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Forensics (civil commitment (legal basis for involuntary (parens patriae -…
Forensics
civil commitment
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institutionalization in mental hospitals has dropped since the 60s; prisons and jails have increased (instead of community based services)
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confidentiality
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exceptions
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Tarasoff case
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liability: failure to ID dangerous patient who has threatened to harm a 3rd party results in ACTUAL harm to intended victim
APA recommendations: if patient makes explicit threat to victim with intent and ability to carry out threat OR has known hx of violence and therapist has reasonable basis to believe there's a clear and present danger - THEN need to take reasonable steps to warn victim, notify law enforcement, arrange voluntary hospitalization or take steps to commit involuntarily
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breaches when there is a need to protect patient or 3rd party - basic duty to protect potential victim
competency
competency = legal, determined by judge
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to plead guilty, be own attorney
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legal req to proceed w/ trial: sufficient ability to consult w/ lawyer w/ reasonable degree of rational understanding (rational/factual understanding of proceedings against them)
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capacity = clinical, determined by MD
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informed consent
legally requires
discussing pertinent info: facts about intervention, benefits, risks, alternatives (including NO intervention)
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exceptions
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therapeutic privilege (withholding info when disclosure would cause harm/undermine informed decision making)
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examining mental state
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"insanity defense"/criminal responsibility - at the time of the crime, did they have the ability to tell right from wrong?
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