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Vård under tvång eller krav på samtycke? En studie av missbruksvården inom verkställigheten av fängelsestraff

Lucic, Niksa LU (2013) JURM02 20131
Department of Law
Abstract (Swedish)
En stor andel av alla brottslingar som kommer i kontakt med den svenska kriminalvården lider av något slags missbruk. Kriminaliteten har ofta ett samband med missbruket och personen kan exempelvis ha begått brottet under någon slags påverkan eller i syfte att anskaffa sig droger. Såväl samhället som den dömde har ett stort intresse av att behandla ett eventuellt missbruk inom ramen för ett fängelsestraff, för att minska risken för återfall i brott. Den dömde kan emellertid sakna insikt om sin missbruks-problematik. Personen kan dessutom sakna motivation till behandling och en probleminsikt kanske uppstår först efter påbörjad behandling. Eftersom missbruksvården inom svensk straffverkställighet i hög grad bygger på motivation och samtycke... (More)
En stor andel av alla brottslingar som kommer i kontakt med den svenska kriminalvården lider av något slags missbruk. Kriminaliteten har ofta ett samband med missbruket och personen kan exempelvis ha begått brottet under någon slags påverkan eller i syfte att anskaffa sig droger. Såväl samhället som den dömde har ett stort intresse av att behandla ett eventuellt missbruk inom ramen för ett fängelsestraff, för att minska risken för återfall i brott. Den dömde kan emellertid sakna insikt om sin missbruks-problematik. Personen kan dessutom sakna motivation till behandling och en probleminsikt kanske uppstår först efter påbörjad behandling. Eftersom missbruksvården inom svensk straffverkställighet i hög grad bygger på motivation och samtycke från den dömde kan denne således gå miste om välbehövlig behandling.

FäL reglerar verkställigheten av fängelsestraff och medger ett utrymme för en individualiserad straffverkställighet, där hänsyn kan tas till individuella behov och förutsättningar i syfte att underlätta återanpassningen av en intagen. De åtgärder som kan vidtas i behandlingssyfte inom ramen för ett fängelsestraff är placering på behandlingsavdelning, tillfällig permission i syfte att delta i behandling utanför anstalten, vårdvistelse på behandlings-hem och stöd och hjälp under den villkorliga frigivningen. Kontraktsvård och överlämnande till vård enligt LVM är alternativa påföljder till ett fängelsestraff, inriktade mot att behandla den dömdes missbruk.

Sedan år 2002 har Kriminalvården genomfört en särskild satsning mot narkotikamissbruk på anstalt. Ett omfattande system för identifiering, motivering och behandling av fängelsedömda missbrukare har utvecklats. Utvärderingar från Brå tyder på att den anstaltsvård som bedrivs idag och som bygger på frivillighet från de intagna är effektiv i att behandla missbruk och minska risken för återfall i brott.

Individualiserad straffverkställighet och en missbruksvård som bygger på motivation och samtycke möter svårigheter i att uppfylla krav på rättssäkerhet. Principer om förutsebarhet, proportionalitet och likabehandling kan åsidosättas när Kriminalvården fattar beslut som i hög grad kan påverka formen för verkställigheten av fängelsestraffet. Obligatoriska regler om missbruksvård på anstalt, med utgångspunkten att samtliga intagna ska få ta del av åtgärder riktade mot behandling av missbruk, skulle eventuellt kunna tillse att krav på rättssäkerhet i högre utsträckning tillgodosågs. Socialrätten ger en möjlighet att tvångsvårda missbrukare i vissa allvarliga fall. Syftet med tvångsvården är emellertid att ingripa med akuta insatser vid mycket svåra fall av missbruk. Införandet av tvångsvård på fängelse för att tillhandahålla långvarig behandling till samtliga intagna framstår således som olämpligt. Vidare talar pragmatiska, kostnadseffektiva och humanitära skäl emot införandet av tvångsvård för fängelsedömda missbrukare. (Less)
Abstract
A large percentage of all the criminals who come in contact with the Swedish correctional system suffer from some kind of substance abuse. The criminality is often related to the abuse and the person may have committed such offense under some kind of influence or to obtain the substance. Both society at large and the offender may have a strong interest in the treatment of abuse in connection with a prison sentence, to reduce the risk of reoffending. The offender may lack insight into their problem with substance abuse. The person may also lack the motivation to undergo treatment and an insight may occur only after initiation of treatment. Because substance abuse treatment within the scope of Swedish criminal enforcement relies largely on... (More)
A large percentage of all the criminals who come in contact with the Swedish correctional system suffer from some kind of substance abuse. The criminality is often related to the abuse and the person may have committed such offense under some kind of influence or to obtain the substance. Both society at large and the offender may have a strong interest in the treatment of abuse in connection with a prison sentence, to reduce the risk of reoffending. The offender may lack insight into their problem with substance abuse. The person may also lack the motivation to undergo treatment and an insight may occur only after initiation of treatment. Because substance abuse treatment within the scope of Swedish criminal enforcement relies largely on motivation and consent by the offender, the person may thus forfeit much-needed treatment.

