CASE OF MOCKUTĖ v. LITHUANIA
Violation of Article 8 - Right to respect for private and family life (Article 8-1 - Respect for private life);Violation of Article 9 - Freedom of thought, conscience and religion (Article 9-1 - Change religion or belief;Freedom of religion;Manifest religion or belief);Non-pecuniary damage - award (Article 41 - Non-pecuniary damage;Just satisfaction)
Carlo Ranzoni;Egidijus Kūris;Ganna Yudkivska;Paulo Pinto De Albuquerque;Vincent A. De Gaetano
5. The applicant was born in 1973. She grew up in Šiauliai, which in 2003, the time relevant in this case, had about 130,000 inhabitants. She currently lives in Vilnius. 6. The applicant’s medical records show that in May 1992 she was treated for three weeks at Kaunas Psychiatric Hospital (Kauno psichiatrijos ligoninė), where doctors diagnosed her with an acute paranoid reaction disorder (ūmi paranoidinė reakcija). The applicant had been taken to hospital by her parents, who had stated that she had previously joined the Believers in God religious sect (Dievo tikėjimo sekta) and that she had become agitated and disorientated. At her parents’ request and once her health had improved, in summer 1992 she continued treatment at a psychiatric institution in Šiauliai (Šiaulių psichoneurologijos dispanseris), where her diagnosis was acute paranoid psychosis (ūmi paranoidinė psichozė). The doctors noted that the applicant had joined another religious sect, the Hungarian sect (Vengrų), and that her condition had worsened after joining in certain of the sect’s activities in a forest. In particular, she had not been able to communicate well and had spoken only about religion-related topics while at the hospital. Subsequently, the applicant received treatment in the same psychiatric institution in Šiauliai in 1994, when she was diagnosed with paranoia (paranoidinė būsena). She was disorientated and depressed. The doctors noted that the applicant had an inner conflict – she was dissatisfied with the hyper care (hipergloba) given to her by her mother, but was nevertheless not independent or mentally mature. In the summer of 1996 the applicant was again admitted to hospital and treated in the psychiatric institution in Šiauliai, where she was diagnosed with moderately severe endogenous depression (endogeninė depresija, vidutinio gilumo). Once her mental state had improved, the applicant refused to stay in psychiatric institution and was released. 7. On an unknown date, the applicant obtained a degree in law. In 1997 she won a competition to pursue postgraduate studies (podiplominei stažuotei) in the United States, where she studied for two years. 8. In May 2002, the applicant’s father became ill with cancer. The applicant was distressed, did not sleep well and had a car accident. Her mother took her the same month to the Volte private hospital in Vilnius, where she was diagnosed with post-traumatic stress disorder (potrauminio streso sutrikimas). She spent a week in the hospital and was released at her own wish so she could be treated as an outpatient. 9. In December 2002 the private company which employed the applicant as an in-house lawyer was put into liquidation. The applicant later found a job as a lawyer at the Ministry of Economy (Ūkio ministerija). 10. In February 2003 the applicant made her first visit to the Ojas Meditation Centre, the Lithuanian branch of the Osho religious movement (see Leela Förderkreis e.V. and Others v. Germany (no. 58911/00, § 6, 6 November 2008), where she started meditating (pradėjo medituoti). She states that she found “inner spiritual and emotional healing for [her] stressed and disharmonious inner state, [caused by her] father’s illness, car accident and the loss of [her previous private sector] job”. 11. According to the applicant’s medical records and court decisions (also see paragraphs 29, 33 and 45 below), on the morning of 7 May 2003 she arrived for work as usual at the Ministry of Economy in Vilnius. She suddenly felt exhausted and asked her superior (viršininkė) for some time off. When her superior refused, the applicant slammed doors and ran out of the office. She was stressed and agitated. She then left her vehicle unlocked in the middle of the street, returned to her apartment, undressed completely, and began screaming on her balcony. She did not open the door to her work colleagues. The applicant’s mother called her the same day, but could not communicate with her because of the applicant’s state of mind. The mother then asked for help from the applicant’s cousin, E.Š. At about 8 p.m. the applicant’s sister, G.M., and her cousin, E.Š., arrived in Vilnius, and called an ambulance. The applicant was then taken by force to Vilnius Psychiatric Hospital (Respublikinė Vilniaus psichiatrijos ligoninė), a public hospital under the Ministry of Health Care. 12. At the psychiatric hospital, the applicant refused to sign a form consenting to her admission and treatment. Her cousin did so instead, at 9.15 p.m. The applicant was agitated, aggressive and could not understand the situation. She was physically restrained three times for forty minutes, and forcibly administered neuroleptics, including haloperidol. She fell asleep at 4.20 a.m. on 8 May. 13. Later the same morning, the applicant was seen by a psychiatrist, doctor D.