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Ethical Issues in Prison Psychiatry by Norbert Konrad,Birgit Völlm,David N. Weisstub Pdf
Recent surveys demonstrate a high and possibly increasing prevalence of mental disorders in prisoners. They have an increased risk of suffering from a mental disorder that transcends countries and diagnoses. Ethical dilemmas in prison psychiatry arise from resource allocation and include issues of patient choice and autonomy in an inherently coercive environment. Ethical conflicts may arise from the dual role of forensic psychiatrists giving raise to tensions between patient care/protection of the public.This book describes models and ethical issues of psychiatric healthcare in prison in several countries. Relevant issues are: the professional medical role of a psychiatrist and/or psychotherapist working in prison, the involvement of psychiatrists in disciplinary or coercive measures; consent to treatment, the use of coercion in forcing a prisoner to undergo treatment, hunger strike, confidentiality. The book ends with consensus guidelines concerning good practice in Prison Psychiatry.
Ethical Issues in Clinical Forensic Psychiatry by Artemis Igoumenou Pdf
This work explores and discusses the ethical dilemmas clinicians face in everyday forensic psychiatry practice. We discuss and reflect on ethical issues involving treatment decisions such as antipsychotic polypharmacy, high doses antipsychotics and prescribing anti-libidinal medications. Ethical issues surrounding the use of technology for the management of mentally disordered offenders are explored in depth. The use of the polygraph test, a controversial method of truth facilitation for sex offenders, is discussed. Similarly, we discuss the use of "tagging" for serious offenders that despite being used in the United States of America for a while it has been heavily criticized and opposed. Tagging is gradually being introduced in the UK and other European countries, making consideration of the ethical issues and dilemmas surrounding its use both timely and necessary. This work is a valuable guide for clinicians working in forensic psychiatry settings, particularly when faced with ethical dilemmas concerning decisions around interventions.
Forensic Psychiatry by John Gunn,Pamela Taylor,Ian D. Hutcheon Pdf
Highly Commended, BMA Medical Book Awards 2014Comprehensive and erudite, Forensic Psychiatry: Clinical, Legal and Ethical Issues, Second Edition is a practical guide to the psychiatry of offenders, victims, and survivors of crime. This landmark publication has been completely updated but retains all the features that made the first edition such a w
Psychiatric Ethics in Late-Life Patients by Meera Balasubramaniam,Aarti Gupta,Rajesh R. Tampi Pdf
The process of aging is frequently associated with changes in the physical and mental functioning of older adults, challenging their autonomy and rendering them vulnerable to exploitation. Certain illnesses that are more common in older adults can affect their capacity to function independently. These include the capacity to make medical decisions, live independently, manage finances, to name a few. Healthcare professionals, especially psychiatrists are often entrusted with the responsibility of assessing an older adult’s capacity to perform one or more functions. This makes it imperative for them to be cognizant of these issues, understand the need for these evaluations, and be able to conduct them in a comprehensive manner. Another way of protecting an older person’s rights and facilitating a life based on their own decisions even after they lose decision making capacity is Advanced Health Care Planning (AHCP). Health care professionals are required to initiate a discussion about AHCP with their patients and their families and review it periodically. Lastly, the older adults incarcerated in prisons is a group that is growing in numbers. They have unique needs at the intersection of the geriatric and forensic services, but are often marginalized by both services. The combination of poor quality of life and increasing costs makes the care of older adults in the criminal justice system makes this topic an important public health concern. There is a pressing need for better training of prison staff in issues of geriatric psychiatry. Assessment of criminal responsibility and competence to stand trial in aging offenders are other complex but under-studied issues. This proposed book will provide a comprehensive view of ethical, medicolegal, and forensic issues that will be useful in clinical practice. There will be three sub-sections, each focusing on ethical, medicolegal and forensic issues respectively. The first section will focus on ethical issues. Its first chapters will provide an overview of the how age and the process of aging influence decision-making and introduce unique ethical dimensions to clinical care. This will be followed by a discussion of the concepts of informed consent and capacity evaluation. The next chapters will focus on common scenarios that arise in the care of elderly patients and offer a practical approach to understanding and managing them. These will include assessments of the capacity to make medical decisions, the capacity to live independently, manage finances, drive a vehicle, have sexual relations etc. A chapter on ethical issues specific to dementia will outline issues related to diagnostic disclosure and genetic testing. Research ethics issues in geriatric psychiatry will also be outlined. The next section of the book will focus on surrogate decision making in an older adult who has been deemed to lack the capacity to serve one or more functions independently. The first chapters in this sub-section will focus on patient directed advance health care planning tools, namely, living will and power of attorney. This will be followed by an overview of default surrogate making. Guardianship will subsequently be covered. A separate chapter will cover the issue of elder abuse and discuss an approach to assessing it. The last section of the book will cover forensic issues in geriatric psychiatry. The first chapter will discuss aging older adults in the criminal justice system from an epidemiological perspective. The growing numbers of incarcerated older adults, their illness burden, the challenges in the diagnosis and management of neurocognitive disorders in the prison setting will be elucidated. The following chapter will discuss competence to stand trial with reference to elderly offenders. This will be followed by a discussion of the concepts of medical reprieve, compassionate release as well as model programs and policies currently in the works for older incarcerated adults.
