Fox Patrick K
Law and Psychiatry Division, Department of Psychiatry, Yale University School of Medicine, 34 Park Street, New Haven, CT 06519-1187, USA.
J Am Acad Psychiatry Law. 2008;36(3):337-9.
The care and management of hospitalized insanity acquittees can be quite challenging. As patients progress in treatment, clinicians must invariably address whether the patient is ready to be returned to the community, balancing the liberty interests of the acquittee with the protection of society. The process by which this determination is made is far from simple and involves review of clinical interview and collateral information, identification of indicators of outcome post-discharge, and the use of structured risk assessment instruments. The decision to release an acquittee conditionally is also influenced by an array of factors that emanate from within the clinician, within the institution, the mental health system, the courts, and the broader society. While such biases affect a clinician's objectivity, they are also a natural part of the evaluation process. Their identification is essential so that the degree to which such biases influence the conditional release decision can be more fully understood and addressed.
对被判定患有精神疾病的住院者的护理和管理可能极具挑战性。随着患者治疗的进展,临床医生必须始终考虑患者是否准备好回归社区,在被判定患有精神疾病者的自由权益与社会保护之间寻求平衡。做出这一决定的过程绝非易事,涉及对临床访谈和旁证信息的审查、出院后结果指标的确定以及结构化风险评估工具的使用。有条件释放被判定患有精神疾病者的决定还受到一系列因素的影响,这些因素来自临床医生自身、机构内部、心理健康系统、法院以及更广泛的社会。虽然这些偏见会影响临床医生的客观性,但它们也是评估过程的自然组成部分。识别这些偏见至关重要,以便能更全面地理解并解决此类偏见对有条件释放决定的影响程度。