Š., who was also a head of division at that hospital, and doctor A.G. The doctors indicated in her medical records that the applicant “did not object to being treated” at that hospital (also see paragraph 29 below). 14. In her application to the Court, and without being contradicted on this point by the Government, the applicant stated that from 8 May to 13 May 2007 she had been placed under the strictest patient regime at Vilnius Psychiatric Hospital. She had been supervised by a nurse twentyfour hours a day in a ward with eight other patients. She had not been able to leave the ward without a nurse. From 13 May to 5 June, the applicant was under a strict care regime. She could have a walk around the hospital grounds, but only if accompanied by a nurse. On 5 June, and until her release on 26 June 2003, the applicant’s care regime was changed and at certain times of the day she could take walks on her own within the territory of the hospital. 15. The applicant’s medical record of 26 May 2003 reads that the applicant at that time did not yet fully understand how sick she was (pilno liguistos būklės suvokimo dar nėra). The record also states that “it has emerged that the patient attends the Osho non-traditional meditation and improvement centre. During conversation [the applicant] states that attending the centre ‘brings her peace’ while not disturbing her social functions; it is also her ‘essential interest’. [The applicant] has an uncritical attitude to attending the centre. Psycho-correction therapy to be continued”. 16. The record of 2 June 2003 reads that the applicant was clear-headed (mąstymas nuoseklus) and was not agitated (afektas adekvatus). The applicant “was gradually adopting a critical attitude towards psychotic behaviour and also about ways to spend her free time. The treatment was to be continued.” 17. The record of 20 June 2003 reads that “during psycho correction, the applicant was categorical about attending the Ojas Centre, and asserted that ‘it was a personal matter (tai jos asmeninis reikalas)’. The applicant showed no psychotic symptoms.” 18. The applicant was released from Vilnius Psychiatric Hospital on 26 June 2003, after fifty-two days. Her medical records, issued by that hospital and later confirmed by the court appointed experts, stated that from 8 May until 26 June 2003 the applicant had a transitory psychotic disorder (tranzitorinis psichozinis susirgimas), which was a serious mental disorder. The applicant’s medical record of 26 June 2003 stated that her affect (mental state) was flat (calm) and stable (afektas lygus, stabilus) and that she was clearheaded. She had realistic and concrete plans for the future, had a critical attitude towards psychotic behaviour (atsiradusi kritika psichoziniam elgesiui), and had promised to continue treatment as an outpatient. 19. On 17 June 2003, while the applicant was still being held in Vilnius Psychiatric Hospital, an episode of the Srovės television programme was aired on the LNK national television channel. The channel made an announcement (anonsas) about the forthcoming broadcast in the following way: “R.S. [journalist]: a secret has been revealed (demaskuota paslaptis). There is a centre which has not been registered anywhere and where the meditation practised is so powerful that to become a member you have to submit medical proof that you are not ill with HIV. ... After such meditation Violeta is today in a psychiatric hospital. Her mother is in tears ...” 20. The programme itself contained the following statements, including two by doctor D.Š., head of division and a psychiatrist at Vilnius Psychiatric Hospital, who was interviewed by the journalist on what appeared to be the premises of Vilnius Psychiatric Hospital: “A.K. [journalist]: B. is a woman who has had a management job all her life. ...Today B. has agreed to talk because what has happened is completely unexpected. The woman did not foresee disaster, she did not foresee how her older daughter, who is now an adult, the thirty-year-old Violeta, had been charmed and what she got herself involved with.” “R.S.: The organisation we are talking about today has many secrets ...” “Doctor D.