This page contains a Flash digital edition of a book.
Handbook of Forensic Psychiatric Practice in Capital Cases


• Physical illnesses, including head injury and neurological disorders • Lack of access to healthcare in order to remediate the effects of disorder • Experience of victimization as an adult


Dangerousness and risk


Tere are a number of factors that might be within the domain of the mental health expert in relation to the assessment of the risk of future violence (the notion of ‘dangerousness’ is misplaced in that the risk of violence being repeated is dependent both upon factors in, and extrinsic to, the defendant, as well as upon their interaction, see Chapter 7).


Risk assessment is fraught with methodological difficulties and uncertainties about validity and reliability (see Chapter 7), and this, together with the implications of ‘doing harm’ by way of clinician involvement in capital sentencing, determines that it is something of an ethical minefield. Certainly, for a doctor, the advice would be ‘if there is no diagnosable condition, then do not comment upon risk’, since to do so will take the clinician far from ordinary clinical practice. However, clinical psychologists operate based upon a paradigm that does not depend upon, and even eschews, ‘diagnosis’, and emphasises ‘understanding (even normal) behaviour’, so that their approach may be more flexible.


At the outset, clarity should be sought from instructing solicitors as to the issue before the court and the potential relevance of any evidence you may give.


Categorisation of someone as having ‘high-’ ‘medium-’ or ‘low-’ risk should not be adopted. Te process of clinical risk assessment is usually with the purpose of identifying appropriate therapeutic interventions, which is in stark contrast to it being utilised for a determination of whether someone should receive a capital sentence. And, although risk assessment is a core aspect of psychiatric practice, used in clinical practice it is a dynamic concept based upon the risk of a specific type of harm occurring in specified circumstances and within a given time period.


Any assessment where risk assessment is to be included, or where the data gained could be used by the court in that regard in its own terms, should incorporate specific informed consent taking.


Any risk assessment used should only be of a type appropriate for the person you are assessing; also it should only be conducted based upon relevant training and with a clear understanding of the limitations of any assessment.


Any opinion on risk should stay within medical boundaries and not address legal concepts directly.


Te sentencer will be concerned about the probability that an individual will act in a way that will be a threat to the public. Tere is no probability that can be reliably applied to any defendant, so there must be careful consideration and documentation of the limitations of accuracy of individual risk predictions.


100


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92  |  Page 93  |  Page 94  |  Page 95  |  Page 96  |  Page 97  |  Page 98  |  Page 99  |  Page 100  |  Page 101  |  Page 102  |  Page 103  |  Page 104  |  Page 105  |  Page 106  |  Page 107  |  Page 108  |  Page 109  |  Page 110  |  Page 111  |  Page 112  |  Page 113  |  Page 114  |  Page 115  |  Page 116  |  Page 117  |  Page 118  |  Page 119  |  Page 120  |  Page 121  |  Page 122  |  Page 123  |  Page 124  |  Page 125  |  Page 126  |  Page 127  |  Page 128  |  Page 129  |  Page 130  |  Page 131  |  Page 132  |  Page 133  |  Page 134  |  Page 135  |  Page 136  |  Page 137  |  Page 138  |  Page 139  |  Page 140  |  Page 141  |  Page 142  |  Page 143  |  Page 144  |  Page 145  |  Page 146  |  Page 147  |  Page 148  |  Page 149  |  Page 150  |  Page 151  |  Page 152  |  Page 153  |  Page 154  |  Page 155  |  Page 156