bluuebunny/crossref_metadata_2025 huggingface dataset:
On the sense of justice
Authors: Gorman Warren
Published: February 2018

The sense of justice is a universal psychosocial preoccupation that has developed in both the individual and society during the course of civilization.

A doctrine, a concept, and a striving comprise its three parts. The first of these finds its origins in fairness as command, fairness as contract, utilitarianism and divine command. The concept of justice is inherent in the child's expression of social justice, as suggested by Piaget, and brilliantly developed by Kohlberg. The striving for justice that is regulated through the harsh superego produces the “injustice collector” and the urge toward retribution; the benign superego encourages orderliness and affectionateness which is essential to the mutual respect that is required for the highest level of moral justice.
Can comprehensive mental healthcare be provided in an overcrowded prison system?
Authors: Kaufman Edward
Published: February 2018

This article deals with the efforts made in a 15-month period to provide mental health services in a large, antiquated, overcrowded prison system. The role of altered public sentiment engendered by recent prison riots and rising suicide rates in making available funding and personnel is discussed. The mental health services which were provided are described in detail as well as their relationship to the correction and criminal justice systems. Plans for viable alternatives to the present system are discussed. The risk that such services can be a perpetuation of a nonfunctional system that prevents needed radical change is explored.
The Mentally Disabled and His Lawyer
Authors: Patch Robert K.
Published: February 2018

Traditional social attitudes toward the mentally ill and mentally retarded, which were based upon misinformation, misunderstanding, and fear, have impeded the development of concern for the legal rights of those so afflicted. Even more, the development of legal services for the enforcement of the substantive and procedural rights of the mentally disabled has not matched comparable developments for those accused of crime. To remedy this gap in our application of justice to one another, it is essential that a system of legal advocacy be established for the mentally disabled, based upon adequate clinical training of lawyers, and their availability as specialists, to provide a continuity of services matching that of their clients’ disabilities.
Behavior Modification for Patients and Prisoners: Constitutional Ramifications of Enforced Therapy
Authors: Kassirer Lynn Bregman
Published: February 2018

Behavior modification is a discipline familiar to psychiatrists and psychologists, which has only recently come to the attention of the legal profession. With the advent of the widespread use of behavioral treatment in our nation's institutions scholars have begun questioning the propriety and legality of such enforced therapy. This article describes learning theory and techniques of behavior modification. It then presents those issues raised by coerced behavior therapy on prisoners and mental patients and discusses relevant case law.
A comparison of Blacks and Whites Committed for Evaluation of Competency to Stand Trial on Criminal Charges
Authors: Cooke Gerald , Pogany Eric , Johnston Norman G.
Published: February 2018

All males referred to the Michigan Center for Forensic Psychiatry for competency evaluation in 1969 were grouped according to race, and differences on demographic variables. Criminal charges, diagnosis, competency finding, and disposition were studied. A subsample of 70 blacks and 70 whites was analyzed for characteristics associated with M M PI administration and for differences in M M PI profile. The results are consistent with previous literature and indicate a tendency to clinically overestimate psychopathology in blacks though there is no supporting evidence for a difference in level of pathology in terms of the more objective M M PI measure. The profound effects of this overestimation on disposition are discussed, and a number of solutions are proposed.
To be Guilty or not to be Guilty
Authors: Jedwab Samuel J. , Gigeroff Alex. K.
Published: February 2018

The efficacy of the question” How do you plead, guilty or not guilty?” is discussed and analyzed in the light of the etymology of the word “guilt.” A survey of alternative approaches to pleadings was carried out involving questionnaires returned by 26 countries (out of 64 submissions). The authors conclude that our system of justice would he better served by the elimination or modification of the question “How do you plead, guilty or not guilty?”
The Relationship between Attitudes toward Capital Punishment and Assignment of the Death Penalty
Authors: Stricker George , Jurow George L.
Published: February 2018

Questionnaires concerning attitude toward capital punishment, liberalism-conservatism, and the assignment of penalties in 13 capital cases were administered to 190 college students. All scales correlated significantly with each other, with Ss who were opposed to capital punishment less likely to assign the death penalty in specific cases. Factor analysis showed separate factors for murderers, assassins, attitudes and demographic data. The relationship of these findings to the Witherspoon case is discussed.
The expanding Fist: A Behavioral Approach to Riot Prevention and Rehabilitation
Authors: Watkins John G.
Published: February 2018

Prison riots tend to occur when a strict, security-minded administration is replaced by a warden interested in rehabilitation. The change, itself, creates insecurity and anxiety in the inmates and induces them to test the limits of the new warden. This article proposes a way, based on psychodynamic understanding, for helping an institution to make the transition successfully using behavior therapy techniques. The same procedures consistently applied can then become a major approach in treatment of offenders. Current resistance to behavior modification methods are analyzed.
The Right to Treatment and the Right to Refuse Treatment-recent Case Law
Authors: Kassirer Lynn Bregman
Published: February 2018