Management of the Mentally Disordered Offender in Prisons by Geoffrey Neil Conacher Pdf
Management of mentally disordered offenders (MDOs) is a major challenge for the clinician, because they have multiple problems and diagnoses, and the cost of a mistake can be very high. The author, former director of psychiatric services at the Regional Treatment Centre in Ontario, traces the MDO management process from initial assessment, through secure stabilization, to preparation for release and subsequent community supervision. He outlines the difficulties of managing a population of serious offenders and highlights elements of treatment that are essential if the MDO is to be reintegrated into the community.
Institute of Medicine,Board on Health Sciences Policy,Committee on Ethical Considerations for Revisions to DHHS Regulations for Protection of Prisoners Involved in Research
Author : Institute of Medicine,Board on Health Sciences Policy,Committee on Ethical Considerations for Revisions to DHHS Regulations for Protection of Prisoners Involved in Research Publisher : National Academies Press Page : 284 pages File Size : 52,5 Mb Release : 2007-02-22 Category : Political Science ISBN : 9780309101196
Ethical Considerations for Research Involving Prisoners by Institute of Medicine,Board on Health Sciences Policy,Committee on Ethical Considerations for Revisions to DHHS Regulations for Protection of Prisoners Involved in Research Pdf
In the past 30 years, the population of prisoners in the United States has expanded almost 5-fold, correctional facilities are increasingly overcrowded, and more of the country's disadvantaged populations—racial minorities, women, people with mental illness, and people with communicable diseases such as HIV/AIDS, hepatitis C, and tuberculosis—are under correctional supervision. Because prisoners face restrictions on liberty and autonomy, have limited privacy, and often receive inadequate health care, they require specific protections when involved in research, particularly in today's correctional settings. Given these issues, the Department of Health and Human Services' Office for Human Research Protections commissioned the Institute of Medicine to review the ethical considerations regarding research involving prisoners. The resulting analysis contained in this book, Ethical Considerations for Research Involving Prisoners, emphasizes five broad actions to provide prisoners involved in research with critically important protections: • expand the definition of "prisoner"; • ensure universally and consistently applied standards of protection; • shift from a category-based to a risk-benefit approach to research review; • update the ethical framework to include collaborative responsibility; and • enhance systematic oversight of research involving prisoners.
