[Forensic psychiatry].
in France about 700 psychiatrists are licensed to determine criminal responsibility before the courts, in other words to assess whether a criminal was capable of knowing what he or she was doing or of controlling him or herself Criminals who are considered irresponsible are committed to psychiatric hospitals. Criminals who are considered to have diminished judgment or control may nonetheless be prosecuted and jailed Psychiatric experts may also be asked to predict aggressive behaviour, and to identify determinants of crime. Too often the answers are not fully grounded in science, and this is not made sufficiently clear. There are 26 psychiatric wards in French prisons, which only treat inmates who accept to be treated. When prisoners are prescribed compulsory treatment, they are discharged from prison and transferred to a psychiatric ward. This situation is more and more frequent but is not the most convenient: it delays treatment and does not facilitate long-term therapeutic relationships. Responsibility or pragmatism? About 20% of French prison inmates are psychotic, and these individuals are at risk of repetitive violent behaviour if left untreated. The main question is not one of criminal responsibility, but rather the most effective response to antisocial behaviour: is punishment or medical treatment the most effective way of preventing future crimes and protecting society? Ethical aspects: the situation could be improved by a number of measures. For example, training in forensic psychiatry should be obligatory before accreditation before a Court, and psychiatric diagnoses should be based systematically on the ICD10. Psychiatrists have a special duty to inform on advances and uncertainties in their field, in terms of diagnosis, prognosis and treatment.
Olié
Jean-Pierre
JP
l'Académie nationale de médecine, Service de Santé mentale et de thérapeutique, Hôpital Sainte-Anne, 1, rue Cabanis 75014 Paris.
Lôo
Henri
H
D003415:Crime / Q000517:prevention & control; D019548:Crime Victims / Q000523:psychology; D003417:Criminal Psychology; D005555:Forensic Psychiatry / Q000193:education / Q000941:ethics / Q000331:legislation & jurisprudence; D005602:France; D006801:Humans; D007298:Insanity Defense; D016743:Mental Competency / Q000331:legislation & jurisprudence / Q000523:psychology / Q000592:standards; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology; D011329:Prisoners / Q000523:psychology; D011678:Punishment; D012941:Social Responsibility