论受审能力的恢复

受审能力评定越来越引起重视的情况下,对于无受审能力者,受审能力的恢复也是一项值得大家关注的问题,受审能力恢复的培训程序包括相关精神障碍治疗、法律知识培训、综合住院治疗;而个别程序的专门培训可能是受审能力最大程度恢复的必要措施。受审能力恢复评定的标准更多的参照于经典的Bennett标准。虽然有关受审能力恢复的研究还存在一些挑战,但为我国相关受审能力恢复的研究指明了道路,提供了很好的参考依据和措施。     

An Examination of the Relationship Between Competency to Stand Trial,Competency to Waive Interrogation Rights,and Psychopathology

This study compared the legal abilities of defendants (N = 212) with current primary psychotic disorders (n = 44), affective disorders (n = 42), substance abuse disorders (n = 54), and no diagnosed major mental illness (n = 72). Defendants with primary psychotic disorders demonstrated more impairment than did other defendants in their understanding of interrogation rights, the nature and object of the proceedings, the possible consequences of proceedings, and their ability to communicate with counsel. Psychosis was of limited value as a predictor however, and high rates of legal impairment were found even in defendants with no diagnosed major mental illness. Sources of within-group variance were examined to further explain this finding. Policy and clinical implications of these results are discussed.     

Competency Restoration: An Examination of the Differences Between Defendants Predicted Restorable and Not Restorable to Competency

According to the U.S. Supreme Court's decision in Jackson v. Indiana (1972), examiners must determine if a defendant has substantial probability of regaining competency through treatment in the foreseeable future. Previous research has indicated that, given the low base rate of defendants unable to be restored to competency, examiners are relatively poor at predicting which defendants will regain competency. Determining the characteristics of not restorable incompetent defendants and restorable incompetent defendants is a necessary first step toward improving examiners' ability to predict a defendant's likelihood of regaining competency. This study examined the competency evaluation reports of 468 defendants evaluated for competency to stand trial. Incompetent defendants significantly differed from competent defendants with regard to age, employment status, ethnicity, criminal charges, and psychiatric diagnosis. Few significant differences existed between defendants predicted restorable and those predicted not restorable by mental health examiners—the differences that did exist were related mainly to nonpsychiatric variables.     

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。     

精神障碍者受审能力评定量表的编制

目的研制符合中国法律体系的精神障碍者受审能力评定量表。方法从法学要件着手,提取出15个条目,编制出初步的精神障碍者受审能力评定量表,从决断值、条目与总分相关、校正条目与总分相关、条目删除后的α值、条目共同性、因素负荷量6个方面对量表进行条目分析,并以Logistic回归方程与ROC曲线划定界值两种方式进行诊断效能的判断。结果各条目极端组的决断值18.390~46.763,各条目与总分相关系数0.639~0.952,校正条目与总分相关系数0.582~0.944,条目共同性0.377~0.916,因素负荷量0.614~0.957。共7个条目进入回归方程,总样本的回判正确率为96.0%。ROC拟合曲线分析出宜以33分作为量表划界分,与专家鉴定意见的重叠率为95.8%,敏感性为0.938,特异性为0.966,阳性似然比为27.67,阴性似然比为0.06。结论量表编制合理,各条目符合同质性检验要求,诊断性评价指标较好。     

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。     

Forensic Applications of the Miller Forensic Assessment of Symptoms Test (MFAST): Screening for Feigned Disorders in Competency to Stand Trial Evaluations

Forensic evaluations must systematically assess malingering and related response styles. In the criminal forensic domain, competency to stand trial evaluations are the most common referrals. Effective screens for feigned incompetency would be valuable assets for forensic evaluations. This study evaluates the effectiveness of the Miller Forensic Assessment of Symptoms Test (MFAST) as a screen for feigned incompetency. Using a simulation design, the MFAST was tested on jail and competency-restoration samples. Most notably, recommended MFAST cut score (6) was useful for the identification of feigning cases in competency evaluations. Recommendations for forensic practice, including the advantages and disadvantages of systematic screens, are discussed.     

