etc.), she says, is, in fact, used by doctors in accordance with the hippocratic oath to do everything to save the patient's life, the listed criteria should be generally valid, i.e. applied also to somatic diseases. the 1993 law is outdated, according to lawyer vladislav lapinsky, who took part in its passage. the law has been foremost for the russian federation within those times but now is already outdated and does not have many issues written in. lapinsky says a very big issue is that the judges are not experts in psychiatry and cannot evaluate the patient's condition objectively. on this ground, the judges in courts openly declare that if the doctors in a mental hospital said that the person is sick, they will not check whether healthy or not he is, whether he needs to be hospitalized or not. they just do what they are told by psychiatrists, and psychiatrists for various reasons are very often motivated to place the person in a psychiatric hospital. according to romek, the restriction of civil rights of a person to the extent of his forced isolation based on the possibility alone of his committing illegal acts, which is defined through the notions about it in psychiatry—a discipline very far not only from jurisprudence but from socio-humanitarian knowledge in general, clearly violates the fundamental principle of the democratic justice—presumption of innocence. since, on the one hand, psychiatry considers a great number of organic anomalies (any brain damages, hormonal imbalances, infectious diseases, etc.) as potential causes of criminal insanity and, on the other hand, the diagnostics of mental disorders is based on very vague descriptions of abnormal behavior, almost anyone can be subjected to involuntary hospitalization by the criterion of social danger and in strict accordance with the law. in addition to the constitution and general international law, the moscow helsinki group (mhg) asserts that current legislation does not comply with the european practice of mental health care. mhg legal programs head, natalia kravchuk, commented on the case of rakevich v. russia considered in the european court of human rights: … russian legislation in this area is featureless and vague. it is for this reason that it is so hard for people to assert their rights, and they have to reach the european court of human rights.st. petersburg lawyer fanis khalikov believes that the mental health legislation is subject to fundamental and in-depth reforming, because it is the current editions of the law no. 3185-1 and other regulations (for example, chapter 35 of the code of civil procedure of the russian federation) that do not hold strength. direct misuse vladimir rotstein, a doctrinist of snezhnevsky's school, states, if the relatives of a "not dangerous" patient with psychosis promise to "reward" the ambulance drivers, then the patient will be hospitalized. the ambulance drivers will ensure that the patient sign a "consent". as well as legislation being unobserved (the patient was hospitalized, though he tried to refuse) there are also more direct abuses of power. rotstein says, "as for preventing abuses on the part of the state so that chaadaev and suchlike are not declared mad, it would be at least naive to hope that the law is able to prevent them." rotstein sums up his opinion by quoting alexander pushkin's aphorism, "in russia there is no law—there is only a pillar; and on that pillar—a crown." nikolay suatbaev expressed a similar opinion, stating that unlawful behavior should be dealt with by police, a public prosecutor's office, a court, even if an offender is mentally ill; after all, only if he is not deprived of his legal capacity, he has rights and obligations equal to those of the healthy. the refusal to institute criminal proceedings is illegal if based on the fact alone that the offender is on the psychiatrist's registry and all the more so if accompanied by the delivery of the materials "for taking measures" to the dispensary, which by definition is not a punitive organ. it corrupts the ill and undermines the reputation of psychiatrists, suatbaev says. new york city, for example, has no dispensaries at all, and if a person broke the law, it is a problem of the police; only later psychiatrists investigate if there is concern of a mental health issue, vladimir pshizov writes. there have been many cases where orphans have been indicted to be sent to psychiatric hospitals, often when the accused are perfectly healthy. in 2010, 20 out of 72 orphans from an orphanage in komsomolsk-on-amur were placed in a psychiatric hospital and exposed to neuroleptic medication. the city prosecutor found that all the children were placed in the hospital to be treated for "emotional disorders" without having been examined by a commission of psychiatrists or provided for by a court judgment. the children told they had been warned that they would be sent to a madhouse because of their bad behavior. infant orphans who came of age and received a diagnosis in a psychiatric hospital are sent to psychoneurological internats without asking their consent. there a new problem arises: quite legally capable people cannot get out of there, work, start their family and live a normal life. in 2003, lawyer mikhail fomin noted that psychiatrists were given preference in order to encroach upon the homes of the elderly and single people. it would seem that the law must counteract such manipulations in psychiatry but, in reality, the law leads to numerous abuses following which single pensioners are sent to internats to live the rest of their life there. in fomin's words, no one disputes that only a specialist can make a diagnosis but vesting a psychiatrist with the unlimited power to decide the fate of a person is an extreme legislative innovation peculiar at present only to russia. the very strict control over involuntary internment in a psychiatric institution is exercised in other countries, specifically on the part of the church, but russian public organizations are almost powerless. in 2008, during a scientific and practical conference held by the advocacy chamber of the moscow oblast, 200 leading legal scholars and human rights defenders noted the same trend when a tool for "relatively honest" encroachment upon property more and more often became the