forensic psychiatry doc. mudr. karel hynek, csc. department of psychiatry, first faculty of...

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 LawSubjects 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 hospitala) 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

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

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