Forensic psychiatry and malpractice

This paper concerning the last 87 malpractice cases referred to the Department of Psychiatry and Law, Menninger Clinic, includes 57 suits against mental health practitioners and/or institutions, and 30 nonpsychiatric suits against general hospitals, surgeons, obstetricians, etc. A patient was available for interview in only 12 percent of the psychiatric cases; in 88 percent we reviewed medical records and consulted with attorneys. In the psychiatric cases the crucial question was whether a generally accepted standard of care was breached. The inherent problems of applying appropriate criteria to standards of care by practitioners and institutions are discussed. In half the psychiatric cases we found no significant deviation from acceptable clinical performance; in half we concluded that negligent practice had occurred. We did see a litigant for evaluation in 90 percent of the nonpsychiatric cases. The main issue involving them concerned harm or disability related to presumed negligence by medical personnel. How we evaluate such cases and apply disability criteria is discussed.     

Forensic psychiatry in China

This article reviews the legal basis for the development of forensic psychiatry in China, the organization of clinical assessments, and training of forensic psychiatrists. Regulations for the management of patients in Ankang hospitals and the role of forensic psychiatrists within the Criminal Justice system are described. The primary role of forensic psychiatrists is to provide expert opinions on competence to stand trial and criminal responsibility in criminal cases. They are increasingly involved in civil court proceedings and tribunals at the request of a range of official agencies. The clinical cases assessed by Chinese forensic psychiatrists are very similar to those of their counterparts in Western countries, but the organizational and legal framework for these assessments reflects a very different system that has evolved independently.     

Forensic child psychiatry: an emerging subspecialty

Forensic child psychiatry emerged as a subspecialty in the early 1900s. Although there are still few formal training programs, a core curriculum of training and experience is described.     

Forensic neuropsychology: a selective introduction

During the last decade, neuropsychology has emerged as one of the fastest growing disciplines within clinical psychology. One of the most important roles for neuropsychologists is their contribution to the forensic sciences. The present paper reviews how lawyers may best utilize the services of clinical neuropsychologists. Suggestions are also offered to neuropsychologists on how better to meet the needs of lawyers. The following forensic science issues are discussed: the legal framework in which neuropsychologists function; contributions psychologists may make towards answering basic medicolegal questions such as the elucidation of the nature, extent, and duration of head injury sequelae; criteria for acceptable neuropsychological reports; medicolegal aspects of severe head injury, minor head injury (posttraumatic syndrome), and pseudo-head injury (malingering). There are many causes of damage to the nervous system (for example, industrial toxins and medical malpractice) that are eligible for compensation. Examples will be confined to head injury since the basic forensic science principles remain the same, whatever the etiology of such brain damage.     

Forensic psychiatry in private practice

This paper presents statistical and explanatory analyses of 637 forensic psychiatry cases in a private practice setting during the past 12 years, highlighting the remarkable variety of clinical and legal issues addressed by forensic psychiatrists. Emphasis is on how and why forensic psychiatrists need to be expert diagnosticians and clinicians, and ways in which they may respond to difficult clinical and legal opinions are recommended.