精神病人受审能力影响因素研究

目的探究精神病人受审能力的影响因素。方法对在四川大学华西基础医学与法医学院法医精神病学教研室进行法医精神病学鉴定的170名被鉴定人进行受审能力评定,评定研究对象的受审能力、精神症状,收集其人口学资料、犯罪学资料,采用统计描述、t检验、χ2检验、秩和检验和logistic回归分析等方法研究精神病人受审能力的影响因素。结果BPRS的思维障碍因子、激活性因子、PANSS的P分对受审能力具有显著影响;无受审能力组病理性和不明作案动机比例较高,且与有受审能力组相比差别具有统计学意义;无受审能力组言语智商低于有受审能力组,差别具有统计学意义;无受审能力组精神分裂症比例较高,差别具有统计学意义。结论BPRS的思维障碍因子、激活性因子、PANSS的P分、言语智商、精神疾病诊断、作案动机对精神病人受审能力具有一定影响。     

刑事强制医疗程序中“精神病人”之司法判定

新《刑事诉讼法》专门规定了强制医疗程序,确定了强制医疗的适用对象为“精神病人”,但是精神病人的认定不管是在理论界还是在实务界都存在诸多问题.“精神病”的概念有广义和狭义两个层面.人格障碍者和性变态者的刑事责任能力评定应从严掌握.强制医疗适用对象应包含无受审能力和无服刑能力的精神病人.司法上判定精神病人应将医学要件和法学要件结合起来.     

论被告人受审能力的鉴定——以美国法为参考

被告人受审能力制度具有仪式化和保护性功能。美国法经过近两百年的发展,在被告人受审能力程序和评价标准上积累了丰富经验。我国被告人受审能力现有规定立法分散、层次较低;内容过于简单;将被告人的诉讼行为能力等同于受审能力。可在被告人受审能力程序和评价标准方面借鉴美国法经验,构建我国被告人受审能力制度。     

受审能力探析

受审能力是被告人接受法庭审判的能力。我国对受审能力的研究还处于起步阶段,立法上还有许多空白之处。本文从评定标准、提起、确认与法律后果等方面对受审能力进行了探讨。     

精神病人的受审能力及相关因素的定量研究

精神病人的受审能力及相关因素的定量研究华西医科大学胡泽卿，刘协和，霍克钧，李焱前言受审能力是指一个人理解他被控告的性质和定罪可能给他带来的后果，以及他能够理智地支持他的律师为他辩护的能力。受审能力检查用于评估审判时被告人的精神状态。在许多国家的司法实...     

受审能力探析

受审能力是被告人接受法庭审判的能力。我国对受审能力的研究还处于起步阶段，立法上还有许多空白之处。本文从评定标准、提起、确认与法律后果等方面对受审能力进行了探讨。     

受审能力的法律辨析

目前司法领域对受审能力缺乏明确的立法规定，实践中也没有统一标准。本文就受审能力的适用于诉讼的范围、受审能力的二分法、评定程序等问题，从法律而非医学的角度来进行分析。以纠正目前对受审能力的部分错误认识。     

刑事受审能力的程序问题分析——由一个案例引发的思考

目次一、案情简介二、问题分析(一)刑事受审能力概述(二)国外刑事受审能力立法之考察(三)处置无受审能力被告人的相关程序问题(四)刑事受审能力与我国刑事诉讼一、案情简介被告人张某(女)与被害人杨某(男)系夫妻关系。某日,张某因琐事在租房内被杨某殴打,张即用一瓷杯朝杨的头部砸     

我国刑事诉讼中受审能力规则的功能反思与制度完善

域外国家围绕受审能力的规则建构，以“恢复能力”为导向，目的在于实现正当程序，强调不能以任何形式对无受审能力的被告人进行刑事审判，并通过衔接强制治疗程序促使被告人受审能力的恢复，最大限度实现惩罚犯罪与保障人权目的。我国刑事诉讼在重疾型缺席审判程序中引入受审能力标准，以“恢复审理”为导向展开制度设计，一方面在规范上引发法律条文之间的矛盾，另一方面在实践中导致立法目的不彰。完善我国刑事诉讼中的受审能力规则，应将其与缺席审判程序剥离，逐步转向与治疗程序的衔接。需强化对受审能力的司法判断，明确司法鉴定的启动条件及标准，通过引入专家陪审员制度补强法官在司法鉴定方面的知识短缺，进一步完善以无异议为例外的鉴定人出庭制度。     

