This is aggravated by the frequent denial of legal capacity in the case of persons with disabilities, allowing others to give consent have them placed in institutions. 270 137. The CPRD Committee has held in that in no case should states allow a person to be institutionalized based on the real or perceived presence of a real or perceived psychosocial impairment 271 or on grounds that they “constitute a danger to themselves or to society.” 272 The European Court found a violation of the right to personal liberty when a person with a psychosocial disability was institutionalized in a mental health center without giving consent. 273 138. In the face of this situation, the CRPD Committee has held that states should eliminate such practices and establish a mechanism for examining the cases in which persons with disabilities have been placed in an institutional setting without their express consent. 274 In addition, the states should proceed to deinstitutionalize, and all persons with disabilities should regain their legal capacity, with the corresponding support, and be able to choose where and with whom to live. 275 The duties of the state on this point are tied to the right to live independently and to be included in the community, established at Article 19 of the CRPD. The institutionalization of a person in a mental health center may constitute an obstacle to that fundamental objective and, as has been indicated, constitutes an arbitrary deprivation of liberty in the terms of the American Convention. One element of the arbitrariness of such a deprivation of liberty takes place when it occurs in breach of the standards on informed consent that will be addressed below. Suffice it to note on this point that in cases of persons with mental disabilities consent is not established by the consent given by a guardian or family member. In any event, as analyzed below, any exception to the obligation to obtain informed consent must be based on a specific and exceptional emergency situation in the particular case, a situation which may not be constituted merely by the fact of having a mental disability. In this sense, in a case such as the instant one, there is a direct relationship between the right to informed consent with the characteristics that will be described next and the arbitrariness of being deprived of liberty in a mental health institution in breach of this right. 139. In addition, the European Court has indicated that states must have adequate and effective remedies so that those persons with disabilities who are institutionalized may challenge the restriction of their liberty. 276 The European Court reiterated the duty of the states to undertake, on their own initiative, periodic judicial reviews when persons are institutionalized. 277 2.3 General considerations on institutionalization and the right to humane treatment 140. As regards the right to humane treatment, the Court has indicated that states have the duty to adopt the measures necessary aimed at addressing the threats to the physical integrity of persons. 278 The IACHR notes that in cases of persons deprived of liberty, such as the persons institutionalized in mental health centers, the states have an enhanced obligation to ensure their integrity since they are under its custody. 141. On this point the Inter-American Court has indicated that one must take into account the special position of guarantor that the state assumes with respect to persons who are under its custody or care, such as persons institutionalized in mental health centers, to whom the state has the positive obligation of United Nations, Committee on the Rights of Persons with Disabilities, General Comment No. 1. Article 12: Equal recognition before the law, May 19, 2014, para. 46. 271 United Nations, Committee on the Rights of Persons with Disabilities. Concluding observations on the initial report on Honduras, April 12, 2017, para. 35. 272 United Nations, Committee on the Rights of Persons with Disabilities, Concluding observations on the initial report on Jordan, April 12, 2017, para. 29. 273 ECHR, Stanev v. Bulgaria. Judgment of January 17, 2012, para. 129. 274 United Nations, Committee on the Rights of Persons with Disabilities, General Comment No. 1. Article 12: Equal recognition before the law, May 19, 2014, para. 40. 275 United Nations, Committee on the Rights of Persons with Disabilities, General Comment No. 1. Article 12: Equal recognition before the law, May 19, 2014, para. 46. 276 ECHR, Stanev v. Bulgaria. Judgment of January 17, 2012, para. 190. 277 ECHR, Stanev v. Bulgaria. Judgment of January 17, 2012, para. 172. 278 I/A Court HR. Case of Suárez Peralta v. Ecuador. Preliminary Objections, Merits, Reparations and Costs. Judgment of May 21, 2013. Series C No. 261, para. 128. 270 24