Baldwin George, Young Samantha, Fitton Lucy, Edwards Ian, Butler Michael, Beazley Peter
Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK.
Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK.
Int J Law Psychiatry. 2025 Mar-Apr;99:102071. doi: 10.1016/j.ijlp.2025.102071. Epub 2025 Feb 10.
In England and Wales, s.45A of the Mental Health Act 1983 allows a judge to pass a sentence including both an immediate direction to hospital as well as a punitive custodial element. R v Vowles provides four specific considerations for judges to attend to when considering such sentences (referred to as the 'Vowles statements'). The section, however, remains infrequently used. The present study adopted an online experimental methodology to explore decision-making in relation to the Vowles statements. We used a proxy judicial sample who made decisions about the same criminal case vignette. The experimental manipulation meant that participants were exposed to the same information except for the clinical diagnosis: 'complex mental health condition', 'Emotionally Unstable Personality Disorder' (EUPD) or 'Schizophrenia'. Participants were asked to decide which sentence they were most likely to give and rate their agreement with the each of the Vowles statements. Analysis considered relationships between Vowles statements, differences between experimental conditions, and the extent to which different factors (including the Vowles statements) predicted the overall sentencing decision. Results identified that s.45A was, by far, the most common sentencing decision, and that agreement on the different Vowles statements was variable. There was limited evidence of an impact of diagnosis on decision-making, except for some weak evidence that an EUPD diagnosis was associated with marginally higher rates of prison sentences. Most importantly, not all of the Vowles statements were predictive of the final sentence, with attitudes towards the need for punishment having the clearest relationship with the final sentencing decision.
在英格兰和威尔士，1983年《精神健康法》第45A条允许法官做出一项判决，其中既包括立即送往医院的指令，也包括惩罚性的监禁要素。R v Vowles案为法官在考虑此类判决时（称为“沃尔斯声明”）提供了四项具体考量因素。然而，该条款的使用频率仍然很低。本研究采用在线实验方法来探究与沃尔斯声明相关的决策过程。我们使用了一个代理司法样本，他们对同一个刑事案件 vignette 做出决策。实验操作意味着除了临床诊断外，参与者接触到相同的信息：“复杂心理健康状况”、“情绪不稳定人格障碍”（EUPD）或“精神分裂症”。参与者被要求决定他们最有可能做出的判决，并对他们对每项沃尔斯声明的认同程度进行评分。分析考虑了沃尔斯声明之间的关系、实验条件之间的差异，以及不同因素（包括沃尔斯声明）预测总体量刑决定的程度。结果表明，到目前为止，第45A条是最常见的量刑决定，而且对不同沃尔斯声明的认同程度各不相同。除了一些微弱的证据表明EUPD诊断与略高的监禁判决率相关外，几乎没有证据表明诊断对决策有影响。最重要的是，并非所有的沃尔斯声明都能预测最终判决，对惩罚必要性的态度与最终量刑决定的关系最为明显。
