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of the services. In this sense, the measures adopted minimize potential human rights
violations. Complains regarding to the situation of patients with mental illness are
rapidly investigated. The number of violations of patients’ human rights in the State
has decreased because hospitals are now smaller and the institutions that have
superseded them are more responsive and approachable to social control and the
participation of patients´ next of kin.
4.
Expert reports by expert witnesses proposed by the representatives
a)
Lídia Dias-Costa, psychiatrist
She has been an expert witness in the case of Mr. Ximenes-Lopes since November
1999. She attended the exhumation of Mr. Damião Ximenes-Lopes´ corpse, which
had started when the corpse was undergoing the process of decomposition, whereby
it was reduced to the skeleton. During the exhumation of Mr. Damião XimenesLopes´corpse, she could verify that his brain had been opened as it is done in
autopsies, but she found no reason why this had not been reported or described in
the autopsy record drawn up in 1999. According to the expert witness, it is a routine
procedure and there is no reason why the brain should not be examined or the
findings resulting from the examination should not be recorded. Furthermore, she
stated that a diagnosis of violent death caused by a skull and brain traumatism could
be established based on the patient´s clinical evolution.
There are domestic and international standards regarding the right treatment of
people with mental health disabilities, which are the principles for the “treatment of
people with mental health disabilities and the improvement of health care,” published
by the United Nations in 1991. These principles were accepted by the State by virtue
of Federal Resolution No. 1,407.
The expert witness visited the Casa de Reposo Guararapes (Guararapes Rest Home) in
May 2000, when the institution was under government intervention, and found that
some of the employees accused in the criminal proceedings were working there. The
Casa de Reposo Guararapes was not in operating conditions.
Containment techniques applied in the Casa de Reposo Guararapes could not be
deemed to be medical procedures, since the patients or other persons admitted in
said center were asked to contain other patients when these appeared to be in a
state of agitation. Containment techniques were applied violently. This was described
by the professionals working at the Casa de Reposo Guararapes, among them Dr.
Francisco Ivo de Vasconcelos, who stated that he used to get to the health center to
find that the patients had been tied by the nurses and that he used to order that
they be untied. This was one of the routine situations at the above health center,
besides other violent acts. However, it is possible to contain patients without causing
them any bruises, by using technical procedures which allow preventing them.
Unfortunately, under the Brazilian health system there are many patients who suffer
this type of containment, which amounts to a cruel and inhuman treatment.
At present, people suffering from problems similar to those suffered by Mr. Damião
Ximenes-Lopes, according to the care they receive may live with other people, have
access to a dwelling place and food, and live long. It is not their mental disabilities
which make it difficult to live with them, but their living conditions, as it happens
with people in general.