Compulsory Medical Measures Combined with the Execution of Punishment

📘 GENERAL OVERVIEW

Article 98 of the Criminal Code of the Republic of Kazakhstan regulates the procedure for the simultaneous execution of a criminal punishment and compulsory medical measures (CMM). This is one of the key provisions applied to convicted persons who:

• suffer from mental disorders that do not exclude criminal responsibility;
• or are prone to sexual violence or have disorders of sexual preference, including cases where chemical castration is imposed.

📌 Main purpose: to ensure the execution of punishment together with medical intervention aimed at preventing recidivism and facilitating correction.

📑 ARTICLE-BY-ARTICLE ANALYSIS

🔹 Part 1 — CMM during the serving of punishment (Article 91, paragraphs 3 and 5)

🔸 Paragraph 3 of Article 91: persons who committed a criminal offense and suffer from mental disorders that do not exclude sanity.🔸 Paragraph 5 of Article 91: persons over 18 years of age who committed crimes against the sexual inviolability of minors.

Application:

• Compulsory medical measures (for example, outpatient psychiatric supervision, chemical castration) are carried out:
  • at the place of deprivation of liberty;
  • or in healthcare organizations if the punishment is not related to isolation from society (restriction of liberty, suspended sentence, etc.).

📌 This makes it possible to continue serving the sentence while simultaneously treating mental or behavioral disorders.

🔹 Part 2 — CMM under paragraph 4 of Article 91 (psychoactive substance dependence)

🔸 Paragraph 4 of Article 91: persons suffering from dependence on psychoactive substances (alcohol, narcotics, etc.).

Application:

• If the person is sentenced to deprivation of liberty — treatment is carried out at the place of serving the sentence (for example, through narcological offices at institutions such as LA-155/14, LA-155/18, etc.);
• If the punishment is not related to isolation (corrective labor, restriction of liberty, etc.) — treatment is provided in outpatient or inpatient healthcare facilities.

📎 Types of treatment may include:

• outpatient narcological therapy;
• psychotherapeutic and pharmacological courses;
• participation in rehabilitation programs.

🔹 Part 3 — Placement in an inpatient facility in case of deterioration of mental condition

“…in the event of a change in the mental condition of the convicted person…”

📌 If the condition worsens and inpatient treatment is required (for example, the development of acute psychosis or aggressive behavior):

• the person is transferred to a psychiatric inpatient facility;
• in accordance with the Law of the Republic of Kazakhstan “On Public Health and the Healthcare System” and the relevant orders of the Ministry of Health of the Republic of Kazakhstan (in particular, Order No. KR DSM-75/2020 dated 27 December 2020).

📎 This applies both to ordinary healthcare institutions under the Ministry of Health and to specialized psychiatric hospitals within the penal enforcement system.

🔹 Part 4 — Credit of treatment time toward the term of punishment

“…shall be credited toward the term of serving the punishment”

✅ Time spent in a medical institution (outpatient or inpatient) is credited toward the term of serving the punishment:

• on the principle of 1 day = 1 day of deprivation of liberty, similar to Article 97, Part 2 of the Criminal Code;
• this is essential for compliance with the principle of justice and for preventing double punishment.

⚠️ Condition: the treatment must be compulsory and imposed by a court decision; voluntary treatment is not credited.

🔹 Part 5 — Termination of CMM during the execution of punishment

“…upon submission by the body executing the punishment…”

📌 Termination of compulsory medical measures is possible:

• only by a court decision;
• on the basis of:
  • a submission from the penal enforcement institution (for example, a correctional colony);
  • a conclusion of a commission of psychiatrists (usually consisting of three or more specialists).

📎 Related procedure: similar to the procedure established by Article 96 of the Criminal Code and Article 437 of the Criminal Procedure Code of the Republic of Kazakhstan.

⚖️ PRACTICAL EXAMPLE

Case No. 2-1946/2022 (Shymkent)

A person was sentenced to 3 years of deprivation of liberty for committing indecent acts against a minor.By the court verdict, an additional compulsory medical measure — chemical castration — was imposed.Treatment was carried out at the place of serving the sentence.After 18 months, based on a medical conclusion, the pharmacological intervention was terminated ahead of schedule.The court canceled the compulsory medical measure, while the punishment continued unchanged.

📚 RELATED LEGAL PROVISIONS

🔸 Criminal Code of the Republic of Kazakhstan:

• Articles 91–97 — types, grounds, and termination of compulsory medical measures;
• Article 55 — postponement of punishment due to illness;
• Article 72 — conditional early release (parole) taking into account compulsory medical measures;
• Article 44 — probation supervision, including cases involving compulsory medical measures.

🔸 Penal Enforcement Code of the Republic of Kazakhstan:

• Articles 173–175 — implementation of compulsory medical measures;
• Chapter 23 — supervision, procedure for execution, and crediting of time served.

🔸 Law of the Republic of Kazakhstan “On Public Health and the Healthcare System”:

• provisions on compulsory psychiatric care;
• rules on transfer, discharge, and medical commission conclusions.

🌍 INTERNATIONAL STANDARDS

🔹 European Convention on Human Rights (Articles 3 and 5):

• compulsory medical measures are permissible only if:
  • a medical condition is proven;
  • there is a risk to society;
  • procedural safeguards are observed.

🔹 WHO and CPT (European Committee for the Prevention of Torture) recommendations:

• compulsory medical intervention is permissible:
  • only through a lawful judicial procedure;
  • only on the basis of a professional medical opinion;
  • for the shortest possible duration, with the right to periodic review.

✅ CONCLUSION

Article 98 of the Criminal Code of the Republic of Kazakhstan is an important element of the legal system that ensures a flexible and humane response to the combination of mental disorders and criminal liability. It:

• guarantees continuity of treatment without suspending the execution of punishment;
• ensures a balance between the protection of society and the rights of the individual;
• minimizes the risk of recidivism and deviant behavior among persons with mental disorders.

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