论法医临床鉴定中被鉴定人的知情同意权

临床医学中的知情同意权是医学实践中由基本伦理上升为受法律保障的患者权利,通过告知同意书的契约形式表达。法医临床鉴定中的被鉴定人与医疗体系中的患者具有类似的法律地位,但尚无相应的法律法规赋予被鉴定人知情同意权。笔者建议法医临床学鉴定中可赋予被鉴定人一定的知情同意权,在与鉴定机构的契约化关系下,参与鉴定过程,知悉必要的鉴定信息,并对鉴定意见有选择性同意权,从而实现司法鉴定程序的公平、正义。     

Quality Control System of Judicial Expertise in China

正The current quality control system of judicial expertise in China For a long time in China,the administrative organization of justice has been subordinate to universities,Ministry of Public Health,Ministry of Public Security,the Procuratorate,the Court and National Security Agency.These administrative organizations are mainly in charge of the management of judicial expertise.The quality control system     

THE SCIENTIFIC BASIS OF PSYCHOLOGICAL TESTING

The legal standards for admissibility of expert testimony have recently been raised following several U.S. Supreme Court decisins. Although forensic mental health experts have relied on psychological testing as a method of data collection for many years, the scientific basis of such testing has traditionally gone unquestioned in court. Given the increased scrutiny currently being applied to expert testimony, it is more important now than ever for attorneys, judges and forensic experts to understand the scientific principles underlying psychological tests. In this article, the scientific principles of validity and reliability are explained, and scientifically acceptable methods for the forensic use of psychological testing are discussed. The application of recent case law to several well-known tests is described.     

Criminal law and mentally ill offenders in comparative perspective

Abstract

In this stick we compare legal arrangements dealing with mentally disordered offenders in the criminal law systems ct Belgium, Canada, Germany, the Netherlands, Norway, Sweden, and the United Kingdom. To describe relevant diffesenoes and similarities in the arrangemeats, we used a checklist containing antral aspects of adjudication, assessment and treatment of mentally ill offenders. These aspects concern: (1) the legal classifications of mental illnesses that can lead to exclusion of criminal responsibility: (2) the acceptance of diminished capacity as a partial excuse; (3) the possibilities for imposing security measures of compulsory treatment instead of or next to criminal punishment; (4) the conditions for their imposition in terms of seriousness of crimes committed and dangerousness of offenders; (5) the available hospitals or special clinics for executing security measures; (6) the role and task of forensic mental health professionals in assessing the offender's state of mind and in advising compulsory treatment; (7) the rules for duration, prolongation and termination of the measures. The findings of this comparative analysis are evaluated in light of legal protection for mentally disordered offenders.     

Assessing change in dynamic risk factors in forensic psychiatric inpatients: relationship with psychopathy and recidivism

This study explored change in dynamic risk for violence using the Clinical and Risk Management subscales of the Historical Clinical and Risk Management-20 version 3 (HCR-20 v3) and sought to determine whether change was associated with violent recidivism. The association between the magnitude of change and psychopathy was also assessed. Participants were 40 male (n = 32) and female (n = 8) forensic psychiatric inpatients discharged from a secure forensic mental health service. Results showed that participants significantly improved on the HCR-20v3 Clinical subscale but significantly worsened on the Risk Management subscale. Psychopathy was unrelated to change in Clinical and Risk Management subscales. The hypothesis that changes in dynamic risk would predict recidivism over and above total pre-treatment risk (HCR-20v3 Total score) and psychopathy was not supported. These results suggest that improvements in mental state risk factors alone are insufficient with regard to lowering violence risk.     

The Empirical Limits of Forensic Mental Health Assessment

This article introduces a special issue of Law and Human Behavior, including five articles describing the limits of forensic mental health assessments of (a) risk of violence in female adolescents, (b) sexually violent predators, (c) dangerousness in capital murder cases, (d) child sexual abuse, and (e) PTSD litigants. Knowing the limits of forensic mental health assessment methods is essential in order to recognize their strengths, increase the credibility of forensic mental health assessment, and drive research that will enhance the value of assessments for the courts.     

患者死亡医疗纠纷司法鉴定24例分析

目的探讨涉及患者死亡医疗纠纷的过错成因,分析其司法鉴定的切入点。方法收集了涉及患者死亡且多次鉴定的医疗纠纷案例24例,从一般情况、科室分布、责任程度划分以及差错分析等方面进行了总结和分析。结果此类案例在技术方面存在患者自身疾病隐匿、接诊部门处理过程简单、科室之间配合不力、紧急情况下措施不果断等问题。此外,告知义务的履行、转诊时机把握以及常备抢救设施的维护等管理方面漏洞也是医疗纠纷的多发环节。结论本文可为进行此类医疗纠纷的司法鉴定提供帮助,也为避免纠纷的发生提供参考。     