论精神病人的民法监护——以民事强制住院司法实践为视角

目前．世界多数国家关于精神病人强制住院的立法都直接与广义上的监护法律相联系。监护制度在保护民事行为能力欠缺的精神障碍患者的身心安全和提供必要的住院及医疗措施方面发挥了重要作用。然而,由于我国关于精神病人监护制度的法律规定较为简陋和滞后,导致了实践中,特别是在涉及民事强制住院措施适用时,很多精神病人的人身自由和健康权益并没有得到有效照管,甚至受到严重侵害,由此引起的医疗纠纷和诉讼也日益增多。在此试图对我国精神病人民法监护制度进行解构分析,以期为进一步完善适合我国国情的精神病人监护制度和维护精神病人健康权益提供一些立法建议。     

女精神病人的性防卫能力鉴定

目的　研究女性精神病人性防卫能力的特点和司法鉴定中应该注意的问题 ;方法　对过去 1 0年间鉴定过的 64例案例进行回顾总结 ;结果　性防卫能力丧失最常见于年轻的衰退期青春型精神分裂症病人、中度以上精神发育迟滞病人、首次发病的年轻轻型躁狂症病人 ,而其他类型的精神病人不容易发生性防卫能力丧失。结论　严重的智能障碍和情感障碍对于精神病人的性防卫能力的丧失有决定性作用 ;而且 ,病人对性行为的控制能力障碍对精神病人性防卫能力丧失有重要影响作用     

女精神病人的性防卫能力鉴定

目的 研究女性精神病人性防卫能力的特点和司法鉴定中应该注意的问题;方法 对过去１０年间鉴定过的６４例案例进行回顾总结;结果 性防卫能力丧失最常见于年轻的衰退期青春型精神分裂症病人、中度以上精神发育迟滞病人、首发发病的年轻轻型躁狂症病人,而其他类型的精神病人不容易发生性防卫能力丧失。结论 严重的智能障碍和情感障碍对于精神病人的性防卫能力的丧失有决定性作用;而且,病人对性行为的控制能力障碍对精神病人性     

服刑能力司法精神鉴定研究

为探索服刑能力鉴定的相关因素 ,对102例服刑能力评定的案例进行分析研究 ,以自制的“服刑环境适应调查表”进行调查比较。结果发现精神病性障碍及以往有精神异常史者无服刑能力比率较高 ,且服刑环境适应能力差     

Restoring Responsibility: Promoting Justice, Therapy and Reform Through Direct Brain Interventions

Direct brain intervention based mental capacity restoration techniques—for instance, psycho-active drugs—are sometimes used in criminal cases to promote the aims of justice. For instance, they might be used to restore a person’s competence to stand trial in order to assess the degree of their responsibility for what they did, or to restore their competence for punishment so that we can hold them responsible for it. Some also suggest that such interventions might be used for therapy or reform in criminal legal contexts—i.e. to make non-responsible and irresponsible people more responsible. However, I argue that such interventions may at least sometimes fail to promote these responsibility-related legal aims. This is because responsibility hinges on other factors than just what mental capacities a person has—in particular, it also hinges on such things as authenticity, personal identity, and mental capacity ownership—and some ways of restoring mental capacity may adversely affect these other factors. Put one way, my claim is that what might suffice for the restoration of competence need not necessarily suffice for the restoration of responsibility, or, put another way, that although responsibility indeed tracks mental capacity it may not always track restored mental capacities.     

合同纠纷中精神障碍者民事行为能力评定

目的寻找并确证合同纠纷中精神障碍者民事行为能力评定的考量的指标。方法回顾性收集合同纠纷中精神障碍民事行为能力评定案例中被鉴定人相关资料;对所提炼民事行为能力评定应当考量的6项指标,即处境认识、争端理解、结果认识、信息利用、环境功能和决定交流进行评定与分析。结果纳入与精神障碍者民事行为评定相关的合同纠纷案例56例,所有案例中民事行为能力均实行三级划分,即完全民事行为能力、限制民事行为能力、无民事行为能力。合同类型主要集中于两类,与房屋相关合同38例,劳动合同14例。经统计发现各考量指标与专家鉴定结论的相关性较高,相关系数0．703～0．834,6项指标内部相关性高,相关系数0．712～0．877。结论合同纠纷中精神障碍者民事行为能力可实行三级划分,上述6项指标对精神障碍者的民事行为评定具有较强代表性,可以此为基础进一步开展民事行为能力评定标准化和量化研究。     

人身损害赔偿中精神障碍者民事行为能力评定

目的寻求并确证人身损害赔偿中精神障碍者民事行为能力评定的考量指标。方法回顾性收集司法部司法鉴定科学技术研究所2003--2005年的关于人身损害赔偿中精神障碍者民事行为能力评定案例中被鉴定人的相关材料,提炼出6个考量指标：处境认识、争端理解、结果认识、信息利用、环境功能和决定交流进行评定,并用SPSS11．5软件进行统计分析。结果考量指标与专家鉴定结论间的相关系数在0．632～0．876,考量指标间的相关系数在0．575～0．911。结论提炼的6个考量指标在人身损害赔偿中精神障碍者民事行为能力评定具有代表性,可以此为基础深入开展民事行为能力标准化评定及量化研究。     

