Ethical issues in child and adolescent forensic psychiatry: a review

Ethical challenges in child and adolescent forensic psychiatry arise, on the one hand, from the dilemmas commonly faced in forensic psychiatry with adult patients, such as the dual role of the forensic psychiatrist, questions of criminal responsibility, autonomy and competence and involuntary treatment, and, on the other, from the immaturity and dependent position of the minor. Child and adolescent forensic psychiatry deals with minors involved in crime, not only as offenders, but also as victims. In this review, we attempt to describe ethical challenges in child and adolescent psychiatry using as a frame of reference the principles of biomedical ethics according to Beauchamp and Childress.     

法医学研究中的伦理审查建设

法医学研究伦理审查既是法医学研究管理工作的内容,也是法医学研究的对象,本文针对法医学研究中的伦理审查问题,论述开展伦理审查的必要性,并对法医学研究伦理审查委员会建设指导原则进行探讨,呼吁开展伦理审查建设。     

Legal and ethical considerations of forensic anthropological research

In the UK, Forensic Anthropology is maturing rapidly, consequently demanding discussion of previously overlooked yet fundamental principles of this discipline. UK law and ethics are interpreted from a forensic anthropological standpoint. First, the influence of UK law and ethics on the stages of forensic anthropological research (the collection, analysis and storage of human remains) are discussed. Existing ethical codes of conduct are investigated for their relevance to researching forensic anthropologists. It is concluded that: when appropriately interpreted, UK law and ethics are extremely influential on forensic anthropological research; debate within this area is required; and that an understanding of the law and ethical thought is vital for the successful growth of forensic anthropology in the UK.     

Three faces of justice: Competing ethical paradigms in forensic psychiatry

Respect for justice has traditionally been an essential principle of health care ethics. However, many bioethical accounts of justice focus only on distributive justice, and how resources for health care should be allocated. In this article, I will argue that the practice of forensic mental health care requires clinicians to engage with justice in three additional and different ways: justice as liberty and fairness; retributive justice and protection of the vulnerable; and justice as the promotion of virtue. I will argue that British forensic psychiatry favours retributive and protective justice; in contrast to a libertarian approach to forensic practice in the United States. I discuss how respect for justice as support for virtue complements therapeutic work with offenders, which aims at the development of pro‐social character. I will conclude that without respect for justice as virtue, there is a danger that clinical forensic psychiatry risks doing harm to patients and bringing the profession into disrepute.     

法医精神病鉴定内容架构及评定要点解析

法医精神病鉴定在刑事、民事和行政三大诉讼领域中,以鉴定意见的证据形式发挥着重要作用。然而,与其重要性不相匹配的是,法医精神病鉴定学科发展尚不完善、专业发育尚不成熟,尚不能满足社会和民众的期盼和要求,甚至引发负面评价。为进一步促进法医精神病鉴定规范化、标准化建设。以法医精神病鉴定人的视角,结合法医精神病鉴定的内容架构,重点阐述法医精神病鉴定主要项目及其作用、评定要点,尤其聚焦刑事责任能力评定,阐明当前存在分歧和困难;简要介绍法医精神病鉴定人执业要求、法医精神病鉴定质量控制;以及简述法医精神病鉴定与临床精神医学实践的区别与联系。     

Why call someone by what we don't want them to be? The ethics of labeling in forensic/correctional psychology

Labeling a person by their past behavior or a criminal conviction is commonplace throughout forensic and correctional psychology. Labels including ‘offender’ and ‘sex offender’ infiltrate academic writing and conference presentations, names of professional organizations and treatment programmes and, at times, traverse therapeutic work. That such labels are frequently used and rarely advocated against suggests that helping professionals either (i) don't recognize labeling as an ethical issue, or (ii) don't consider it their role to challenge. The current paper aims to encourage critical reflection on the use of labels in forensic and correctional psychology. Key concerns are illustrated through a focus on labels commonly assigned to individuals who have sexually abused, where labeling is especially prolific. The scope of labeling is reviewed, and implications for rehabilitation and reintegration discussed. Next, an analysis of the ethics of labeling individuals on the basis of criminal convictions, past behavior or psychological phenomena is presented. It is argued that the use of such labels contradict core ethical principles including beneficence and nonmaleficence, respect for the dignity of all persons, and responsibilities to society. A de-labelling movement for forensic/correctional psychology and related fields is proposed.     

