After Spivak: Towards a distinct ECHR framework for non-consensual psychiatric treatment

The European Court of Human Rights (ECtHR) has developed detailed standards for involuntary psychiatric detention. Its treatment case law is less coherent: the relevant principles are dispersed across Articles 3, 5 and 8 of the European Convention on Human Rights (ECHR). This article asks whether Spivak v Ukraine (2025), read with the earlier authorities, marks the emergence of a distinct body of standards for psychiatric treatment administered without valid consent. It argues that the judgment brings four requirements into a closer relationship: a legal basis directed to treatment itself; an individualised demonstration of necessity that addresses the person's consent or refusal; current evidence open to independent examination; and timely review of the treatment decision. This is an interpretative reconstruction, not a test expressly formulated by the Court. Article 3 cannot give these requirements a general field of application because it applies only when the minimum level of severity has been attained. Article 8 should therefore govern the ordinary examination of treatment without valid consent. Article 5 would continue to govern detention and its therapeutic purpose, while Article 3 would supply additional absolute protection. The UN Convention on the Rights of Persons with Disabilities (CRPD) is used as a critical benchmark. It tests whether the ECHR approach adequately addresses equality, support in the exercise of legal capacity and institutional reliance on coercion; it does not automatically determine the meaning of the ECHR.