Rachlin S
Department of Psychiatry and Psychology, Nassau County Medical Center, East Meadow, NY 11554.
Bull Am Acad Psychiatry Law. 1988;16(1):25-33.
In deciding Ake v. Oklahoma, the Supreme Court held that, when defendants demonstrate that their sanity is likely to be a significant factor at trial, the State must assure them access to a competent psychiatrist who will not only examine them but also render other assistance to the defense. There have been 28 known subsequent decisions in which appellate courts have ruled on the validity of Ake-based claims; in only four did the defendant prevail. The case nonetheless raises issues relative to the proper role of the psychiatric expert. The Supreme Court's decisions, although not introducing a new ethical topic, appear to be favoring a more adversarial posture, at least within certain parameters. I suggest that impartiality, independence, and advocacy need not be mutually exclusive concepts and that some of our traditional beliefs about what part we should play in criminal law may have to be modified and expanded.
在判决“阿克诉俄克拉何马州案”时,最高法院裁定,当被告证明其精神状态在审判中可能是一个重要因素时,州政府必须确保他们能够接触到一名合格的精神病医生,该医生不仅要对他们进行检查,还要为辩方提供其他协助。已知此后有28个判决,上诉法院对基于“阿克案”的主张的有效性作出了裁决;只有4个案件中被告胜诉。尽管如此,该案还是引发了与精神病专家恰当角色相关的问题。最高法院的判决虽然没有引入一个新的伦理话题,但似乎倾向于一种更具对抗性的姿态,至少在某些范围内是这样。我认为,公正性、独立性和辩护性并非相互排斥的概念,我们一些关于在刑法中应扮演何种角色的传统观念可能需要加以修改和扩展。