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Forensic psychiatry

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					    Forensic Psychiatry

    doc. MUDr. Karel Hynek, CSc.
Department of Psychiatry, First Faculty of
Medicine, Charles University and General
     University Hospital in Prague
• Human Rights (constitution ČR 1993)
• Declaration Human Rights of Mental
  patients (Luxor 1989)
  –   don't separated Mental patients
  –   act with them as equal
  –   protect their Law
  –   informed them about their health and Th
  –   informed them about their Laws
          Codex Law of patients
•   Ethic commission ministry of health ČR 1992
•   Rights for careful, professional care
•   Known of name of M.D.
•   Information about treatment, DG
•   Refuse the Therapy
•   Respect their private and shines
•   Secret report
•   Written agree with therapy
  Hospitalization without agree
• Compulsory admission
• Emergency situation (s. attempts ,
  aggressive behavior, behavior endangering)
• Reported to the local court within 24 hours
        Compulsory treatment
• Psychiatric, sexological, antialcoholic
    History of Forensic Psychiatry
•   Roman Law „furios, mente capti, dementes“
•   Constitutio criminalis Carolina 1532 Charles V
•   Hrdelní řád Josef I. 1707
•   Constitutio criminalis Teresiana 1768
•   Criminal Law 140/61Sb Republic Czechoslovakia
•   Austrian General Civil Law 1811
•   Every Country has its particularly approach
Criminal Law
• Responsibility, diminution (decrease) of
  responsibility (§ 32 tr. z.), nonresponsibility (§ 12
  tr. z.) of criminal with mental disease
• Recognition and controlling possibilities
• Possibility to speak in the Court
• Social dangerousness from psychiatric aspect
• Resocialization
• Protective – involuntary treatment
• Protective education
           In Criminal Law
• Acts who asks the psychiatric expertise
  – Policy
  – Prosecutor
  – Court
• Solicitor
• Private Person
     Characteristic Criminal Trial
•   Presumption of innocence
•   Judge 3 members
•   Prosecution
•   Psychiatric expertise is made by one expert
         Content of Expertise
1. Summary from police record
2. Summary from health's report
3. Psychiatric examination
  –   Event. lab. examinations
  –   Event. psychological examination
  –   Event. other special examination
4. Summary and conclusions of expertise
5. Answer for applied questions
               Civil Law
      Subjects Have Equal Rights
         Principle of Equality

•   Civil Law
•   Business Law
•   Familiar Law
•   Labor Law
 Civil Law in Cz. § č.86/92 Sb. a
            20/96 Sb.
• Abilities for legal capacity
• Involuntary admission to hospital
   a) Infection diseases (TBC)
   b) Mental illness , intoxication if he is
      dangerous himself or others
   c) Impossible agreement
   Psychiatric Expertise in Civil
               Law
• Abilities for legal Capacity
• Testamentary capacity (Invalid Testament).
• A Person certified insane was presumed to be
  incapable of making a valid contract.
• Marriage and Divorce. Feeble – minded persons,
  psychopaths addicts and a serious brain injury can
  be placed under guardianship, their guardian‘s
  consent.
• Responsibility for Damage, Loss
             Legal Capacity
• Possibility to have human Right and Duty
• It is one human Right start with Birth and
  ending with Death. It is gradually increases
  with Development of Pearson, and
  maturated at 18 years.
• Recognition control own behavior and its
  adequacy.
             Legal Capacity
• Is limited mental illness, addiction of drugs
  and alcohol for a long time (§ 38 odst. 2)
• Legal act in transient mental illness or
  intoxication is invalid
              Competency
              to juristic act
• Overture to competency to juristic act
• Member of family, G.P. another
  M.D.
• Curator or guardian
• Court asked experts for examination
       Family and Labor Law
• Financial compensation for pain and social
  handicap. (§ 32 1965 Sb.)
• Insurance (vyhl. Č. 49/64 Sb. Novela 55/79
  Sb.)
• Abilities for driving
• Fosterage - given to keep
• Ability to hold arms (zák. č 288/95 Sb.)
     Forensic Expertise

    doc. MUDr. Karel Hynek, CSc.
Department of Psychiatry, First Faculty of
    Medicine, Charles University and
  General University Hospital in Prague
           Suicidology

    doc. MUDr. Karel Hynek, CSc.
Department of Psychiatry, First Faculty of
Medicine, Charles University and General
     University Hospital in Prague
•   Incidence of 8 per 100 000
•   Physical illness………. 20%
•   Mental illness ………...10%
•   Health people …………70% (personality
    disorders , abuse, loneliness, death of
    somebody from family)
          SUICIDOLOGY

• Suicide is medical problem
• Suicide is social problem
• Ratio women x        men
           1     x     2-3
• Age 1st maximum 15-19 years
        (20-29 years)
•      2nd maximum
        over 60 years
          Presuicidal syndrome
•   Cessation of interest, hobbies …..
•   Emotional isolation
•   Social isolation
•   Depressive symptoms

• Cause: stress situation
           Autoaggressiveness

•   Psychological
•   Automutilation
•   Attempted suicide (6x)
•   Committed suicide (1x)
                 Diagnosis
•   Healthy
•   Personality disorders
•   Schizophrenia
•   Depressive illness
•   Addictions alcohol drugs
•   Aging
•   Others
             Risk of realization

•   Suicide in family
•   Suicide in past history
•   Social isolation
•   Autoaggression, phantasy of suicide
•   Real plan of suicide