Rappeport J R
Medical Service of the Circuit Court for Baltimore City, Maryland.
Can J Psychiatry. 1987 Nov;32(8):719-27. doi: 10.1177/070674378703200817.
Kenneth Gray, an attorney as well as a psychiatrist, was the leader in the development of law and psychiatry in Canada prior to his death in 1970. He lived during the post WWII years which saw a phenomenal growth of psychiatry as well as the beginnings of the modern era of a renewed concern for human rights. This later concern has caused the belegalment of many areas of psychiatric practice. Kenneth Gray would have to learn a new set of rules for commitment, the use of ECT and informed consent. He would discover that a patient has a right to treatment that must be buttressed by an individual treatment plan. He would discover that a committed patient has a right to refuse treatment and that some courts in the United States have said that anti-psychotic medications are mind-altering and thus an invasion of the patients 1st amendment rights. He would see untreated refusing patients languishing in the hospital or the homeless mentally ill on the streets because of restrictive commitment laws. As an attorney he would also be concerned about the proposed solution to the homeless, outpatient commitment. He certainly would have been impressed with some of the recent decisions in the United States on our duty to warn or protect known and unknown victims. Seeing patients' advocates on the hospital wards would be a real surprise to him. These controls on the practice of psychiatry for the protection of our patients cut both ways. Dr. Gray's medical/legal education would be tested to its full.
肯尼斯·格雷既是一名律师，也是一名精神科医生，在1970年去世前，他是加拿大法律与精神病学发展领域的领军人物。他生活在二战后的年代，当时精神病学取得了显著发展，同时人权重新受到关注的现代时代也初露端倪。后来这种关注导致了精神病学实践许多领域的法律化。肯尼斯·格雷将不得不学习一套关于非自愿住院、电休克治疗的使用以及知情同意的新规则。他会发现患者有权接受必须由个人治疗计划支持的治疗。他会发现非自愿住院的患者有权拒绝治疗，而且美国的一些法院表示，抗精神病药物会改变心智，因此侵犯了患者的第一修正案权利。他会看到因限制性非自愿住院法律而拒绝治疗的患者在医院里日益衰弱，或者看到街头无家可归的精神病患者。作为一名律师，他也会关注针对无家可归者提出的解决方案——门诊非自愿住院。他肯定会对美国最近一些关于我们有责任警告或保护已知和未知受害者的判决印象深刻。看到医院病房里有患者权益倡导者对他来说会是一个真正的惊喜。这些为保护患者而对精神病学实践进行的管控是双刃剑。格雷医生的医学/法律教育将受到全面考验。