Š.: It does not appear that this young woman (mergina) would participate in orgies. She is not hypersexual, and, well, you know, as far as I have learned, she is of high morals and studied for a couple of years in America for a master’s degree.” ... “R.S.: We are meeting Violeta’s mother and her seventeen-year-old sister at Vilnius train station. The mother and her daughter came here by train from Šiauliai, wishing to tell Violeta’s story. They did not wish to meet in Violeta’s home town (gimtuosiuose namuose), Šiauliai. They are afraid to hurt Violeta’s father. He is seriously ill and it would be hard for him to accept (išgyventi žinią) what has happened to his elder daughter. More than a month ago, in the apartment in the capital where Violeta lives, the most horrible event in the young woman’s life took place. Violeta suddenly had a complete nervous breakdown, acute psychosis. For Violeta’s family, the reason for that psychosis is the influence of the Ojas Meditation Centre.” The programme then discussed the activities of the Ojas Meditation Centre in Vilnius. The journalist implied that the followers of Osho in Vilnius held sex orgies. As to the applicant’s identity, the journalist also mentioned that “Violeta obtained a master’s degree abroad, had an important job in State service (dirbo atsakingą valstybinį darbą)” and that the person was “currently being treated at a psychiatric hospital”. The programme included the following statements: “R.S.: Violeta’s family state that a couple of weeks before the tragedy Violeta would meditate all day and practically not speak to anyone else. She is currently being treated in a psychiatric hospital. ...After two months of meditation Violeta was placed in a psychiatric hospital, in a state of acute psychosis (ūmios psichozės būsenoje).” “Doctor D.Š.: They [people belonging to sects] do not talk about it at all. As far as I have heard, the teachings there [at the Ojas Meditation Centre] take a couple of years, and enlightment happens or something of that kind. This takes place over four years, something is being cleansed. She [Violeta] does not talk about that. She even says that she performs some kind of practice (atlieka praktikas) there; she hides [things]. This is a common trait of members of sects, that they very much hide that fact. Or, if [things] come to light, they portray it as completely innocent. That is very common.” M.V., who according to the register of religious organisations in Lithuania is the “leader” and master (lyderis (meistras)) of the Ojas Meditation Centre in Vilnius, stated during the broadcast that the applicant had been terrorised by her mother. The broadcast concluded with statements by the journalist and M.V.: “R.S.: Maybe it is a coincidence, but a clear danger to Violeta’s mental state appeared just after she had started meditating in accordance with Osho teachings. The young woman will need a long and difficult course of medical treatment (mergina dar ilgai ir sunkiai gydysis). The fact that she has only been in this [Ojas Meditation] centre for a couple of months leads one to reflect on how the practices of the Ojas Meditation Centre can affect someone who is constantly seeking to liberate their soul.” “M.V.: Actually, there is a Catholic atmosphere and a Catholic resistance, maybe even a Christian resistance, against meditation, because there is no God in meditation ...” The applicant’s mother and sister were shown during the programme and identified by their real first names as “B., Violeta’s mother” and “G., Violeta’s sister”. They made statements about the destructive influence that, in their view, the Ojas Meditation Centre had had on the applicant. 21. On 14 August 2003 on the internet site of the Ojas Meditation Center the applicant published a five-page open letter to the journalists at Srovės, signing it with her real name and surname. She expressed regret that the broadcast had not been an objective portrayal of her story. She stated that “by using me, you have maybe created an interesting story, but it is very one-sided. Maybe by unraveling (narpliodamos) the story through my mother you also wanted to protect me and sought to help me, but in reality your broadcast has caused me to feel much distrust and a lot of pain”. The applicant then mentioned that she had previously been admitted to psychiatric institutions in 1992 and 2002, emphasising that those two periods had been unrelated to meditation. She also wrote that she had only started attending the Ojas Meditation Centre in February 2003 and that her emotional breakdown in May 2003 had had no connection to those visits. For the applicant, the Srovės journalists had therefore given an unfair account of her story, and had shown bias by implying that her mental health issues had been caused by meditating at the Ojas Centre. The applicant also stated that in 2002 she had consulted several psychotherapists (psichoterapeutai), who had helped her realise that her psychological problems had roots in her childhood, when she had been controlled by and had lived in fear of emotional and physical violence from her mother. Even at the time of writing there had been resistance and mockery from her family when the applicant had shared her new interests, such as yoga or meditation. The applicant also stated that she “had not been put under a spell (neapžavėjo)” by meditation. Instead, meditation