Perhaps no other area of constitutional law has been expanding as rapidly as that pertaining to the rights of the incarcerated. The right to treatment has received the most judicial attention; one such case has just recently been granted review by the Supreme Court. This important case, and others which have appeared in recent months are presented for discussion in this article.
Training Lawyers in Behavioral Science and Its Applications
Authors: Foster Leila M.
Published: February 2018

Behavioral science can be of assistance to the legal profession in (1) substantive development of the law from interdisciplinary contributions and (2) improvement of professional skills. A questionnaire sent to law professors teaching law and psychiatry and law and society courses reveals some of the innovative programs offered to some law students. Bar associations also are becoming interested in providing continuing education in this area. Professionals of both behavioral science and law should be encouraged to increase areas of communication between the disciplines.
The Courts and the Lallapaluza Rule
Authors: Feldman Walter S.
Published: February 2018

With regard to medicine, conformity to the community standard no longer always satisfies the courts. Now they sometimes insist that an even higher standard be utilized. In some instances this is a standard that isn't followed by any of the best practitioners in the community. As a result, a physician who practices his art in conformity with the highest standards of his medical community still has cause to fear a successful malpractice suit.
Prolixin Decanoate: Big Brother by Injection?
Authors: Zander Thomas K.
Published: February 2018

This article examines the psychiatric research and legal doctrine concerning the psychotropic drug Prolixin Decanoate. Prolixin is a unique drug because, once it is injected into a person, its effects last from two to four weeks. Some courts are now considering the circumstances under which this drug should be forced upon an involuntarily committed individual. The article concludes that because of (a) the shortcomings of psychiatric research of Prolixin, and (b) the adverse effects of the drug, courts should consider Prolixin to be an experimental treatment modality—like psychosurgery—when deciding whether it should be forcibly administered to an involuntarily committed individual.
The Dangerousness of Patients Released from Maximum Security: A Replication
Authors: Pruesse Manfred , Quinsey Vernon L.
Published: February 2018

Two hundred six male discharges from a maximum security psychiatric institution were followed up for a 37–49 month period. Failures were defined as men with new convictions or a readmission to the security hospital. Forty-six percent of the sample failed, usually by the commission of minor property offenses, and 17% of the total committed at least one violent offense against persons. As in earlier studies of patients discharged from this hospital, younger, personality disordered patients were more likely to fail. Younger, personality disordered patients were also more likely to commit a violent offense than older, nonpersonality disordered patients.
The Role of Counsel in Civil Commitment: Changes, Effects, and Determinants
Authors: Hiday Virginia Aldigé
Published: February 2018

To investigate the “post-reform” role of counsel in civil commitment hearings, courtroom proceedings in 132 cases were observed in one county in a state with representative statutory reform incorporating judicial decisions and professional recommendations. Behavior was recorded by checklist and notetaking; and background information was collected from court records. Counsel was found to assume an advocate's role in less than half of contested cases. The effect of such a role was a significant reduction in commitments. In-depth interviews with a nonsystematic sample of counsel provided information on counsel's prehearing behavior and on the determinants of counsel's role. It is hypothesized that counsel's behavior is determined by one of three decision models—(1) medical, (2) client, or (3) counsel—and that these decision models are influenced by counsel's beliefs about mental illness, mental hospitalization, and psychiatry.
The Therapeutic Significance of the Civil Commitment Hearing: An Unexplored Potential
Authors: Ensminger John J. , Liguori Thomas D.
Published: February 2018

The evidence adduced in the past for the proposition that civil commitment hearings are deleterious to mental patients was largely theoretical, occasionally supported by anecdotes. The criticism seems to have reflected the general antipathy of doctors for everything legal. In fact, the relationship of the involuntarily committed patient to his attorney and numerous aspects of the commitment process contain considerable potential for therapeutic effects. Properly used, the process should be adjunctive to the hospital's function rather than an impediment to it.
On Unicorns Blocking Commitment Law Reform
Authors: Kahle Lynn R. , Dennis Sales Bruce , Nagel Stuart
Published: February 2018

Four surveys of the attitudes of psychiatrists toward issues related to involuntary civil commitment law are reviewed. This article shows that, contrary to popular opinion, psychiatrists favor increased due process of law protections and rights for patients both during and after commitment proceedings. These attitudes have been relatively stable over the past decade. In contrast with other groups, psychiatrists may be less emphatic in their support of rights, but the attitudes of psychiatrists when examined on an absolute scale clearly favor increased rights.
Child Custody Determination—A Proposed Psychiatric Methodology and Its Resultant Case Typology
Authors: Levy Alan M.
Published: February 2018

