scholarly journals Offenders with a Mental Impairment Under a 'Fusion Law': Non-Discrimination, Treatment, Public Protection

2021 ◽  
pp. 35-51
Author(s):  
George Szmukler
Keyword(s):  
Decision Making ◽  
Treatment Decision ◽  
Best Interests ◽  
Hospital Treatment ◽  
Mental Functioning ◽  
Mental Impairment ◽  
The Public ◽  
Common Criticism

A common criticism of a ‘fusion law’ - a generic law covering all instances where a person’s ability to make a treatment decision is impaired, regardless of the cause, and furthermore which only allows non-consensual treatment if it is in the person’s ‘best interests’ – is that it fails to deal adequately with the protection of the public. This paper examines the implications of a ‘fusion law’ where a person with an ‘impairment or disturbance of mental functioning’ has committed an offence or where the person has been found ‘unfit to plead’ or ‘not guilty by reason of insanity’. It is argued that within the parameters of a fusion law, unfair discrimination towards those with a mental impairment placed on treatment orders by a court - as exists presently in nearly all jurisdictions - can be avoided while at the same time providing satisfactory public protection. This can be achieved through hospital treatment, voluntary or involuntary depending on the person’s decision-making ability and best interests (or best interpretation of ‘will and preferences’), and a form of supervision order in the community that is supportively structured, but includes special conditions to ensure compliance.

‘Mental disorder’ and public protection

2017 ◽  
Author(s):  
George Szmukler
Keyword(s):  
Decision Making ◽  
Mental Illness ◽  
Mental Disorder ◽  
Treatment Decision ◽  
Persons With Disabilities ◽  
The Public ◽  
Treatment Decision Making ◽  
Decision Making Capacity ◽  
United Nations Convention ◽  
Current Systems

The implications of a Fusion Law for the management and treatment of people with impairments or disturbances in the functioning of mind who have committed offences is examined in this chapter. Concerns about public protection under a Fusion Law have been raised, particularly in relation to serious offences. Fusion Law principles can be applied with fair procedures regarding sentencing and hospitalization for those with a mental illness. The public can be protected on the same basis as for those without a mental illness. Options for extended sentences exist in many countries, equally applicable to all persons. ‘Unfitness to plead’ and ‘not guilty by reason of insanity’ present, under current systems, a problem when a person now has treatment decision-making capacity but is deemed a risk. The implications of the Fusion Law for the treatment of ‘psychopathy’ and the addictions are examined. The United Nations Convention on the Rights of Persons with Disabilities poses dilemmas for which solutions are uncertain.

scholarly journals Providing treatment to prisoners with mental disorders: development of a policy

2003 ◽  
Vol 182 (4) ◽  
pp. 299-302 ◽  
Author(s):  
Mark Earthrowl ◽  
John O'Grady ◽  
Luke Birmingham
Keyword(s):  
Decision Making ◽  
Mental Disorders ◽  
Psychiatric Hospitals ◽  
Treatment Decision ◽  
Case Law ◽  
Care Staff ◽  
Best Interests ◽  
Health Care Staff ◽  
Ethical Implications ◽  
Decision Making Capacity

BackgroundMental disorder is more prevalent among people in prison than in the general population. Prisoners who require transfer to psychiatric hospitals for treatment face long delays. Doctors working in prisons regularly face ethical and legal dilemmas posed by prisoners with mental illness.AimsTo develop a policy for providing treatment under the common law to prisoners with mental disorders who lack treatment decision-making capacity while arrangements are made to transfer them to hospital.MethodThe policy was developed through literature review and consultation with the Faculty of Law at Southampton University and health care staff at Winchester prison in the UK.ResultsThe policy provides guidelines for establishing decision-making capacity standards for documentation, and guidelines for implementation based on the Mental Health Act Code of Practice, other best-practice guidelines and case law.ConclusionsIt can be argued that case law allows more-extensive treatment to be provided in the best interests of the incompetent prisoner, beyond emergency situations. The policy has ethical implications and its use should be carefully monitored.

On being able to make decisions and making decisions for others

2017 ◽  
Author(s):  
George Szmukler
Keyword(s):  
Decision Making ◽  
Treatment Decision ◽  
Best Interests ◽  
Radical Interpretation ◽  
Decision Making Capacity ◽  
Beliefs And Values ◽  
Principle Of Charity ◽  
Problematic Situations ◽  
Decisions For Others ◽  
Difficult Cases

In this chapter, the meaning of ‘decision-making capacity’ is examined. A ‘procedural’, ‘value-free’ notion of its assessment is inadequate, especially in difficult cases where a consideration of a person’s ‘values’ may be unavoidable. An approach influenced by Davidson’s ‘radical interpretation’ is proposed, in which, under the ‘Principle of Charity’, a person’s system of beliefs and values is presumed to be, by and large, ‘coherent’. It asks how coherent are the present beliefs underlying a person’s apparently unwise treatment decision—how well do they fit with their previously deeply held beliefs and value commitments? A disruption of coherence may suggest an undermining of a person’s decision-making ability. The meaning of ‘best interests’ is also clarified in this context; it may mean giving effect to the person’s deep value commitments. Problematic situations are examined where questions arise concerning whether changes in a person’s values are of a nature that undermine decision-making or not. Dementia is an example.

