Vasyukov v. Russia

The applicant was Russian who was sentenced to 12 years of imprisonment in 1997. The government submitted that the applicant had undergone chest fluorography examination twice a year except for the year 2000 and 2001. There had not been a sign of Tuberculosis (TB) from the first examination in 1997. His medical records from 1998 referred the applicant’s contraction of TB from another inmate. The applicant submitted that in 2000 he had been detained with an inmate who had an active TB who died in 2001, and his requests to be placed out of that cell had not been answered. The government denied this argument stating that there was no inmate with an active Tb that could pose danger to the health of detainees by then.

The government submitted that the applicant was hospitalized and subjected to chemotherapy regimen in 2001 which in 2002 was continued with a phase named “HR Regimen” which was accompanied with pathogenetic and general health-improving therapy with a daily special dietary food ration. By the time the applicant was discharged in June 2002, the final diagnosis was “focal tuberculosis of the left lung in the resolution phase”, the HR regimen and the special food ration was to continue.  In October 2002,  a panel of medical specialists made a diagnosis of “focal tuberculosis of the upper lobe of the left lung in the resolution and consolidation phase,… (fading of the tuberculosis process)”. [Para. 16] The HR regimen was to continue twice a year in detention. From January to September 2003, the applicant underwent a number of tests and treatments. The applicant was severely ill in March 2004 due to his suffering from a complete collapse of the left lung. He remained hospitalized until May 2004 when he was discharged with a new chemotherapy regimen, ‘2 HRZE regimen’. In August 2004, the applicant complained to the Prosecutor’s office about inadequate medical assistance and received no response.

Starting September 2004, the applicant refused examinations and treatments by the medical unit in the prison in several instances despite efforts made to explain his need for and consequences of his refusal of treatment by the prison’s administration. He later submitted that he would undergo the examination and treatment if he would be hospitalized at the TB hospital where he could be examined by independent specialists invited by his relatives. He had refused an offer to be admitted to Livny Town Hospital. In August 2005, the applicant requested the district court to be released due to his health conditions. The district court ordered medical assessment in order to decide on the applicant’s request. During the assessment at the TB hospital, the applicant underwent a number of tests and refused certain examinations. The hospital made a determination that the applicant was medically fit to continue to serve his detention with out performing a pathology. The court thus dismissed the applicant’s request to be released in February.

The applicant’s refusal to undergo prophylactic and clinical examinations from September 2005 to February 2007 had been recorded by the attending physicians, some of them had written statement of the same.  The Director of the prison requested the Livny District Court of the Oryol Region to effect compulsory examination and treatment of the applicant to avoid the risk his refusal will present against other detainees. The applicant submitted that he didn’t have the form of TB that would be transmitted and that he would undergo such examination and treatment so long as it was to be done at a hospital other than that of the prison or the TB facility.

In December 2007, the district court ordered the placement of the applicant at the Special Medical Tuberculosis Establishment due to his refusal to undergo examinations that could exclude relapse. The applicant later brought action before the district court against the Russian Ministry of Justice, the Oryol Regional Service for Execution of Sentences and the prison to be compensated for the damage caused to his health due to his contraction of TB while in detention and for not being provided with effective medical assistance. The district court rendered unreliable the statements made by prison inmates as to the detention of healthy inmates with those that had TB and the transmission of TB from one to another. The court dismissed the applicant’s complaint on grounds that there was no evidence as to the fault allegedly committed by the authorities and there was no cause-effect relationship between the alleged fault and the damage to the applicant’s health. 

The applicant was released in 2009 after serving his sentence. The applicant had complained to the European Court of Human Rights (the ECHR) that he contracted TB while he was detained and domestic authorities failed to take measures that could protect his health through late diagnosis and failure to provide adequate medical care for him, in violation of Article 3 of the Convention.

The ECHR found that the authorities failed to timely diagnose and treat the applicant as regards the TB infection. The applicant hadn't received "comprehensive, transparent and effective medical care" during his detention from October 1998 to September 2004. [Para. 75] The ECHR noted that the applicant's state of physical and mental health had been severely affected due to inadequate medical treatment, which degraded his dignity as human. The ECHR held that the state's failure to provide the necessary medical care to the applicant amounted to inhuman and degrading treatment, a violation of Article 3 of the Convention.

The ECHR concluded that the applicant hadn't been denied medical care in the period of his detention after September 2004. It also noted that the applicant hadn't provided an evidence to support his argument that his condition of health worsened during that period' there hadn't been a violation of Article 3 of the Convention after September 2004. The ECHR awarded non-pecuniary damage for the applicant.

"The State must ensure that a person is detained in conditions which are compatible with respect for human dignity, that the manner and method of the execution of the measure do not subject him to distress or hardship of an intensity exceeding the unavoidable level of suffering inherent in detention and that, given the practical demands of imprisonment, his health and well-being are adequately secured..." [Para. 61]

".....the Court has also held that Article 3 of the Convention cannot be interpreted as securing for every detained person medical assistance at the same level as “in the best civilian clinics”." [Para. 62]

".....the State does have a responsibility to ensure treatment for prisoners in its charge, and a lack of adequate medical assistance for serious health problems not suffered from prior to detention may amount to a violation of Article 3..." [Para. 66]