Psychiatrists have yet to agree upon a method of psychiatric evaluation of children in custody disputes that can confidently produce a valid exposition of the “best interests of the child” or the existing emotional and psychological relationship between the child and parent. This article outlines a proposed method of psychiatric evaluation in custody cases. It emphasizes the need to see each family member alone and together with all other family members. It stresses the need for open and free discussions of all pertinent issues including the custodial preferences of the child.
Residents of State Mental Institutions and their Money (Or, the State Giveth and the State Taketh Away)
Authors: Kapp Marshall B.
Published: February 2018

This article explores the legal, ethical, and policy considerations raised by the economic relationship between the state and residents of the state's institutions for the mentally ill and mentally retarded. The focus is upon two interrelated aspects of this relationship: (1) compensation for labor performed by residents within the institution, (2) the resident's obligation to reimburse the state for care and treatment received. Each of these issues is traced historically; current state practice is surveyed; and alternatives to present practice are suggested.
The Reinforcement of Social Cohesion: Humean Philosophy, the Therapeutic State and the Exclusion Ritual
Authors: Hrezo Margaret S.
Published: February 2018

There appear to be some unquestioned, although potentially illiberal, implications present in Hume's thought. This article will contend that Hume's ideas may provide the justification for an unconscious social policy which excludes from liberal society as ill those who cannot or will not adapt themselves to a Humean liberal lifestyle. Further, it attempts to support the idea that the therapeutic state is the social instrument utilized in this process and that the values of Humean philosophy provide the underlying foundation for its labeling of illness. Finally, it hopes to document the belief that the pervasiveness of Humean values also has contributed to the recent confusion of deviancy, illness, and crime in the American psychiatric and legal spheres as society seeks to protect itself by excluding those whom it perceives as potential threats.
Devāna
Authors: Hoch Erna M.
Published: February 2018

The legal concept of insanity is examined in the context of a case of manslaughter in a non-Western culture. The magical and religious beliefs of the people make it extremely difficult for a Western psychiatrist to determine whether the individual charged with the crime was insane. Modern concepts of psychiatry seem out of place when deeply entrenched beliefs motivate actions deemed criminal.
The Psychiatrist on Trial
Authors: Rappaport Richard G.
Published: February 2018

A psychiatrist who examines a criminal defendant pleading insanity may have the notes he takes in such an examination subpoenaed by the opposition. In Illinois, if such notes are “personal” rather than part of the record he may be able to keep them confidential. This article describes such a situation in which a subpoena is contested, and the arguments used to support the psychiatrist. The psychiatrist-witness here becomes a defendant. Wider ranging principles are established in the outcome which could be rewarding to all psychiatric patients.
Competency to Waive Counsel: A Step beyond Competency to Stand Trial
Authors: Felthous Alan R.
Published: February 2018

Jurists and expert witnesses regard competency to waive counsel much like competency to stand trial. Although the legal purposes are the same, competency to waive counsel and argue one's own case implies additional mental requirements, which in turn suggest the need for clarification of criteria.
The use of Involuntary Commitment and Videotape in the Psychiatric Treatment of an Incarcerated Offender: A Case Study
Authors: Moore Dixie
Published: February 2018

The psychiatric and legal history of a prisoner is reviewed. Ethical, legal and clinical problems related to his mental illness including his refusal to accept a not guilty by reason of insanity defense, his dual role as prisoner and patient, and his subsequent involuntary hospitalization are discussed. Use of a videotape interview as an adjunct procedure in his involuntary treatment is described and recommended.
Forensic and Jail Psychiatry in a Developing Tropical Region: Initiating a Consultation Program in Micronesia
Authors: Wilson Lawrence G.
Published: February 2018

This article summarizes 15 months' experience as the only psychiatrist available to jails, courts and attorneys for the huge tropical area of the Trust Territory of the Pacific Islands (Micronesia). Twelve percent of all psychiatric evaluations during this time were court- or jail-related. All but one of these “forensic” cases had a psychiatric illness at the time of evaluation, using strict diagnostic criteria. Even in this unsophisticated developing region, the Micronesian police recognized the most serious cases by identifying persons in jail who acted and talked “abnormally” as compared to the rest of the jail population.
Application of the Sads Diagnostic Interview to Forensic Psychiatry
Authors: Rogers Richard , Cavanaugh James L.
Published: February 2018

The Schedule of Affective Disorders and Schizophrenia (SADS), a sophisticated, semi-structured diagnostic interview, is introduced as a significant advance in forensic evaluations. Pertinent research on the SADS' development is summarized and its administration and use in the forensic setting are described in detail. Particular attention is focused on evaluations involving legal questions of sanity, fitness to stand trial, and treatability in delineating the clinical strengths and limitations of the SADS diagnostic interview.
Emergency Detention of the Mentally Ill
Authors: Bonovitz Jay S. , Bonovitz Jennifer Caldwell
Published: February 2018