Mental health legislation and human rights in England, Wales and the Republic of Ireland

In 2005, the World Health Organization (WHO) published its Resource Book on Mental Health, Human Rights and Legislation (Geneva: WHO) presenting a detailed statement of human rights issues which need to be addressed in national legislation relating to mental health. The purpose of this paper is to determine the extent to which revised mental health legislation in England, Wales (2007) and Ireland (2001) accords with these standards (excluding standards relating solely to children or mentally-ill offenders).Legislation in England and Wales meets 90 (54.2%) of the 166 WHO standards examined, while legislation in Ireland meets 80 standards (48.2%). Areas of high compliance include definitions of mental disorder, relatively robust procedures for involuntary admission and treatment (although provision of information remains suboptimal) and clarity regarding offences and penalties Areas of medium compliance relate to competence, capacity and consent (with a particular deficit in capacity legislation in Ireland), oversight and review (which exclude long-term voluntary patients and require more robust complaints procedures), and rules governing special treatments, seclusion and restraint. Areas of low compliance relate to promoting rights (impacting on other areas within legislation, such as information management), voluntary patients (especially non-protesting, incapacitated patients), protection of vulnerable groups and emergency treatment. The greatest single deficit in both jurisdictions relates to economic and social rights.There are four key areas in need of rectification and clarification in relation to mental health legislation in England, Wales and Ireland; these relate to (1) measures to protect and promote the rights of voluntary patients; (2) issues relating to competence, capacity and consent (especially in Ireland); (3) the role of “common law” in relation to mental health law (especially in England and Wales); and (4) the extent to which each jurisdiction wishes to protect the economic and social rights of the mentally ill through mental health legislation rather than general legislation.It is hoped that this preliminary analysis of mental health legislation will prompt deeper national audits of mental health and general law as it relates to the mentally ill, performed by multi-disciplinary committees, as recommended by the WHO.     

Coercion,competence, and consent in offenders with personality disorder

Competence to consent to treatment has not previously been examined in a personality disorder cohort without comorbid mental disorder. We examined competence and coercion in 174 individuals diagnosed with severe personality disorder using two validated tools (the MacArthur Competence Assessment Tool for Treatment and the MacArthur Coercion Assessment Scale – Short Form). Competence was not categorically impaired, but there were variations within the sample on dimensional competence measures. Further, there were significant negative correlations between experienced coercion and competence. Higher coercion scores were associated with two components of competence: lower understanding and reasoning. Patients who consented to treatment had higher scores on competence measures and experienced less coercion. These findings suggest that therapeutic approaches that decrease experienced coercion and increase competence may increase the engagement of individuals diagnosed with severe personality disorders in treatment.     

Client abilities to assist counsel and make decisions in criminal cases

Three studies of attorney-client decision making were conducted in a public defender office. In studies 1 and 2 a structured interview was used to debrief attorneys regarding clients' participation in their cases. Study 1 examined a sample of 200 felony and misdemeanor cases selected prospectively and resolved by any means (92.5% by plea); study 2 examined 200 felony and misdemeanor cases resolved by trial. Study 3 involved debriefing both attroneys and clients regarding perceptions of client participation in 35 recently closed felony cases. Attorneys doubted the competence of 8%–15% of clients charged with felonies and 3%–8% of clients charged with misdemeanors. In cases involving clients of doubted competence, attorneys often responded by means other than referral to mental health professionals for competence evaluations. As compared with clients whose competence was presumed, attorneys tended to view clients whose competence was doubted as less helpful and as less actively involved in their cases, but as actively involved in making key decisions. Defendants' perceptions appeared to be roughly consistent with attorneys' perceptions, allaying concerns that attorneys' reports may be distorted in order to conform to expected norms.     

Roman concept of mental capacity to make end-of-life decisions

When assessing decisional competence of patients, psychiatrists have to balance the patients' right to personal autonomy, their condition and wishes against principles of medical ethics and professional discretion. This article explores the age-old legal and ethical dilemmas posed by refusal of vital medical treatment by patients and their mental capacity to make end-of-life decisions against the background of philosophical, legal and medical approaches to these issues in the time of the Younger Pliny (c62-c113 CE). Classical Roman discourse regarding mental competency and "voluntary death" formed an important theme of the vast corpus of Greco-Roman writings, which was moulded not only by legal permissibility of suicide but also by philosophical (in modern terms, moral or ethical) considerations. Indeed, the legal and ethical issues of evaluating the acceptability of end of life decisions discussed in the Letters are as pertinent today as they were 2000 years ago. We may gain valuable insights about our own methodologies and frames of reference in this area of the law and psychiatry by examining Classical Roman approaches to evaluating acceptability of death-choices as described in Pliny's Letters and the writings of some of his peers.