Attitudes among medical and law students toward decision-making in regard to involuntary psychiatric hospitalization

Background

The management of individuals with mental illnesses sometimes requires involuntary hospitalization. The Israel Mental Health Act requires that cases of involuntary psychiatric hospitalization (IPH) be periodically reviewed by the district psychiatric committee. The discussion in the committee often leads to debate regarding the need for an IPH potentially depriving the patient of his freedom. Little is known about the way in which the psychiatrists and attorneys on these committees arrive at their decisions. The present study was designed to examine the views of future doctors and attorneys concerning cases of possible IPH to determine whether their decisions would be influenced by their respective professional educational backgrounds.

Methods

After compiling demographic data, we asked 170 students from each of the two disciplines what their decision would be in two hypothetical cases that dealt with the question of a prolongation of a psychiatric hospitalization. Questionnaires examining social distance and possible stigmatizing views concerning psychiatric patients were also distributed and collected.

Results

The response rates for the medical and law students were, respectively, 90% and 85%. We found no differences between the medical and law students regarding their views on prolongation of a psychiatric hospitalization. This was consistent regardless of whether the hospitalization was against the patient's will or according to his wish and against the treating physicians' advice. We also found that the medical and law students had similar general views regarding psychiatric patients, but that the latter evidenced greater social distance than the former.

Conclusions

Academic background and socialization were not found to influence the decisions of students regarding IPH. Educational programs and exposure to psychiatric patients during law studies are proposed to lessen psychiatric stigma and promote better understanding between members of the two disciplines.     

From a Pluralism of Grounds to Proto‐Legal Relations: Accounting for the Grounds of Obligations of Justice

In this paper I discuss critically Mathias Risse's paper “Responsibility and Global Justice.” First, I argue that for Risse's pluralist account of the grounds of justice to hold together, there is need to presuppose a monist standpoint which ultimately contributes to grounding principles of justice. Second, I point out that Risse's understanding of obligations of accountability and justification is rather narrow in that it functions as an addendum to obligations of justice. Conversely, I will suggest that the obligation of accountability plays a deeper role: The conditions that ground it feature at the same time among the grounds of obligations of justice. Accordingly, the kind of relation that gives rise to a duty among agents to account for their actions must be in place when obligations of justice obtain. Following on from these remarks I will adumbrate an alternative account of the relation which grounds (enforceable) obligations of justice.     

放火罪的处罚根据

放火罪的保护法益是公共安全。行为人烧毁自己财物本身并不违法,行为人烧毁自己财物构成放火罪的处罚根据在于这种行为危及公共安全,因此,公共安全应当解释为是一种构成要件要素。即便放火后达到独立燃烧的程度,还不能说发生了财产侵害,因此,通说有过于强调危及公共安全而忽视放火罪所具有的毁弃、损坏罪的一面。独立燃烧说将会导致放火罪的既遂时点提前而几乎没有成立未遂犯和中止犯的余地的后果。     

The use of harmful to others-criterion for involuntary treatment in Finland

During the past decades the Western countries have paid attention to their Mental Health legislation, in particular, by making changes concerning involuntary treatment. In Western countries legislation allows involuntary treatment of the mentally ill. Involuntary psychiatric treatment is motivated by either potential harm to others (for the good of society) or by need for treatment and/or potential self-harm (for the good of the patient). The aims of this study were to describe to what extent the danger to others criterion is used as a motivation for involuntary hospitalization and detainment in Finland, and to what kind of patients this criterion is applied. The study involves a retrospective chart review of all the treatment periods of a six month admission sample in three Finnish university hospitals. We found that potential harm to others has been rarely used as a motivation for involuntary referral or detainment together with other motivations, and virtually never as the sole motivation. With the exception of gender, which was most often male, patients with potential harm to others did not differ significantly from other involuntarily treated patients. Coercion (defined as seclusion, the use of restraints, forced medication, physical restraint or restrictions in leaving the ward) was not used with these patients more regularly than with the patients motivated by the other criteria. Length of stay (LOS) in a psychiatric hospital did not differ between the patients determined harmful to others and the other involuntarily treated patients.     

The Economics of the Grounds for Divorce in Great Britain

Despite similarities in their socio-economic environments and the provision of identical legal grounds for divorce, England & Wales is dominated by fault divorce decrees whereas no-fault divorce dominates in Scotland. Indeed, during the past fifteen years, the shares of fault and no-fault divorce have increasingly diverged across these two regions. The paper proposes an explanation for this remarkable contrast based on cost incentives generated by procedural and legal interventions within the respective legal systems. In particular, the introduction of the Simplified Procedure in Scotland and the reduction in the time bar to divorce in England & Wales are key causal factors.     

非自愿性口供的排除规则--从刑讯逼供角度的分析

由于涉及到口供和排除规则这些重要问题,非自愿性口供的排除规则受到了我国学者的普遍关注,但是,现在对该规则本身的研究还不够深入.本文从刑讯逼供的角度出发,对于排除规则中的几个要素,如"刑讯逼供"的含义、排除模式、"毒树之果"规则、排除后果等进行了分析,希望能够加深我们对于该问题的理解.     

论精神障碍患者强制住院异议机制的完善

以维护精神障碍患者的合法权益为立法宗旨、经过27年反复斟酌的《精神卫生法》终于出台，填补了精神卫生领域立法的空白，也将人权保障写入法律。精神障碍患者以自愿住院为原则，强制住院为补充，减少了“被精神病”的发生，但是对于强制住院的异议机制规定甚少且可操作性不强，不利于维护精神障碍患者的权利。在借鉴国外精神障碍强制住院异议制度的基础上，从提出异议的主体、异议机构以及异议程序方面，结合我国国情，对强制住院异议机制进行完善。     

Perceived coercion and need for hospitalization related to psychiatric admission

Psychiatric hospitalization constitutes a moment of major stress to the point that occurrences of posttraumatic stress disorders have been described. Feelings of coercion are usual, whatever the legal status of admission. Patients may also consider afterwards that they needed hospitalization even if they refused it initially. A cross-sectional survey has been conducted among the inpatients of a Swiss psychiatric hospital to assess their subjective view of admission with emphasis on legal status, perceived coercion and need for hospitalization. Eighty-seven questionnaires were completed and analyzed. Results indicated that 74% of patients felt that they had been under pressure to be hospitalized, whether or not they were involuntarily admitted. Seventy percent felt their admission was necessary. More involuntary patients reported a subjective lack of improvement. Clinicians could decrease feelings of coercion of their patients while discussing need for hospitalization, legal status and subjective feeling of coercion as different dimensions. An argument is presented to favor positive pressure from social environment over legal involuntary commitment in many hospitalizations.     

论依法行政的评估主体选择

随着人类社会组织形式和治理结构的变迁,特别是资本主义代议制政府的确立,政府工作的代理性就得到了确立。及至以后的社会主义人民民主制,更强调国家的一切权力属于人民,政府代表国家管理社会和人民群众。自从代议制确立以来,作为治理权力的代理人的政府就必须依据明确的授权范围行事。在当今世界,这种授权的内容普遍以法律的形式展现出来,就构成了依法行政。十九世纪末期,德国社会学家马克斯·韦伯第一次将这种社会治理形式以理论的形式再现出来,他详尽地将这种社会设置概括为科层制（因为以政府的组织形式为典型,所以又称为官僚制）。     

Peter Fitzpatrick,Modernism and the Grounds of Law

International Journal for the Semiotics of Law - Revue internationale de Sémiotique juridique -