河南省刑事案件司法精神病学鉴定案例的随访研究

目的研究司法精神病学鉴定后各方对结论及处理的看法及社会影响等随访因素。方法作者通过通信函调、电话随访和登门拜访等三种方法,用自编调查表对208例鉴定案例分别向委托机关、被鉴定人本人或家属、受害人本人或家属进行随访。结果被鉴定人受教育年限平均为4.84年,以30岁左右已婚男性农民居多。暴力犯罪(129例占83.77%)远较非暴力犯罪(25例占16.23%)为多,前者又尤以杀人(44例占28.57%)为最常见。本资料再鉴定率为2.93%。被鉴定人及其家属对34例无责任能力的处理意见认为恰当的占76.47%,对判为无罪释放的28例,认为处理恰当的占71.43%,认为不恰当的占10.7%。对就医者几乎全都满意,对判刑或关押的认为恰当与不恰当者各占43.18%。受害人目前现状为死亡7例,残废10例,恢复健康10例。被鉴定人及其家属的意见与司法机关认为案件引起的社会影响似乎无关。被司法机关无罪释放的41例(26.62%)被鉴定人中,再杀人2例(4.87%),放火2例(4.87%),盗窃2例(4.87%),回归社会后有破坏行为但尚未构成犯罪者3例(7.31%)。结论建议政府有关部门尽快建立违法犯罪精神病人的监管和医疗机构。     

Kumho, Daubert, and the nature of scientific inquiry: implications for forensic anthropology

In the last 15 years, the US Supreme Court has implemented major changes concerning the admittance of expert testimony. In 1993, Daubert v. Merrell Dow Pharmaceuticals superseded the Frye ruling in federal courts and established judges, not the scientific community, as the gatekeepers regarding the credibility of scientific evidence. In 1999, a lesser-known but equally important decision, Kumho Tire v. Carmichael, ruled that technical expert testimony needed to employ the same rigor as outlined in Daubert, but experts can develop theories based on observations and apply such theories to the case before the court. Anthropology has never been defined as a hard science. Yet, many recent publications have modified existing techniques to meet the Daubert criteria, while none have discussed the significance of Kumho to anthropological testimony. This paper examines the impact of Daubert and Kumho on forensic anthropology and illustrates areas of anthropological testimony best admitted under Kumho's guidance.     

72例情感性精神障碍司法精神病鉴定分析

目的 探讨情感性精神障碍患者作案特征.方法 对杭州市公安局安康医院2000-2004年鉴定的72例情感性精神障碍案例进行分析.结果 情感性精神障碍患者作案与发作次数有一定关联性,躁狂症与抑郁症危害行为有统计学意义(P<0.01).情感性障碍患者作案特征与精神分裂症不同,主要是作案的病理性动机较少,现实动机较多.结论 反复发作是情感性精神障碍患者作案的预警性指标.在作案特征上与精神分裂症有各自不同的特点,可能与病因、病情发展、症状表现和严重程度等差异有关.     

简易精神症状自陈量表对主观夸大精神症状的测试分析

目的 应用简易精神症状自陈量表检测法医精神鉴定中主观夸大精神症状的情况,并分析其测试结果。方法 对206名不同类型的法医精神鉴定的被鉴定人用该量表进行检测．并由两名鉴定专业人员对被鉴定人是否有主观夸大精神症状分别进行评定。结果 （1）以该量表判断主观故意或夸大精神症状的划界分（13分）对测试的被鉴定人进行检测,206例被鉴定人中有71例被判定为主观夸大精神症状（34．5％）。与专家评定的结果相比,量表评定的假阴性为19．8％,假阳性率为1．7％;总准确率为90．8％。（2）工伤和交通事故精神伤残理赔鉴定案例主观夸大精神症状的比例较高（51％）。结论 简易精神症状自陈量表是检测主观夸大精神症状的有效评定工具。     

Perceptions and use of videoconferencing in forensic mental health assessments: A survey of evaluators and legal personnel

ABSTRACT

The use of videoconferencing (VC) to conduct forensic mental health assessments (FMHA) is increasing. Yet, little is known about its acceptability among clinicians or legal professionals. In Study 1 (N?=?156), forensic evaluators were asked about their use of VC, reasons for its use, and opinions about the validity, usefulness, ethics, and legality of its use. An estimated one-third of evaluators have used VC in the past. Although evaluators overall expressed moderate concern over the ethics and legality of use, prior experience appeared to mitigate concerns. Younger practitioners were also more open to using VC. Reduced costs for courts was the most frequently endorsed benefit associated with VC, while restricted ability to administer psychological testing and potential technological problems were seen as the biggest disadvantages. In Study 2 (N?=?27), attorneys and judges were surveyed about frequency with which they encounter VC for FMHA and their perceptions about the validity of those assessments. Findings indicated legal personnel expressed rather negative views without having much first-hand experience of VC, including concerns about establishing rapport and technical difficulties. These studies have implications for whether VC will be adopted more frequently in FMHA.     

