精神病人合同能力鉴定的相关问题

为了探讨精神病人合同能力鉴定的相关理论 ,解决合同能力鉴定中鉴定标准混乱的问题 ,对合同能力鉴定的法律基础、标准、民事行为能力与民事权利能力的区别 ,民事行为能力的广义、狭义区分进行了论述。提出合同能力鉴定的核心问题是意思表示的真实性 ,主张将合同能力分为有、无两级 ,强调合同能力的分级与民事行为能力的等级存在区别。并提出合同能力鉴定的程式为 :首先判定其行为能力 ,有行为能力相应具有合同能力 ,无行为能力即无合同能力 ,限制民事行为者 ,应根据年龄、智力、精神健康状况、生活关联度 ,再分为有合同能力、无合同能力。     

First report from the Swedish National Forensic Psychiatric Register (SNFPR)

To the best of our knowledge, the present register is the only nationwide forensic psychiatric patient register in the world. The aim of this article is to describe the content of the Swedish National Forensic Psychiatric Register (SNFPR) for Swedish forensic patients for the year 2010. The subjects are individuals who, in connection with prosecution due to criminal acts, have been sentenced to compulsory forensic psychiatric treatment in Sweden. The results show that in 2010, 1476 Swedish forensic patients were assessed in the SNFPR; 1251 (85%) were males and 225 (15%) were females. Almost 60% of the patients had a diagnosis of schizophrenia, with a significantly higher frequency among males than females. As many as 70% of the patients had a previous history of outpatient psychiatric treatment before becoming a forensic psychiatric patient, with a mean age at first contact with psychiatric care of about 20 years old for both sexes. More than 63% of the patients had a history of addiction, with a higher proportion of males than females. Furthermore, as many as 38% of all patients committed crimes while under the influence of alcohol and/or illicit drugs. This was more often the case for men than for women. Both male and female patients were primarily sentenced for crimes related to life and death (e.g., murder, assault). However, there were more females than males in treatment for general dangerous crimes (e.g., arson), whereas men were more often prosecuted for crimes related to sex. In 2010, as many as 70% of all forensic patients in Sweden had a prior sentence for a criminal act, and males were prosecuted significantly more often than females. The most commonly prescribed pharmaceuticals for both genders were antipsychotics, although more women than men were prescribed other pharmaceuticals, such as antidepressants, antiepileptics, and anxiolytics. The result from the present study might give clinicians an opportunity to reflect upon and challenge their traditional treatment methods.     

Courts' misplaced confidence in psychiatric diagnoses

In considering psychiatric evidence, criminal justice systems make considerable use of labels from official psychiatric classificatory systems. There are legislated requirements for psychological and/or behavioural phenomena to be addressed in legal tests, however medico-legal use of the current categorical diagnostic frameworks which are increasingly complex is difficult to justify. The lack of validity in large domains of the present classificatory systems is now more openly acknowledged, prompting a critical rethink. Illustrative examples include post-traumatic stress disorder, various personality disorders, and dissociative identity disorder. It follows that the Courts' faith in the present categorical classifications (e.g., DSMIV and ICD10) is misplaced and may be ultimately unhelpful to the administration of justice.     

精神障碍者刑事责任能力判定研究

为推介中国人民大学法学院博士培养成果,搭建论文品评乃至学术评价之平台,《法学家》专辟博文精萃一栏。该栏目由两部分组成:其一是论文要旨,由博文作者对其博士论文进行全面系统而重点突出的介绍,一般宜包括如下要素:论文的体系架构;论文每章节的主要内容;论文的主要特点;论文的主要创新和不足;论文所研究领域的课题展望。其二是论文评议,可以是答辩委员会的论文审查意见,或者评审专家的点评,具体宜包括如下要素:对论文的总体评价;对论文的体系及各章节的评价;对论文创新的评价;指出论文的不足以及进一步完善的方向。敬请关注并提出宝贵建议。     

The “Bestie di Satana” Murders

In recent years, satanic groups have been responsible for various types and degrees of crimes. We report the case of a number of murders committed in Italy by a group of young people calling themselves the “Bestie di Satana”. Forensic psychiatric assessment of the members of a satanic sect charged with the crime revealed that all the young people had a fragile, immature personality, a very low level of education and were socially disadvantaged. The trial of the members of the “Bestie di Satana” sect was concluded with the verdict of deliberate murder, and all the members were given long jail sentences. This report should lead us to explore social and cultural responses to juvenile satanism, statistically shown to be a relatively rare phenomenon but with a high criminal potential.     

