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Handbook of Forensic Psychiatric Practice in Capital Cases


As described in the Preface, forensic psychiatry comprises both the psychiatry of mental disorder and offending behaviour, that is, clinical forensic psychiatry, plus law as it relates to all psychiatry, both civil and criminal law, or legal psychiatry.


Te handbook concentrates on presenting aspects of clinical forensic psychiatry; description of law per se relevant to capital trials, sentencing, mercy hearings and to the carrying out of execution are presented in a separate handbook, written by legal practitioners. However, a crucial ‘bridge’ between clinical forensic psychiatry and law as it relates to psychiatry is ‘the role of psychiatry within legal process’. And the handbook does ‘refer across’ to legal tests, so as to offer an understanding of the ‘frontier’ between psychiatry and elements of law applicable to capital cases (see Chapter 2 generally). So, for example, in the chapters which offer advice on assessment and report writing each for pre-trial matters, trial matters, including psychiatric defences, sentencing hearings and mercy hearings we describe relevant legal tests so as to offer advice on how psychiatric assessment and report writing can be properly conducted, in order to be directly relevant to, and ‘translated into’, (see Chapter 2) those individual tests.


Hence, what the handbook offers mainly is presentation of clinical information and method relevant particularly to stages of capital legal cases. It does not, therefore, offer a comprehensive guide broadly to clinical forensic psychiatric practice in a health setting, other than where such information is of particular relevance to legal process. It follows that, if the reader requires a comprehensive guide to assessing and treating mentally disordered offenders, be it under court originating orders or under civil mental health legislation, s/he should consult a comprehensive forensic psychiatric text, such as the Oxford Specialist Handbook of Forensic Psychiatry.


Tis handbook also cannot, and does not, offer a fully comprehensive and general guide to ‘practicing forensic psychiatry in the courts’. Rather, it offers a much reduced version of what might be found dealt with extensively within the Oxford Handbook, and focused particularly on the application of psychiatry within capital cases. By way of illustration of the point, Chapter 3, which deals with the relationship between mental disorder and violence, is much reduced from what appears within the equivalent section of the Oxford Handbook. In this handbook all we can attempt is to offer skeletal information about a topic, sufficient to give the reader ‘the bare bones’ of a topic and sufficient to give him/her an ‘understanding’ of the topic.


As further illustrations of the ‘reduction’ which we have applied, the reader will find only limited coverage of ‘risk assessment’, and coverage which is focused particularly on presentation of risk assessments into legal proceedings. In addition only limited, ‘first principle’ coverage of ‘ethical issues’ and ‘ethical decision making’ in forensic psychiatry are included, with particular emphasis upon ethical issues for clinicians as they occur within capital cases.


In summary, therefore as described in the Oxford Handbook, clinical forensic psychiatry is concerned with the assessment and treatment of mental disorder where that disorder appears to be associated (not necessarily causally) with offending behaviour, whether or not the patient has been convicted. Clinical forensic psychiatry is also particularly closely engaged with law and legal psychiatry so that a clear understanding of law is necessary in order to practise clinically. For example, it is not possible to negotiate your patient out of the criminal justice system and into mental health care without knowledge of the relevant law. Clinical forensic psychiatry can be pursued effectively and ethically only if it is based on substantial knowledge of the law and legal process, and its interface with psychiatric practice (see


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