Legal and Ethical Issues Flashcards
Civil commitment
Legal declaration of mental illness
Can be held involuntarily
Needs treatment: danger to self or others or is unable to care for self
Can remove person’s rights only if…
Person is an immediate danger to others
Person is an immediate danger to self
Person can’t care for self
Police power
Court’s ability to protect society
Parens patriae
Court’s ability to act as parent/guardian
Psychiatric hold
Can only be done by psychiatrists or emergency room doctors
Person is held in psychiatric hospital for usually about 72 hours
Legal proceedings of civil commitment
Psychological tests
Witnesses
Testimony
Determination is made by judge or jury
Criminal commitment
Person is detained in mental health facility until assessed as fit or not fit to stand trial
Not guilty by reason of insanity: if court decides this, person is put into mental hospital until he/she is no longer considered dangerous (oftentimes, hospital stay is longer than jail time for crime committed)
M’ Naghten rule
Beginning of insanity defense
Person is not considered to be responsible for criminal act if he/she doesn’t know what he/she’s doing or if he/she doesn’t know that what he/she’s doing is wrong
Durham rule
Modification to M’ Naghten rule
No longer used
If criminal behavior is product of mental disease or defect, person isn’t held responsible
American Law Institute (ALI)
Modification to Durham rule
Person is not responsible if person doesn’t know right vs. wrong, is incapable of self-control, or if person’s ability to understand the consequences of his/her behavior is diminished by mental disorder
Mens Rea
Criminal intent
Not present in mentally ill people
Guilty but mentally ill (GBMI)
Person is imprisoned and treated for mental illness in prison, if psychological services are available
How often insanity defense is used
Actually: 1% of time
Public perception: about 35% of time
Therapeutic jurisprudence
Courts use mechanism of behavior change
Drug courts: treat drug problem before sentencing
Marriage/family courts: refer to programs and involve family members to help mentally ill person in trouble with the law
Competence to stand trial
Requirements: can understand legal charges, can assist in one’s own defense
Determined by court: all evidence is considered and burden of proof is put on defense (must prove that person is incompetent to stand trial)
If found incompetent, person loses decision-making authority and may end up being criminally committed
Expert witness
Psychologists
Assist in competency determinations
Make predictions about danger level (accurate over short term)
Assist in making diagnoses
Advise regarding psychological assessment and diagnosis
Assess malingering
How psychologists tell if someone is malingering
Person who is malingering will overreport symptoms that mentally ill people usually don’t report
Duty to warn
Psychologists have a duty to warn the authorities and the person in danger when their client is dangerous
Tarasoff v. Regents of the University of California
Case that made it necessary to warn person in danger as well as police
Tarasoff’s boyfriend was in therapy and the therapist determined that he was a danger to her. The therapist called campus security, but not the girlfriend. The boyfriend killed Tarasoff later that day.
Patient’s rights
Right to treatment (cannot be involuntarily committed without treatment)
Right to least restrictive alternative
Right to safety from abandonment
Right to refuse treatment of medical or psychological basis (exceptions: person is deemed incompetent to stand trial or court mandates treatment)
Standards for clinical efficacy research
Must determine if treatment in question is better than no therapy, non-specific therapy, or alternative therapy
Standards for clinical utility (effectiveness)
Must determine if therapy in question works in clinical settings as well as research settings
