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PSYCHIATRIST AS SERVANT OF THE SYSTEM - A HIPPOCRATIC DILEMMA (FROM CRITICAL ISSUES IN CRIMINAL JUSTICE, 1979, BY R G IACOVETTA AND DAE H CHANG - SEE NCJ-63717)

NCJ Number
63721
Author(s)
G MERSEREAU
Date Published
1979
Length
11 pages
Annotation
THE ROLE OF THE PSYCHIATRIST IN CRIMINAL LEGAL PROCESSES AND REHABILITATION PROGRAMS IS EXAMINED, AND BROADER PSYCHIATRIC ISSUES SUCH AS SOCIAL SCEPEGOATING ARE DISCUSSED.
Abstract
WHEN DOING AN EXAMINATION FOR THE COURT, THE PSYCHIATRIST TREATS AN INDIVIDUAL AS A SUBJECT AND NOT AS A MEDICAL PATIENT. SOME CRITICS MAINTAIN THAT THIS IS CONTRARY TO THE BASIC PHYSICIAN-PATIENT RELATIONSHIP AS DEFINED BY MEDICAL ETHICS AND THAT SUCH EXAMINATIONS SHOULD BE ABANDONED. ALTHOUGH COURTS REQUEST PSYCHIATRIC SERVICES MORE FREQUENTLY THAN DO CORRECTIONAL PERSONNEL, THESE EXAMINATIONS SELDOM OFFER TREATMENT AND MAY MISLEAD THE SUBJECT. AS THE USE OF THE INSANITY PLEA DECLINES, PSYCHIATRISTS ARE BEING UTILIZED TO DIVERT OFFENDERS FROM THE JUSTICE SYSTEM INTO MENTAL HEALTH CHANNELS. THE PRISON PSYCHOLOGIST IS IN A UNIQUE POSITION TO RECONCILE PROBLEMS BETWEEN INMATES AND PRISON PERSONNEL. PRISONS CAN MAKE INMATES BECOME TOO DEPENDENT ON AUTHORITARIAN STRUCTURE, BUT A THERAPEUTIC COMMUNITY PROGRAM CAN BE AN EFFECTIVE REHABILITATIVE TOOL. THE TRANSITION PERIOD WHEN AN EX-OFFENDER MUST REENTER NORMAL SOCIETY PRESENTS MANY PROBLEMS, AND IMPROVED FOLLOWUP PROGRAMS ARE NECESSARY. THE LOCATION OF CORRECTIONAL FACILITIES IN ISOLATED AREAS AWAY FROM POPULATION CENTERS MAKES THE PROVISION OF ADEQUATE AFTERCARE DIFFICULT. OUTPATIENT CLINICS ARE NOT AS VISIBLE AS PRISONS AND HOSPITALS, AND THE LATTER SEEM TO BE MANIFESTATIONS OF SOCIETY'S NEED TO IDENTIFY SCAPEGOATS. FUTURE PSYCHIATRIC RESEARCH SHOULD CONCENTRATE ON REINTEGRATION PROGRAMS, HOMICIDAL INTERACTIONS, RELATIONSHIP OF PRISON STRUCTURES TO BEHAVIOR, AND ANALYSIS OF PRISON RIOTS. QUESTIONS FOR DISCUSSION AND FOOTNOTES ARE INCLUDED. (MJM)