Author : Robert L. Sadoff Publisher : John Wiley & Sons Page : 321 pages File Size : 50,6 Mb Release : 2011-06-13 Category : Medical ISBN : 9781119957355
Ethical Issues in Forensic Psychiatry by Robert L. Sadoff Pdf
Ethical medical practice and treatment in psychiatry are based on the concept of first do no harm. However, this cannot, and does not, apply to forensic cases where there is no doctor–patient relationship and the forensic psychiatrist may indeed cause harm to the examinee. In this book, Robert Sadoff analyzes the ethical issues affecting forensic psychiatric practice, especially those promulgated by the American Academy of Psychiatry and the Law. Within those guidelines, he looks at individual bias, vulnerability of the examinee, and potential harm to the mental health professional. The book discusses each of the procedures of the forensic expert separately with respect to minimizing harm. It has been written with an international audience in mind and features chapters reviewing the European and UK perspectives, by Emanuele Valenti and John Baird, respectively. Robert Sadoff addresses the long-term harm that can be either avoided or minimized through careful planning and application of ethical principles. He is not advocating that the harm can be totally eliminated, because that is impossible in the adversarial system in which forensic psychiatrists work. However, there are means by which harm may be minimized if care is taken during the assessment, the report writing, and the testimony phase of the proceedings. The book develops the scope of forensic psychiatry from the standpoint of administrative, civil and criminal cases. It presents the practical issues involved in conducting forensic psychiatric assessments under various conditions plus special considerations, such as bias, minimizing harm, developing a therapeutic approach, and elaborating on various vulnerable individuals who are frequently examined in forensic cases. These include juveniles, mentally retarded, autistic, sexual assault victims, the elderly, the organically damaged, the psychotic, and mentally disabled prisoners. Immigrants are covered in a chapter by Solange Margery Bertoglia. The ethical issues in conducting forensic psychiatric examinations and presenting psychiatric testimony in court are examined and discussed. Cases illustrating the difficulties involved punctuate the presentation. The book closes with a fascinating account of the legal perspective by Donna Vanderpool. In summary, this book illustrates the ethical and practical issues that affect forensic psychiatric practice. The question is not what we do, but how we do it, and which standards, ethical guidelines and personal values contribute to the total picture. Despite the fact that we cannot always adhere to the doctrine of "primum non nocere," we can minimize the harm caused inherently by the adversarial system in which we participate. Praise for Ethical Issues in Forensic Psychiatry "One of the founding giants of the forensic psychiatric field has written here far more than a "mere" ethics textbook. Instead, this compendium serves multiple purposes: it is a valuable primer on forensic techniques of examination and testimony, a model of best forensic practices, and an instruction on the most appropriately civilized way in which to conduct oneself as a forensic psychiatrist. The success of these multiple accomplishments clearly derives from characteristics of the author. In both sage advice to practitioners and in many revealing case examples, Dr. Sadoff displays the tact, good manners and sensitivity of a consummate gentleman – a term not always associated with the hurly-burly of courtroom work. The book's primary focus on avoiding harm to all the parties involved in the work places it on the moral high ground of the legal system in which participating clinicians must find a place." Thomas G. Gutheil, MD, Professor of Psychiatry and Co-Founder, Program in Psychiatry and the Law, Beth Israel Deaconess Medical Center, Harvard Medical School
Ethical Issues in Forensic Mental Health Research by Chris Brown,Gwen Adshead Pdf
A contemporary case-based discussion of ethical dilemmas faced by researchers in forensic mental health, this book offers useful guidance to anyone planning research in this field. It focuses on problems frequently encountered, such as issues of capacity to consent in forensic settings and the meaning of consent to participate. Chapters cover issues such as the procurement of consent among incarcerated people; the ability of young people to provide consent; the effects of culturally specific lay beliefs about mental illness; confidentiality; multidisciplinary approaches; and ethics in risk assessment research. The contributors address questions such as whether research can be therapeutic, and whether it is ever reasonable to compromise patient confidentiality for the wider benefits of publishing research. Based on empirical data from researchers' own experiences, this comprehensive book will be essential reading for anyone planning research in the area of forensic mental health, and all whose work is in this area.
Ethical Considerations at the Intersection of Psychiatry and Religion by John Peteet,Mary Lynn Dell,Wai Lun Alan Fung Pdf
Psychiatry and religion/spirituality (R/S) share an interest in human flourishing, a concern with beliefs and values, and an appreciation for community. Yet historical tensions between science and religion continue to impede dialogue, leaving clinicians uncertain about how to approach ethical questions arising between them. When are religious practices such as scrupulosity disordered? What distinguishes healthy from unhealthy religion? How should a therapist approach a patient's existential, moral or spiritual distress? What should clinicians do with patients' R/S convictions about faith healing, same-sex relationships, or obligations to others? Discussions of psychiatric ethics have traditionally emphasized widely accepted principles, generally admired virtues, and cultural competence. Relatively little attention has been devoted to the ways that R/S inform the values of patients and their clinicians, shape preferred virtues, and interact with culture. Ethical Considerations at the Intersection of Psychiatry and Religion aims to give mental health professionals a conceptual framework for understanding the role of R/S in ethical decision-making and serve as practical guidance for approaching challenging cases. Part I addresses general considerations, including the basis of therapeutic values in a pluralistic context, the nature of theological and psychiatric ethics, spiritual issues arising in diagnosis and treatment, unhealthy and harmful uses of religion, and practical implications of personal spirituality. Part II examines how these considerations apply in specific contexts: inpatient and outpatient, consultation-liaison, child and adolescent, geriatric, disability, forensic, community, international, addiction and disaster and emergency psychiatry, as well as in the work of religious professionals, ethics committees, psychiatric education, and research. Thick descriptions of case examples analyzed using the framework of Jonson and Winslow show the clinical relevance of understanding the contributions of religion and spirituality to patient preferences, quality of life, decision making, and effective treatment.
