Domingue Jean-Laurent, Jacob Jean-Daniel, Perron Amélie, Foth Thomas, Pariseau-Legault Pierre
Author Affiliations: School of Nursing, University of Ottawa.
Department of Nursing, Université du Québec en Outaouais.
J Forensic Nurs. 2023;19(1):21-29. doi: 10.1097/JFN.0000000000000387. Epub 2022 Apr 2.
Forensic psychiatric nursing is a specialty at the junction of two well-researched intersecting systems with two mandates: criminal justice and health care. Nurses' involvement at one of the systems' points of juncture, review board (RB) hearings, has largely been left unexplored. At RB hearings, a panel of legal and healthcare professionals determines if persons unfit to stand trial (UST) or not criminally responsible on account of mental disorder (NCR) represent significant threats to the safety of the public and orders conditions aimed at keeping the community safe. The aim of this article is to present the results of a critical ethnography that explored how psychiatric and public safety discourses construct the identity of persons UST or NCR during RB hearings as well as nurses' contribution to such identity construction. The main finding is that the forensic psychiatric structure leverages nursing interventions and documentation as evidence of deviancy, so that persons UST or NCR can be objectified and produced as dangerous. Structures sustaining the forensic psychiatric system inscribe nursing care within a disciplinary scheme, rendering the care-and-custody dichotomy insufficient to explain the complex processes at play in forensic psychiatry. These findings have implications for the practice of nurses working in forensic psychiatric settings and for that of other nurses who practice on the medicolegal borderland.
法医精神病护理是一门处于两个经过充分研究的交叉系统交汇处的专业,这两个系统有两项任务:刑事司法和医疗保健。护士在其中一个系统的交汇点,即审查委员会(RB)听证会上的参与情况,在很大程度上尚未得到探讨。在RB听证会上,一个由法律和医疗专业人员组成的小组会判定那些因精神障碍而不适合受审(UST)或不负刑事责任(NCR)的人是否对公众安全构成重大威胁,并制定旨在保障社区安全的条件。本文的目的是展示一项批判性人种志研究的结果,该研究探讨了在RB听证会期间,精神病学和公共安全话语如何构建UST或NCR人员的身份,以及护士对这种身份构建的贡献。主要发现是,法医精神病学结构将护理干预和记录用作偏差行为的证据,以便将UST或NCR人员客观化并认定为危险分子。维持法医精神病学系统的结构将护理工作纳入一个纪律体系,使得护理与监管的二分法不足以解释法医精神病学中正在起作用的复杂过程。这些发现对在法医精神病学环境中工作的护士的实践以及在法医学边缘领域执业的其他护士的实践都有影响。