Sexual offenders with serious mental illness: prevention, risk, and clinical concerns

Individuals with serious and persistent mental illness who have also engaged in illegal sexual behavior present a unique challenge for our legal and clinical systems. Frequently, these individuals may engage in problematic sexual behaviors which result in hospitalization rather than incarceration, and an overburdened and resource-deficient public community mental health system is ill-equipped to address the seriousness of these sexual behaviors. We have a rather limited understanding of how prevention programs, intervention strategies, and risk assessment would work with this population. Here we evaluate data from a sample of 245 inpatient psychiatric sexual offenders in a forensic mental health setting and compare these with what information has already been presented in some of the literature. Through an examination of seriously mentally ill sexual offenders and their clinical presentation, legal history, and risk management concerns, we illustrate a variety of tertiary prevention needs. Future directions in the area of prevention and risk management for seriously mentally ill sexual offenders are also discussed.     

CCK受体基因多态性及与部分精神疾病症状的相关性

胆囊收缩素(CCK)不仅存在于消化系统,而且还广泛存在于中枢及外周神经系统,并以神经递质的形式通过其受体(CCK-R)发挥着重要的生理作用。CCK-R有两种类型,CCK-AR和CCK-BR。CCK-R基因具有遗传多态性,并通过影响或改变CCK对中枢神经系统的作用强度而与酒精中毒、精神分裂症、恐慌症等人类精神疾病密切相关。CCK-R基因遗传多态性的研究可能为法医学个人识别与亲权鉴定新提供新的遗传标记及为司法精神病鉴定提供参考性遗传学指标。     

Competence to Complete Psychiatric Advance Directives: Effects of Facilitated Decision Making

Psychiatric advance directives (PADs) statutes presume competence to complete these documents, but the range and dimensions of decisional competence among people who actually complete PADs is unknown. This study examines clinical and neuropsychological correlates of performance on a measure to assess competence to complete PADs and investigates the effects of a facilitated PAD intervention on decisional capacity. N=469 adults with psychotic disorders were interviewed at baseline and then randomly assigned to either a control group in which they received written materials about PADs or to an intervention group in which they were offered an opportunity to meet individually with a trained facilitator to create a PAD. At baseline, domains on the Decisional Competence Assessment Tool for PADs (DCAT-PAD) were most strongly associated with IQ, verbal memory, abstract thinking, and psychiatric symptoms. At one-month follow-up, participants in the intervention group showed more improvement on the DCAT-PAD than controls, particularly among participants with pre-morbid IQ estimates below the median of 100. The results suggest that PAD facilitation is an effective method to boost competence of cognitively-impaired clients to write PADs and make treatment decisions within PADs, thereby maximizing the chances their advance directives will be valid.     

初探精神鉴定中人为性鉴定失误行为

目前,我国尚无统一的精神卫生法,关于鉴定人员在鉴定中的行为,缺少相应的法律规范。而由于各种原因所致,鉴定中时有“人为性鉴定失误”现象发生。致使精神正常人被错关入院的案例不断出现。文章对该现象出现的原因、该不当行为的违法性,进行具体分析。并提出关于消除该现象的个人观点。以期能对未来我国精神卫生法的制定有所启发。     

Regional psychiatric boards in Israel: expectations and realities

As laid down by Israeli legislation, the Regional Psychiatric Board constitutes one of the chief instruments in the monitoring of compulsory hospitalization, of compulsory outpatient treatment and of the quality of all inpatient care of the mentally ill. This article presents the findings of a study into the working of these boards. Taking a sample of every second application (N=168) over a 6-month period to one of Israel's six existing Regional Psychiatric Boards, an examination was made of the decisions issued by the board and of other aspects of its functioning. Explanations for the findings of this analysis are suggested, and generalizing from these findings, recommendations are offered for the improvement of the future functioning of all six Boards.