A consultant's survey of the patients in a maximum security hospital

The patients at a state maximum security forensic facility were interviewed by a psychiatrist and their files reviewed. Only 43 of the 203 patients were judged to be suitable for the facility. Nearly 60% of the pretrial defendants were judged to be capable of proceeding to trial. Of the patients, 18% were judged to be malingering or avoiding trial or prison. The implications of these findings are discussed.     

Mortality in maximum security psychiatric hospital patients

Numerous studies have mentioned to the high percentage of violent deaths in prison psychiatric hospitals, with suicide being the principal cause. The aim of this study was to analyze the circumstances related with the deaths recorded in a high security institution. Postmortem reports on all the deaths at the Alicante Psychiatric Prison between 1984 and 1997 were studied (36 cases of unnatural death and 28 of natural death). Of the violent deaths recorded 34 (94.4%) were suicides. Demographic, clinical and interpersonal variables factors were registered. In the cases of suicides, the method used, the place of death, season, month and time of suicide were analyzed. In our study, 64.7% of suicides were schizophrenic and 32.4% had inflicted self-harm previously. We found a statistically significant association between the cause of death (natural, suicide or homicide) and age, 47.1% of suicides being between the ages of 18 and 30 and 29.4% between the ages of 30 and 45. Natural causes predominated in older subjects. The prison population studied showed grave negative traits, mental illness and criminal behavior having forced them to the very edge of society. Our results were compared with the death and suicide rates of the general Spanish population.     

Behavior on the ward of personality-disordered inpatients and chronically psychotic inpatients during a three-year stay in a Dutch forensic psychiatric hospital

To gain insight into the behavior of a group of personality-disordered patients and a group of chronically psychotic patients during their stay in a Dutch forensic psychiatric hospital, data on these patients were collected biannually for seven years. Three aspects of the patients’ behavior were examined: the prediction of institutional behavior shortly after admission, changes in the patients’ behavior on the ward during their stay in hospital, and the prediction of these changes. In the personality-disordered patients, observed irritation/anger and aggressive behavior on the ward turned out to be positively related to psychopathy, the PCL-R lifestyle and antisocial facets, and the neuroticism domain. A positive relationship was also found between aggressive behavior on the ward and trait anger. In the chronically psychotic patients, a positive relationship was found between irritation/anger and the PCL-R interpersonal and lifestyle facet. During a stay of three years, the aggressive behavior of both patient subgroups, which was already low at the start, did not decrease further, but their prosocial behavior increased. In the personality-disordered patients, relatively high scores on the antisocial facet of the PCL-R indicated an increase in prosocial behavior, whereas in the chronically psychotic patients no relationship was found between any PCL-R facet and behavior change. Effect studies on treatment programs for forensic psychiatric inpatients have to contend with the problem of a low base rate of institutional aggression. Therefore, we advise that such studies focus not only on a decrease in negative behaviors but also on an increase in positive behaviors.     

论医疗机构对患者的安全保障义务

患者在医院走失(丢失)、财产被盗、受到第三人侵害的事情时有发生，因此而发生的损害赔偿纠纷成为医息诉讼新的焦点。本文对与此相关的理论进行探析，旨在探讨法院在评判双方过错时所应适用的标准。笔者认为，附随义务是医疗机构对患者及其财产进行安全保障的依据，法院在认定医疗机构是否有过错应当以具体情事和诚信原则作为标准。     

论医疗机构对患者的安全保障义务

患者在医院走失 (丢失 )、财产被盗、受到第三人侵害的事情时有发生 ,因此而发生的损害赔偿纠纷成为医患诉讼新的焦点。本文对与此相关的理论进行探析 ,旨在探讨法院在评判双方过错时所应适用的标准。笔者认为 ,附随义务是医疗机构对患者及其财产进行安全保障的依据 ,法院在认定医疗机构是否有过错应当以具体情事和诚信原则作为标准。     

Self-deception and other-deception among admissions to a maximum security hospital and a medium secure unit

Abstract

Other-deception and self-deception are important variables to consider when conducting a forensic psychological evaluation. The main aim of the present study was to investigate the effects of setting on other-deception and self-deception scores. It was hypothesised that patients at a maximum security hospital (Broadmoor) would score lower on an other-deception questionnaire than similar patients at a medium secure unit (Denis Hill Unit). All the patients completed the other-deception (ODQ) and self-deception (SDQ) questionnaires of Sackeim and Gur (1979) on admission to the two security hospitals. The Broadmoor patients (N = 46) obtained significantly lower ODQ score than the Denis Hill Unit (N = 52) patients, after controlling for differences in ethnic background and diagnosis among the two populations. No significant difference in setting was found for the SDQ score. The ODQ and SDQ scores were significantly associated with the type of diagnosis and the ethnic background of the patient, with patients diagnosed as mentally ill scoring higher than those with a diagnosis of personality disorder, and ethnic minority patients scoring higher than Caucasian patients.     

