July 21, 2014
Last week, the Grand Chamber of the European Court of Human Rights delivered a ruling in the Câmpeanu versus Romania case, which relied greatly on an expert opinion issued in 2012 by IFHHRO. Valentin Câmpeanu (18) died in a psychiatric hospital in Romania in early 2004. The Court ruled that the Romanian government had breached his right to life, and criticised the authorities for not conducting any investigation.
Valentin Câmpeanu was born in 1985 in Romania and was abandoned at birth. He was of Roma origin and grew up in orphanages. He developed learning disabilities at a young age and was also diagnosed with HIV. On reaching the age of 18 he was transferred to an adult institution which denied him antiretroviral medication. When his physical health deteriorated, he was transferred to a psychiatric hospital in February 2004. Staff of the NGO Centre for Legal Resources (CLR) visited the hospital and met Mr Câmpeanu, half-clothed, kept in a side room in sub-zero temperatures and severely malnourished. He weighed 45 kg at that time. They saw how nurses refused to touch him for fear of contracting HIV. A few hours later, he died.
Following his death there was no investigation and no-one was held to account. As Valentin had no relatives, the Centre for Legal Resources applied to the European Court of Human Rights on his behalf.
In 1990, aged 5, Valentin Câmpeanu was diagnosed with HIV. Later he was also diagnosed with profound intellectual disability, with an IQ of 30. In 2003, the Dolj County Child Protection Panel ordered that Mr Câmpeanu should no longer be cared for by the State, given the fact that he recently turned 18 and was not enrolled in any form of education at the time. He was then placed in the Cetate-Dolj Medical and Social Care Centre (CMSC), which was informed that he was HIV positive. However, the Child Protection Panel did not mention that he also had learning difficulties. According to a report issued by the CMSC detailing his condition upon admission, Mr Câmpeanu was in an advanced state of “psychiatric and physical degradation”. A medical examination carried out concluded that he suffered from severe intellectual disability, HIV infection and malnutrition.
According to the report he “became violent, assaulted other patients, broke a window and tore up a mattress and his clothes and sheets” soon after his admission. In just a few days, his health worsened considerably. At that time, the CMSC had received a supply of ARV medication and thus his treatment with ARVs was resumed. Despite these measures, his condition did not improve, the medical records mentioning that he continued to be agitated and violent.
A week later, Mr Câmpeanu was transferred from the CMSC to the Poiana Mare Neuropsychiatric Hospital (PMH). Soon, he stopped eating and refused to take his medication. He was therefore prescribed an intravenous treatment which included glucose and vitamins. Upon examination by the doctor, he was found to be “generally unwell”. Despite efforts of the Centre for Legal Resources to transfer him to a more supportive medical facility, Valentin Câmpeanu died on the evening of 20 February 2004. According to his death certificate, the officially certified cause of death was cardiorespiratory insufficiency related to HIV.
Gross medical negligence
Immediately after Mr Câmpeanu’ death, the CLR requested a criminal investigation in relation to the circumstances leading up to and surrounding his death, accusing all child protection and medical structures involved of negligence and maltreatment. The CLR further argued that the Medical Examination Panel had wrongly classified Mr Câmpeanu as being in the medium disability group, contrary to previous and subsequent diagnoses.
After many years of unfruitful litigating, the case was finally brought to the European Court of Human Rights based in Strassbourg. In January 2012, the CLR (represented by Mr Constantin Cojocariu) submitted an expert opinion to that court, written by IFHHRO staff members and Anca Boeriu and Adriaan van Es. Besides Coordinator of IFHHRO, the latter is also a Medical Doctor and a member of the Forensic Expert Advisory Team at the International Rehabilitation Council for Torture Victims (IRCT).
The expert opinion referred to the “very poor, substandard, often absent or missing” medical records at the PMH and the CMSC, in which the description of Mr Câmpeanu’s clinical situation was “scant”. It noted that while at the PMH, the patient had never been consulted by an infectious‑disease specialist. Also, contrary to Romanian law, no autopsy had taken place immediately after the patient’s death. The opinion noted that pneumonia – the immediate cause of death – had not been diagnosed or treated while the patient was at the PMH or the CMSC, even though it was a very common disease in HIV patients. The report concluded that Mr Câmpeanu’s death at the PMH had been the result of “gross medical negligence”. Moreover, the disciplinary proceedings before the Disciplinary Board of the Medical Association had been substandard and negligent, in the absence of important medical documentation.
On 17 July 2014, the Grand Chamber of the European Court of Human Rights ruled that there has been a violation of Article 2 and 13 of the European Convention on Human Rights and that the Romanian government is responsible for Valentin Câmpeanu’s death. In a joint press release issued by the Centre for Legal Resources (CLR) and three other international human rights organizations, Georgiana Pascu of CLR said: “This decision is extremely important in Romania and also across Europe. The death of Valentin Câmpeanu occurred after several authorities failed. Our view is that the whole system dealing with people with mental disabilities is responsible. The ECHR decision sets a precedent that will help tens of thousands of people in similar situations to Valentin Câmpeanu across Europe.”
Iustina Ionescu of the Euroregional Center for Public Initiatives said that there is a pressing need for the Romanian authorities “to assume responsibility for combating stigma and discrimination related to HIV status. […] We believe action must be taken to prevent further human rights violations against persons living with HIV, as this case has demonstrated.”