The Prison Act regulates the enforcement of prison sentences and allows for individualized sentences, which take into account individual needs and conditions in order to facilitate the reintegration of prisoners. The measures that can be taken in order to treat abuse within the scope of a prison sentence are placement at a treatment compartment, temporary leave in order to participate in treatment outside the prison, stay for care at a treatment facility and support and help during the conditional release. Contract treatment and delivery of care under the Care of Abusers Act are alternative sanctions to imprisonment, geared toward treating the offender's abuse.

Since 2002, the Swedish Prison and Probation Service has conducted a special enterprise against substance abuse in institutions. A comprehensive system for identification, motivation and treatment of imprisoned substance abusers has developed. Evaluations from the The Swedish National Council for Crime Prevention suggest that the institutional care, as currently conducted and based on voluntary participation from the inmates, is effective in treating abuse and reducing the risk of reoffending.

Individualized criminal enforcement and abuse treatment based on motivation and consent encounter difficulties in fulfilling the requirements of legal certainty. Principles of predictability, proportionality and equal treatment can be disregarded when the Swedish Prison and Probation Service makes decisions that greatly affect the shape of the execution of the prison sentence. Mandatory rules of abuse treatment in institutions, on the basis that all inmates should take part in measures aimed at the treatment of abuse, could possibly ensure that the requirements of legal certainty are met to a greater extent. Social law provides an opportunity to force substance abusers to undergo treatment in some serious cases. The purpose of compulsory treatment is however to intervene with emergency interventions in very severe cases of abuse. The introduction of compulsory treatment in prisons for providing long-term treatment to all inmates therefore seems inappropriate. Pragmatic, cost-effective and humanitarian reasons also contradict the introduction of compulsory treatment of imprisoned addicts. (Less)
Please use this url to cite or link to this publication:
author
Lucic, Niksa LU
supervisor
organization
alternative title
Compulsory treatment or requirement for consent? A study of substance abuse treatment in the enforcement of prison sentences
course
JURM02 20131
year
type
H3 - Professional qualifications (4 Years - )
subject
keywords
straffrätt, criminal law, straffverkställighet, missbruksvård, anstaltsvård, vårdvistelse, permission, rättssäkerhet, proportionalitet, förutsebarhet, likabehandling, humanitet, kriminalvården
language
Swedish
id
3800047
date added to LUP
2013-06-13 15:18:43
date last changed
2013-06-13 15:18:43
@misc{3800047,
  abstract     = {A large percentage of all the criminals who come in contact with the Swedish correctional system suffer from some kind of substance abuse. The criminality is often related to the abuse and the person may have committed such offense under some kind of influence or to obtain the substance. Both society at large and the offender may have a strong interest in the treatment of abuse in connection with a prison sentence, to reduce the risk of reoffending. The offender may lack insight into their problem with substance abuse. The person may also lack the motivation to undergo treatment and an insight may occur only after initiation of treatment. Because substance abuse treatment within the scope of Swedish criminal enforcement relies largely on motivation and consent by the offender, the person may thus forfeit much-needed treatment.

The Prison Act regulates the enforcement of prison sentences and allows for individualized sentences, which take into account individual needs and conditions in order to facilitate the reintegration of prisoners. The measures that can be taken in order to treat abuse within the scope of a prison sentence are placement at a treatment compartment, temporary leave in order to participate in treatment outside the prison, stay for care at a treatment facility and support and help during the conditional release. Contract treatment and delivery of care under the Care of Abusers Act are alternative sanctions to imprisonment, geared toward treating the offender's abuse.

Since 2002, the Swedish Prison and Probation Service has conducted a special enterprise against substance abuse in institutions. A comprehensive system for identification, motivation and treatment of imprisoned substance abusers has developed. Evaluations from the The Swedish National Council for Crime Prevention suggest that the institutional care, as currently conducted and based on voluntary participation from the inmates, is effective in treating abuse and reducing the risk of reoffending.

Individualized criminal enforcement and abuse treatment based on motivation and consent encounter difficulties in fulfilling the requirements of legal certainty. Principles of predictability, proportionality and equal treatment can be disregarded when the Swedish Prison and Probation Service makes decisions that greatly affect the shape of the execution of the prison sentence. Mandatory rules of abuse treatment in institutions, on the basis that all inmates should take part in measures aimed at the treatment of abuse, could possibly ensure that the requirements of legal certainty are met to a greater extent. Social law provides an opportunity to force substance abusers to undergo treatment in some serious cases. The purpose of compulsory treatment is however to intervene with emergency interventions in very severe cases of abuse. The introduction of compulsory treatment in prisons for providing long-term treatment to all inmates therefore seems inappropriate. Pragmatic, cost-effective and humanitarian reasons also contradict the introduction of compulsory treatment of imprisoned addicts.},
  author       = {Lucic, Niksa},
  keyword      = {straffrätt,criminal law,straffverkställighet,missbruksvård,anstaltsvård,vårdvistelse,permission,rättssäkerhet,proportionalitet,förutsebarhet,likabehandling,humanitet,kriminalvården},
  language     = {swe},
  note         = {Student Paper},
  title        = {Vård under tvång eller krav på samtycke? En studie av missbruksvården inom verkställigheten av fängelsestraff},
  year         = {2013},
}