An Evaluation of Malingering Screens with Competency to Stand Trial Patients: A Known-Groups Comparison

The assessment of malingering is a fundamental component of forensic evaluations that should be considered with each referral. In systematizing the evaluation of malingering, one option is the standardized administration of screens as an initial step. The current study assessed the effectiveness of three common screening measures: the Miller Forensic Assessment of Symptoms Test (M-FAST; Miller, 2001), the Structured Inventory of Malingered Symptomatology (SIMS; Widows & Smith, 2004), and the Evaluation of Competency to Stand Trial-Revised Atypical Presentation Scale (ECST-R ATP; Rogers, Tillbrook, & Sewell, 2004). Using the Structured Interview of Reported Symptoms (SIRS) as the external criterion, 100 patients involved in competency to stand trial evaluations were categorized as either probable malingerers (n=21) or nonmalingerers (n=79). Each malingering scale produced robust effect sizes in this known-groups comparison. Results are discussed in relation to the comprehensive assessment of malingering within a forensic context.     

The role of cognition in fitness to stand trial: a systematic review

The aim of the current paper was to systematically review the quality and design of the literature examining cognition and fitness to stand trial (FST). Ten empirical studies published between 1970 and July 2013 met the inclusion criteria. All studies utilised cross-sectional designs and six were prospective. Study quality was appraised based on FST research guidelines. The study quality was highly variable. Intelligence was controlled statistically in only half of the included studies. Cognitive processes, specifically, processing speed, verbal memory and visuoperceptual skills differentiated fit and unfit groups. Aspects of executive functioning, including social knowledge and abstract thinking, influenced FST. Future studies should use prospective consecutive designs and multivariate statistical strategies that control for potential confounds. Comprehensive assessment across a number of cognitive domains is needed in order to validate research conducted to date and guide forensic assessment of FST.     

The Effect of Competency Restoration Training on Defendants with Mental Retardation Found Not Competent to Proceed

The present investigation focused on the reevaluations of competency to stand trial (CST) of 75 criminal defendants with mental retardation (MR) who were originally found incompetent and who were referred for treatment. The effect of competency restoration training was examined. Site of training was also investigated. Because habilitation facilities are specially designed to help individuals with MR, it was suspected that training at habilitation centers would have a greater effect on restoration of defendants with MR than the training at state hospitals. Results showed that significantly more defendants did not gain competency following training than those who did. Analysis revealed that (a) higher IQ and (b) being African American rather than Caucasian American were predictive of restoration. When discriminating factors were held constant, site of training did not significantly affect competency restoration. Possible explanations for this finding were discussed.     

试论精神病人的受审能力

本文讨论了受审能力的概念,针对精神病人的特点阐述了受审能力的评定标准,将中外有关此方面的立法和实践进行了对比,指出现阶段我国立法方法的不足之处,提出了根据国情对受审能力实行三分法的设想,并建议指定辩护制度应惠及精神病人以维护他们的诉讼权利。     

An Investigation of the Construct of Competence: A Comparison of the FIT,the MacCAT-CA,and the MacCAT-T

The 1990s witnessed Supreme Court decisions in both Canada and the United States on issues of competence that went against longstanding case law, psychological research, and common sense. These decisions held that there is to be one standard for all types of criminal competencies. The present research attempts to investigate whether this is an appropriate assumption and thus tests whether there are one or more constructs that underlie different types of competence. Two divergent types of competence were examined, competence to stand trial (both Canadian and American conceptualizations) and competence to consent to treatment, to determine if these different types of competence share a common underlying construct. Confirmatory factor analysis was used to test this question and results indicate that there is a common construct that underlies different types of competence.     

