关于社会转型期医患冲突问题的若干思考

在社会转型的特殊历史时期,尤其是在努力实现"病有所医"的重大医改过程中,因医疗纠纷引发医患冲突甚至导致群体性事件不断增多,呈现出秩序危机、暴力危机、信任危机、赔偿危机、舆情危机"五大危机",究其根源是利益博弈的集中体现,只有做到以民生为本,才能从根源上有效减少医患冲突,而作为维护社会稳定主力军的公安机关,要立足本职,做到情法交融,既积极介入,有情操作;又适时出手,无情打击,切实促进社会和谐稳定。     

Treatment as punishment: Forensic psychiatry in The Netherlands (1870–2005)

This article provides an overview of the development of forensic psychiatry in the Netherlands from the late nineteenth to the early twenty-first century. The first part addresses the ways forensic psychiatry established itself in the period 1870–1925 and focuses on its interrelatedness with forensic practice, psychiatry's professionalization, the role of the government, the influence of the so-called New Direction in legal thinking and (Italian and French) anthropology of crime, and the debates among physicians as well as between psychiatrists and legal experts on the proper approach of mentally disturbed offenders. From the mid-1920s on the so-called ‘psychopaths laws’ anchored forensic psychiatry in the Dutch legal system. The second part zooms in on the enactment of these laws, which formalized special measures for mentally disturbed delinquents. These implied a combination of sentencing and forced admission to and treatment in a mental institution or some other form of psychiatric surveillance. The article deals with the meaning, reach and consequences of this legislation, its debate by psychiatrists and legal experts, the number of delinquents affected, the offenses for which they were sentenced and the (therapeutic) regime in forensic institutions. The goal of the Dutch legislation on psychopaths was ambiguous: if it was designed to protect society against assumed dangerous criminals, at the same time they were supposed to receive psychiatric treatment to enable their return to regular social life again. These legal and medical objectives were at odds with each other and as a result discussions about collective versus individual interests as well as about the usefulness and the effects of this legislation kept flaring up. To this day the history of this legislation is characterized by the intrinsic tension between punishment and security on the one hand and treatment and re-socialization on the other. Whether at some point one or the other prevailed was largely tied to the social climate with respect to law, order and authority.     

医疗执业风险行业内分担机制的初步探讨

为有效规避和转移医疗执业风险、解除医疗机构和医务人员的后顾之忧,本文对设立与完善医疗执业风险行业内分担机制的必要性和可行性进行探讨。通过深人分析本文认为,通过整合社会各方面力量和医疗行业内的资源,建立医疗责任商业保险机制,可分担医疗执业风险,维护社会和谐与稳定。     

Review of point-of-reception mental health screening outcomes in an Australian Prison

The point-of-reception into prison is a critical juncture as it provides early opportunities to identify mental illness and initiate treatment. Although large numbers of mentally ill prisoners are received into prison each day, research investigating mental health screening outcomes at the point-of-reception is limited. This study aimed to address this gap by examining reception screening outcomes for all prisoners received into an Australian prison during 2009 (n?=?4229). Overall, 19% of all prisoners were mentally ill, and another 20% had a history of psychiatric illness that required ongoing care. Mentally ill prisoners had a higher risk of suicide or self-harm and required more observation than other prisoners. At reception, no mentally ill prisoners were transferred to the state’s forensic hospital and few were transferred to the prison’s mental health unit, or provided support service referrals. These findings highlight that outcomes made at the point-of-reception are heavily influenced by the availability of prison mental health resources.     

The Endowment of Patients with Mental Disorders and Its Influencing Factors: An Empirical Study Based in Shanghai

This paper explores the willingness of the patients with mental disorders and the influencing factors in choosing their way of old-age care, and puts forward the corresponding policy guidance. A total of 220 patients with mental disorders in Shanghai were surveyed with the purposive sampling method. Statistical analysis was performed using χ2 test and multiple logistic regression method. The results showed that the selection of family support accounted for 23%, institution endowment by 12%, community home-based care took up19%, community nursing agency for patients with mental disorders accounted for 46%. Age, monthly income, type of mental illness, length of hospital stay, "raising children" attitude, and whether nursing homes accept elderly patients with mental disorders, all had significant influence on the old-age care inclination. Analysis of the old-age care inclination of the patients with mental disorder is unique. It is proposed that more construction of community nursing agency of mental disorders is necessary.     