An evaluation of the Enhanced Thinking Skills (ETS) programme with mentally disordered offenders in a high security hospital

Purpose. Further to evidence of the successful application of cognitive skills programmes with offenders in HM prison service, the Enhanced Thinking Skills (ETS) training course is now delivered in various secure forensic hospitals, and its usefulness with an offender patient population merits examination. Our aim was to evaluate the impact of ETS using measures designed to capture change in key areas targeted by the course, and a more global measure of mental well‐being. Methods. Offender patients (N = 83) referred for ETS between 2001 and 2006 via a wider groupwork service within a high security hospital were administered questionnaires before and after the training course, which was minimally adjusted to meet the needs of the patient population. Attendance rates, including ‘drop‐out’ (completion of 10 or less sessions) were recorded. Demographics by subgroup (completers vs. non‐completers), and the clinical significance of any changes endorsed by participants post‐group were examined. Results. ETS completers were significantly more likely than non‐completers to endorse changes in thinking style (e.g. a reduction in post‐course scores). Significant differences were observed at both the group and individual level in the direction of less externalization of blame, a slight increase in tolerance of frustration, an increase in social conformity, and improvement in critical reasoning skills. Furthermore there was a reduction in the endorsement of aggressive solutions to social problems. Conclusions. These findings demonstrate a significant short‐term impact of the course for mentally disordered offenders with regards change in aspects of their thinking style and enhancement of their social problem solving skills. This profile lends some support to the provision of ETS within secure hospital settings.     

时某医疗损害赔偿案归责原则探讨

案情简介 时某,女,29岁,农村妇女.1999年4月12日下午,因病到当地卫生院就诊,卫生院予以对症治疗处理.次日晨,时某仍感头晕,伴有恶心、发热,并出现面色紫绀,不能言语,时某又到该卫生院就诊,卫生院诊断为:头晕待查,上感?利君沙反应,即予: 5% GS 250 ml+ 丁胺卡那霉素0.2×3支及10% GS 500 ml+10% 氯化纳10 ml,维生素B6 4支,辅酶A 1支,10 %氯化钾10 ml,维生素C 6支,ATP 2支,静滴(该组未用),配合吗叮啉口服液治疗.上午 7∶30时,当5% GS 250 ml+丁胺卡那毒素0.2×3支静滴快结束时,患者突然面色发绀,呼吸不规则,卫生院立即采取胸外按摩,吸氧,注射肾上腺素、洛贝林等抢救措施,但时某已停止呼吸,至7∶50时抢救无效死亡.     

时某医疗损害赔偿案归责原则探讨

案情简介时某 ,女 ,2 9岁 ,农村妇女。 1999年 4月 12日下午 ,因病到当地卫生院就诊 ,卫生院予以对症治疗处理。次日晨 ,时某仍感头晕 ,伴有恶心、发热 ,并出现面色紫绀 ,不能言语 ,时某又到该卫生院就诊 ,卫生院诊断为 :头晕待查 ,上感 ?利君沙反应 ,即予 :5 %GS 2 5 0ml+丁胺卡那霉素 0 .2× 3支及 10 %GS 5 0 0ml+10 %氯化纳 10ml,维生素B6 4支 ,辅酶A 1支 ,10 %氯化钾 10ml,维生素C 6支 ,ATP 2支 ,静滴 (该组未用 ) ,配合吗叮啉口服液治疗。上午 7∶30时 ,当 5 %GS 2 5 0ml+丁胺卡那毒素 0 .2× 3支静滴快结束时 ,患者突然面色发绀…     

我国环境法律中的国家安全刍议

鉴于国家安全在我国经济和社会可持续发展中居于举足轻重的地位,本文从国家安全的内涵及其发展入手,论述运用环境法律制度保障国家安全的现实急迫性和法理基础,最后提出完善相关环境法律维护国家安全的建议措施。     

The efficacy of home security measures

Crime prevention through environmental design(CPTED) assumes criminal acts are influenced by their inherent costs and benefits. Policy implications drawn from CPTED suggest home security measures increase these costs and reduce the likelihood of burglary. This paper tests the efficacy of home security measures. A telephone survey of 566 residents in Mobile County, Alabama, inquired about security measures burglary victims and nonvictims employed. A logistic regression solution found some, but not all, of these security measures to be quite effective. The author would like to thank Bill Doerner and the anonymous reviewers for their helpful comments and patience. Thanks also go to Sheriff Jack Tillman, Captain Ronnie Phillips, and Thomas Barclay of the Mobile County (AL) Sheriffs Office for their support in this project.     

The collision of healthcare and corporate law in a hospital closure case

This Article analyzes potential conflicts that arise from both the judicial and administrative approval processes that govern the closure of charitable hospitals through a sale of all or substantially all of their assets. Examining the recent closure attempt by the Manhattan Eye, Ear & Throat Hospital as an example, the Article highlights the various public health and corporate law issues that are raised when a not-for-profit hospital seeks closure. The Article thoroughly discusses both the statutorily and judicially required approval schemes applicable to the closure of charitable hospitals. The Article also suggests ways in which these conflicts might be avoided or remedied, as well as gives advice regarding hospital board decisionmaking.