had entered her life naturally as the result of a long and intense spiritual search. She continued: “Meditation for me is a way to learn about myself and the world, and on the basis of that understanding and by deepening it, to open myself to peace, joy, truth and love. Today meditation for me is a means to reduce emotional, spiritual and psychological tension and stress, to understand the reasons behind unhappiness, including by learning how to avoid it. Meditation allows me to live a more conscious life (sąmoningesnis) and one which is full of joy.” 22. The applicant also referred in the letter to her involuntary admission to Vilnius Psychiatric Hospital in 2003, where she had been taken by force and deceit, and where she had never agreed to be treated. She wrote that the psychiatrists had blindly believed her mother’s stories and had diagnosed her as being under the influence of a sect (sektantiškumas). That had led to the psychiatric treatment she had received being mainly directed at how to cure her from practising meditation (pagydyti nuo meditacijos) in a hostile environment that had damaged her psychologically and emotionally. In particular, the psychiatrists at the hospital had interrogated her (buvau kamantinėjama) about the Ojas Meditation Centre and its practices, forced her to promise not to meditate, alleged that sex orgies had taken place there, that meditation was harmful for her mental health, that she should follow the Catholic religion which is traditional in Lithuania and that meditation was not compatible with her “social status”. During one visit (vizitacija), a doctor had called her “the one from the Ojas Centre”, rather than using her name. The applicant also wrote that when she had spoken about meditation at the Ojas Meditation Centre doctor D.Š. had simply made fun of it, had said that that was not meditation, and that the applicant knew nothing about what meditation actually was. The applicant had not been able to resist the psychiatrists at the hospital because refusing to talk to them or disagreeing with their statements about the Ojas Meditation Centre or their instructions to stop meditating had been treated as signs of mental illness. For that reason, the amount of medication at the hospital had not been reduced for a long time, strong drugs had been injected into her, and her release from hospital had been postponed. The applicant also noted that she had intended to submit a written statement to the hospital that she refused treatment, but she had been persuaded not to do so because the doctors had threatened that otherwise they would diagnose her problems in such a way that could later prevent her from getting a job. 23. The applicant concluded by noting that in July 2003 she had attended a session at the Ojas Meditation Centre, and had finally been able to meditate and recover after nearly two months in Vilnius Psychiatric Hospital in a hostile environment that had harmed her mind and body. She saw meditation as means to live a more conscious and meaningful life. 24. In May 2006 the applicant sued Vilnius Psychiatric Hospital for compensation for non-pecuniary damage. She alleged: (1) unlawful deprivation of liberty; (2) a violation of her right to a private life; (3) a violation of her right to freedom of religion; (4) a violation of her right to the inviolability of her body; (5) failure to provide proper medical care; and (6) a breach of her right to be properly informed about her diagnosis, methods of treatment and prognosis. 25. Vilnius Psychiatric Hospital responded by saying that on 7 May 2003 the applicant had been involuntarily hospitalised since she had been in a state of acute psychosis and had posed a danger to herself and others. The hospital also submitted that the applicant had never complained in writing about being held unlawfully. The hospital argued that it had not disclosed any confidential information about the applicant, and that it could not be responsible for the actions of the applicant’s mother and the way the Srovės broadcast had been presented. It added that the Osho religious movement had been acting outside the law in 2003 because it had only been registered in Lithuania as a religious movement on 12 April 2005 (see paragraph 56 below). Furthermore, the applicant had not proved that the hospital had had no reason to think that her non-traditional religious beliefs had been the reason behind her emotional outburst (emocinės iškrovos priežastis). 26. The Vilnius Regional Court ordered the State Forensic Psychiatry Service at the Ministry of Health Care to produce a report to answer certain questions regarding the applicant’s medical condition and her admission to Vilnius Psychiatric Hospital between 7 May and 26 June 2003 on the basis of her medical records. The forensic report was produced in November 2007. 27. On 25 June 2008 the Vilnius Regional Court granted the applicant’s action. 