Forensics

Question 1

List some evaluation tools that can be used to assess fitness to stand trial

Answer 1

● McGarry’s criteria
● Fitness Interview Tests - Revised (FIT-R)
● The Nussbaum Fitness Questionnaire (NFQ)
● Georgia Court Competency Screening Test, Canadian Adaptation

Question 2

what was the relevance of the case Regina vs. Taylor

Answer 2

Canadian Supreme Court case where accused was unable to communicate need for counsel due to mental health reasons which ruled in favor of accused and leading to the standards of fitness to stand trial

Question 3

what are the two components of a crime

Answer 3

Actus Reus

Mens Rea

both must be proven by the prosecution beyond a reasonable doubt

Question 4

what is Actus Reus

Answer 4

guilty act

Question 5

what is Mens Rea

Answer 5

guilty mind

Question 6

who bears the burden of proof that an accused was suffering from a mental disorder so as to be exempt from criminal prosecution

Answer 6

the party that raises the issue

Question 7

what is the legal basis for NCRMD

Answer 7

(Criminal code of Canada)
● No person is criminally responsible for an act committed or an omission made while suffering from a mental disorder that rendered the person incapable of appreciating the nature and quality of the act or omission or of knowing that it was wrong
● Every person is presumed not to suffer from a mental disorder so as to be exempt from criminal responsibility until the contrary is proved on the balance of probabilities
● Burden of proof that an accused was suffering from a mental disorder so as to be exempt from criminal responsibility is on the party that raises the issue

Question 8

what is the McNaughten Rule

Answer 8

a PRESUMPTION OF SANITY unless the defense proved that “at the time of committing the act, the accused was laboring under such a DEFECT OF REASON, from DISEASE OF THE MIND, as not to know the NATURE AND QUALITY of the act he was doing or, if he did know it, that he did not know what he was doing was wrong”

Question 9

what must happen before someone can be found NCR

Answer 9

must be first found guilty of the act

Question 10

how is someone managed once they are found NCR

Answer 10

● Two main questions:
○ Does the person pose a significant threat?
○ If so, how can the threat be reasonably managed

● If there is a threat, then disposition must be the least onerous and least restrictive available

● Dispositions:
○ Absolute discharge - “not a significant threat to safety of the public”

○ If a threat then least onerous / restrictive:
■ Conditional discharge
■ Detained in hospital

Question 11

what is the significance of the case of Winko vs BC

Answer 11

ruled that treatment can be forced on someone that poses a significant threat to public (the accused appealed against the forced treatment)

Question 12

list 4 assessment tools for violence risk

Answer 12

○ HCR-20 V3 (historical clinical risk)
○ VRAG (violence risk assessment guide)
○ PCL-R (psychopathy checklist)
○ McArthur - Iterative Classification Tree

Question 13

how do recidivism rates compare between those found NCR and those released from general prison population and who did not receive forensic care

Answer 13

general population re-offends TWICE AS OFTEN as those found NCR (at 3 year follow up)

NCR recidivism for any offense is 17% compared to general prison pop 34%

Question 14

what is the most common mental illness in those found NCR

Answer 14

psychotic disorder

Question 15

who is on a review board

Answer 15

Review board is usually chaired by a lawyer the other members will include psychiatrist and public member (odd numbers of 3 or 5 members total)
○ Review board is federally legislation but provincial boards
○ Quasi Judicial Tribunals

Question 16

what is the paramount consideration that the review board considers when making a disposition for someone found NCR

Answer 16

the SAFETY of the public is PARAMOUNT

Question 17

what does the review board consider when making a disposition for someone who is NCR

Answer 17

○ the safety of the public, which is the paramount consideration
○ the mental condition of the accused
○ the reintegration of the accused into society
○ the other needs of the accused

Question 18

where does a duty to protect/warn exist

Answer 18

○ in the event that risk to a clearly identifiable person or group of persons is determined
○ when the risk of harm includes severe bodily injury, death, or serious psychological harm
○ when there is an element of imminence, creating a sense of urgency

Question 19

what are the legal cases related to duty to warn

Answer 19

● Tarasoff case was the index case in US for duty to warn
● Smith vs. Jones is Canadian case to protect public safety

Question 20

is there a MANDATED duty to warn in canada

Answer 20

short answer, NO, we dont HAVE to but we are protected if we DO

Canadian courts have not expressly imposed a mandatory “duty to warn” on physicians to alert third parties of a danger posed by patients. However, the Supreme Court of Canada has held that a physician was permitted to warn police when aware of the serious, imminent danger posed by a patient to an identifiable group against whom the patient had made specific threats.3
The Supreme Court recognized that physicians may disclose confidential patient information in the limited and exceptional circumstances in which they have reason to believe there is an imminent risk of serious bodily harm or death to an identifiable person or group. The Court, however, expressly refused to address whether physicians had a mandatory “duty to warn” in the context of the doctor-patient relationship.

Tarasoff I (1974) - duty to warn - the court held that a therapist bears a duty to use reasonable care to give threatened persons such warning as are essential to avert foreseeable danger arising from a patient’s condition–> this was in the USA

Tarasoff II (1976) - duty to protect - “The protective privilege ends where the public peril begins.”

Question 21

what is the difference between competency and capacity

Answer 21

competency–> legal term, determined by the legal system

capacity–> determined by clinician in clinical assessment