Juvenile Competency to Stand Trial: A Systemic Look Under the Hood: Reasonable Accommodations

Juvenile competency to stand trial has historically involved the intrinsic abilities of a juvenile to understand and appreciate the nature of the proceeding against the juvenile and the juvenile’s ability to assist in his/her defense and communicate effectively with defense counsel. The literature has not addressed the recursive systemic competency process between the juvenile, defense counsel, and hearing officer. This article discusses the communication skills of defense counsel and hearing officers as part of the systemic equation in a juvenile’s competency to stand trial. A case example is used to demonstrate the importance of reasonable accommodations as part of the systemic, recursive interactions between a juvenile and court personnel. The authors conclude with recommendations for training in the areas of linguistics and the psychosocial development of juveniles in the socio-cultural context in which they live.     

Developmental incompetence to stand trial in juvenile courts

Juveniles' competency to participate in delinquency proceedings has received increased attention in recent years. Developmental incompetence, whereby juveniles' incompetency is based upon their immaturity, as opposed to a mental disorder or developmental disability, is an evolving and important aspect of this area of law. The following paper reviews theories used to support the notion of developmental incompetence, as well as the extant empirical research on juveniles' competency-related abilities. Using a LexisNexis search, statutory and case laws pertaining to juvenile competency were identified across the 50 states and the District of Columbia. Only six states clearly allow developmental incompetence, whereas 17 have laws that do not include developmental immaturity as an acceptable basis of incompetence in juvenile courts. Developmental incompetence is likely to affect a relatively small proportion of juvenile cases, but has important implications for juvenile forensic practice. Recommendations are offered for forensic practitioners conducting this type of evaluation.     

沉默权三论

在刑事诉讼中是否应当赋予犯罪嫌疑人、被告人保持沉默的权利,在我国一直见仁见智。本文从司法文明、公民权利及改变警察办案作风、提高司法人员素质的角度,阐述了在我国实行沉默权的必要性。     

精神分裂症与司法精神病鉴定

精神分裂症在司法精神病鉴定中占首位,精神分裂症患者的作案动机、作案方式及作案后果均具有特殊性,因此精神分裂症在司法精神病鉴定中占有很重要的地位。笔者结合国内外有关文献,对精神分裂症患者所致司法案件的作案特征以及患者的责任能力、受审能力、服刑能力的研究进行综述。     

Utility of the Inventory of Legal Knowledge in detecting feigning

The Inventory of Legal Knowledge (ILK) is an instrument designed to detect feigning of competency-specific knowledge deficits. Available studies have suggested the ILK may require modification of its cut score to more accurately classify those who are feigning. In this study, the ILK’s concurrent validity and cut scores were tested using 100 college students in a simulation design. Students were randomly assigned to fake (n = 50) or honest (n = 50) groups. Those assigned to the faking group had significantly lower ILK scores than individuals responding honestly with a large effect size between the groups. Despite some promising results, utility estimates indicated an unacceptable level of false positives using the recommended cut score. Tentative recommendations are made in order to improve the efficacy of the ILK in detecting feigning legal knowledge.     

沉默权制度的发展、利弊与限制

沉默权制度作为诸多国家在刑事诉讼中保障犯罪嫌疑人、被告人人权的一项重要制度,有必要对其历史发展、利弊及现今限制等问题予以了解,这对我国正在酝酿的刑事诉讼法的整体修改以及相关问题的废、改、立具有重要意义。     

病人家属参与医疗决定之法律研究

在我国目前的收入结构与医疗体制之下,对于大多数人而言,一旦面对大的病患风险,家属往往是其医疗成本以及医疗后果的直接承担者。当医疗决定牵涉到家庭成员的重大利益时,患者自主权应该受到家属决定权的制约。病人并非如病患自主理论所预设的前提一样是一个自由且理性的选择者,而是一个组织社群所有关系的总和,因此个人自决并不应该豁免其社群义务,尤其是对于家庭之义务。即使是成年具有意思能力病人其家属亦应具有相应的权利。