 30, 2019. Until then, however, they will be allowed to continue to restrain patients without a court order as they have in the past.

The ruling in detail

• Restraining patients can only be used as a "last resort" and only in instances in which a patient poses a threat to themselves or others.
• Patients must also be supervised during the entirety of their restraint and not simply left alone.
• Patients may not be restrained due to lack of personnel. Previously, some states allowed doctors to order the restraint of patients on their own.
• Institutions will be required to attain a court order before restraining a patient, or to attain the order retroactively should it be unable to do so ahead of time.
• Only in cases in which a patient is restrained for less than 30 minutes can such a decision be made without the need for a court order.
• Patients must also be informed of their right to challenge the validity of the order.

New law creates clarity

Observers were generally pleased with the Court's ruling. Arno Deister, President of the German Society for Psychiatry and Psychotherapy, Psychosomatic and Neurology (DGPPN), called the decision heartening as, "it creates clear, long overdue rules that apply to all." He pointed out that currently only the states of North Rhine-Westphalia and Lower Saxony require a court order before patients can be restrained.

Critics say it legalizes torture

Martina Heland-Graef a representative from the Federal Association of Psychiatry Experienced (Persons), however, criticized the Karlsruhe ruling. She had hoped for a much more far-reaching decision and claims Tuesday's verdict did no more than legalize a practice that the United Nation Human Rights Convention defines as torture.

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She pointed out that a number of other approaches can be taken to effectively quiet a patient, adding: "Once they have been forcibly restrained they can never forget the experience."

js/rt (AFP, dpa)

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