Heitzman Janusz, Opio Małgorzata, Waszkiewicz-Białek Ewa
Klinika Psychiatrii Sadowej Instytutu Psychiatrii i Neurologii w Warszawie.
Psychiatr Pol. 2008 Jul-Aug;42(4):609-22.
The challenges met by the psychiatrist and the psychologist and the difficulties in providing forensic-psychiatry and forensic-psychology opinions have been reviewed, based on examples. The studied patient was hospitalised 10 times and the forensic-psychiatry opinion passed 15 times during the judiciary process. Different psychiatric diagnoses were made and different soundness of mind were passed. The psychiatric health status were expresses by professors of psychiatry who did not participate directly in passing the forensic-psychiatry opinion. The studied patient was examined by other specialists and assessed by certificating medical doctors with the aim of getting disability pension benefits. The effect of medical certificates and testimonials from different medical doctors were analysed. Analysing this example, revealed the problem of proper formulation of content of medical documents to support the medical diagnosis and declared soundness of mind during the passing of forensic-psychiatry opinion. The doctors treating the patients and doctors passing opinion on the treated patient had a different assessment of the diagnoses and soundness of mind for the studied patients. Irrespective of the immediate aim of the examinations, all professionals providing assessment should mind the consequences of opinions passed by them and especially, the possibility of the opinion being used by the subject to prolong the judiciary process or even avoid legal responsibility. The independence (sovereignty) of the expert requires consideration in the context of prior multiple forensic-psychiatry opinion leaders in the field of psychiatry and the need for the expert to assume an attitude towards these opinions.
基于实例，回顾了精神科医生和心理学家所面临的挑战以及提供法医精神病学和法医心理学意见时遇到的困难。在司法程序中，研究对象住院10次，法医精神病学意见通过了15次。做出了不同的精神科诊断，判定了不同的心智健全状况。精神科健康状况由未直接参与出具法医精神病学意见的精神科教授表述。研究对象接受了其他专家的检查，并由认证医生进行评估，目的是获得残疾抚恤金。分析了不同医生开具的医疗证明和鉴定书的影响。通过分析这个例子，揭示了在出具法医精神病学意见过程中，为支持医学诊断和宣称的心智健全而恰当拟定医疗文件内容的问题。治疗患者的医生和对接受治疗的患者出具意见的医生对研究对象的诊断和心智健全状况有不同的评估。无论检查的直接目的是什么，所有提供评估的专业人员都应考虑他们所出具意见的后果，尤其是该意见被当事人用来拖延司法程序甚至逃避法律责任的可能性。在精神病学领域先前有多位法医精神病学意见领导者的背景下，需要考虑专家的独立性（自主性），以及专家对这些意见应持的态度。