法医学鉴定实践中的伦理考量

法医学鉴定的对象是人及与人相关材料,因此在法医学检案实践中需要考虑伦理问题。基于法医学鉴定中的公平正义、尊重、真相告知三大基本原则,进一步衍生出法医学检案实践活动的具体伦理要求,即法医学鉴定的称职性、对鉴定涉及案件及其当事人伦理考虑、如何处理案件检材。然而当前法医学鉴定却存在部分法医鉴定人不称职、重技术轻程序、鉴定机构选择出现争议、利益输送与利益冲突等问题。笔者针对以上问题提出相应对策,并重点讨论三大矛盾,保证法医学鉴定称职性。     

Creating a State‐Academic Partnership to Advance a Forensic Teaching Service: Benefits and Barriers

In Washington State, like many states, there is a shortage of forensically trained mental health clinicians to work with criminal justice‐involved individuals. At the direction of the state legislature, a collaborative project was undertaken by the University of Washington, the state Department of Social and Health Services, and a state psychiatric hospital to develop a proposal for a jointly sponsored forensic teaching service. The authors reviewed the literature, surveyed and interviewed forensic psychiatry and psychology training directors, and conducted site visits of selected training programs that offer multidisciplinary training or have affiliations with state hospitals. The authors conducted focus groups of additional stakeholders, including clinicians and patients in forensic settings, to better understand the needs in Washington. The authors report on several common benefits and barriers to establishing forensic teaching services. Other states and forensic programs may find this article useful in identifying common considerations for forensic mental health teaching services.     

精神损伤的研究现状

关于精神损伤的法医精神病学鉴定争议较大,相关研究成为法医精神病学界的热点。为此,我们对精神损伤的相关概念、法律依据、鉴定中的几个难点问题进行了简要的综述,特别提到颅脑外伤后精神损伤的鉴定,希望能为精神损伤的研究提供一些思路。     

Failings of Trauma‐Specific and Related Psychological Tests in Detecting Post‐Traumatic Stress Disorder in Forensic Settings

Judges and juries tend to be particularly impressed by test data, especially quantitative test data. Psychometric tests specific for assessing the presence of post‐traumatic stress disorder (PTSD) are commonly employed by forensic mental health evaluators. Most of these instruments, however, have been designed to detect PTSD in treatment or research, and not forensic, settings. Those who rely on these measures without adequate awareness of their often significant limits in correctly identifying malingering may induce finders of fact to inordinately confidently accept the presence of PTSD. This article reviews problematic structural and content components of trauma‐specific and related instruments used to evaluate PTSD and discusses the utility of specific techniques liable to be used in forensic settings to “fool” these measures.     

刑事责任能力评估工具在司法精神病鉴定中的应用

目前,我国刑事责任能力采用三分法,分为完全责任能力、限定责任能力和元责任能力.但在司法精神病鉴定工作中,由于缺乏客观标准,三者的区分尚带有较大主观性,常导致不同鉴定人对同一案例的责任能力判定存在分歧.因此,刑事责任能力的评定一直是司法精神病鉴定亟待解决的难题.本文综述了在司法精神病鉴定中使用的几种责任能力评定量表及其应用情况,认为虽然目前这类量表的信度和效度存在争议,但其对提高鉴定结果的科学性、客观性提供了一种良好思路.     

The Value of Crime Scene and Site Visitation by Forensic Psychologists and Psychiatrists

Site visits and crime scene visitation by forensic psychologists and psychiatrists may enhance the accuracy and credibility of their forensic work in criminal, civil, and other important contexts. This ethically sound technique of after‐the‐fact data collection and verification offers numerous potential benefits to the forensic mental health professional: clarifying the subject's actions, assessing the reliability of witness reports, identifying contextual determinants of behavior, and more fully illuminating subject motivation and decision‐making. Limitations and suggested guidelines for conducting site visits are offered. Guidelines include preplanning, arranging for an informed guide to accompany and narrate the visit, and conducting the site visit prior to forensic examinations.     

Characteristics of male patients admitted to an adolescent secure forensic psychiatric hospital

This paper examines the characteristics of a group of 64 young men, who were consecutively admitted to Bluebird House, an NHS mixed gender, adolescent forensic, medium secure hospital. The characteristics examined focus on the young men’s clinical presentations, as informed by the Millon Adolescent Clinical Inventory, and their ICD10 (WHO 1992) diagnoses. The paper also examines the males’ route into, and out of, Bluebird House, as well as their risk profiles, especially with regards to others, as informed by Structured Assessment of Violence Risk in Youth findings and staff recorded incidents. Correlational analysis is performed to try and understand this population, with statistically significant findings highlighted. The discussion considers the trajectory for some of these young men into adult personality disorders, their presentation and prognosis compared to their female counterparts, and how their presentation contrasts with adult male forensic populations.     

损伤导致精神损伤程度评定标准的研究

目的探讨损伤导致精神障碍损伤程度评定标准。方法受理的297例损伤导致精神障碍损伤程度的法医学鉴定资料进行回顾性研究。结果297例中,重伤91例,轻伤93例,轻微伤44例,伤病关系评定69例。结论通过对297例精神损伤程度司法鉴定的分析,提出了具体的可操作性强的评定标准,以期在实践中进一步完善。     

Arsonists Suffering From Schizophrenia—A Description in Comparison with Other Offenders with a Similar Diagnosis

This study aims to describe the small and distinct subgroup of arsonists diagnosed with schizophrenia, their motives, personal, and crime scene characteristics. While prior research identified significant differences to other criminals, firesetters in general, or mentally disordered offenders, there are no comparisons with other offender patients with schizophrenia so far. In a forensic institution in Switzerland, a group of 30 arsonists with schizophrenia spectrum disorder (SSD) was compared to 340 other offender patients with SSD using retrograde file analysis and multiple adapted Fisher´s exact tests. While symptoms of SSD were most defining of both groups, arsonists with SSD were more often single, unemployed, prescribed psychiatric medication at index offense, had a smaller variety of criminal motives, and acted out of anger or revenge in the context of a relationship. In conclusion, symptoms of SSD may be more defining and useful in guiding clinical practice than aspects specific to arsonists.     

