Facts of the Case

The applicant, Giuseppe Morabito, born in 1934, was a prominent figure in the Calabrian ‘Ndrangheta and convicted of being one of its leaders. He was arrested in 2004 and placed under the 41-bis regime, a special security measure under the Italian Penitentiary Act designed to prevent high-ranking mafia members from exercising influence over criminal organisations from behind bars. This regime is one of the strictest forms of detention in Europe. It severely restricts contacts with the outside world, visits, correspondence, access to communal activities, and even social interactions with other prisoners. The regime, while lawful in principle, is subject to strict judicial review and must be periodically renewed with updated evidence demonstrating its necessity.

For nearly twenty years, the Italian Ministry of Justice repeatedly renewed the application of section 41-bis to Morabito. During this period, his health deteriorated sharply. He suffered from multiple chronic conditions, including hypertension, prostate problems, arthritis, and hernias. Most importantly, he developed progressive cognitive decline, medically diagnosed as Alzheimer’s disease. His capacity for memory, reasoning, and communication deteriorated significantly, limiting his ability to function independently in daily life.

Despite numerous medical reports and repeated applications by the defence, domestic courts consistently rejected requests for a relaxation of detention measures, such as home detention, and continued to uphold the 41-bis regime. Their reasoning largely relied on Morabito’s historic criminal role and the generalised risk posed by mafia-type organisations, rather than on an individualised risk assessment.

In 2022, Morabito lodged an application with the ECtHR, alleging that his continued subjection to the 41-bis regime amounted to inhuman and degrading treatment, in breach of Article 3 of the Convention. His case echoed earlier ECtHR judgments such as Enea v. Italy (2009) and Provenzano v. Italy (2018), both of which scrutinised the compatibility of 41-bis detention with the Convention.

The Court’s Findings on the Merits

The Court structured its analysis around two central questions. The first was whether the applicant’s overall state of health was compatible with his continued detention. The second was whether the maintenance of the 41-bis regime, in light of his advanced age and cognitive impairment, constituted inhuman or degrading treatment.

On the first question, the Court found no violation of Article 3. It acknowledged that Morabito was a vulnerable detainee due to his age and illnesses. However, it noted that he received regular and adequate medical care while in prison. He had access to medical specialists, treatment was adapted to his condition, and there was no evidence that the authorities had neglected his health needs. In the Court’s assessment, although detention inevitably imposed strain, the threshold of Article 3 had not been crossed regarding his general medical treatment.

The second question proved decisive. By six votes to one, the Court held that there had been a violation of Article 3 in relation to the prolonged application of the 41-bis regime. The judges emphasised that while the regime was not unlawful per se, its continued imposition requires compelling, current, and individualised justification. In Morabito’s case, the Italian authorities relied almost exclusively on his past criminal role and the abstract dangers of mafia criminality. They failed to demonstrate concretely how, given his advanced cognitive decline, he could still maintain operational or symbolic control within his criminal network.

The Court stressed that Alzheimer’s disease is degenerative, profoundly impairing memory, communication, and decision-making capacity. In such circumstances, it was doubtful whether Morabito retained the agency necessary to pose a real threat. By neglecting to reassess this in light of medical evidence, the domestic authorities did not meet the high standards required under Article 3.

Furthermore, the Court considered the duration of the measure. Morabito had been held under 41-bis for nearly twenty years. The cumulative effect of such prolonged isolation, particularly on a prisoner with serious cognitive decline, constituted inhuman and degrading treatment. This reasoning echoed the Court’s earlier findings in Provenzano v. Italy, where the extended application of 41-bis to a terminally ill detainee was also found disproportionate.

As a remedy, the Court considered that the declaration of a violation was in itself sufficient just satisfaction for the moral harm suffered. No monetary compensation was awarded.

Dissenting Opinion of Judge Balsamo in Part

Judge Balsamo, sitting as an ad hoc judge, issued a separate opinion agreeing in part and dissenting in part. He concurred with the majority that there had been no violation concerning the adequacy of medical care in detention. However, he disagreed with the finding that the continued application of the 41-bis regime violated Article 3.

In his view, cognitive impairment does not automatically neutralise the capacity for influence within mafia-type organisations. He argued that mafia groups often operate through symbolic authority and hierarchical loyalty. Even a figure with diminished cognitive capacity might continue to inspire or direct subordinates, whether explicitly or implicitly. Thus, preventive measures such as 41-bis could remain justified.

Judge Balsamo further warned against an overly medicalised approach to dangerousness. He stressed that the assessment of risk must include criminological and sociological considerations, not only neurological evaluations. In his opinion, the Italian authorities acted within their margin of appreciation in continuing to apply the 41-bis regime, given the enduring threat posed by organised crime in Italy.

He therefore concluded that the continuation of the 41-bis regime, even in the specific circumstances of Morabito’s case, did not exceed the threshold of inhuman or degrading treatment. His dissent illustrates the persistent tension between security concerns and human rights protections in the Court’s jurisprudence.

Significance of the Judgment

The Morabito judgment represents a milestone in the ECtHR’s case law concerning the treatment of elderly and cognitively impaired detainees. It builds on earlier rulings such as Enea v. Italy and Provenzano v. Italy, but introduces a new dimension by directly engaging with the impact of neurodegenerative conditions on the justification for exceptional regimes.

The Court reaffirmed that Article 3 imposes an absolute obligation. States must ensure that detention conditions are compatible with human dignity, regardless of the seriousness of the crime. The ruling highlights three key principles:

1. Vulnerability as a legally relevant factor: Advanced age and cognitive decline increase the level of protection required under Article 3.
2. Necessity and proportionality of exceptional regimes: States must show, through updated and individualised evidence, that restrictions such as 41-bis remain indispensable.
3. Cumulative effects of prolonged isolation: Long-term imposition of restrictive regimes may in itself constitute inhuman or degrading treatment, particularly for vulnerable detainees.

The case also underscores the importance of judicial review. Italian courts repeatedly relied on generic reasoning rather than engaging with the applicant’s current medical state. This failure reflects a broader risk of mechanical renewals of exceptional regimes, a practice the Court explicitly condemned.

From a comparative perspective, the judgment aligns with a growing body of international human rights law recognising that deprivation of liberty must never result in deprivation of dignity. It echoes themes found in UN treaty body jurisprudence on the treatment of vulnerable prisoners and highlights the need for dynamic, evidence-based decision-making in detention contexts.

Conclusions

Morabito v. Italy reinforces the principle that security considerations cannot justify indefinite, automatic restrictions without rigorous and individualised justification. Even detainees convicted of the most serious offences retain their fundamental rights under Article 3.

The ruling confirms that Italy, and by extension all Council of Europe member States, must carefully review the necessity of special detention regimes, particularly when applied to elderly or cognitively impaired detainees. Past criminal conduct cannot indefinitely substitute for current risk assessments.

The judgment also highlights the role of the ECtHR in setting human rights standards for prison systems, pushing States to reconcile crime control policies with obligations under the Convention. For Italy, it will prompt reforms in how renewals of 41-bis are justified, requiring closer integration of medical expertise and human rights standards into judicial reasoning.

In broader terms, the decision illustrates the ECtHR’s increasing willingness to engage with issues of ageing, disability, and detention. It signals that conditions of detention must evolve in line with a prisoner’s health, and that human dignity remains the core standard by which all detention practices are measured.