监狱精神病罪犯问题及法律规制

对精神健康问题的关注程度标志着一个国家文明程度的提升,相应地对精神病人的刑事处遇政策也体现了一个国家刑事法治的发达水平,目前,监狱精神病犯人数有所增加,对这些特殊人群的关爱和保障要尽快提上议事日程,应当结合监狱的具体实际,建立罪犯服刑能力鉴定机制,强化“司法审查关”;构建强制治疗程序,发挥其防卫社会、治疗疾病和保障人权的功能;在监狱系统设立专门的精神病医院或监区,以维护监狱安全和保障罪犯权利。     

性被害人司法精神鉴定有关问题探讨

性被害人司法精神鉴定有关问题探讨李孝福，郑瞻培（１．安徽省黄山市第二人民医院；黄山２４５０２１；２．上海市精神卫生中心；上海２０００３０）ＡＰＲＯＢＥＯＦＳＯＭＥＰＲＯＢＬＥＭＳＲＥＧＡＲＤＩＮＧＰＳＹＣＨＩＡＴＲＩＣＥＸＰＥＲＴＩＳＥＦＯＲＳＥＸＵ...     

患方维权误区的法理学剖析

随着法治进程的推进,公众维权意识的提升,越来越多的患者在认为自身权利受到侵害时,倾向于主动维权。然而在实践中,相当一部分患者基于对权利概念和维护行为的错误认识和理解,在维权过程中陷入误区。一系列典型事例揭示出迷信行政权力、重实体轻程序、滥用权利、缺乏法律信仰等法理学层面上的患方不稳定因素。而相对于医方因素和社会因素,患方不稳定因素易被忽视,以致无法全面、客观分析当前日趋尖锐的医患冲突,对和谐医患关系的构建产生负面影响。     

颅脑损伤与人格障碍的关系研究

目的　为探讨颅脑损伤与人格改变的相互关系 ,特别是颅脑损伤的严重程度与人格改变的严重程度是否平行 ,为颅脑损伤的法医学鉴定提供科学依据。方法　对 1 97例颅脑损伤鉴定案例及住院病例进行分析 ,并对其中伴有人格改变的案例的颅脑损伤严重程度和人格改变的严重程度的相关性和其他影响因素进行分析。结果　 1 97例颅脑损伤中有 1 6 2例出现人格改变 ,占 82 3% ;其中在 1 1 3例中的重度颅脑损伤案例中 ,有 98例伴有人格改变 ,占 86 7% ;其中衰弱型人格改变与攻击型人格改变之比为 6 3:35 ;在 84例轻微颅脑损伤病例中 ,有 6 4例伴有人格改变 ,占 76 2 % ,衰弱型与攻击型之比为 4 0 :2 4 ;2 3例女性患者有 1 7例出现人格改变 ,衰弱型与攻击型之比为 1 3:4。结论　颅脑损伤的严重程度与人格改变的严重程度无相关性 ,轻微颅脑损伤所引起的严重攻击型人格改变是法医精神病学鉴定中的特殊课题     

重症病人犯罪侦防对策

重症病人一方面承受着疾病带来的生理痛苦，另一方面还承受着由于疾病所带来的心理痛苦，以及由于疾病而引起的经济上的拮据。当重症病人面对这些问题而又无法得到有效的解决时，重症病人就成为了犯罪的高危人群。由于重症病人生理和心理上的特殊性，使得对于重症病人犯罪的侦查与预防面临着更多的考验，因此科学合理的侦防对策是当下中国构建和谐社会的重要课题之一。