28. The Vilnius Regional Court noted at the outset that according to Articles 27 and 28 of the Law on Mental Health Care a person could be placed in hospital without his or her consent if there was a clear and present danger of him or her harming themselves or others. Even then, a court order was needed within two days to keep the person in hospital. Should a court refuse such an order, the forced hospitalisation and treatment had to be discontinued (see paragraph 69 below). 29. On the basis of the forensic expert report and other material, the Vilnius Regional Court firstly observed that the applicant had not actually denied that she might have required medical assistance on 7 May 2003 because of her state of mind. However, the court found that as of 8 May 2003 she had no longer been in need of medical support. That was confirmed by the applicant’s medical file, where doctor D.Š. had noted on 8 May at 8.15 a.m. that “the patient is responding to meaningful contact, is correctly orientated (pacientė prieinama prasmingam kontaktui, orientuota teisingai)”. Also, at 8.30 a.m. on the same day, doctor A.G., the other psychiatrist treating her at Vilnius Psychiatric Hospital, had written that “currently the patient is sleepy because of medication ... her mind is clear, she is well orientated when it comes to place and time ... currently the affect is flat (pacientė š.m. mieguista dėl vaistų poveikio, sąmonė aiški, orientacija vietoje ir laike tiksli... šiuo metu afektas lygus)”. The court also based itself on the applicant’s other medical records. All that meant that the applicant’s state of health had no longer corresponded to that set down in Article 27 of the Law on Mental Health Care to permit her further forced hospitalisation. Despite that, the applicant had been held against her will and treated at Vilnius Psychiatric Hospital until 26 June 2003, without the hospital ever asking for a court order. That had been in breach of the twoday time-limit set in Article 28 of the Law on Mental Health Care. 30. The Vilnius Regional Court also agreed with the applicant’s argument that she had not been able to leave the hospital because she was under the influence of drugs, had faced a threat of being physically restrained if she disobeyed the doctors, and had been under a strict regime. The court noted that the requirement that a psychiatric patient should normally be able to express his or her consent to be hospitalised and treated had also been underlined by the Committee for the Prevention of Torture. 31. The Vilnius Regional Court also observed that there was no written evidence that the applicant had ever agreed to be placed in Vilnius Psychiatric Hospital between 7 May and 26 June 2003. According to the forensic expert report, the applicant had not been able to understand her actions on 7 May 2003; however, the experts had not reached the same conclusion about the period between 8 May and 26 June 2003. That notwithstanding, the applicant had been forced to stay in hospital for fiftytwo days for treatment. The court also emphasised that the patient was always the weaker party in relation to the hospital and its personnel. The hospital’s argument that the applicant had agreed to stay by acquiescence was therefore null and void. The court also relied on doctor D.Š.’s admission during court hearings that the applicant’s life had “not necessarily been in danger” for all of the fifty-two days of treatment and to the same conclusion by the applicant’s treating doctor A.G. In fact, the records signed by doctor A.G. on 8 and 12 May 2007 stating that the applicant was being treated at the hospital had given only one side (vienašališki) of the situation as they had not been countersigned by the applicant. In that context, the court also had regard to the applicant’s explanation that because of the side effects of the medication (sleepiness, inability to concentrate) and the possibility of physical restraint (being tied down) in case of disobedience, she had not been able to express her disagreement about being treated at the hospital in writing. The court also considered that the consent given on 7 May 2013 by the applicant’s cousin, E.Š., for the applicant to be put in hospital and treated could also not be considered as an act of agreement expressed by the applicant. 32. In the light of those factors, the Vilnius Regional Court concluded that the procedure set down in domestic law for forced admission to hospital and treatment had not only been breached in the applicant’s case, but outright disregarded. 33. The applicant’s mother also testified before the Vilnius Regional Court. She said that she had learned on 7 May 2003 that the applicant was delirious and had asked E.