Medicine, Science and the Law最新文献

In 2013, Spain aligned its capacity modification processes (CM) legislation with the UN Convention on the rights of persons with disabilities, specifically for individuals with severe mental disorders (SMD). The reforms replaced incapacity verdicts with support provision and introduced the term "CM". However, the social impact of these changes remains uncertain. The RECAPACITA project was initiated to generate knowledge on SMD and CM, and this study aims to investigate modifications in CM sentences and associated terminology. Using a qualitative-quantitative methodology, content analysis was conducted on 56 sentences from individuals with SMD. Terminology analysis utilized 19 sentences to achieve information saturation. A comparison was made between sentences prior to 2013 and those spanning 2014 to 2023, analyzing the data through ANOVA and Bonferroni tests (significance level: 0.05). The analysis revealed that psychiatric illness, its evolution, lack of self-governance, and economic management were frequently mentioned aspects in the sentences. However, no significant correlations were found. Qualitatively, mentions of self-governance were more prevalent in sentences before 2013. Conversely, after 2013, there was an increased focus on substances use, lack of insight and medical adherence, and the need for support in daily life. The term "incapable person" appeared in 100% of the sentences, indicating no differences in terminology. The study suggests that current CM sentences provide increasingly individualized information, addressing the specific support needs of individuals. To enhance future legal proceedings, incorporating neuroscience in studying SMD individuals and reconsidering terminology based on Convention guidelines is recommended.

Electronic monitoring (EM) of individuals has been used by the criminal justice system for the past thirty years, and in the UK, use is on the increase. Its use has been justified as an alternative to prison to reduce recidivism and allowing early release of prisoners, however, the evidence base for this remains mixed. In 2010, it was employed for the first time in a forensic psychiatry setting. A study investigating the effects of EM on leave episodes concluded that EM may improve the speed of patient progress and reduce the length of admission, leading to reduced costs and increased public safety. However, the intervention generated considerable controversy and sparked discussion about ethical concerns. Here, we consider specifically legal and human rights issues that emerge from use of EM in forensic healthcare settings, scrutinising its use in the context of the Mental Health Act and the Human Rights Act. We conclude that EM is legal and justifiable, providing it is used judiciously and with due consideration of concerns for the individual and the given context.

Pesticides are used to kill, repel or control any animal or plant species which are considered pests, but have also been associated with intentional and unintentional human fatalities. A rapid increase in pesticide suicides was observed during 'The Green Revolution' after pesticides were introduced into low- and middle-income rural households without appropriate guidelines for safe use and storage. While national pesticide bans have contributed to a significant decrease in pesticide-related suicides, such cases still comprise a large proportion of all suicides around the world. The aim of the current study was to provide a profile of pesticide suicides in a high-income country as a point of comparison against studies from low- and middle-income countries. Statistical analyses were performed using R (version 4.2.3). Over the 20-year study period, there were a low, yet consistent number of pesticide suicides which were most common among males over the age of 40. Paraquat and methomyl pesticides collectively contributed to almost half (48.8%) of all fatalities. Consistent with the literature, such cases often occurred with little premeditation in response to an acute emotional crisis. While interpretation of autopsy findings was mostly limited, there were some pesticides that demonstrated findings consisted with previously reported characteristics (e.g., gastroesophageal erosions with paraquat). Given the high proportion of cases where paraquat and methomyl pesticides were implicated, it may be appropriate to review the availability and accessibility of such compounds to reduce the occurrence of pesticide suicides in South Australia and potentially the wider Australian population.

The "right" of an adult patient with capacity to refuse treatment has been very well recognized by the courts over the years. Recently, it was the central issue in this recent case, PH (by his litigation friend, the Official Solicitor) v Betsi Cadwaladr University Health Board ([2022] EWCOP 16). This paper briefly reviews the case and goes on to present the author's views on the general "right" to refuse treatment and the meaning of "right" in the expression, "the right to refuse treatment". It then points out other relevant matters worth noting.