Domingue Jean-Laurent, Jacob Jean-Daniel, Perron Amélie, Pariseau-Legault Pierre, Foth Thomas
School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Département des Sciences infirmières, Université du Québec en Outaouais, Québec, Canada.
Nurs Inq. 2023 Apr;30(2):e12521. doi: 10.1111/nin.12521. Epub 2022 Sep 1.
In the Canadian forensic psychiatric context, the concepts of risk and dangerousness interact, intersect, and morph into the notion of significant threat to the safety of the public. Stemming from the results of a critical ethnography of the Ontario Review Board, this article unpacks the central role of forensic psychiatric nursing, as an example of a 'psych' discipline (e.g., psychiatry and psychology), in a system that is built to produce risky persons and to legitimize their detention and supervision. By using excerpt of interviews conducted with nurses, ethnographic observations of Review Board hearings, and other documentary artifacts, the findings illustrate how rationalizations of risk and dangerousness are contingent on space, time, and observer. Depending on the time of the assessment or on the health-care professional who performs it, different elements including, but not limited to, mental illness, interpersonal relationships, financial instability, and sexual vulnerability, are relied upon in very fluid, interchangeable, and discretionary ways to justify findings of dangerousness. Such a dynamic expands the reach of psychiatry's legitimacy at identifying risky conduct and controlling risky persons to domains very loosely associated with the notion of dangerousness. The work of Foucault and Castel provides the theoretical backdrop on which rests the discussion and the implications for nursing.
在加拿大法医精神病学背景下,风险和危险性的概念相互作用、交叉,并演变成对公众安全的重大威胁这一概念。基于安大略审查委员会一项批判性人种志研究的结果,本文剖析了法医精神病护理作为“心理”学科(如精神病学和心理学)的一个范例,在一个旨在制造有风险人员并使其拘留和监管合法化的系统中所起的核心作用。通过使用对护士进行访谈的节选内容、对审查委员会听证会的人种志观察以及其他文献资料,研究结果表明,对风险和危险性的合理化解释取决于空间、时间和观察者。根据评估时间或进行评估的医疗保健专业人员的不同,包括但不限于精神疾病、人际关系、经济不稳定和性脆弱性等不同因素,会以非常灵活、可互换和随意的方式被用来为危险性的判定提供依据。这种动态变化将精神病学在识别风险行为和控制有风险人员方面的合法性范围扩展到与危险性概念联系非常松散的领域。福柯和卡斯泰尔的著作提供了支撑该讨论及对护理工作启示的理论背景。