60 i) Basic care and decent hospitalization conditions 131. The Principles for the Protection of People with Mental Health Illness and the Improvement of Health Care published by the United Nations offer useful guidelines for determining whether medical care has been in keeping with the minimum requirements to preserve the patient´s dignity. Principles 1, 8 and 9 of the above mentioned decalogue set forth the fundamental freedoms and rights and the standards regarding the medical care and treatment to be provided to persons with mental illness. Furthermore, the facilities and physical conditions in which treatment is administered should be in accordance with the respect for the dignity of the person, pursuant to Principle 13. 132. The Court considers that the precarious operating conditions of Casa de Reposo Guararapes, both regarding the general conditions of the place and the medical care provided therein, were quite far from being adequate to administer a decent health treatment and were in and of themselves incompatible with the appropriate protection of personal integrity and life, particularly as they affected persons who were extremely vulnerable due to their mental illness. ii) The use of restraint 133. Restraint is understood as any action which interferes with the ability of a patient to take decisions or which restricts his or her freedom of movement. The Court notes that the use of restraint poses a high risk of doing harm to the patient or causing his or her death and that falls and lesions during such procedure are quite common.118 134. The Court considers that restraint is one of the most aggressive measures to which a patient under psychiatric treatment can be subjected. In order for restraint to be in accordance with the respect for the psychological, physical, and moral integrity of a person, pursuant to the standards required by Article 5 of the American Convention, it should be used as a last resort and with the only purpose of protecting the patient, or else the medical staff or third persons, when the behavior of the patient involved is such as to pose a threat to their safety. Restraint can have no purpose other than the foregoing, and should be implemented only by qualified staff rather than by patients.119 of the World Health Organization. Ten Basic Principles of Mental Health Care Law, supra note 37, principles 5, 6 and 9; Pan American Health Organization, Caracas Declaration, adopted by the Conference on the Modernization of Mental Health Legislation in Latin America on November 14, 1990, art. 3; World Psychiatric Association (WPA), Madrid Declaration on Ethical Standards for Psychiatric Practice, approved by WPA General Assembly Resolution of August 25, 1996, as revised on August 26, 2002, preamble and para. 4; and World Psychiatric Association (WPA), Declaration of Hawaii/II, adopted by the WPA General Assembly on July 10, 1983, p. 2 and 5. 118 Cf. Standards of the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment, CPT/Inf/E (2002) 1 – Rev. 2004. Extract from the Eighth General Report CPT/INF(98) 12, paras. 47 to 49; American Hospital Association/National Association of Psychiatric Health Systems, Guiding Principles on Restraint and Seclusion for Behavioral Health Services, 25 February 1999; American Geriatrics Society Position Statement: Guidelines For Restraint Use, Last Updated January 1, 1997; and American Medical Association, Guidelines for the Use of Restraints in Long-Term Care Facilities, June 1989, p. 5. 119 Cf. Principles for the Protection of People with Mental Illness and the Improvement of Health Care, supra note 32, principle 11(11).