Department of Forensic Psychiatry, University of Basel, Switzerland.
Office of Corrections and Rehabilitation, Zürich, Switzerland.
Swiss Med Wkly. 2023 May 16;153:40073. doi: 10.57187/smw.2023.40073.
Criminal courts of law rely on forensic psychiatric/psychological reports when clarifying legal questions of culpability, dangerousness, and the need for therapeutic measures for offenders. Incorrect decisions owing to a lack of expert report quality and comprehensibility can have serious consequences for potential victims, offenders themselves, or societal use of resources. In this pilot study, we started from the hypothesis that forensic psychiatric/psychological reports meet the minimum requirements for legally admissible expert opinions.
Within the framework of assessment by the Concordat Expert Commission of Northwestern and Central Switzerland, 58 adult criminal law reports were randomly selected. Two researchers extracted and analyzed standardized data descriptively. For quality assurance, they followed the extended codebook of the Research and Development Department of the Zürich Office of Corrections and Reintegration.
Psychopathological findings accounted for only 1% of the reports, which seemed problematic considering that these findings reflect the personality traits of offenders. Furthermore, only 7% of offenders underwent physical examinations, and the reasons for not performing physical examinations were noted in fewer than half of these offenders. Of 26 sexual offenders, only one was physically assessed. Additional imaging or neurophysiological examinations (e.g. electroencephalogram) were conducted in only one offender. Furthermore, published baseline recidivism rates were used in only 37.9% of the reports.
The results of this study suggest that current forensic psychiatric assessment is deficient. The infrequent use of published recidivism rates for risk communication denies prosecutors and judges solid reference values for the actual recidivism probability. Moving away from somatic medicine contradicts the federal court judgment, which disqualifies psychologists from providing a forensic report owing to their lack of expertise in physical examination. The authors recommend the multidisciplinary involvement of forensic psychiatrists and psychologists and, in certain cases, of specialists in somatic medicine to produce accurate and well-founded reports.
刑事法庭在澄清刑事责任、危险性和罪犯治疗措施必要性等法律问题时,依赖法医精神病学/心理学报告。由于缺乏专家报告的质量和可理解性,错误的决策可能会对潜在受害者、罪犯本身或社会资源的利用产生严重后果。在这项初步研究中,我们从法医精神病学/心理学报告满足法律可接受专家意见的最低要求这一假设出发。
在西北和中瑞士协议专家委员会的评估框架内,随机选择了 58 份成人刑法报告。两名研究人员对标准化数据进行了描述性提取和分析。为了保证质量,他们遵循了苏黎世惩教和重返社会办公室研究和发展部的扩展代码本。
心理病理学发现仅占报告的 1%,考虑到这些发现反映了罪犯的人格特征,这似乎有问题。此外,只有 7%的罪犯接受了身体检查,而这些罪犯中不到一半的人记录了不进行身体检查的原因。在 26 名性犯罪者中,只有 1 人接受了身体评估。只有 1 名罪犯接受了额外的成像或神经生理学检查(如脑电图)。此外,只有 37.9%的报告中使用了已发表的基线累犯率。
这项研究的结果表明,目前的法医精神病学评估存在缺陷。由于缺乏对实际累犯概率的可靠参考值,风险沟通中很少使用已发表的累犯率。这种与躯体医学的背离与联邦法院的判决相矛盾,该判决因心理学家缺乏体检方面的专业知识而取消了他们提供法医报告的资格。作者建议法医精神病学家和心理学家以及在某些情况下躯体医学专家的多学科参与,以生成准确和有充分依据的报告。