Faculty Bibliography

These practice parameters describe the forensic evaluation of children and adolescents who may have been physically or sexually abused.The recommendations are drawn from guidelines that have been published by various professional organizations and authors and are based on available scientific research and the current state of clinical practice. These parameters consider the clinical presentation of abused children, normative sexual behavior of children, interview techniques, the possibility of false statements, the assessment of credibility, and important forensic issues. These parameters were previously published in J. Am. Acad. Child Adolesc. Psychiatry, 1997, 36:423-442. J. Am. Acad. Child Adolesc. Psychiatry, 1997, 36(10 Supplement):37S-56S

OBJECTIVE: The purpose of this article is to discuss the interface between judicial discipline and behavioral science in the context of substance-related disorders. METHOD: We review the epidemiology of psychoactive drug use and crime and discuss the courts' decisions on relevant landmark cases, particularly as they influence the practice of psychiatry. RESULTS: (1) The phenomenology of addiction and crime is of great epidemiological import. (2) Our legal system inclines toward the view that the use of alcohol or other substances involves an element of choice and therefore would not amount to a legal insanity defense if the substance abuser commits a crime while intoxicated. (3) A state can confine an addict or alcoholic for compulsory treatment if that individual presents a danger to self or others. (4) The law has found that alcoholism and drug abuse are both 'willful misconduct' and a disabling condition; the former definition contains the end in view of punitive action. The latter is aimed toward treatment and rehabilitation. (5) The law gives the right to the employer to test a suspected employee for drug abuse. The addicted or alcoholic employee has the choice to either go for treatment or face job termination. (6) Our judicial system gives serious consideration to the welfare of a child whose parents are alcoholic or drug addicted. CONCLUSION: The two disciplines of psychiatry and law follow their own modes in resolving issues in alcoholism and other substance abuse. We need research and new approaches to build a bridge between the two

The evolving American family presents new psycholegal dilemmas. Recently many publicized landmark cases have involved custody disputes in which settlements turn on the genetic component. Although the court acknowledges the principle of 'the best interest of the child' as important to the determination of custody, this interest is not absolutely paramount. Court rulings have taken the position that the rights of biological parents are a threshold issue that must be resolved first. Thus, children may be removed from their adoptive and psychological parents through a court order. The authors present a psycholegal analysis of important cases with a guideline for the future

The U.S. Supreme Court has made a number of recent rulings in regard to the death penalty that will likely have the effect of increasing the use of psychiatry during the trial and sentencing process in capital cases. Any such changes are bound to increase the number of ethical dilemmas faced by psychiatrists involved in such work. The rulings affecting psychiatry include: (1) The Eighth Amendment forbids the execution of persons who are mentally incompetent in regard to their ability to appreciate the reasons for punishment. (2) A mentally-ill prisoner may be forcibly given neuroleptics if he presents a danger to himself or others. (3) Forced medication may not be used during the trial and sentencing phase if it has the potential to change the defendant's demeanor significantly enough to affect his defense. (4) Aggravating psychological factors affecting a convictee may be balanced against mitigating factors in considering whether death sentence should be imposed. (5) The psychosocial impact of the crime upon the victim's family may be presented during the sentencing phase as factors relevant to sentencing. (6) Adolescents and retarded individuals are not immune from the death penalty simply by virtue of their age or level of intelligence

In deciding a landmark child sexual abuse case, the U.S. Supreme Court broke new ground in addressing the unique needs and qualities of child witnesses. The Court unanimously decided that the spontaneous statement of an abused child, made outside of a courtroom and while receiving medical treatment because of molestation, is trustworthy and may be allowed as evidence at trial. The Court curtailed the right of a defendant to go face to face against the child accuser, considering that a victimized child's statement, made while he or she is emotionally injured, has substantial value that cannot be duplicated simply by testifying later in court

A series of ethical, moral, and legal dilemmas are presented along with the related landmark case law. The definition of motherhood and the types of mothers, such as genetic, gestational, and surrogate, have become a confusing matter, not only for a growing child but for lawmakers and mental health professionals as well. Pregnancy through artificial insemination gives certain rights to women who are not married to the father, even when these women have contracted to surrender the baby after birth. The law has recognized that biological mothers have a potential right to custody or at least visitation. Such a right, however, is not established on behalf of a father whose only relationship with a child is through his genetic component unless a strong emotional bond exists, and the mother is not married to and cohabiting with her husband. The author argues that the principle of 'the child's best interest' must prevail in all custody disputes, regardless of who the biological parent is

In deciding seven recent landmark child abuse cases, the U.S. Supreme Court has addressed and sought to balance the inherent conflict between the constitutional rights of the defendant and the best interests of the child. In four of the cases, the Court found that the interests of the child superseded the rights of the defendant. In three cases, the Court gave more validity to the constitutional rights of the defendant. The author examines the lengthy nature of such legal proceedings and the reasoning forming the basis for the Supreme Court's decisions

Persons with positive HIV appear to have the same right to confidentiality as other medical psychiatric patients. The ethical and legal duties of practitioners who learn that their HIV positive patients are endangering others is discussed. The essential policies of the CDC, AMA, and APA are reviewed along with the current legal situation. One conclusion reached is that applying the Tarasoff doctrine to warn/protect a third party, if that party may already be infected, is useful only when the third party is moral and sensible enough to cease behavior that would spread the disease to others