Quality of criminal responsibility reports submitted to the Hawaii judiciary

This paper is the third in a series of research reports on quality of forensic mental health evaluations submitted to the Hawaii judiciary. Previous studies examined quality of reports assessing competency to stand trial (CST) and post-acquittal conditional release, in felony defendants undergoing court-ordered examinations. Utilizing a 44-item quality coding instrument, this study examined quality of criminal responsibility reports in a sample of 150 forensic mental health evaluations conducted between 2006 and 2010 by court-appointed panels. Raters attained high levels of agreement in training and quality coding. Similar to the previous studies, overall quality of reports was mediocre, falling below the .80 quality criterion score for report elements, regardless of evaluator professional identification or employment status. Level of agreement between evaluators and judicial sanity determinations was “fair” using Cicchetti's (1994) standards for interpretation of intra-class correlations. Level of agreement was lower than previously published findings for CST reports and better than conditional release reports. Reasons for mediocre report quality and “fair” inter-rater agreement are discussed, including the fact that criminal responsibility evaluations are complex, retrospective in nature, and involve significant degrees of inference. In contrast to CST evaluations, assessment of criminal responsibility involves a mental state at the time of the offense evaluation. Threats to reliability in forensic reports are discussed. Suggestions for improvement of report quality are proffered, including standardization of procedures and report format and use of forensic assessment instruments.     

Using the National Diabetes Audit to improve the care of diabetes in secure hospital in-patient settings in the UK

To examine the ability of two forensic units, one high secure and one medium secure, to meet the NICE (National Institute for Health and Care Excellence) standards of care for diabetes. We applied the National Diabetes Audit programme, which uses as standards the NICE guidelines, to assess the quality of care provided for patients in two forensic units. Of the 500 patients, 200 in high secure and 300 in medium secure, 88 (17.6%) had type 2 diabetes. None had Type 1 diabetes. Of those with Type 2 diabetes, the care of 74 (84%) met all 8 NICE recommended standards. Glucose levels were lower in the medium/low secure unit compared to the higher security environment. Whilst achievement of process-based outcomes was higher than those reported nationally, achieving clinical outcomes was more challenging. High-quality diabetic care can be provided for patients in forensic units. Benchmarking physical health outcomes against national criteria in mental health inpatients is a potential method of improving outcomes.     

Perceptions of Older Adult Eyewitnesses: Will You Believe Me When I'm 64?

Participant-witnesses (young adults/young seniors/older seniors) viewed one of two versions of a simulated videotaped crime (crime context either familiar to young or older adults). The witnesses were videotaped responding to direct and cross-examination questions about the video. The older seniors were significantly less accurate than the young adults and young seniors. Familiarity of the crime context did not affect testimony accuracy. However, the older seniors were more verbose when describing a familiar context. Participant-jurors viewed the testimony videotapes and evaluated the witnesses' credibility. All witnesses were regarded as equally credible in testifying and less accurate in response to cross-examination questioning.     

新冠肺炎疫情下司法精神医学鉴定的应对

新冠肺炎疫情已被公认为全球性重大挑战。已经、正在,同时仍将对人类社会的诸多方面产生深远的影响。新冠肺炎疫情下司法精神医学鉴定面临诸多挑战,通过梳理疫情下已实施的有关司法鉴定方面的做法、经验,分析涉疫情主要犯罪类型,开展司法精神医学远程鉴定具有必要性和可行性。但应关注其局限性,实施之前应制定相应的操作规范。     

Sexual assault complainants on the stand: a historical comparison of courtroom questioning

Because most cases of alleged sexual assault involve few sources of evidence, the complainant’s testimony is crucial. In line with empirical research findings, the way in which police question sexual assault complainants has evolved to ultimately maximise both the completeness and accuracy of evidence. But has courtroom questioning changed over time? To answer this question, we compared the courtroom questioning of sexual assault complainants in the 1950s to that used in cases from the turn of the twenty-first century. Overall, lawyers in contemporary cases asked complainants more questions and uttered more words than they did historically. Complainants, too, appear to have become more vocal over time. Across the two time periods, the questioning style used by prosecuting lawyers has shifted towards a more open style. In stark contrast, the format of cross-examination questions has remained remarkably consistent over time, with leading questions still making up the bulk of the questions asked. These findings have important implications for future legal reform and legal practice.     

Forensic mental health assessment in France: Recommendations for quality improvement

The quality of forensic mental health assessment has been a growing concern in various countries on both sides of the Atlantic, but the legal systems are not always comparable and some aspects of forensic assessment are specific to a given country. This paper describes the legal context of forensic psychological assessment in France (i.e. pre-trial investigation phase entrusted to a judge, with mental health assessment performed by preselected professionals called “experts” in French), its advantages and its pitfalls. Forensic psychiatric or psychological assessment is often an essential and decisive element in criminal cases, but since a judiciary scandal which was made public in 2005 (the Outreau case) there has been increasing criticism from the public and the legal profession regarding the reliability of clinical conclusions. Several academic studies and a parliamentary report have highlighted various faulty aspects in both the judiciary process and the mental health assessments. The heterogeneity of expert practices in France appears to be mainly related to a lack of consensus on several core notions such as mental health diagnosis or assessment methods, poor working conditions, lack of specialized training, and insufficient familiarity with the Code of Ethics. In this article we describe and analyze the French practice of forensic psychologists and psychiatrists in criminal cases and propose steps that could be taken to improve its quality, such as setting up specialized training courses, enforcing the Code of Ethics for psychologists, and calling for consensus on diagnostic and assessment methods.