Š. for help. That had led to the applicant being taken to Vilnius Psychiatric Hospital. The mother also said she had contacted the Ojas Meditation Centre in Vilnius about her daughter, but had not received a constructive response. She had then contacted the journalists from Srovės, because she had wished to find out what was happening to her daughter. She had not known what diagnosis the psychiatric hospital had given the applicant and had only told the Srovės journalists which hospital her daughter was in. 34. Doctor D.Š. testified that she was head of division (skyriaus vedėja) at Vilnius Psychiatric Hospital when the applicant had been treated there. She said that the journalists had not called her directly but that the hospital administration had informed her that they would come and had “kind of stated that the talk would be about Mockutė”. The doctor testified that she had “not discussed [the applicant’s] health” with the journalists, only the Ojas Meditation Centre and meditation as such. 35. The Vilnius Regional Court then turned to the applicant’s complaint of a breach of her right to privacy. Relying on Article 14 of the Law on Mental Health Care and Article 2 § 1 of the Law on the Legal Protection of Personal Data (see paragraphs 59 and 61 below), the court noted that “there was evidence in the case-file (byloje yra pateiktas įrodymas) that doctor D.Š. had, without obtaining the applicant’s consent to disclose confidential information, revealed to the Srovės journalists that the applicant had been diagnosed with acute psychosis (ūminė psichozė), that she was being treated at Vilnius Psychiatric Hospital, and that she had studied in the United States”. The interview with the doctor had been shown during the Srovės programme on 17 June 2003. The court noted that even in 2008 (šiuo metu) there were not many people in Lithuania who had studied in the United States and so that characteristic had not been very common. The court also considered that “other information revealed to the journalists about the applicant could also allow the applicant’s identity to be established”, although the court did not specify what other information it meant. 36. The court then had regard to the applicant’s complaint about freedom of religion by referring to Article 9 of the Convention. It also relied on Article 7 of the Law on Mental Health Care (see paragraph 67 below). 37. The court found valid the applicant’s complaints that the doctors had tried to dissuade (atkalbėti) her from meditating, attempted to alter her views on non-traditional meditation religion and had treated her against meditating and attending the Ojas Meditation Centre. That conclusion was based on the applicant’s medical file, which contained the following records for 26 May and 20 and 23 June 2003: “ ... absence of a critical attitude towards attending [the Ojas Meditation] Centre”; “during psycho-correction expressed opinion in categorical terms about attending the Ojas Centre, argues, that ‘it is a personal matter’”; “when efforts were made during psycho-correction to get the applicant to form a critical attitude (suformuoti kritiką) towards non-traditional religious beliefs, [the applicant] for a long time remained uncritical and also categorical”. The first-instance court underlined the fact that the psychiatric hospital had not provided any proof of the suggestion that practising a non-traditional religion would place the applicant or others in danger. The court thus concluded that “by attempting to alter the applicant’s attitude to non-traditional religion, meditation, and their practice at the Ojas Meditation Centre” the hospital had breached her right to freedom of religion. Lastly, the court rejected as legally irrelevant the hospital’s assertion that at the time of the applicant’s admission to hospital the meditation centre had been operating “unlawfully”. The Vilnius Regional Court observed that the religious movement had been a party to court proceedings for its registration at the time and had been registered on 12 April 2005. 38. After finding that between 9 May 2003 and 26 June 2003 the applicant had been placed in hospital and given treatment against her will in breach of domestic law (see paragraph 31 above), the Vilnius Regional Court considered that there had therefore been a breach of the applicant’s right to the inviolability of her body. Furthermore, Vilnius Psychiatric Hospital had failed to prove that it had properly informed the applicant about her state of health, her diagnosis, the methods of treatment and the prognosis for her condition (see paragraph 70 below). 39. However, the Vilnius Regional Court dismissed as unsubstantiated the applicant’s claims that she had been provided with inappropriate medical care at Vilnius Psychiatric Hospital and that the doctors there had forged her medical records. 40. The Vilnius Regional Court thus granted the applicant’s civil claim in full and awarded her 110,000 Lithuanian litas (LTL, approximately 31,850 euros (EUR)) in compensation for non-pecuniary damage. She was also awarded legal costs of LTL 1,000 (EUR 290). 41. Vilnius Psychiatric Hospital appealed. According to the hospital, there was no proof that doctor D.