Radiological safety and assessment of the performance of X-ray systems in veterinary facilities

2020 ◽  
Author(s):  
S. Economides ◽  
C.J. Hourdakis ◽  
C. Pafilis ◽  
G. Simantirakis ◽  
P. Tritakis ◽  
...  
Keyword(s):  
Decision Making ◽  
Radiation Protection ◽  
Atomic Energy Commission ◽  
Atomic Energy ◽  
Regulatory Control ◽  
Continuous Training ◽  
X Ray ◽  
The Public ◽  
Radiological Safety ◽  
High Level

This paper concerns an analysis regarding the performance of X-ray equipment as well as the radiological safety in veterinary facilities. Data were collected from 380 X-ray veterinary facilities countrywide during the on-site regulatory inspections carried out by the Greek Atomic Energy Commission. The analysis of the results shows that the majority of the veterinary radiographic systems perform within the acceptable limits; moreover, the design and shielding of X-ray rooms as well as the applied procedures ensure a high level of radiological safety for the practitioners, operators and the members of the public. An issue that requires specific attention in the optimization process for the proper implementation of veterinary radiology practices in terms of radiological safety is the continuous training of the personnel. The above findings and the regulatory experience gained were valuable decision-making elements regarding the type of the regulatory control of veterinary radiology practices in the new radiation protection framework.

Patients’ practices for taking the initiative in decision-making in outpatient psychiatric consultations

2017 ◽  
Vol 13 (2) ◽  
pp. 169-184 ◽  
Author(s):  
Shuya Kushida ◽  
Takeshi Hiramoto ◽  
Yuriko Yamakawa
Keyword(s):  
Decision Making ◽  
Conversation Analysis ◽  
Treatment Decision ◽  
Close Inspection ◽  
Important Resource ◽  
Treatment Decision Making ◽  
The Way

In spite of increasing advocacy for patients’ participation in psychiatric decision-making, there has been little research on how patients actually participate in decision-making in psychiatric consultations. This study explores how patients take the initiative in decision-making over treatment in outpatient psychiatric consultations in Japan. Using the methodology of conversation analysis, we analyze 85 video-recorded ongoing consultations and find that patients select between two practices for taking the initiative in decision-making: making explicit requests for a treatment and displaying interest in a treatment without explicitly requesting it. A close inspection of transcribed interaction reveals that patients make explicit requests under the circumstances where they believe the candidate treatment is appropriate for their condition, whereas they merely display interest in a treatment when they are not certain about its appropriateness. By fitting practices to take the initiative in decision-making with the way they describe their current condition, patients are optimally managing their desire for particular treatments and the validity of their initiative actions. In conclusion, we argue that the orderly use of the two practices is one important resource for patients’ participation in treatment decision-making.

Bid rigging in public procurement market according to the decisions of the President of the Office of Competition and Consumer Protection

2018 ◽  
Vol 5 (2) ◽  
pp. 161
Author(s):  
Konrad RÓŻOWICZ
Keyword(s):  
Decision Making ◽  
Comparative Analysis ◽  
Consumer Protection ◽  
Design Research ◽  
Public Procurement ◽  
Appeal Chamber ◽  
Interesting Issue ◽  
Market Control ◽  
The Public ◽  
Bid Rigging

Aim: In the practice of awarding public contracts, sometimes the behavior of market actors, instead of competing with other entities, are aimed at illegal cooperation, including bid rigging. The above shows that healthy competition is not possible without efficient market control. In public procurement market this control is, primarily, carried out by public procurement entities: the President of the Public Procurement Office (Prezes UZP) and the National Appeal Chamber (KIO), and furthermore by President od the Office of Competition (Prezes UOKiK) and Consumer Protection and the Court od Competition and Consumer Protection. and Consumer Protection (SOKiK). The interesting issue is how the activities of the President of Office of Competition and Consumer Protection targeted  to contend with bid rigging affects on the activities of President of the Public Procurement Office (Prezes UZP) or the National Appeal Chamber (KIO). Design / Research methods: analysis and comparison decisions/ judgment issued by the President of the Public Procurement Office, National Appeal Chamber, the President of  the Office of Competition and Consumer Protection and the Court of Competition and Consumer Protection. Conclusions: The analysis has shown that the existence of specificities in the activities of the decision-making bodies and the judgments examined. However, in keeping with the specificity of the forms and objectives of control, these entities should cooperate, to a greater extent than before. Expanding the scope of cooperation would make it possible to better contend with bid rigging without changing the competition protection model. The introduction of institutionalized instruments for cooperation between the authorities seems to be valuable in terms of system solutions. Value of the article: The main value of the article is the comparison of selectively selected decisions and judgments representative of the problem under consideration and their comparative analysis in order to achieve the research objectives. The article deals with issues relevant to both public procurement practitioners and the state bodies dealing with procurement matters.

Sign in / Sign up

Export Citation Format

Share Document