1.Legal medicine: assessing mental capacity and writing medical reports for deputy applications.
Hui Min LIM ; Lee Gan GOH ; T THIRUMOORTHY
Singapore medical journal 2017;58(1):18-23
Medical reports are required to support court applications to appoint a deputy to make decisions on behalf of a person who has lost mental capacity. The doctor writing such a medical report needs to be able to systematically assess the mental capacity of the person in question, in order to gather the necessary evidence for the court to make a decision. If the medical report is not adequate, the application will be rejected and the appointment of the deputy delayed. This article sets out best practices for performing the assessment and writing the medical report, common errors, and issues of concern.
Documentation
;
Humans
;
Mental Competency
;
legislation & jurisprudence
;
Patient Advocacy
;
legislation & jurisprudence
;
Physicians
;
legislation & jurisprudence
;
Proxy
;
legislation & jurisprudence
;
Singapore
;
Third-Party Consent
;
legislation & jurisprudence
;
Vulnerable Populations
;
legislation & jurisprudence
;
Writing
3.Schizophrenia and jurisdictional identifications of mental diseases.
Ya-hui WANG ; Ke QIAO ; Guang-you ZHU
Journal of Forensic Medicine 2007;23(1):57-59
Schizophrenia is the most common in forensic psychiatry. The motive, the style and the consequence of any schizophrene's misdeed have its own particularity. So schizophrenia is significant in the forensic practice. The characteristics of schizophrene's misdeed and the peace breaker's responsibility, competence to stand trial and to serve a sentence werereviewed.
Crime/psychology*
;
Expert Testimony/standards*
;
Forensic Psychiatry/standards*
;
Humans
;
Liability, Legal
;
Mental Competency/legislation & jurisprudence*
;
Schizophrenia
4.The mental capacity act: implications for patients and doctors faced with difficult choices.
Annals of the Academy of Medicine, Singapore 2013;42(4):200-202
The Mental Capacity Act (MCA) came into effect in March 2010 but the impact of this groundbreaking legislation on the doctor-patient relationship has not yet been studied in Singapore. It is evident that communication between healthcare professionals, patients and their loved ones has never been so critical. Translating this into practice, healthcare professionals must identify the decision-maker to obtain consent from the correct person. Consent for healthcare and treatment must be obtained from the patient with capacity or the patient's legally appointed proxy decision-maker under a Lasting Power of Attorney (LPA) where the patient lacks capacity. However, the doctor is the decision-maker for patients lacking capacity in matters of life-sustaining treatment or treatment to prevent a serious deterioration of the patient's health. All decisions made on behalf of persons lacking capacity must be made in their best interests. Capacity assessments must be properly conducted and if a patient has the capacity to make the decision then healthcare professionals must take practicable steps to help them make a decision.
Advance Directives
;
legislation & jurisprudence
;
Decision Making
;
Delivery of Health Care
;
legislation & jurisprudence
;
Humans
;
Informed Consent
;
legislation & jurisprudence
;
Mental Competency
;
legislation & jurisprudence
;
Physician-Patient Relations
;
Physicians
;
legislation & jurisprudence
;
Singapore
;
Third-Party Consent
;
legislation & jurisprudence
5.Civil competence assessment of the mental disorders involved in compensation of personal injury.
Yan-xia PANG ; Qin-ting ZHANG ; Wei-xiong CAI ; Fu-yin HUANG ; Tao TANG ; Jia-sheng WU ; Jian-jun WANG ; Ri-xia DONG
Journal of Forensic Medicine 2009;25(1):24-32
OBJECTIVE:
To seek and ascertain indicators that can be used in the civil competence assessment of the mental disorders involved in compensation of personal injury.
METHODS:
A retrospective study was made on the data related to the interviewee's mental status assessed by forensic experts during the period from 2003 to 2005 in Institute of Forensic Science, Ministry of Justice, P.R.China. The 6 indicators, including awareness of situation, factual understanding of issues, appreciation of likely consequences, rational manipulation of information, functioning in one's own environment, and communication of choice, were graded and statistically analyzed using SPSS 11.5 software.
RESULTS:
The 6 indicators correlated well with the assessment of forensic experts ,with the related coefficient between 0.632 and 0.876, and the inter-related coefficient among the 6 indicators between 0.575 and 0.911.
CONCLUSION
The 6 indicators could be used for the civil competence assessment and may also be taken as the basis for further standardization and quantification of civil competence.
Antisocial Personality Disorder/diagnosis*
;
Compensation and Redress/legislation & jurisprudence*
;
Expert Testimony/legislation & jurisprudence*
;
Forensic Psychiatry
;
Humans
;
Insanity Defense
;
Mental Competency/legislation & jurisprudence*
;
Psychotic Disorders/diagnosis*
;
Wounds and Injuries/economics*
6.Advanced investigation of testamentary capacity of the mentally disordered.
