论医患法律关系及医改法律原则

医疗卫生体制改革已进行了多年,但“看病难、看病贵”仍持续存在,医患关系凸显了社会矛盾,严重影响和谐社会的构建。文章从医患关系现象这一最基本的问题出发,探析其法律性质、特征,有针对性地提出医改的法律原则。     

An Action Research of Constructing Self-awareness of HospitalizedPsychiatric Patients from the Strength Perspective

The research selected K hospital in Kunming as the case, and applied action research methods to explore the ways and methods of how social workers helping patients construct a positive self-awareness. The result shows that under the guidance of the strength theory, comprehensive service to the hospitalized psychiatric patients and their families could help patients recognize their own physical self objectively and reduce their fears and anxiety. At the same time, the life-course review and the Iceberg Theory are likely to help patients to accept themselves, find their own inner needs and strengths, and build a positive psychological self. By providing external support and promoting the patients to participate in community life actively we could help them to build a positive social self. The paper also presented several principles necessary for the construction of positive self-awareness of the psychiatric patients in the local context.     

MMPI profiles of males accused of severe crimes: a cluster analysis

Abstract

In studies attempting to classify criminal offenders by cluster analysis of Minnesota Multiphasic Personality Inventory-2 (MMPI-2) data, the number of clusters found varied between 10 (the Megargee System) and two (one cluster indicating no psychopathology and one exhibiting serious psychopathology). The latter results raise doubts about the suitability of the MMPI-2 for classification in forensic settings. The present study aimed at deriving an empirical classification system using cluster analysis of 247 MMPI-2 profiles of pretrial criminal defendants in a forensic psychiatric observation clinic. Results indicated only a ‘non-disturbed’ and a ‘disturbed’ profile, differing on general elevation of MMPI-2 profiles but displaying no qualitatively distinct profiles. The clusters differed on age at admission and first conviction, indicating a late onset of criminal activity for disturbed offenders. Also, the clusters differed significantly on Axis I diagnosis and borderline significantly on Axis II diagnosis. The absence of distinct personality profiles between the clusters suggests restricted usefulness of the MMPI-2 in a forensic context of diverse and severe psychopathology and serious crimes. Either the investigated population is in fact extremely homogeneous, truly comprising only two kinds of offenders, or the types of offenders in these populations are not effectively distinguished by the MMPI-2.     

Alexithymia in Dutch violent forensic psychiatric outpatients

Abstract

Until now alexithymia has not been investigated in Dutch low-educated offenders who are known for their violent behaviour. We therefore investigated a sample of aggressive forensic psychiatric outpatients, who are characterized by emotional dysregulation in conflict situations. For that purpose we used a Dutch questionnaire, the Bermond-Vorst Alexithymia Questionnaire (BVAQ; Vorst & Bermond, 2001), which we also administered in a sample of secondary vocational students for a comparison. Unfortunately, the five-factor structure of the BVAQ could not be confirmed in both samples, but in the patient sample the test-retest reliability of the total score turned out to be moderate, and meaningful correlations were found with measures of relevant personality domains and problem behaviours. When both samples were compared, patients were found to display significantly higher total scores on the BVAQ than the secondary vocational students, when controlled for age. Therefore, we concluded that alexithymia may contribute to the aggressive behaviour of violent forensic psychiatric outpatients. However, patients as well as students had much higher total scores on the BVAQ than found by Vorst and Bermond (2001) in a sample of Dutch psychology students. This indicates that alexithymia as measured by the BVAQ is also inversely related to educational level and perhaps to intelligence.     

论患者隐私权保护——兼论侵害“告知后同意”之请求权基础

隐私权已从传统消极防御面向发展到兼具积极支配面向,主要包括四项权能:隐私隐瞒权、隐私利用权、隐私维护权和隐私支配权.《侵权责任法》第62条、第61条、第55条和第56条对应以上四种权能并共同构筑了患者隐私权范畴.患者隐私支配权需要借助于对患者的“告知后同意”实现,告知的内容应当包括医师同时兼具的研究者身份与潜在利益冲突.“告知后同意”虽然可以作为一种法益或者注意义务之违反得到救济,但作为某种权利得到保护系必然趋势,这种权利应是隐私权而非自主权.侵害患者“告知后同意”之隐私权的请求权基础应为第6条第1款,涉及赔偿责任时应适用特别规定第55条第2款,所涉损害主要系精神损害.     

38例精神分裂症患者凶杀行为研究

目的　探讨精神分裂症患者的凶杀犯罪行为各个方面的特点。　方法　对 38例具有凶杀行为的精神分裂症患者 ,在心理学、生理学、社会学等各方面进行实例分析。　结果　这些患者在犯罪动机、行为特点、犯罪工具、被害人等诸多方面与正常人的凶杀犯罪有明显的差异。　结论　应加强对精神分裂症患者的诊治 ,普及精神卫生的知识 ,从而预防、控制犯罪。     

重庆劳教所民警精神症状及影响因素调查研究

为了了解重庆劳教所民警的精神症状及其影响因素,使用以Derogatis编制的Hopkin＇s症状清单（HSCL1973）为基础的SCL-90精神症状自评表进行测试,结果显示：不同年龄组和不同性别的劳教所民警在SCL-90上各因子的得分均有显著差异,劳教所民警的精神症状不容乐观。     

吸毒“正常化”与香港防治毒品政策之转变——以青少年吸食氯胺酮为例

香港政府的防治毒品政策大体可分为两大主轴。第一主轴是刑事司法,包含立法禁毒、执法及针对毒品相关罪行及吸毒者的判刑。第二主轴是社会政策,包括预防吸毒行为、识别吸毒者及提供戒毒复康服务。就吸食氯胺酮而言,香港青少年群体很大程度出现了帕克所述的"正常化"现象。同时,日常社交圈子中网络状的接触点大幅增加了非滥药群尝试氯胺酮的可能性。这种吸毒"正常化"对香港毒品防治政策有很大的影响。     

关于进一步规范精神疾病司法鉴定执业活动的几点思考

精神疾病司法鉴定问题一直以来备受公众责难,处理不好将影响社会公共安全和秩序,并对精神疾病患者的合法权益造成损害。解决此问题的关键是要认清精神疾病司法鉴定的特点,进一步规范精神疾病司法鉴定的执业活动,并在此基础之上正确厘清审判职能与鉴定功能的关系,以确保精神疾病司法鉴定活动的顺利进行。