This article evaluates psychiatric patients' response to a procedural change in Pennsylvania's mental health law that extended the period of emergency detention from three to five days. Findings did not support the hypothesis that the proportion of emergency committed patients agreeing to voluntary hospitalization would increase post-amendment. Patients who did not consent to voluntary care within a few days of admission were unlikely to consent later. Their view of their illness and negative attitude toward hospitalization remained stable.
A Workshop for Judges Involved in Child Custody and Other Domestic Relations Disputes
Authors: Stollak Gary E. , Casbergue John , Kreider Susan M.
Published: February 2018

A workshop format was developed to help judges to increase their awareness and sensitivity to the psychological needs of all parties in domestic relations disputes and to increase their skills to communicate this sensitivity. Guidelines and suggestions for interviewing children were also presented and discussed.
Historical Perspectives on the Treatment of Mental Illness in the United States
Authors: Ray Joyce M. , Gosling F.G.
Published: February 2018

The traditional historical view of medicine is one of progress—slow but steady improvement made possible by the achievements of earlier pioneers. In psychiatry, a field in which cures remain elusive, this view has been called into question. The following article surveys the past treatment of mental illness in the United States and analyzes the work of various historians of the field. Changing definitions of insanity and concepts of care are considered, and implications for social policy are suggested.
Seriousness of Charge and Length of Hospitalization for the Unfit Defendant
Authors: Cuneo Daniel J. , Brelje Terry B. , Randolph John J. , Taliana Lawrence E.
Published: February 2018

Mean length of hospitalization by type of offense for 816 male patients adjudicated as unfit to stand trial and discharged from a forensic psychiatric hospital between 1975 and 1979 was compared with the seriousness of the alleged offense. Seriousness of the alleged offense was defined by length of possible maximum sentence if convicted. There was a positive correlation between length of hospitalization and seriousness of the alleged offense. This correlation was greatly increased when those found unfit to stand trial on misdemeanor charges were excluded. Implications for such a finding are discussed.
The Irony of the Insanity Defense: A Theory of Relativity
Authors: Bulmash Kathleen Jones
Published: February 2018

The insanity plea has been the object of intense political controversy. This article explores the conflicting models of human behavior which underlie changing definitions of insanity in the law. The argument is that the psychoanalytic model defines rationality as an irreducibly social phenomenon. Consequently, an individual's capacity for rationality is dependent upon the adequacy of social conditions conducive to its development. But this model of rationality remains incompatible with a theory of responsibility which can only assign guilt to individuals.
“Extraordinary Circumstances” in Custody Contests between Parent and Non-parent
Authors: Hoorwitz Aaron N.
Published: February 2018

When consulting to juvenile and family courts, many mental health professionals address the question of what is in a child's best interests, making the assumption that the “best interests” test is applicable in all court cases involving children. This assumption is incorrect, resulting in recommendations which are not maximally useful to the court and which do not further the children's interests as much as is possible. The best interests test does not apply in custody contests between parent and non-parent. In these cases, the court must first conclude that a parent has been disqualified in some respect or that “extraordinary circumstances” exist. Only then can the court apply the best interests test. This article suggests how the consultant can make use of these considerations by addressing more specific questions in evaluations, thereby improving the utility of evaluations and furthering the child's interests.
The defense of insanity
Authors: Simon Rita J.
Published: February 2018

This article traces the history of the insanity defense and reviews the controversies surrounding it. It compares the “wild beast test” introduced by Justice Tracy in 1723 with the criterion proposed by the Reagan administration following the attempted assassination of the president by John Hinckley. It assesses the role of the psychiatrist as an expert witness and that of the jury in defense-of-insanity trials, and reviews the press that both received following the Hinckley trial and jury verdict of not guilty by reason of insanity.
Characteristics, dispositions, and subsequent arrests of defendants pleading insanity in a rural state
Authors: Randolph Robert L. , Pasewark Richard A.
Published: February 2018

Of sixty-eight defendants pleading insanity in Wyoming in 1967–68, two were adjudicated insane. Defendants were primarily white, unskilled or semiskilled males who had not completed high school. Their histories tended to be characterized by sporadic employment, substance abuse, and prior arrests. Although only two were adjudicated insane, the rates of dismissal and nolle prosequi were considerably higher than those for other arrestees.
The “Psychiatric Will” Debate: Illogic and Hidden Agendas
Authors: Vatz Richard E. , Weinberg Lee S.
Published: February 2018

