Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA 01655, USA.
J Am Acad Psychiatry Law. 2011;39(2):183-8.
The task of evaluating psychiatric disability poses several ethics-related and practical challenges for psychiatrists, especially when they are responding to a request from a third party for a disability evaluation on their own patient. This study sought to evaluate the differences in how forensic and nonforensic psychiatrists approach and view evaluations for Social Security disability benefits. Thirty-two forensic and 75 nonforensic psychiatrists were surveyed on their practice patterns and perceptions of role, objectivity, and dual agency in the disability evaluation process. Significant differences were found between forensic and nonforensic psychiatrists' perceptions of the dual-agency conflict, beliefs about who should perform evaluations, and beliefs about the weight given to different opinions when decisions of whether to award disability benefits are made. A minority of respondents in both groups reported having identified a patient as disabled, despite believing otherwise. The implications of these findings are discussed.
评估精神残疾给精神科医生带来了一些与伦理和实际相关的挑战，尤其是当他们应第三方要求对自己的患者进行残疾评估时。本研究旨在评估法医精神病学家和非法医精神病学家在评估社会保障残疾津贴方面的方法和观点的差异。对 32 名法医精神病学家和 75 名非法医精神病学家进行了调查，了解他们在残疾评估过程中的实践模式以及对角色、客观性和双重代理的看法。在双重代理冲突的看法、谁应该进行评估的信念以及在做出是否授予残疾津贴的决定时对不同意见的重视程度方面，法医精神病学家和非法医精神病学家的看法存在显著差异。两组中的少数受访者报告说，尽管他们有不同的看法，但已经确定了一名患者为残疾。讨论了这些发现的意义。
