精神疾病患者强制医疗的证明标准研究

证明标准是强制医疗程序中的关键问题。在美国,一般以“清晰和令人信服”标准作为非自愿治疗最低限度的证明标准,从而排除适用民事案件的“优势证据”标准。我国《精神卫生法》并未建立强制医疗司法审查模式,而是由精神卫生机构行使强制医疗的决定权,强制医疗决定程序中的证明责任和证明标准问题均被淡化。在刑事强制医疗诉讼中,则应根据不同的证明内容设置不同的证明标准。     

That’s One Heck of an “Unruly Horse” Riding Roughshod overr Autonomy in Wrongful Conception

The case of Rees v. Darlington Memorial Hospital N.H.S. Trustarises from a lower court backlash against the a prior decision of the British House of Lords in McFarlane v. Tayside Health Board. McFarlane holding that healthy children brought about by negligence in family planning procedures are blessings, and parents should therefore be denied the costs of child maintenance. But, would the House agree with the Court of Appeal in Reesthat the factual variation in that case of a disabled parent with a healthy child should form an exception? In tracing the appeal of Reesto the House of Lords, this note explores their Lordships’ refusal in principle to depart from McFarlane, as well as the invocation of an autonomy-based approach to address the harm of unsolicited parenthood. In reflecting on the extent to which the wrongful conception action can be said to reinforce the value of reproductive autonomy, this note argues, nevertheless, that Reesillustrates in another way a significant departure from McFarlane, but that this is still a turn in the wrong direction. Far from resonating with women’s diverse experiences of reproduction, the law of negligence continues to illustrate little respect for reproductive choice. Therefore, this note calls for a deeper understanding of autonomy, one that recognises and embraces the diversity of individuals’ reproductive lives.     

Protracted Refugee Situations: Parallel Health Systems and Planning for the Integration of Services

The international community typically responds to refugee situationsby establishing ‘care and maintenance’ programmesspecifically for refugees. Limited resources may also be directedto hosting communities, but donors often channel the bulk offunding through UNHCR and its implementing partner NGOs, whoin turn create service delivery structures that are operatedin parallel to local structures. Although there may be causefor this approach in a short-term emergency phase, particularlyif the host country systems are very weak, this eventually becomesfinancially problematic if refugees continue to live in exilefor years at a time. In the short term, it can also engenderan inequitable and inefficient use of scarce resources. Thispaper traces the evolution and impact of implementing refugeehealth services in parallel to local systems using observationsfrom Uganda, and offers Quality Design as a model for planningthe local integration of services.     

LEGAL USE OF MENTAL HEALTH EVALUATIONS IN CHILD PROTECTION PROCEEDINGS

The authors examine the use of mental health evaluations in legal decision making within a large, urban juvenile court system. The focus was on court files in child protection cases relating to 171 randomly selected mental health evaluations completed on parents and 44 evaluations completed on children. Parent evaluations (46.7%) were much more likely to be present in court files than child evaluations (5.9%), and evaluations conducted by in-house court clinicians (63.8%) were more often present than those conducted by noncourt clinicians (37.5%). References to evaluations in child welfare, legal, or mental health documents varied with the type of information, subject (parent or child), and source of the evaluation. Findings and/or recommendations of evaluations were cited in legal or mental health documents for approximately two thirds of parent evaluations but only one third of child evaluations. Evaluation findings and/or recommendations were stated as a basis for legal decisions in 36.2% of court-based parent evaluations, 21.0% of noncourt-based parent evaluations, and 2.3% of child evaluations. These results provide evidence of a modest impact of parent evaluations on legal decisions and notably less impact for child evaluations. The authors suggest directions for future research and practice in order to increase the accessibility and usefulness of clinical evaluations in legal decision making.     

提高警察群体身心健康水平的对策与思考

大幅度提高公安民警的身心健康水平应受到党和政府的高度关注,这是公安机关乃至全社会应该认真思考的一个社会问题。本文在调查研究的基础上,对提高警察群体身心健康水平作了一些对策性思考。     

210例司法精神病学鉴定案例分析

作者对210例司法精神病学鉴定案例进行分析。该组刑事案例以凶杀居首位,被鉴定人以患精神分裂症为多。鉴定结论评为无责任能力者占41.6％。案件中受害者以精神发育迟缓、正处于发病期的精神分裂症或情感性精神病的女性患者(78.4％)被奸污为多。经随访司法部门的最后处理结果和我们的鉴定结论意见较为一致。     

The elderly's access to health care services: The crude and subtle impacts of Medicare changes

Medicare, the federal government's health insurance program for the aged and disabled, has been subjected to a number of legislative and regulatory changes since 1981 aimed at reducing the costs of the program. About a third of the cutbacks have been in activities that directly increase patient cost sharing. Other changes, while aimed at improving efficiency, may also shift costs onto program beneficiaries. This paper estimates the differential impacts of such program changes by age and income of elderly Medicare enrollees and discusses the likely resulting impact on their access to care. Surprisingly, such equity concerns have been largely overlooked in the policy debate concerning cost containment under Medicare.     

中外妇女生殖健康比较研究

女性生殖健康是妇女的一项基本人权,也是妇女解放程度和妇女地位提高的重要标志.中国妇女许多生殖健康指标已经达到甚至超过发达国家水平,表明尽管中国经济水平和整体医疗保健水平尚未达到中等发达国家水平,但中国妇女尤其是广大农村妇女生殖保健水平得到国家在现有条件下的最好关照.在这一领域,中国妇女已经获得比世界许多国家包括许多中等发达国家更高的解放程度和社会及家庭地位.中国政府在经济文化水平欠发达条件下对人权的争取和维护,在妇女生殖健康问题上得到最充分的诠释.     

公安民警心理健康状况及其对策

警察是一种压力密集型职业,因而公安民警的心理健康状况不容乐观。当务之急要采取有效措施,缓解民警的心理压力,开展民警心理保健,提高民警的心理健康水平。从六个方面提出了解决问题的思路和方法。     

Rationale and Strategies for Central Involvement of Educators in Effective School-Based Mental Health Programs

Unfortunately, for many mental health professionals classroom teachers and other educators are, at best, viewed primarily or solely as useful sources of information about a child, and their broader, invaluable roles as members of the mental health team are diminished or dismissed. This article examines the conceptual rationale and empirical support for central involvement of educators (especially classroom teachers) in effective mental health services, and in effective expanded school-based mental health programs. The importance of partnerships with educators for school-wide mental health promotion efforts, as well as for the success of primary and secondary prevention initiatives, are highlighted. Effective strategies and recommendations for enhancement of educator-mental health professional collaboration are included.