法医神经学和神经学家在法医评估中的作用。

Hal S Wortzel
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引用次数: 0

摘要

显然,需要具备必要知识和经验的专家就各种神经精神疾病提供法医意见。临床和法医角色之间也存在着重要的区别,因此也需要适用于法医评估的培训和专业知识。但是,具有神经精神病学和法医评估资格证书的专家仍然很少。这就造成了一个两难的局面,即涉及神经精神疾病或伤害诉讼的当事人经常被迫在具备神经精神疾病知识和技能的专家和具备法医评估技能和经验的专家之间做出选择。无论哪种选择都会带来风险。无论有缺陷的法医意见是由于医学知识不足还是法医评估程序不当造成的,其结果都是一样的,即事实审判者可能会接触到有问题的证词。然而,还有一个更根本的问题牵涉到更广泛的患者护理:精神病学和神经病学的历史分隔造成了虚假的二分法。因此,要优化神经精神疾病患者的临床护理、改善医学教育以支持此类护理,以及开展法医神经精神评估,就必须从更加积极主动地重新整合精神病学和神经病学开始。
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Forensic Neurology and the Role of Neurologists in Forensic Evaluations.

There is a clear need for experts with the requisite knowledge and experience to offer medicolegal opinions pertaining to various neuropsychiatric conditions. There is also an important distinction between clinical and medicolegal roles, and the need for training and expertise applicable to forensic assessment. But there remain few available experts with credentials spanning neuropsychiatry and forensic assessment. This creates a dilemma whereby parties involved in litigation featuring neuropsychiatric illness or injury are frequently forced to choose between experts with either knowledge and skills applicable to neuropsychiatric conditions or experts with skills and experience applicable to forensic assessment. Either choice introduces risk. Whether flawed medicolegal opinions are a consequence of deficient medical knowledge or an inadequate forensic evaluation process, the result remains the same, with triers of fact potentially being exposed to problematic testimony. There is, however, a more fundamental problem that implicates patient care more broadly: spurious dichotomies created by the historical segregation of psychiatry and neurology. Optimizing clinical care for patients with neuropsychiatric conditions, improving medical education in support of such care, and enabling forensic neuropsychiatric assessment must then start with more proactive efforts to reintegrate psychiatry and neurology.

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来源期刊
CiteScore
2.00
自引率
29.60%
发文量
92
期刊介绍: The American Academy of Psychiatry and the Law (AAPL, pronounced "apple") is an organization of psychiatrists dedicated to excellence in practice, teaching, and research in forensic psychiatry. Founded in 1969, AAPL currently has more than 1,500 members in North America and around the world.
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