Dr. Thomas Szasz's recent proposal to legally recognize the concept of a “psychiatric will” in which individuals might exert control over future attempts to administer involuntary psychiatric treatment to them is defended as a rational means of satisfying both the supporters and opponents of involuntary psychiatry. Criticisms of the “psychiatric will” are analyzed and rejected as resting on misinterpretations of the proposal and its potential legality, and are seen instead to be further arguments in defense of the appropriateness of the social control function as well as the medical model for psychiatry.
Tarasoff, the Doctrine of Special Relationships, and the Psychotherapist's Duty to Warn
Authors: Schopp Robert F. , Quattrocchi Michael R.
Published: February 2018

Although the legal doctrine of special relationships was a cornerstone of the Tarasoff decision, the authors argue that the conceptual relationship among that doctrine, the documented inability to predict violence, and the duty to warn is such as to preclude the foundation of a duty to warn on the doctrine of special relationships.
The Psychiatrist as Expert Witness: The Roman Catholic Church Marriage Tribunal
Authors: Severino Sally K. , Mcnutt Edith R.
Published: February 2018

Psychiatrists, regardless of faith, serve as expert witnesses in Roman Catholic church court trials regarding marriage annulments. The authors describe the function of the expert witness within the Marriage Tribunal procedures as well as the clinical and ethical dilemmas inherent in the process. They recommend that psychiatrists abide by the advice of the Ethics Committee of the American Psychiatric Association when serving in this capacity.
Civil liabilities of government psychotherapists and agencies for the release of the mentally ill
Authors: Del Carmen Rolando V.
Published: February 2018

The release of the mentally ill carries potential liabilities, under state and federal laws, for psychotherapists and agencies. While plaintiffs have had no widespread success in liability lawsuits, damage awards have been given in cases where there is abuse of discretion, gross negligence, or lack of due care; when the injury is foreseeable; and when a special relationship exists between the victim and the released patient.

Case law suggests several operational models in cases where liability is imposed. Among these are the foreseeability model, the special relationship model, and the strict liability model. This article suggests a modified strict liability model where the government, instead of the injured party or the psychotherapist, generally bears the burden of loss.
Escape from Freedom, Criminal Style: The Hidden Advantages of Being in Jail
Authors: Perry Bruce
Published: February 2018

There is an unspoken theoretical assumption, among criminologists and noncriminologists alike, that jail is a place criminals try to avoid. Consciously, of course, most of them do. But, unconsciously, many of them want to go to prison for the reasons suggested in the following article, which is based upon several well-documented case studies.
Violent Patients and the Tarasoff Duty in Private Psychiatric Practice
Authors: Beck James C.
Published: February 2018

The author reports the results of interviews with 34 psychiatrists who practiced privately outside major metropolitan areas. The psychiatrists discussed experience with violent patients, and their knowledge of, attitudes toward, and experience with the Tarasoff duty. Most psychiatrists were aware of the duty and accepted it as an ethical responsibility. In their response to Tarasoff, this sample was not substantially different from a national sample of psychiatrists practicing in metropolitan areas. Violence toward psychiatrists was more common in office practice than elsewhere. Tarasoff cases in office practice more often ended in violence or in a ruptured therapeutic relationship than Tarasoff cases in other settings. The author concludes that the threat of violence is a greater problem for the office practice of psychiatry than has previously been described.
Inpatient Psychiatric Treatment in a County Jail
Authors: Meloy J. Reid
Published: February 2018

Inpatient psychiatric services within large metropolitan jails are a new treatment phenomenon in the United States. The author describes one such program in San Diego County, California. Particular attention is focused upon the description of the services and the admitted patients. Psychological and social dynamics unique to an inpatient staff within a custody setting are discussed. The problem of patients’ rights in such a setting and several working solutions are addressed. Finally, the impact of an inpatient psychiatric unit within a jail upon the reliability and validity of mental disability defenses is noted.
The case Dispositions of Temporarily Trial-Incompetent Criminal Defendants
Authors: Fontaine Patricia A.
Published: February 2018

The case dispositions of criminal defendants with a history of temporary trial incompetency were compared to dispositions of the criminal defendant population in Atlanta, Georgia. The comparison revealed no significant intergroup differences in respect to sentencing patterns. In regard to prosecution rates, temporarily trial-incompetent defendants were significantly more often prosecuted for the crimes of trespass and rape.
Dangerousness Review Boards in Texas
Authors: Reinehr Robert C. , Dudley Harold K. , White John V.
Published: February 2018

In Texas, the responsibility for the determination of dangerousness has, since 1975, been vested in a board appointed by the commissioner of the Texas Department of Mental Health and Mental Retardation. The composition of this board has twice been changed by the legislature as a result of public concern that review boards may have been too lenient in releasing potentially dangerous individuals from custody. The performance of the two most recent of these boards is compared and decision patterns are found to be complex and not directly related to the professional affiliations of board members.
Consistency in the Application of Civil Commitment Standards in Psychiatric Emergency Rooms
Authors: Segal Steven P. , Watson Margaret A. , Nelson Scott
Published: February 2018