Ethical Practice in Psychiatry and the Law by Richard Rosner,Robert Weinstock Pdf
We would expect a successful series such as Critical Issues in American Psychiatry and the Law to present timely, relevant issues in a high-quality manner, and such is the hallmark of this outstanding series. But we might not expect the editors to dive into the especially controversial issues, e.g., ethics, and I applaud them for doing so and in such a comprehensive and thorough fashion. Public and professional concern about ethical aspects of psychiatrists' be havior and practice is growing, and exponentially. Concern about the ethical practice of modern forensic psychiatry is paralleled by deep-seated apprehen sion not only about the ethical dilemmas of psychiatry and medicine (e.g., societal versus individual patient values, the corporatization of medicine, access to versus cost of medicine) but also about the widely publicized ethical trans gressions of religious and political leaders. That's why this volume is so timely and important. Ethics-the principles and rules of right conduct. Sounds simple. We know it is not. When I'm asked by colleagues to consider the perceived unethical behavior of a fellow professional, I often find that, like obscenity, they can't always define it but they are definite that they know it when they see it. The perception of ethical conduct often appears to be in the eyes of the beholder. read this volume. It may not always please you, Well, that's why you will want to it may upset you and even offend you, but it will definitely inform you.
Ethics in Psychiatry by Hanfried Helmchen,Norman Sartorius Pdf
Ethics in Psychiatry: (1) presents a comprehensive review of ethical issues arising in psychiatric care and research; (2) relates ethical issues to changes and challenges of society; (3) examines the application of general ethics to specific psychiatric problems and relates these to moral implications of psychiatry practice; (4) deals with recently arising ethical problems; (5) contains contributions of leading European ethicists, philosophers, lawyers, historians and psychiatrists; (6) provides a basis for the exploration of culture-bound influences on morals, manners and customs in the light of ethical principles of global validity.
The Use of Coercive Measures in Forensic Psychiatric Care by Birgit Völlm,Norbert Nedopil Pdf
This book presents the legal context and describes the ethical and practical challenges when using coercive measures in forensic psychiatric settings. A wide range of aspects relevant to the use of such measures, including environmental, patient-related, and staff-related factors, are explored, and the experience of coercive interventions is described from the staff and the patient perspective. Differences in jurisdictions and examples of good practice are highlighted. The authors are from a range of professional backgrounds, ensuring breadth as well as depth in discussion of the topic. The use of coercive measures, in particular restraint, seclusion, and involuntary medication, for the control of aggression in psychiatry remains controversial. Forensic mental health care deals with individuals who pose a risk to others and often present with significant management problems within institutions. The care of patients in these settings gives rise to debates about the balance between care and safety, and between the interests of the patients and those of the wider society to be protected. Despite these tensions, limited research has been conducted specifically on the use of coercive measures in forensic mental health care. This volume aims to fill the gap and will be of value to all professionals working in forensic psychiatric settings as well as to those working in general psychiatric and custodial settings, law professionals, and patients.
Forensic Psychiatry and Psychology in Europe by Kris Goethals Pdf
This study guide aims to make European trainees in forensic psychiatry and psychology and young forensic psychiatrists and psychologists aware of the differences and commonalities in forensic psychiatry and psychology in different countries within Europe and to enable them to learn from the approaches adopted in each country. The guide is divided into five main sections that address legal frameworks, service provision and frameworks, mandatory skills, teaching and training in forensic psychiatry and psychology, and capita selecta. In addition, recommendations are made with respect to the practice of teaching and training across European countries. It is anticipated that the guide will provide an excellent means of improving specific skills and that, by learning about the offender/patient pathways in the different jurisdictions of Europe, the reader will gain a deeper understanding of the principles that govern methods and practices in their own work with mentally disordered offenders.
Correctional Psychiatry by Ole Thienhaus,Melissa Piasecki Pdf
This collaborative text addresses the full range of issues faced by correctional psychologists and other mental health service providers who offer programs and services within correctional institutions--from critical program development and management issues to specific treatment options for special populations.