Adolescents and mental disorder: who consents to treatment?

Although English law recognises that developing adolescents may acquire the capacity to make decisions about medical treatment themselves it does not address the problem of mentally disturbed or disordered adolescents. This article examines the nature of adolescent refusal of treatment and suggests that a line be drawn between three categories of adolescent disturbance--the competent young person who refuses treatment that an adult too may refuse, the rebellious teenager whose refusal is triggered by simple teenage angst, and the mentally ill teenager whose refusal is triggered by mental illness. It suggests that adolescent autonomy needs to be more fully understood and the Mental Health Act more readily used in treating young people.     

Terrorism and mental illness: is there a relationship?

This article examines the connections between mental illness and terrorism. Most social scientists have discounted a causal relationship between mental illness and terrorism. This is not necessarily always the case within terrorism studies, the media, or political circles where the psychology of terrorism is often expressed in the language of mentalisms, and theories of pathologisation continue to exist. This article reaffirms the view that apart from certain pathological cases, there is no causal connection between an individual's mental disorder and engagement in terrorist activity. The individual terrorist's motivations can be explained by other factors, including behavioural psychology. However, there may be a connection between an individual engaging in terrorist activity and developing a mental disorder[s]. Certain stressors that occur because of terrorist activity may result in psychological disturbance in terrorist individuals. These factors may partially explain terrorist group instability and should be taken into account when detaining and interrogating terrorist suspects.     

Russia and Ukraine: Transition or tragedy?

Conclusion The political-criminal nexus that emerged in the post-Soviet period represents a transformation of the relationships which existed in the Soviet period. The division of the property of the Soviet state gave ample possibilities for the political-criminal nexus to obtain significant political assets. They were able to transform their power from one that was rooted in the managerial apparatus of the Soviet state and the consumer economy into one with international dimensions and control of very large shares of the domestic economy. The rise of the political-criminal nexus, while hardly surprising in light of the structure of power relations in the final decades of the Soviet period, precludes full democratization or the rise of a real market economy. In the initial years of the transformation process from a socialist to a post-socialist economy, insufficient attention was paid to the containment of the political-criminal nexus in both Russia and Ukraine. Most Western politicians and international organizations focused on the collapse of communism rather than the rise of these pernicious alternative power relationships. The prognosis for the containment of the political-criminal nexus in either country is rather limited at the moment. Ukraine, however, is at a comparative disadvantage because it has failed to sufficiently acknowledge the high costs of organized crime and its political links. This has been done at the highest levels of Russian government although precious little has been done to address the problem. The Ukraine situation is more difficult because its institutional resources are much more limited than Russia which inherited a disproportionate share of the Soviet Union's financial and institutional resources. With limited civil society and the economic precariousness of much of the population, little can be done to control the problem at its roots. The political-criminal nexus in Russia and Ukraine will remain a serious problem in coming decades. It cannot be ignored in appraising the development of the domestic political situation in either country or determining foreign policy in relation to these two newly independent states.     

Are there lessons to be learned from a more scientific approach to mental condition defences?

The timing of the English Law Commission's consideration of reform to the law of insanity coincides with increasing scientific and in particular neuroscientific understanding of the brain. The work of researchers is leading to a greater comprehension of what had been termed irresistible impulses to commit crime and of the impact of brain damage, particularly evidence of brain lesions and frontal lobe damage on behaviour. There remain problems in establishing causal relationships which might diminish or eliminate criminal responsibility for crimes committed by those suffering from pre existing mental conditions at the time they commit a criminal offence. This is especially the case where those mental conditions are of short duration. However, the law should not ignore the best available scientific knowledge. Neuroscientific advances are already informing court deliberations in England and Wales: assisting in considerations of guilt, fitness to plead and in sentencing. In terms of the insanity defence the questions that the law seeks to address are not necessarily the most medically or scientifically pertinent questions. They remain grounded in 19th century scientific understanding. It is argued that the more nuanced Dutch approach to mental condition defences warrants very serious consideration by those charged with making proposals to reform the English law.     

Insulin- or morphine-injection?: Immunohistochemical contribution to the elucidation of a case

Two autopsy cases of an elderly couple who died on the same day will be used to underline the importance of immunohistochemistry in forensic practice. At first unexplainable injection marks on the upper arms of the corpses and the possibility of a closely related physician injecting insulin and certifying a natural death made it important, considering suspect insulin concentrations in the blood, to exclude insulin injections in these marks. Further, the statement that morphine had been injected for the analgesia of tumour pains, was reinforced by immunohistochemistry.     

Litigation: a threat to obstetric practice?

Claims that the practice of obstetrics is in crisis appear regularly in the media, but evidence for the claims is scarce. This article examines a range of evidence from Australia and overseas and explores the relationship between obstetric practice and litigation. While anecdotal evidence abounds, there is no hard evidence to confirm that litigation is the threat to obstetric practice that many practitioners strongly believe it is. It is likely that such practitioners respond by practising defensive medicine but this is very difficult to measure.     

What does recovery mean to a forensic mental health patient? A systematic review and narrative synthesis of the qualitative literature

This is a systematic review and narrative synthesis of qualitative literature for forensic mental health patients’ perceptions of recovery. Relevant databases were searched and a total of 11 studies that fit the inclusion criteria were identified. Thematic Synthesis was applied to synthesise the collated themes into six superordinate themes: connectedness, sense of self, coming to terms with the past, freedom, hope and health and intervention. Two superordinate themes were particularly prevalent: connectedness and a sense of self. It is argued that a focus on increasing opportunities for forensic mental health patients to develop a sense of self and connectedness could help improve recovery. Future recommendations to expand on these findings include using grounded theory methods to develop theoretical understanding of the data.     

Interviewing to Detect Deception: When to Disclose the Evidence?

Research shows that there are few objective cues to deception. However, it may be possible to create such cues by strategic interviewing techniques. Strategic Use of Evidence (SUE) is one such technique. The basic premise of the SUE technique is that liars and truth tellers employ different counter-interrogation strategies, and that the evidence against the suspect can be used to exploit these differences in strategies. This study examined the effect of the timing of evidence disclosure (early vs. late vs. gradual) on verbal cues to deception. We predicted that late disclosure would be most effective in differentiating between liars and truth-tellers, and that cues to deception in the gradual disclosure condition would progressively disappear due to the suspects’ realization that evidence against them exists. That is, we expected that liars in the gradual presentation condition would become more consistent with the evidence over time. A sample of 86 undergraduate students went through a mock-terrorism paradigm (half innocent, half guilty), and were subsequently interviewed using one of three disclosure strategies: early, gradual, and late disclosure. We measured statement-evidence inconsistencies as cues to deception . Results supported our predictions in that cues to deception were most pronounced in the late disclosure condition. Contrary to our expectations, the results suggested that presenting the evidence gradually may put innocent suspects at a higher risk of misclassification as they seem to adopt a strategy that is more similar to guilty suspects.