In the controversy over civil commitment procedures, reliability as well as validity of clinicians’ assessments have been challenged. In this study, the generalizability of TRIAD, an observational assessment device, was tested. Patient load strongly influenced the degree to which TRIAD predicted case disposition and clinician global ratings of dangerousness and grave disability. Given comparable patient-clinician ratios, TRIAD predicted 81% to 86% of case dispositions. Agreement between clinician global assessments and TRIAD ratings was high to moderate. Clinicians apparently agree on sets of indicators which can be consistently weighted, but the application of the standard described by TRIAD may be jeopardized by increasing patient loads.
A Discriminant Analysis of Committed and Voluntary Psychiatric Patients
Authors: Nicholson Robert A. , Horn Joseph M.
Published: February 2018

Eleven background, diagnostic, and hospitalization characteristics were used to discriminate committed and voluntary psychiatric patients in a double cross-validation design. Diagnosis was more important than individual social and status resources (race, marital status, education, and employment status) in discriminating the two groups of patients. Further, characteristics of hospitalization (length of stay, percentage of patients receiving maximum benefit from treatment, and frequency of discharge referrals) did not contribute significantly to discrimination of the two groups, suggesting that committed and voluntary patients did not differ with regard to the adequacy or effectiveness of treatment in the hospital.
Neurobiological Substrates of Violence: An Overview for Forensic Clinicians
Authors: Hamstra Bruce
Published: February 2018

Accurate assessment of violent behavior requires an extensive evaluation of neurobiological as well as psychological components. Although controversial, a growing body of research raises important questions about the role of organic predispositions in certain types of explosive behavior. This article attempts to integrate these findings and explores the implications for assessment and treatment. These issues are also considered in relation to the criminal justice system.
The Right to Refuse Treatment
Authors: Temple Kristin
Published: February 2018

Most mental patients have scant protection from psychiatrists’ historical, absolute control in diagnosis, treatment, and the disabling effects of treatment. This article discusses the reversal of a recent trend in the federal courts that afforded protective procedures to mental patients by requiring the involvement of decision makers outside the institution. Also discussed is the lack of constitutional, statutory, and common-law protections in all but a few states. The safeguards provided by the minority of states are explored, and it is suggested that other states follow their lead in providing human rights and dignity to the mentally ill.
Legal Liability for a Patient's Suicide
Authors: Swenson Elizabeth V.
Published: February 2018

Lawsuits alleging psychotherapist liability for a patient's suicide have increased in number recently. Although the traditional theory of negligence is still popular, issues involving the standard of care and proof of causation are particularly difficult when one of the parties to the therapeutic relationship is not living. These problems have different implications when failure to prevent suicide is alleged than when a psychotherapist is said to have caused the suicide. In the latter, the presence of informed consent and assumption of the risk must be carefully evaluated as defenses. Alternative theoretical bases for these suits include implied contract, breach of fiduciary duty, and strict liability.
Most-violent Psychiatric Inmates and Neuroleptics
Authors: Scarnati Richard Alfred
Published: February 2018

A unique population of the most violent psychiatric inmate patients was found to obtain excellent results with high doses of neuroleptics, over long periods of time, for resolution of their psychoses and prevention of relapse. Fluphenazine decanoate proved to be an excellent medication for the usually noncompliant inmate. Various therapies were also a necessary adjunct to the medication.
The Psychotherapist's Third-party Liability for Sexual Assaults Committed by his Patient
Authors: Melella John T. , Travin Sheldon , Cullen Ken
Published: February 2018

Since the landmark Tarasoff decision, courts have expanded third-party liability to psychotherapists for the harm done to others by patients in their care. While this is an issue which affects all psychotherapists, it has particular importance for those treating sexual offenders. Recent advances in assessment techniques provide the psychotherapist with a more accurate profile of the patient and his potential victim(s). While this improvement in diagnostic accuracy affords greater potential for more focused treatment, it may also increase the psychotherapist's risk for incurring liability should the patient recidivate during treatment. This article examines some of the possible legal implications relevant to treating the sexual offender.
A Visitor from another Planet: The Case of D. J.
Authors: Meyers C. J.
Published: February 2018

D. J., a white female, killed R. W., a black male, because of his race and because he was small—he was four years old. She was in favor of genocide, she said, and one “had to start somewhere” and with a victim weak enough to ensure success. The killer also was an advocate of cannibalism—whites the eaters, darker races the eatees. She believed she was the descendant, as were all whites, of extraterrestrial beings, and she hoped that the killing of the lesser creature would awaken her fellow humans to this forgotten truth. She had a documented history of paranoid schizophrenia. The article discusses the problems of mounting and combating a mental defense in the ensuing trial, where the defendant, but for her obvious craziness, appears to have committed an unforgivable crime.
The Prison as Dumping Ground: Mainlining Disturbed Offenders
Authors: Toch Hans , Adams Kenneth
Published: February 2018

