Secondary Iatrogenic Harm: Claims for Psychiatric Damage Following a Death Caused by Medical Error

The purpose of this paper is to investigate the feasibility of claims for psychiatric damage following the death of a family member, where that death has been caused by medical error. ¹ The relative's position is a subject of heightened interest since the exposure of the plight of the parents involved in the UK organ scandal, ² and in the case of an iatrogenic death it is, of course, the family who are essentially the focus of the law's attempts to provide redress. Whilst the cases of deceased patients' relatives seeking damages for mental harm are inherently problematic in light of the restrictive secondary victim criteria applicable to psychiatric damage claims, a close look at the rules which permeate this area of compensation reveals that denying compensation to the relative suffering psychiatric harm is difficult to sustain. ³     

精神失常抗辩及其刑事证明——以美国法为视角

心智健全推定卸除了控方对被告人心智健全的证明责任,将争点形成责任交由辩方承担。而精神失常在美国刑事法中属于积极抗辩事由,根据联邦和多数州的司法实践,由辩方承担提出初步的举证责任,并承担“清晰、信服”程度的说服责任。相较之下,我国目前刑事实体法的建构与刑事证明之间没有明确的衔接,以至于刑事证明的功能无法有效实现。司法精神病鉴定是目前查实被告人是否精神失常的主要手段,但启动权主要其中在公安司法机关手中,辩方权利受到较大限制,而对鉴定人以及鉴定证据亦缺乏体系性的证据审用规则。司法精神病鉴定应当纳入刑事证明的轨道,辩方如欲推翻心智健全推定,应提出相应证据,继而说服责任的分配要区分辨方证明主张：该鉴定意见是对控方对犯罪主观方面要素证明的反驳,还是主张责任阻却。前者由控方证明到排除合理怀疑的程度,而后者则由辩方证明到清晰、信服的程度。在此证明原理的基础上,鉴定人有义务出庭对鉴定意见进行口头陈述或展示,并接受对造的质证。鉴定意见的证据能力则由法庭依法判断,其证明力则由法庭自由评价。     

强制医疗中精神病人刑事责任能力的认定

精神病人刑事责任能力的认定,是启动强制医疗程序的闸口.由于我国精神病人刑事责任能力认定理论没有统一标准,导致精神病鉴定专家充当了医学裁判和法学裁判的双重角色,对精神病人鉴定程序流于形式.只有明确精神病人的法律定义,发挥法官的自由心证,提前检察机关审查和监督的介入环节,才能使精神病人肇事肇祸事件得到妥善处置.     

论精神病人强制医疗程序中存在的问 题简

2012年刑事诉讼法增设了“依法不负刑事责任的精神病人的强制医疗程序”,从而解决了强制医疗程序在程序法层面立法空白的缺陷问题,但仍存在着鉴定程序的规定存在立法空白、危害性条件缺乏具体标准、程序启动主体缺少当事人、临时的保护性约束措施未具体规定、合议庭的组成缺乏合理规定、法律援助仅适用审判阶段等问题.为使该程序在司法实践中取得预期效果,必须解决上述问题.     

Characterising the psychiatric comorbidities among adults with ADHD who have a history of offending

The prevalence of attention deficit hyperactivity disorder (ADHD) among adult offenders is significantly higher than in the general population. Adults with ADHD often present with multiple psychiatric comorbidities. This study aims to characterise the comorbidities presented by adults with ADHD who have offended and also to investigate predictors of offending among this population. Seventy-three participants with a diagnosis of adult ADHD were divided into a group with a history of offending behaviour (n = 30) and a group of non-offenders (n = 43). Groups were compared on measures of ADHD symptoms, substance use and DSM-IV Axis I and Axis II disorders using the Millon Clinical Multiaxial Inventory – 3rd Edition. Major depression, cannabis use and childhood hyperactivity-impulsivity symptoms predicted offending. These findings indicate that adults with ADHD who have a history of offending behaviour are more likely to present with complex psychiatric needs.     

105例生前精神异常的水中尸体回顾性分析

目的：分析生前精神异常的水中尸体的特点,为此类案件鉴定和分析提供参考。方法调查2010年1月至2014年6月上海市公安局水上公安局检验的所有生前精神异常的水中尸体档案105例,对死者一般情况、尸检情况、案情调查情况和疾病史进行统计分析。结果自杀104例,死者受教育程度较低,天气较暖时案件较多,尸体多在2d内被发现。多数死者没有自杀史,没有遗书,但在临死前出现行为、心理的异常变化。抑郁症、抑郁状态和精神分裂症是主要的精神障碍类型,仅有9名死者曾坚持进行正规治疗。结论精神异常是投水自杀的高危因素,监护人员应该警惕患者的异常行为,特别是气温转暖时。     

Donald Davidson and section 2.01 of the model penal code

Abstract

In a 1967 article that is considered a classic of criminal justice scholarship, Abraham Blumberg portrayed defense attorneys for accused offenders as more responsive to the demands of the court entourage for smooth and expeditious functioning than to the needs of their clients for a stalwart representation. The article suggests that Blumberg's view, while provocative and with a considerable element of accuracy, may have reflected a somewhat jaundiced and overstated perspective when he was on the verge of leaving law practice for academia. The article also speculates about the current accuracy of Blumberg's observations.     

民事诉讼能力的影响因素

目的探索精神病人民事诉讼能力的影响因素,为民事诉讼能力量化评定奠定基础。方法以司法部司法鉴定科学技术研究所2002—2005年期间进行民事诉讼能力评定案例中的被鉴定人为研究对象,采用RTHD和自编的民事诉讼相关情况调查表,从医学要件和法学要件两方面探索民事诉讼能力影响因素。结果共纳入100例研究对象,分为有或无民事诉讼能力两组,在一般状态、认知障碍、情感症状、行为异常和法律心理能力等方面均存在显著差异,自知力、记忆力、智能对民事诉讼能力具有显著影响,两组社会功能也存在显著差别。结论在精神症状的影响下,精神病人理解表达、判断和控制能力等明显受损,不能正常地进行民事诉讼。     

医-患双方关系与医-患-社保三方关系——由深圳市社保局“钓鱼执法”引发的思考

我国已进入了医-患-社保三方关系的社会本位时代,但人们的思维意识、行为习惯还依然停留在医-患双方关系的个人本位时代。近年来社保定点医疗机构多发不规范医疗行为,甚至与参保患者不谋而合联手“作局”侵害社保利益也屡见不鲜。定点医疗机构与参保患者趋利内核中蕴藏的是强烈的自私利己之人性欲望本能,他们无视了一点：不能只享受社保带来的巨大好处而拒绝维护社保利益。因此,深圳市社保局处理违规定点医疗机构不但完全于法有据而且合理正当甚至难能可贵。但仅此是远远不够的,我们需要更彻底的观念更新及更深刻的制度变革。     

精神病患者违法暴力案件的现状及处置预防对策

精神病患者违法暴力事件时有发生,对社会稳定以及当事双方人身安全和公共安全造成极大影响。随着精神病患者违法暴力事件呈不断上升趋势,为避免处置中的不当或过度等情况发生,针对性的日常管控、安全保障、病理对症、语言交流、现场武力使用以及战术科目训练等方法,对妥善处理精神病患者暴力违法案件有十分重要的意义。