7.1 Forensic Psychiatry and Involuntary Commitment Flashcards
What is the HIPAA in the United States?
The HIPAA is a federal statute governing patient confidentiality and disclosure of information.
Name the 6 major areas of legal consideration pertinent to forensic psychiatry.
When is it acceptable in the United States to breach patient confidentiality?
(Note that there is no ‘duty to warn’ in Australia.)
Discuss the keynote case in the United States underlying the ‘duty to warn’.
What is the process of hospitalising a person against his or her will due to mental illness called in the United States?
Involuntary civil commitment.
What does the Supreme Court case of O’Connor vs. Donaldson (1976) conclude?
https://law.jrank.org/pages/24781/O-Connor-v-Donaldson-Significance.html
Mentally ill persons have constitutional rights.
A harmless patient cannot be confined against his/her will without treatment if they could survive in a less restrictive environment.
In the 1960’s and 1970’s, it was very common for mentally ill people to be confined in institutions without treatment. The Supreme Court ruled unanimously in favour of Donaldson, who argued that he had been kept in a state facility for 14.5 years without access to treatment and no clear indication for confinement.
What is a writ of habeus corpus?
In the United States, the habeus corpus is a petition that a person can file with the court if they believe that they have been illegally deprived of their liberty.
Everyone has the right to a habeus corpus prior to being committed involuntarily.
A writ of habeas corpus is used to bring a prisoner or other detainee (e.g. institutionalized mental patient) before the court to determine if the person’s imprisonment or detention is lawful. A habeas petition proceeds as a civil action against the State agent (usually a warden) who holds the defendant in custody.
https://www.law.cornell.edu/wex/habeas_corpus
In Australia, the right of judicial review is similar.
List the 2 ways a patient can be admitted into a psychiatric inpatient unit.
- Voluntary admission, i.e., patient agrees to admission or requests an admission.
- Involuntary admission, known as “civil commitment” in the United States.
What is a ‘civil commitment’ in the United States?
Involuntary admission to a psychiatric hospital. It involves the deprivation of rights guaranteed by the United States constitution. Hence, due procedure must be undertaken and the patient must meet the criteria for civil commitment.
What are the 3 criteria for ‘civil commitment’ in the United States?
- Harm to self.
- Harm to others.
- Unable to meet the basic demands of life or gravely disabled.
What is the key ruling from Cardoza in 1914?
Patients of adult age and sound mind have the right to refuse treatment.
To ensure that this occurs, you must undertake the process of informed consent. (Pictured)
Cardoza’s ruling is from the case of Schloendorff v. Society of New York Hospital (1914), when a patient provided consent to being examined under ether to see whether a tumour was malignant, but withheld the consent for removal of the tumour, and the doctor removed the tumour anyway.
http://self.gutenberg.org/articles/eng/schloendorff_v._society_of_new_york_hospital
List what the doctor must inform the patient of with regards to a course of treatment in order for it to be informed consent in the United States?
See left panel.
In what cases is parental consent not required for minors in the United States?
See image.
What is the difference between the legal terms of ‘competence’ and ‘capacity’ in United States?
Name 4 key criteria for the assessment of competence/capacity in the United States.
Explain in legal terms, what 2 abilities a patient must have in order to be deemed mentally competent to stand trial in the United States.
What are the 3 things which must be proven for someone to successfully enter a plea of “Not Guilty by Reason of Insanity”?
- One must have a mental illness.
- One must not understand right from wrong.
- One must not understand the consequences of actions at the time the act was committed.
What are the different statutory criteria for the insanity defense in United States law?
Here are 3 common statutory criteria used:
- M’Naghten** **Rule (used in NSW, but not in QLD) assesses whether the person understands the nature, consequences and wrongfulness of his or her actions.
- America Law Institute - Model Penal Code, has a Cognitive Prong to determine whether a person understands the wrongfulness of his or her actions.
- Volitional Prong determines whether a person is able to act in accordance to the law.
https://www.findlaw.com/criminal/criminal-procedure/the-m-naghten-rule.html
Briefly describe the evolution of the insanity defense in the United States legal system.
