ISSN:0951-7367    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0951-7367    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Purpose of reviewThe authors review the latest publications that deal with the legal aspects of dementia. The paper is mainly focused on competence assessment to give consent for medical treatment and for participating in research. Special attention is paid to the analysis of the elements that influence the decision to participate in research, particularly in decisions made by the caregiver when the patient is unable to consent. The indications of genetic testing, from an ethical point of view, are analysed.Recent findingsThe two major areas of research in the legal aspects of dementia are competence assessment and the ethical and legal implications of genetic testing. A significant number of research studies has appeared recently relating to the process of consenting to medical treatment and participating in research protocols.SummaryTwo different perspectives in competence assessment have been found: psychometric and functionalistic. In research and clinical practice a distinction has to be made between the moral and scientific problem. Elements of both are necessary, but one should not overlap the other.

ISSN:0951-7367    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Purpose of reviewThis paper deals with the situation of mentally ill patients in the prison system. In particular, aspects of the high prevalence of mentally ill inmates as well as care problems are discussed.Recent findingsThere are regional differences in the number of mentally ill individuals in the penal system, although the majority of inmates with severe mental illness can be returned to the community, sometimes even after years of inpatient psychiatric care. Considering all countries and diagnoses, prisoners tend to have a considerably higher prevalence of mental disorders than the general population. Care structures are frequently rated as being inadequate even inside penal institutions.SummaryThe large number of mentally ill inmates necessitates the further development of person-centered and need-oriented care structures inside and outside the criminal justice system for the purpose of prevention. It is important for research to compare all state systems that examine not only care aspects but also legal constructs such as criminal liability and the competence to stand trial.

ISSN:0951-7367    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Purpose of reviewPublic concern about violence by the mentally ill means that mental health professionals are increasingly called upon to assess the risk of violence in a wide range of client populations. The past year, like the previous few, has seen an increase in the number of articles on the topic.Recent findingsThe evidence favouring actuarial methods for appraising the risk of violence is increasing. There are, however, some professionals who still argue against their use, especially their exclusive use. One of the liveliest debates is the extent to which dynamic variables, especially those to do with treatment, can add to static variables in the prediction of violence. The available evidence suggests that dynamic predictors contribute little to the question of who is at greatest risk, but might be valuable in predicting when an individual at high risk is likely to offend. Several papers in the past year have compared the accuracy of two or more actuarial or other prediction instruments. Surprisingly, instruments often show little variation in predictive accuracy, although actuarial instruments frequently outperform non-actuarial instruments. Several articles have examined predictors of violence among civilly committed patients and other subgroups of violent individuals. Schizophrenia and psychotic symptomatology have been found to be negatively, if at all, related to future violence. The predictors of violence appear to be common across subgroups, follow-up periods, and definitions of violent recidivism.SummaryRisk assessments using empirically validated instruments can enhance public safety without increasing the number of individuals detained.

ISSN:0951-7367    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Purpose of ReviewThe introduction of compulsory community treatment has recently been proposed in England and Wales, despite the lack of evidence to suggest that it will be effective in either reducing risk or improving care. The proposed legislation includes provisions for all the principal types of involuntary outpatient treatment (IOT): diversion from hospital to compulsory treatment, conditional discharge, and preventive treatment. Controversially, the proposals also extend to those with personality disorders for whom effective treatments may be unavailable. Recent research on IOT, and its relevance to the proposals, is reviewed.Recent findingsIn the last year there have been further reports from the two RCTs of IOT, a new cohort study, and further debates about ethics and effectiveness. IOT continues to spread despite the failure of research to show clear benefits, and the new proposals for England and Wales raise issues not yet considered by systematic research.SummaryRandomized controlled trials of the proposed legislation are unlikely to be carried out. However, the question of the effectiveness of IOT remains important for research. Other possibilities for research include further database studies, and also work which develops concepts and measures, and models the interacting components of this most complex of interventions.

ISSN:0951-7367    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Purpose of reviewAfter describing the main ethical problems in the field of forensic psychiatry, articles published from May 2001 to the present are reviewed. Forensic psychiatry is a fertile ground in which ethical and legal problems exist, and to be updated with these issues is a fundamental task for forensic practitioners.Recent findingsThis review covers the current discussion on the ethical framework of the specialty, the evolution of the duty to protect, the competence and capacity assessment, the new legislation on euthanasia and physician-assisted suicide, and the ethical problems of psychiatric research.SummaryIt is concluded that more attention should be paid to improvements in the field, as the discussion is still very limited and there have been no major advances. Critical issues, such as the development of the ethical framework in the forensic field and research with prisoners, are in need of development.

ISSN:0951-7367    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

More than 700 persons have been executed in the USA over the past 25 years. Notwithstanding the codes of ethics of the American Medical Association and the American Psychiatric Association, which prohibit participation in legal executions, physicians have indeed participated in one way or another in most, if not all, of these cases. Given that state laws preclude the disciplining of participating physicians on the grounds that participation in executions is not considered the practice of medicine and that in no instance has a participating physician been disciplined by a medical society, it is our view that nothing less than abolition of capital punishment can bring to an end the unethical participation of physicians in executions.

ISSN:0951-7367    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Purpose of reviewIn recent years, sequels to torture as a specific and frequent form of social violence have become a major focus of research and clinical practice. A shift in attention from physical to short and long-term sequels has been followed by a large number of studies that have demonstrated sequels to be highly prevalent in different populations and that the scale of the problem has been underestimated before. The review focuses on forensic aspects of political torture.Recent findingsStudies published over the last years are characterized by the increasing use of structured criteria and interviews, but also by a growing understanding of torture as a phenomenon that is embedded in other negative live events and culture-dependent reactions that might contribute to the severe suffering of many survivors. This makes forensic evaluation but also rehabilitation a complex challenge. Epidemiological studies underline that torture and persecution-related sequels are partly covered by the post-traumatic stress disorder concept, but a too narrow focus on the combination of this causal link and torture as an isolated act might not do justice to all factors. The lack of integration of psychological with psychophysiological imaging and somatic findings reflects the present focus on epidemiological approaches that are necessary for a culture-sensitive and community-oriented approach to support the victims, but require an additional focus in future forensic research.SummaryForensic evaluation of sequels to torture is still a developing field in spite of excellent recent studies. Psychiatrists must be careful to avoid retraumatization and respect the survivor, while following an open approach to the possible complex physical and psychological sequels that cannot be reduced to a simple universal model.

ISSN:0951-7367    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0951-7367    

出版商:OVID    

年代:2002

数据来源: OVID