Some offenders who are sentenced to prison are emotionally disturbed at the time of their offense and continue to be disturbed through their admission to prison. Such offenders often have difficulties adjusting to confinement and create problems for prison staff A review of records suggests that the imprisonment of disturbed offenders becomes more likely where questions can be raised about their abilities to cope in the community, or where they are resistant to service and/or disruptive. Such issues might be addressed through diversion programs involving interagency arrangements, which would make imprisonment less likely.
Evaluation of and Treatment to Competency to be Executed: A National Survey and an Analysis
Authors: Miller Robert D.
Published: February 2018

Following a series of U.S. Supreme Court decisions that approved revised capital punishment statutes that provided for individualized determination of sentence in capital cases, and further procedural rulings that significantly diminish the numbers of appeals possible from death sentences, the number of executions has risen dramatically in the United States. Attorneys representing condemned prisoners and those generally opposed to the death penalty have discovered that common law prohibitions against the execution of “insane” prisoners may provide the last legal chance to avoid execution. The number of allegations of incompetency to be executed has risen concomitantly with the number of approaching executions. Despite a recent Supreme Court decision barring execution of incompetent prisoners and commenting on acceptable procedures for determination of competency to be executed, a number of issues remain unresolved. Particularly troubling for many clinicians is the prospect of having to treat an incompetent prisoner without consent to render him/her competent to be executed. The author presents the results of a national survey of attorneys general inquiring about current procedures for the determination of competency to be executed and treatment of incompetent condemned prisoners, and discusses the ethical issues involved.
Emergency Civil Commitment: Predicting Hospital Violence from Behavior in the Community
Authors: Beck James C. , Bonnar James
Published: February 2018

The authors investigated whether violence to others in the community relates to violent behavior in the first 72 hours of hospitalization. They reviewed emergency room records, and they concurrently reviewed and monitored hospital violence for 100 patients committed to a state hospital. Patients committed after assaults on others were more likely than other patients to threaten or assault others during the first day of hospitalization, but not later. Independent of the reason for commitment, manic patients were more likely to be violent. The implications of these results for the validity of psychiatrists’ predictions of violence are discussed.
Perceptions of Prehospital Dangerous Behavior by Psychiatric Inpatients and their Families
Authors: Williams Wright , Thornby Jack , Sandlin Ponce
Published: February 2018

Eighty hospitalized patients and a family member of each were interviewed to determine factors associated with involuntary commitment and family perceptions of prehospital dangerousness. Although families were twice as likely as patients to describe patients as dangerous, according to both groups a large percentage of patients were dangerous prior to psychiatric hospitalization. Patients viewed as dangerous had less education, were less likely to be employed full or part time, were more likely hospitalized because of impending harm to themselves or others, and were prone to drug or alcohol abuse. Dangerous behavior was associated with involuntary commitment in patients considered dangerous by their families who denied they were dangerous.
The Bus Stop Revisited: Discipline and Psychiatric Patients in Prison
Authors: McShane Marilyn D.
Published: February 2018

Prisoners requiring intensive psychiatric care are one of the most difficult populations to manage in terms of manpower, resources and potential liabilities. This study examines the discipline and control of psychiatric inmates, contrasting the amount and types of disciplinary actions they receive with those of non-patient inmates. The disciplinary histories of the psychiatric patients are discussed using Toch's model of the “disturbed disruptive” inmate. The difference between this study and previous efforts is that an attempt is made to control for disruptiveness. Using samples composed of inmates currently involved in disciplinary actions, it is hoped that differences between the two groups will be explained by psychiatric status.
Demographic Variables Associated with Competence to Stand Trial Referral and Evaluation of Criminal Defendants with Mental Retardation
Authors: Everington Caroline
Published: February 2018

Four groups of offenders at the pretrial level–-mentally typical defendants, mentally retarded defendants who were not referred for competence evaluations, and mentally retarded defendants recommended as competent or as incompetent–-were compared on selected demographic variables. The results indicated that mentally typical defendants were more likely to be on pretrial release and that mentally retarded defendants who had been recommended as incompetent to stand trial were more likely to be charged with crimes against persons. No significant difference was found among the four groups in number of prior offenses. No significant difference was found between the groups who had mental retardation in IQ score or in the presence of dual diagnosis. However, a second analysis, examining the defendants referred for competence evaluations and those not, found that defendants with mental retardation referred for evaluations were more likely to have a dual diagnosis. The implications of these findings to the issues of competence referral and evaluation of offenders with mental retardation are discussed.
Hidden Agendas at the Law-psychiatry Interface
Authors: Miller Robert D.
Published: February 2018