mental health law. in 2014, legal proceedings started against a criminal group that took away apartments from patients of a town narcology dispensary in novocherkassk. according to the data of law-enforcement agencies alone, the doctors sold seven apartments of patients and tried to do so in six cases more. an ill person who has lost his home often becomes a tramp, and citizens with no fixed abode, as a rule, do not appeal to the police. according to the 2013 interview of the representatives of the independent psychiatric association of russia to radio free europe, because of the russian mental health law, sending people away for a month in a mental hospital is easy for prosecutors—with the help of pliable judges—and becomes an increasingly common tactic in the country's campaigns against political dissidence, extremism, and corruption. robert van voren says, "the law itself is ok but the abuse of it exists." the same occasionally happens in many countries monitored by the global initiative on psychiatry. psychiatry is regarded as a handy tool to solve disputes, and one can easily buy a diagnosis from a psychiatrist. in most of the countries, forensic psychiatry has changed only slightly, the strong resistance to introducing the modern practices of forensic psychiatry is due to not disparities in schools or views but the fact that the reform of the system would mean the end of corruption. criminals pay off their imprisonment of many years by having themselves declared insane. wealthy husbands declare about the mental illnesses in their wives to get rid of them and yet keep control over their children. children declare their parents and grandparents legally incapable to sell their apartments. even medical institutions recognize their patients as insane to take their property. civil rights concerns russian psychiatrists valery krasnov, isaak gurovich and alexey bobrov suppose the law works successfully enough, though the results of monitorings show that the violations of the rights of patients in psychiatric hospitals are massive. most psychiatric institutions deny patients the right to receive information about the condition of their mental health, copies of medical documents. the grounds of placing in a hospital are not only undisclosed and unexplained to patients, but even are concealed from them, their consent to hospitalization and treatment are forged. the patient's right to send uncensored complaints and petitions to authorities, the prosecutor's office, court is ignored. such correspondence is opened and inspected and, instead of being sent to the recipient, is filed to the medical history. some hospitals censor not only outgoing correspondence (as doctors say, "not to send claptrap") but also ingoing one ("not to injure the patient"). because of omissions of the administration of hospitals, patients are, as a rule, deprived of daily walks, the right to use the telephone. they are forbidden to see lawyers and other representatives chosen by them, to receive representatives of human rights organizations. in many hospitals, telephone calls and appointments with relatives are allowed only in the presence of attendant staff (a nurse, social worker or hospital attendant), that violates the privacy of such meetings. receiving an appointment requires beforehand permission of the administration. the patient's natural right to privacy is not implemented. in all psychiatric hospitals, there are patients who are there not for medical but exclusively for social indications, including conflict relationships with family members who live with them. according to former radio liberty commentator eugene novozhilov, who was persecuted by psychiatrists, human rights of a person registered in a psychiatric dispensary in russia exist only on paper. in the eyes of so-called "law-enforcement agencies", such a person in any situation is always guilty even if attacked and beaten by hooligans. such a person under any hollow pretext can be deprived of his liberty by being placed in a mental hospital for an indefinite period of time. then he can easily be declared legally incapable and stripped of property and all his "paper" rights, when being turned into a silent animal that spends the rest of his days. with the help of psychotropic drugs in a psychiatric hospital, a vegetable can be made out of a person within a week. to a person trapped in psychiatric torture chambers, the rest of his life can be turned into a long, painful and humiliating agony. lyubov vinogradova believes the law is good in theory, but in reality there has been a continuous reduction in patients' rights as independent experts are now excluded from processes, cannot speak in court and can do nothing against the state experts. disasters a 2006 fire in a drug rehabilitation clinic in moscow killed forty-five female patients; the windows of the clinic had bars fitted to them. in 2013 a psychiatric hospital north of moscow, which also housed patients with alcohol and drug addiction, and also had bars fitted to all windows, saw the deaths of thirty-six patients and two doctors. official sources said that some of the victims were tied to their beds. related international documents in the countries of the former soviet union, there is very limited knowledge and understanding of declarations and international documents that guarantee the rights of the mentally ill and include the ethical codes, adopted by the world psychiatric association, and the convention on the rights of persons with disabilities with far-reaching implications for the mental health profession. individual cases can be solved by litigation at the european court of human rights in strasbourg, however it does not change the attitudes of both mental health professionals and government officials. reports on failures in december 2013, the independent psychiatric association of russia wrote to the world psychiatric association the open letter "on the failure of the mental health law and alarming trends in domestic forensic psychiatry." the letter reports on the failure of article 38 of the law and requests to dispatch the audit commission to investigate a number of cases published in the nezavisimiy psikhiatricheskiy zhurnal—the herald of the ipa, and at first to express formal concern about the contents of its letter.