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

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• Human Rights (constitution CR 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

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Codex Law of patients

• Ethic commission ministry of health CR 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

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Hospitalization without agree

• Compulsory admission
• Emergency situation (s. attempts , aggressive
  behavior, behavior endangering)
• Reported to the local court within 24 hours

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Compulsory treatment

• Psychiatric, sexological, antialcoholic

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History of Forensic Psychiatry

• Roman Law furios, mente capti, dementes
• Constitutio criminalis Carolina 1532 Charles V
• Hrdelní rád Josef I. 1707
• Constitutio criminalis Teresiana 1768
• Criminal Law 140/61Sb Republic Czechoslovakia
• Austrian General Civil Law 1811
• Every Country has its particularly approach

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• 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

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In Criminal Law

• Acts who asks the psychiatric expertise
• Policy
• Prosecutor
• Court
• Solicitor
• Private Person

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Characteristic Criminal Trial

• Presumption of innocence
• Judge 3 members
• Prosecution 
• Psychiatric expertise is made by one expert

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Content of Expertise

• Summary from police record
• Summary from health's report
• Psychiatric examination
• Event. lab. examinations
• Event. psychological examination
• Event. other special examination
• Summary and conclusions of expertise
• Answer for applied questions

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Civil LawSubjects Have Equal Rights Principle
of Equality

• Civil Law
• Business Law
• Familiar Law
• Labor Law

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Civil Law in Cz. c.86/92 Sb. a 20/96 Sb.

• Abilities for legal capacity
• Involuntary admission to hospital
• Infection diseases (TBC)
• Mental illness , intoxication if he is
  dangerous himself or others
• Impossible agreement

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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
  guardians consent.
• Responsibility for Damage, Loss

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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.

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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

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Competencyto juristic act

• Overture to competency to juristic act
• Member of family, G.P. another M.D.
• Curator or guardian
• Court asked experts for examination

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Family and Labor Law

• Financial compensation for pain and social
  handicap. ( 32 1965 Sb.)
• Insurance (vyhl. C. 49/64 Sb. Novela 55/79 Sb.)
• Abilities for driving
• Fosterage - given to keep
• Ability to hold arms (zák. c 288/95 Sb.)

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

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

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• Incidence of 8 per 100 000
• Physical illness. 20
• Mental illness ...10
• Health people 70 (personality disorders ,
  abuse, loneliness, death of somebody from
  family)

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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

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Presuicidal syndrome

• Cessation of interest, hobbies ..
• Emotional isolation
• Social isolation
• Depressive symptoms
• Cause stress situation

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Autoaggressiveness

• Psychological
• Automutilation
• Attempted suicide (6x)
• Committed suicide (1x)

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Diagnosis

• Healthy
• Personality disorders
• Schizophrenia
• Depressive illness
• Addictions alcohol drugs
• Aging
• Others

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Risk of realization

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