参与度在与精神损害有关的司法鉴定中的应用

纠纷事件与其伴发的精神障碍之间的因果关系是民事纠纷司法精神鉴定中的难点,鉴定结论往往存在争议,对同一结论的描述也有所不同。本文介绍了参与度的概念,试从事件参与度的角度论述精神损害案中纠纷事件与伴发的精神障碍之间的因果关系。     

Roman concept of mental capacity to make end-of-life decisions

When assessing decisional competence of patients, psychiatrists have to balance the patients' right to personal autonomy, their condition and wishes against principles of medical ethics and professional discretion. This article explores the age-old legal and ethical dilemmas posed by refusal of vital medical treatment by patients and their mental capacity to make end-of-life decisions against the background of philosophical, legal and medical approaches to these issues in the time of the Younger Pliny (c62-c113 CE). Classical Roman discourse regarding mental competency and "voluntary death" formed an important theme of the vast corpus of Greco-Roman writings, which was moulded not only by legal permissibility of suicide but also by philosophical (in modern terms, moral or ethical) considerations. Indeed, the legal and ethical issues of evaluating the acceptability of end of life decisions discussed in the Letters are as pertinent today as they were 2000 years ago. We may gain valuable insights about our own methodologies and frames of reference in this area of the law and psychiatry by examining Classical Roman approaches to evaluating acceptability of death-choices as described in Pliny's Letters and the writings of some of his peers.     

Functional mental capacity is not independent of the severity of psychosis

BACKGROUND: Function-specific mental capacities are the legal criteria for competence. These are regarded as superior to clinical assessments of mental state and general function. AIMS: To determine whether tests of fitness to plead and capacity to consent are independent of each other and independent of mental state and global function in psychosis. METHOD: The MacCAT-T and MacCAT-FP, PANSS and GAF were administered to 102 compulsorily detained forensic patients with psychosis. Criteria for incompetence were inability to express a preference concerning treatment, and independent rating as unfit to plead. RESULTS: MacCAT-T, MacCAT-FP totals and sub-scales correlated with each other and with PANSS and GAF. Those independently rated unfit to plead or who were incapable of making a treatment choice scored significantly worse on all rating scales. No test had satisfactory sensitivity or specificity. CONCLUSIONS: Legal definitions of mind and of functional capacity offer a basis for structured clinical judgement regarding decision-making capacity. However, function-specific measures of understanding, reasoning and appreciation generate much the same results as measures of mental state and global functioning.     

精神发育迟滞患者辨认能力的影响因素研究

目的　探讨司法鉴定中精神发育迟滞 (MR)患者辨认能力的影响因素。方法　对 86例MR司法鉴定资料进行判别分析 ,选出影响辨认能力的判别因子 ,并建立判别方程 ,进行组内回代检验。结果　经判别分析 ,有 5个因素被选入 :个性特征、诊断分组、是否伴有癫痫及其他精神病性症状、作案类型、作案动机 ,组内回代检验不同程度辨认能力的判断正确率分别为 :有完全辨认能力 93 8%、有部分辨认能力73 4 %、无辨认能力 1 0 0 %,总判断正确率为 89 0 %。结论　MR患者作案时辨认能力受多种因素的影响 ,否认了“单纯以诊断分级判断辨认能力”的观点。     

精神障碍者民事行为能力评定量表研制

目的制定精神障碍者民事行为能力评定量表,并探讨其在司法精神病鉴定中的适用性。方法将民事行为能力的考量指标进行细化,经讨论、咨询专家后确定量表条目,按照评定逻辑顺序排列并完成操作手册,形成评定量表。在四家司法鉴定机构试用量表。结果精神障碍者民事行为能力评定量表共有14个条目。共纳入202例样本,根据专家意见划分为完全、限制和无民事行为能力3组。3组量表总分分别为2.32±2.45、11.62±4.01、25.02±3.90,两两得分差异均具有统计学意义。全量表Cronbachα为0.9724,分半信度检验中两分半量表间具有较高的相关系数(r=0.9729,P=0.000);各条目与总分的Spearman相关系数在0.643～0.882(P=0.000)。量表得分结论与专家意见的分组结论一致性较高(κ=0.841,P=0.000)。7个因子被有效纳入判别方程,92.6%的样本回代划分正确。结论精神障碍者民事行为能力评定量表具有良好的信度和效度,能对精神障碍者的民事行为能力进行有效分类。     

精神发育迟滞患者辨认能力的影响因素研究

目的 探讨司法鉴定中精神发育迟滞（ＭＲ）患者辨认能力的影响因素。方法 对８６例ＭＲ司法鉴定资料进行判别分析,影响辨认能力的判别因子,并建立判别方程进行组内回代检验。结果 经判别分析,有５个因素被选入;个性特性、诊断分组、是否伴有癫痫及其他精神病性症状、作案类型、作案动机,组内回代检验不同程度辨认能力的判断正确率分别为：有完全辨认能力９３．８％、有部分辨认能力７３．４％、无辨认能力１００％,总判断正     

The precarious practice of forensic psychiatric risk assessments

The development of forensic psychiatric risk assessments is discussed from a clinical point of view using the example of Sweden. A central task in forensic psychiatry has traditionally been to identify dangerous, mentally disordered subjects considered to be prone to commit violent acts. Over time, “dangerousness” has been reworded into “risk”. Nevertheless, such assessments have generally been based on the psychiatric factors characterising the individual patient, while group interaction, situational factors, or social and cultural circumstances, such as the availability of alcohol and drugs, have been largely overlooked. That risk assessments have a focused on people with a diagnosis of “mental disorder” and been used as grounds for coercive measures and integrity violations has somehow been accepted as a matter of course in the public and political debate. Even the basic question whether offenders with a mental disorder are really more prone to criminal recidivism than other offenders seems to have been treated light-handedly and dealt with merely by epidemiological comparisons between groups of persons with broad ranges of psychosocial vulnerability and the general population. Legal texts, instructions and guidelines from the authorities in charge are often vague and general, while actors in the judicial system seem to put their trust in psychiatric opinions. The exchange of professional opinions, general public expectations, and judicial decision processes poses a huge risk for misunderstandings based on divergent expectations and uses of terminology.     