Š. had disclosed confidential information about the applicant’s acute psychosis and that she was being treated at the hospital. The doctor had merely given an opinion about an unidentified person. Moreover, the doctor had pointed out during the firstinstance hearings that she had only given her views when answering the questions the journalists had put to her. Three witnesses – the applicant’s mother, sister and the journalist R.S. – had explained during the firstinstance court’s hearings that the television programme had been initiated by the applicant’s relatives, who had provided information about the applicant. The first-instance court’s reference to studies in the United States as a way of identifying someone was not sufficiently weighty either, and such information was not protected under Article 14 of the Law on Mental Health Care. 42. As to the applicant’s right to freedom of religion, the hospital argued that the lower court had erred in equating meditation with religion. The fact that since February 2003 the applicant had attended meditation sessions of “unknown origin and manner (neaiškios kilmės ir pobūdžio meditacijas)” and that they could have been one of the reasons behind her illness, had not been denied. The hospital insisted that in February 2003 the Ojas Meditation Centre had been operating outside the law. The hospital also relied on a 29 August 2003 statement by the Ministry of Justice that Osho movement centres did not have the status of a religion (see paragraph 55 below), which supported the hospital’s view that meditation was not a religious practice. Accordingly, the applicant’s “fictitious” (tariama) religious freedom had not been breached. 43. The applicant responded by submitting that the right to privacy included the right not to have her health or other confidential information revealed to the journalists or her mother. The applicant added that when she had been in the psychiatric hospital, doctor D.Š. had persistently asked about the meditation she practised and had spoken of it with contempt. Doctor A.G. would tenaciously try to persuade her to denounce her religion and give up meditation. 44. On 20 March 2009 the Court of Appeal upheld the hospital’s appeal in part. 45. The appellate court upheld the Vilnius Regional Court’s finding that on the basis of her health on 7 May 2003 the applicant had been lawfully placed in Vilnius Psychiatric Hospital. Her condition that day had corresponded to the domestic legal requirements for involuntary hospitalisation (see paragraph 68 below). However, the hospital had not provided any evidence that her treatment from 8 May had been indispensable. It was therefore clear that as of that date her treatment at the hospital and her presence there had been involuntary and also amounted to an unlawful deprivation of liberty. The Court of Appeal relied on the Supreme Court’s practice in case no. 3K-3110/2004 of 11 February 2004 to the effect that it was obligatory to follow the procedure set out in Articles 16 and 28 of the Law on Mental Health Care, both when providing a patient with the necessary help (būtinoji pagalba) and when placing that person in hospital without his or her consent. Under that procedure, it had been possible to place the applicant in hospital and treat her without her consent for no longer than forty-eight hours. Without a court order, the forced hospitalisation and forced treatment had to be discontinued. However, there was no information in the case file that such an order had been granted. To make matters worse, the hospital had never even asked the court for such an authorisation. The Court of Appeal thus fully shared the lower court’s view that legal procedures had been outright disregarded, making the applicant’s stay in the hospital unlawful. 46. The Court of Appeal noted that under Article 22 of the Constitution and Article 14 of the Law on Mental Health Care, patients had a right to have information about their health kept confidential (see paragraphs 58 and 59 above). It could not be disclosed by doctor in charge of treatment or by hospital administration. 47. That being so, the Court of Appeal did not agree with the firstinstance court’s conclusion that doctor D.Š.’s interview with the journalists, which had been shown during the television programme of 17 June 2003, had disclosed information that had revealed the applicant’s identity. The appellate court relied on the Supreme Court’s ruling in case no. 3K-3-630/2004 of 24 November 2004, where it had found that in cases where there was no direct mention of a person in a publication, the process of identification was based on the aggregate evidence of the presence of features which could sufficiently describe the person in mind (see paragraph 63 below). In the particular case of the applicant, the Court of Appeal also referred to her open letter of 14 August 2003 to the Srovės journalists (see paragraphs 21 and 22 above), where she had acknowledged that the television broadcast had been instigated by members of her family, that she had not been shown in the programme in person, and that she had been given a different name. The Court of Appeal considered that the fact that the main character of the programme (laidos herojė) had studied in the United States was not sufficient to establish that the programme was about the applicant. As the applicant had not established that the information disclosed during the broadcast had allowed her to be identified, her claim for breach of privacy had to be dismissed. 