Teaching police ethics: analysis of an increasingly complex teaching context

ABSTRACT

The importance of ethics in policing and, therefore, in police education and training, is widely acknowledged. Nonetheless, disagreement often exists about the ways in which police ethics subjects should be taught and who should teach them. In this paper, three areas of debate will be critiqued, with the aim of arriving at principled responses to the underlying issues. The first issue will be whether police ethics subjects should include any ethical theory and, if so, to what extent. Related to this, but also a distinct issue in itself, is the question of whether standalone police ethics subjects should be valued over dispersing ethics learning throughout a police curriculum (e.g. as a ‘golden thread‘ running through every subject). Finally, the question of who should teach police ethics subjects will be considered. Here, the issues largely revolve around the relevant significance of philosophical expertise, knowledge and critical analysis as compared to policing expertise. Importantly, the principled responses developed in the paper will not only be theoretically sound. They will also take account of the real-world conditions in which many police ethics subjects are delivered, particularly situations where agreements in place require police ethics subjects to be taught by both police officers and academics.     

略论“鉴定留置”——由邓玉姣案说起

邓玉娇故意伤害案中的司法精神医学鉴定的过程,非常典型地暴露出了我国司法精神医学鉴定中有关＂鉴定留置＂制度缺位的严重问题。精神病鉴定虽然是一个医学问题,但它更是一个法律问题,我国对司法精神病鉴定制度的规定存在严重的缺失,对精神病鉴定等一系列问题的立法必须提升到我国立法的议事日程上来。对此,我们应当借鉴国外成熟经验,首先,应认识到对犯罪嫌疑人精神病鉴定是需要干涉公民人身自由的强制处分行为,并明确限定鉴定留置的范围。其次,对于鉴定留置的适用条件,在决定适用此措施之前必须听取鉴定人、辩护人意见,同时,鉴定留置措施只能适用于具有重大犯罪嫌疑的被指控人。再次,应明确规定对犯罪嫌疑人精神病鉴定的期间,在对犯罪嫌疑人精神病鉴定的期间不计羁押期限的基础上,明确犯罪嫌疑人精神病鉴定的时间,应当能够折抵刑期。     

Institutional change in the European Parliament: balancing legislative ethics and parliamentary independence

Research on legislative ethics has shown how scandals often trigger ethics reform; yet, the content of the reform often differs from that of the scandal. Why is this the case? And if scandals don't explain legislative ethics reform outcomes, then what does? If not this kind of external shock, then what factor(s) shape legislative reform outcomes? These questions provide the point of departure for a case study of the European Parliament's 2011 ethics reform. Drawing from the legislative ethics literature and from recent theories of institutional change, the article examines the impact of the scandal that initiated the reform, the interests and strategies of reform agents who wanted a quick reform process that would not undermine the EP's independence; and the institutional order in which those actors were embedded. It argues that an institutional logics perspective offers a convincing and comprehensive account of EP ethics reform, and suggests a new analytical framework that might be used by researchers in future research on legislative ethics.     

A review of Anglo-American forensic professional codes of ethics with considerations for code design

Continuing instances of ethical misconduct and recent advances in the practice of forensic science, the latter reflected by increased growth and professionalism, along with heightening public scrutiny, require that the profession be clear, current, and forthright about its core values. A way of expressing these values is through the codes of ethics of its professional membership organizations. Codes of ethics/conduct from 14 Anglo-American professional forensic membership organizations are reviewed for their clarity, construction, cogency, and the normative form of their provisions. Ethical precepts from the forensic codes reviewed are organized, in summary fashion, by obligation form and application context. Functions that professional codes have served in other professions are described. The codes are found to vary considerably. Some provisions are unclear, and most of the codes are less than comprehensive. There is very little guidance for application of ethical obligations in any of the codes reviewed. Suggestions for redesign, with a partial example, are provided.     

A Perspective on Errors,Bias, and Interpretation in the Forensic Sciences and Direction for Continuing Advancement*

Abstract: The forensic sciences are under review more so than ever before. Such review is necessary and healthy and should be a continuous process. It identifies areas for improvement in quality practices and services. The issues surrounding error, i.e., measurement error, human error, contextual bias, and confirmatory bias, and interpretation are discussed. Infrastructure is already in place to support reliability. However, more definition and clarity of terms and interpretation would facilitate communication and understanding. Material improvement across the disciplines should be sought through national programs in education and training, focused on science, the scientific method, statistics, and ethics. To provide direction for advancing the forensic sciences a list of recommendations ranging from further documentation to new research and validation to education and to accreditation is provided for consideration. The list is a starting point for discussion that could foster further thought and input in developing an overarching strategic plan for enhancing the forensic sciences.