Yan-Xia PANG ; Wei-Xiong CAI ; Qin-Ting ZHANG ; Fu-Yin HUANG ; Tao TANG ; Jia-Sheng WU ; Jian-Jun WANG ; Ri-Xia DONG
Journal of Forensic Medicine 2009;25(3):208-211
Testamentary capacity is one of the civil competences, it means that a natural person enjoys the capacity or qualification to establish testament and deal with his property. Recently, the cases of testamentary capacity assessment of the mentally disordered are increasing. This article firstly introduces the concepts of the testament as well as the testamentary capacity, and then summarizes the assessment standard of the testamentary capacity, by using the Banks v. Goodfellow case as a basis to make the standard criteria including: the understanding of the nature of a will and codicil, the knowledge of the general extent of one's assets, the knowledge of the natural object of one's bounty, the understanding of the impact of the distribution of the assets of the estate, and the absence of a delusion specifically affecting the distribution of the estate. The impact factors of the testamentary capacity, including dementia, mood disorder, schizophrenia, alcohol, drug, and undue influence, etc., are summarized. Lastly, the related assessment tools such as the Mini-Mental State Examination, the Clock-Drawing Test, and the Testament Definition Scale are introduced briefly.
Alcoholism/psychology*
;
Dementia/psychology*
;
Expert Testimony/standards*
;
Forensic Psychiatry
;
Humans
;
Mental Competency/standards*
;
Mental Disorders/psychology*
;
Mental Status Schedule
;
Wills/legislation & jurisprudence*
7.Civil competence assessment of the mental disorders involved in contract dispute.
Qin-Ting ZHANG ; Yan-Xia PANG ; Wei-Xiong CAI ; Tao TANG ; Jian-Jun WANG
Journal of Forensic Medicine 2009;25(2):95-101
OBJECTIVE:
To search the criteria for evaluating the civil competence of the mental disorders involved in contract dispute.
METHODS:
Data on the interviewee's mental status and the forensic expertise were collected retrospectively. And 6 indexes were selected and graded: awareness of situation, factual understanding of issues, appreciation of likely consequences, rational manipulation of information, functioning in one's own environment and communication of choice. All of the data were analyzed by SPSS.
RESULTS:
Fifty six cases were included and interviewee's civil competence was graded to three levels: full civil competence, diminished civil competence, and no civil competence. These cases included two types of contract: the real estate related contract (38 cases) and the labor related contract (14 cases). All of the 6 indexes were well correlated to the forensic expertise. The related coefficient was from 0.703 to 0.834, and the interrelated coefficient of the 6 items was also high, from 0.712 to 0.877.
CONCLUSION
It is feasible to divide the civil competence of the mental disorders into three grades. As the basis, these 6 indexes mentioned above are representative and can be applied in further standardized and quantified assessment of civil competence.
Contract Services/legislation & jurisprudence*
;
Dissent and Disputes
;
Expert Testimony
;
Female
;
Forensic Psychiatry
;
Humans
;
Informed Consent
;
Male
;
Mental Competency/psychology*
;
Mental Disorders/psychology*
8.The application of evaluation tools for criminal responsibility in forensic psychiatric expertise.
Pei-Xin FU ; Jing WANG ; Tian-Tao SHI ; Ji-Nian HU ; Ming-Xia ZHU
Journal of Forensic Medicine 2010;26(3):210-213
Criminal responsibility is divided into three types: full criminal responsibility, diminished criminal responsibility and criminal irresponsibility in China. In forensic psychiatric expertise, doctors often have different opinions about the responsibility in a given case because of lacking objective criteria. The evaluation of criminal responsibility is always unresolved problem in forensic psychiatric expertise. Application of these evaluation tools in forensic psychiatric expertise were reviewed in this article. The value of the tools were still controversial in the reliability and validity, but it is clear that these tools have the positive roles in ensuring the standardization and the uniformity of the forensic investigation.
Crime/psychology*
;
Expert Testimony/legislation & jurisprudence*
;
Forensic Psychiatry
;
Humans
;
Liability, Legal
;
Mental Competency
;
Mental Disorders/psychology*
;
Psychiatric Status Rating Scales
;
Social Responsibility
9.Progress in standard assessment on competency to stand trial of mentally disordered offenders.
Xiao-Bing CHEN ; Wei-Xiong CAI
Journal of Forensic Medicine 2012;28(4):293-298
Competency to stand trial relates directly to legal rights of the appraised individual as well as whether criminal procedure can be carried out smoothly. Foreign scholars have conducted a large number of theoretical researches, and developed a series of standardized evaluation tools. However, the assessment on competency to stand trial has mainly focused on medical criteria in China for a long time, and most cases were judged by forensic psychiatrists' experience. Recently, Chinese scholars have started the initial research on standardized evaluation. This paper reviews the notion of competency to stand trial, the evaluation criteria, and the assessment tools domestically and abroad. The main focus is on foreign assessment tools, which included three categories. First category includes checklist, self-report questionnaires and sentence-completion tasks. Second category is the interview-based instruments without criterion-based scoring. Last category is the interview-based instruments with criterion-based scoring. This literature may be helpful for further research and standardization on assessment tools of competency to stand trial of mentally disordered offenders.
Crime/psychology*
;
Criminal Law/legislation & jurisprudence*
;
Criminals/psychology*
;
Forensic Psychiatry/standards*
;
Humans
;
Insanity Defense
;
Mental Competency/psychology*
;
Mental Disorders/psychology*
;
Psychiatric Status Rating Scales
;
Psychological Tests
;
Reference Standards
;
Reproducibility of Results
;
Surveys and Questionnaires