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Handbook of Forensic Psychiatric Practice in Capital Cases


Process not theory


Te purpose of this chapter is to offer the reader, clinician or lawyer, a guide to clinical risk assessment where the assessment will be used in legal decision making, for example sentencing or release. Te chapter should be read in conjunction with other relevant chapters of the handbook, since risk assessment utilises a wide variety of techniques of forensic assessment and proposed treatment, as well as information about the relationship generally between mental disorder and offending.


Risk assessment for legal purposes


Te chapter does not deal comprehensively with risk assessment, management and treatment, since this handbook approaches all topics in relation specifically to offering assistance to courts and parole boards, rather than being a handbook designed for a clinical setting. Similarly therefore, it does not deal with the risk of suicide, but will focus on risk of violence to others.


Risk assessment is ethically problematic


Risk assessment is fraught with ethical problems for the clinician, and particularly so where the purpose is solely to assist the justice process.


• Any technique chosen will have within it built in value judgments, including judgements about what is an acceptable level of reliability and validity


• If a clinician takes on the task of risk assessment for legal purposes, it is crucially important for them to be clear about the boundaries of their role, and to be firm in communicating this


to others


• Tis is particularly the case where the assessment is to be used in relation to the established legal criterion for imposition of the discretionary death penalty of ‘beyond reformation’ (see


Chapter 12)


Some clinicians eschew risk assessment in capital cases, on the basis that not to do so potentially contravenes the ethical principle of ‘non-maleficence’; others accept that they owe a duty to society in accordance with the competing principle of ‘justice’.


Definition


Risk assessment is a term that is widely used, and often mis-used. However, it is a more appropriate term than ‘dangerousness’, which falsely assumes that all risk of future violence resides in factors intrinsic to the individual concerned, rather than in interaction between factors both in the individual and in his environment.


Crucially, ‘zero risk’ is unachievable, and neither does ‘definite risk’ exist. Rather, ‘risk prediction’ amounts to a statement of the probability of a type of event occurring within a given time period. Such risk prediction


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