Many of the key concepts in the ongoing dialogue between legal and mental-health professionals have become accepted over the years, while each side continues to define them differently without making explicit the significant differences in definition. Although the differences in meaning are generally clear to their respective advocates, they are often obscure to the decision-makers who are called upon to arbitrate between the two sides. The author discusses a number of such hidden agendas and argues that they need to be brought into the open so that all the issues can be discussed directly.
Prescribing Privileges for Psychologists: Should only “Medicine Men” Control the Medicine Cabinet?
Authors: Coleman Phyllis , Shellow Ronald A.
Published: February 2018

This article discusses the proposal by members of the American Psychological Association to grant psychologists the privilege of prescribing medication. Legislative history establishing regulation of the privilege of prescribing was initiated to promote the public welfare. Most medical and legal authorities agree that prescribers have to “do what doctors do” and know what doctors know to safely prescribe. Thus, based on training and intellectual orientation, psychologists and other non-physician professionals are simply not prepared to prescribe medicine. The article explores issues of legal liability and decreased protection to patients and to pharmaceutical manufacturers if the privilege is expanded and patients are injured by medication prescribed by psychologists.
Tarasoff down Under: The Psychiatrist's Duty to Warn in Australia
Authors: Mendelson Danuta , Mendelson George
Published: February 2018

The authors discuss the differences between the U.S. and Australia in legal approach and in the codes of medical ethics to the issues of medical confidentiality and disclosure as represented by the Tarasoff case. It is argued that in Australia, a psychotherapist would not be justified in breaching his duty of confidentiality towards a patient. The ethical codes that govern clinical practice in Australia, and the common law, focus primarily upon the therapeutic relationship between the doctor and the patient, virtually excluding any considerations extraneous to that relationship.
Defining the Tarasoff Duty
Authors: Egley Lance C.
Published: February 2018

The Tarasoff duty has been controversial law partly because the duty is not clearly defined. Components of a clear definition include whether the duty exists in the specific state, to which relationships the duty applies, under what conditions the duty arises, how the duty may be discharged, and what uses can be made of confidential information when the duty arises. Within these components of the definition, key terms, including violence and the role of the police, are often not defined. Consistency in the duty's definition also requires distinguishing the cluster of concepts concerning the Tarasoff duty from the cluster concerning negligent release, a pre-Tarasoff legal tradition. A professional standard must be systematically distinguished from a lay standard. Legislatures offer greater opportunity to completely define the duty than do courts. Currently, no statute or any model law offers complete definition of all the components. However, Colorado law seems closest to clearly defining the duty.
A Judicial Dilemma: Expert Witness Testimony in Child Sex Abuse Cases
Authors: Mason Mary Ann
Published: February 2018

This study first analyzes the content of 122 appellate court decisions in which expert witness testimony on the characteristics of sexually abused children is challenged. The nature of the testimony, the identity of experts, and the patterns of judicial response to this testimony are both quantitatively and qualitatively examined. The study then reviews the concerns raised by the clinical/scientific community about the validity of this behavioral syndrome testimony and the role of the therapist as expert. The gulf between the judicial community and the clinical/scientific community is addressed. Alternative forms of expert testimony that more closely meet the criteria of both communities are suggested.
On Psychiatry and its Disavowal of Mind: Legal and Cultural Implications
Authors: Kaplan Leonard V. , Miller Robert D.
Published: February 2018

Biology is increasingly replacing psychology as the frame of reference for understanding human behavior. Where previously the schizophrenias and affective disorders attracted and vindicated biological explanation, now even psychodynamic explanations of the so-called neuroses are being replaced by biological understanding. This essay considers the potential loss entailed by perhaps premature biological reductionism. Anxiety has been a critical concept for psychological explanations of behavior. The move to biology resolves the mystery of anxiety by biochemically removing it. We trace what meaning anxiety had for three critical thinkers who used the term: Kierkegaard, Freud and Sartre. We argue that the loss of anxiety is a symptom of the loss of psychology and abdication on the part of psychiatry in contributing to the representation of human subjectivity for culture and law.
Insanity Defense: Ethnicity of Defendants and Mock Jurors
Authors: Towers Tori , McGinley Hugh , Pasewark Richard A.
Published: February 2018

Prior research, in which only white subjects were used and socioeconomic status (SES) of the defendant was not controlled, has indicated that ethnicity of defendants influences the decisions of mock jurors in homicide trials in which insanity is an issue. Controlling for SES, the present study used black and white mock jurors who rendered verdicts about black or white defendants. No significant effect was found for ethnicity of either defendant or respondent.