48. Lastly, the appellate court rejected the applicant’s argument that her privacy had been breached because confidential information had been given to her mother. The applicant had been treated earlier in psychiatric institutions in Kaunas and Šiauliai because of mental health problems and her mother had been aware of those previous periods in hospital. Moreover, providing information to close relatives about the applicant’s health could not be regarded as a breach of her right to privacy. 49. The Court of Appeal noted that the right to freedom of religion had been enshrined in Article 26 of the Constitution (see paragraph 64 below) and Article 9 of the Convention. It also noted that under Article 7 of the Law on Mental Health Care, people in hospital had the right to perform religious rites. That right could be restricted by a psychiatrist’s decision only if there was a clear danger to the patient or others, and such restrictions had to be recorded in the patient’s medical file (see paragraph 67 below). 50. On the facts of the case, the Court of Appeal disagreed with the lower court’s conclusion that there had been a breach of the applicant’s right to freedom of religion while she was in Vilnius Psychiatric Hospital. For the Court of Appeal, there was no evidence in the file that the applicant had been forbidden from performing religious rites. Even though the medical records showed (yra matyti) that her doctors had tried to get the applicant to form a critical attitude towards her religious convictions (religinius įsitikinimus), there was no information that any restrictions had been applied to her. The Court of Appeal found that “the doctors’ attempts to get the applicant to form a critical attitude towards her religious convictions did not mean that [the applicant’s] religious freedom had been breached”. 51. The Court of Appeal upheld the lower court’s findings that there was no proof that the applicant had received inappropriate medical treatment. It also shared the lower court’s conclusion that Vilnius Psychiatric Hospital had not properly informed the applicant about the treatment she received therein. 52. Having dismissed part of the applicant’s complaints, the Court of Appeal lowered the award for non-pecuniary damage to LTL 20,000 (approximately EUR 5,800). The applicant was also ordered to pay Vilnius Psychiatric Hospital’s legal costs of LTL 3,202 (approximately EUR 927). Lastly, the appellate court quashed the part of the first-instance decision on the applicant’s costs being paid by the hospital so she had to bear the legal costs herself. 53. On 17 June 2009 the applicant submitted an appeal on points of law. She argued that the lower courts had failed to properly apply Convention norms on the right to privacy and freedom of religion. 54. By a ruling of 19 June 2009 the Supreme Court refused to admit the appeal for examination, holding that the applicant’s arguments were not sufficient to merit examination. 55. On 12 March 2003 the Ojas Meditation Centre applied to the Ministry of Justice to be registered as a religious community. On 29 August 2003 the Ministry of Justice rejected the application because it considered that although the Centre was on the “border between self-help psychology and religion (egzistuojantis savipagalbos psichologijos ir religijos paribyje)”, it should not be treated as a religious community. Even though the Osho teachings mentioned in the Ojas Meditation Centre’s by-laws were called religious, meditation there was more based on esoteric doctrines of self-improvement than on a religious practice whose main feature was connecting with God, gods or other sacred forms. The Ministry of Justice also noted that Osho movements did not have the status of a religion in western Europe countries. 56. The Ojas Meditation Centre then started court proceedings. Its action was eventually granted by the Supreme Administrative Court on 4 February 2005. The court found no evidence that the Ojas Meditation Centre propagated any controversial practices amongst its members. It was registered as a religious community (religinė bendruomenė) on 12 April 2005 (see Gineitienė v. Lithuania, no. 20739/05, § 24, 27 July 2010). 57. In her observations sent to the Court on 13 January 2015, the applicant stated that she had continued to that day to practise meditation at the Ojas Meditation Centre.