Ethical and Legal Issues

In order for someone to be treated differently under the law due to their mental state, it must not be….

situational, self-induced or a transient state

T/F: All DSM-5 disorders are recognized under the legal definition of mental disorder.

False

What is civil commitment?

court-ordered institutionalization of a mentally ill or dangerous person

T/F: An individual must have or be suspected of having broken a law in order for civil commitment to be carried out.

False

Civil commitment is what type of statute?

Provincial/Territorial

What is criminal commitment?

court-ordered institutionalization of a person undergoing determination of competency or who was deemed not criminally responsible on account of mental disorder

Criminal commitment is what type of statute?

Federal

What is a community treatment order (CTO)?

An order issued by a doctor to receive supervised treatment and care in the community

Who conducts the reviews of community treatment orders?

the consent and capacity board

What does parens patriae mean in relation to civil commitment?

government has right to act as guardian/parent of mentally ill people

Which of the following is NOT necessary for civil commitment

never been formally diagnosed with a mental disorder

What are the two ways involuntary treatment can happen?

1. Formal commitment ordered by the court

2. Informal, emergency commitment without involving the courts i.e. hospital determines that voluntary patient is too disturbed/dangerous to release

How long may a patient be committed for during involuntary hospitalization?

2-4 weeks

Who is typically the temporary substitute decision maker for patients who can’t make their own treatment decision?

Physician

What two principles must be used by the temporary substitute decision maker?

the best interest principle, the capable wishes principle

What is the best interest principle?

maximize good for patient

What is the capable wishes principle?

when the patient is/was capable, we should stick to those wishes and give them the greatest weight

What is the legal term used to refer to someone’s potential to harm self or others?

dangerousness

What are the four parts of dangerousness?

severity, imminence, frequency, probability

What two sets of circumstances increase dangerousness in the mentally ill?

1. mental illness involves psychosis

2. serious mental illness combined with substance abuse

T/F: Most mentally ill people are not violent.

True

T/F: Criminal behaviour is more common in mentally ill people than the general population.

False.

What is the major reason for involuntary hospitalization?

risk of violence

What is Tarasoff Rule?

psychologists have a duty to protect potential victims who are in imminent danger

When a mental health professional decides a patient is going to harm a specific person, they can…

(3 options)

warn the intended victim or someone who can warn the victim

Notify law enforcement

Take other reasonable steps i.e. committing patient to psychiatric facility

When may a psychologist breach confidentiality?

when they suspect a third party is at risk

What is a false confession?

An admission of guilt to a crime that the confessor is not responsible for

How can false confessions be induced?

through coercion or mental disorder/incompetency of the accused

T/F: It is possible for a person to be deemed competent to stand trial yet subsequently be deemed not criminally responsible by reason of mental disorder.

True

T/F: Fitness to stand trial has to do with accused’s present condition, not condition at the time of alleged offence.

True

T/F: Attorneys may recognize their client has diminished competency, but not request evaluation.

True

Defendants found incompetent can be given medication against their will to allow them to stand trial, unless…

it is a non-violent crime

T/F: Being found not criminally responsible does not result in an acquittal.

True

Is confidentiality an ethical or legal term?

ethical

Is privileged communication an ethical or legal term?

legal

What is confidentiality?

the ethical requirement to not disclose any information about a patient to others unless legally compelled to do so

T/F: Confidentiality includes not disclosing if the person is even your patient.

True

What is privileged communication?

information that is protected from being disclosed during legal proceedings

What is informed consent?

potential participants must be capable of understanding what they are consenting to

T/F” Insanity is a legal term, but is not a recognized diagnosis in the DSM-5

True

What does insanity mean in legal instances?

the person was not criminally responsible when they committed the crime

What does criminally responsible mean?

a defendant’s crime was the product of action (or attempted action) and the intention to perform that crime

To be deemed fit/competent to stand trial, the defendant must…

1. understand the proceedings that will take place

2. understand the facts in the case and legal options available

3. consult a lawyer

4. assist lawyer in building a defense

What is the right to refuse?

when civilly committed, a person has the right to refuse medication or treatment (normally related to antipsychotics with adverse side effects)

T/F: The right to refuse can be overridden.

True

What is the goal of mandated outpatient commitment?

to prevent the cycle of getting discharged, stopping medication/treatment, becoming dangerous and ending up incarcerated again