Faculty Bibliography

The arguments for and against mental health professionals' participation in death penalty proceedings are presented against the background of U.S. Supreme Court decisions which have had a bearing on this issue. It is concluded that the possibility of presenting mitigating psychologic testimony in such proceedings necessitates the possibility of exacerbating psychiatric testimony and that hence, mental health professionals who testify for the prosecution in such cases do not, on a wider view, violate their hippocratic oaths or other ethical codes. A number of safeguards, however, should be instituted with respect to such testimony. Psychiatrists, psychologists or other qualified mental health professionals should (1) testify with medical 'possibility' or 'probability,' (2) not be permitted to address ultimate legal issues and (3) be permitted, in fact encouraged, to present alternative interpretations of forensic psychiatric findings. It is further argued that in addition to being justified in testifying for the prosecution on death penalty cases, mental health professionals may have a moral rationale for treating death row prisoners and restoring them to competency

The landmark cases on the 'duty to warn' concept are reviewed. Two trends are noted in the court rulings. The first trend narrowly interprets the duty to warn as applying only to situations involving a serious threat to a specific individual. The second trend has broadened the doctrine to include warnings about patients who do not make threats and whose potential victims are unspecified. The authors argue that the original Tarasoff Doctrine is sound both from the perspective of public policy and psychotherapeutic practice, but that its broader interpretation is problematic for psychotherapists

A 33-year-old male homosexual AIDS patient was initially admitted to a psychiatric hospital for treatment of a manic episode. Over a 2-month hospitalization, the patient developed progressively severe memory and cognitive impairments which were documented by neuropsychologic testing and were consistent with abnormal EEG and CT scan findings. This case illustrates that major psychiatric symptoms can be profoundly involved early in the natural course of AIDS

A review of court rulings on psychotherapists reveals that: privilege of communication may be overruled; lawsuits may be brought against psychiatrists because they were unable to curb their countertransference and because they had had sexual encounters with patients; psychiatrists were found not guilty if their patients committed suicide; involuntary psychotherapy might be ordered by the court; abusive language does not constitute malpractice; and psychotherapists, records are private material and should not be published

In a study of fifty-three violent psychiatric patients in a psychiatric hospital setting, it was found that there are two distinct major groups of violent patients--one of patients with a long history of antisocial behavior who are often chronically homicidal and suicidal, and another of patients who neither have a history of destructive behavior nor exhibit homicidal or suicidal tendencies. The latter become acutely assaultive only during the course of psychiatric illness. The personality traits and background associated with these two groups offer additional contrasts. Each group presents different problems and, of major importance to the psychiatric practioner, each group requires different management