Perceptions and use of videoconferencing in forensic mental health assessments: A survey of evaluators and legal personnel

ABSTRACT

The use of videoconferencing (VC) to conduct forensic mental health assessments (FMHA) is increasing. Yet, little is known about its acceptability among clinicians or legal professionals. In Study 1 (N?=?156), forensic evaluators were asked about their use of VC, reasons for its use, and opinions about the validity, usefulness, ethics, and legality of its use. An estimated one-third of evaluators have used VC in the past. Although evaluators overall expressed moderate concern over the ethics and legality of use, prior experience appeared to mitigate concerns. Younger practitioners were also more open to using VC. Reduced costs for courts was the most frequently endorsed benefit associated with VC, while restricted ability to administer psychological testing and potential technological problems were seen as the biggest disadvantages. In Study 2 (N?=?27), attorneys and judges were surveyed about frequency with which they encounter VC for FMHA and their perceptions about the validity of those assessments. Findings indicated legal personnel expressed rather negative views without having much first-hand experience of VC, including concerns about establishing rapport and technical difficulties. These studies have implications for whether VC will be adopted more frequently in FMHA.     

The reliability of eyewitness identification

This study examines the effects of 14 estimator variables (e.g., disguise of robber, exposure time, weapon visibility) and system variables (e.g., lineup instructions, exposure to mugshots) on a number of measures of eyewitness performance: identification accuracy, choosing rates, confidence in lineup choice, relation between confidence and identification accuracy, memory for peripheral details, memory for physical characteristics of target, and time estimates. Subjects viewed a videotaped reenactment of an armed robbery and later attempted an identification. Characteristics of the videotape and lineup task were manipulated. Prominent findings were as follows: identification accuracy was affected by both estimator and system variables including disguise of robber, weapon visibility, elaboration instructions, and lineup instructions. Memory for peripheral details was positively correlated with choosing on the identification task but negatively correlated with identification accuracy.     

Patient competence and professional incompetence: disagreements in capacity assessments in one Australian jurisdiction, and their educational implications

The determination of capacity to make medical, personal and financial decisions has significant individual and social implications. Medical and other health professionals are traditionally relied on by courts and tribunals to provide clinical and psychometric evidence of the presence or absence of capacity, or competence. Concern has long been expressed over the variability of these assessments. A survey of 285 decisions of the Queensland Guardianship and Assessment Tribunal (GAAT) between 2005 and 2008 was conducted to estimate the incidence of disagreement between health professionals in capacity assessments; to provide examples of conflicting assessments and models of assessment used; and to consider the educational implications of disagreements. While the final capacity determinations by the GAAT appear sound, this case series, and other studies in the capacity literature, strongly suggest the need to improve the education of health professionals, especially doctors, at undergraduate and postgraduate levels, in the practical assessment of capacity as a fundamental clinical skill.     

女精神病人性自我防卫能力鉴定的几个问题

最高人民法院、最高人民检察院、公安部在1984年颁布的<关于当前办理强奸案件的具体应用法律的若干问题的解答>(以下简称<解答>)指出:明知妇女是精神病患者或者痴呆者(程度严重的)而与其发生性行为的,不管犯罪分子采取什么手段,都应以强奸论处.     

精神发育迟滞患者的犯罪学特征分析

目的探讨司法精神病学鉴定中精神发育迟滞(MR)患者的犯罪学特征。方法采用自编的司法精神病学鉴定案例登记量表,对83例MR患者的犯罪学特征进行分析,并对轻度MR与中重度MR的犯罪学特征进行比较。结果MR涉嫌犯罪者中轻度MR占62.7%,中度MR占22.9%。性犯罪占37.3%,凶杀占34.7%,财产犯罪等占28.0%。犯罪动机明确者占96.1%。有犯罪史者占34.7%。轻度MR与中重度MR两组间作案预谋(χ2=11.9,P=0.001)、作案目标确定(χ2=7.531,P=0.006)、作案动机(χ2=7.920,P=0.019)、作案类型(χ2=7.855,P=0.02)有显著性差异。结论MR涉嫌犯罪者以轻度居多,犯罪类型以性犯罪及凶杀犯罪占比例较大,大多数犯罪动机明确。轻度MR组有作案预谋、作案前确定目标者明显高于中重度MR组。中重度MR作案动机为性满足者明显高于轻度MR。     

论法人的民事能力

为建立适应社会主义市场经济客观需要的较完善的民事主体制度,需要对法人的民事能力问题进行更深入的研究。法人的民事权利能力不存在范围限制问题,也不是指法人可以享受权利的范围。法人民事权利能力的特殊性实指其与自然人民事权利能力相比所具有的特点。法人的民事行为能力同自然人一样,由于其意思能力的不同,可以划分为完全民事行为能力、限制民事行为能力和无民事行为能力。应当建立有中国特色的法人民事能力宣告制度。这一制度应包括法人民事权利能力宣告制度和行为能力宣告制度两大系统。