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Biomedical subjects

I N Perr

Publications and source records attributed to I N Perr.

At least 37 records · Page 2Linked to original sources
PubMed1985

The insanity defense: the case for abolition.

The author discusses psychiatrists' objections to the insanity defense, including the negative publicity generated by murder trials in which psychiatrists provide expert testimony. He also examines the legal profession's attitudes toward the defense and the pressure applied to expert witnesses through our adversarial system of justice. The abolition of the insanity defense might expedite the legal process, the author concludes, but it would not greatly affect the courtroom role of psychiatrists. Psychiatric evaluation would still be required in certain cases, such as those involving diminished responsibility and competency to stand trial.

Commitment of Persons with Psychiatric Disorders↗
PubMed1984

Medical and legal problems in psychiatric coding under the DSM and ICD systems.

The various diagnostic systems in psychiatry have differed in their terminology and associated numerical codes. Lack of attention to coding variations in the DSM and ICD systems during the review of patient records can lead to misinterpretation and confusion; reliance on historical or statistical studies that use differing systems may be questionable. Two cases illustrate the problems caused by lack of awareness of these factors. Specification by the psychiatrist of both the diagnostic system used and the appropriate revision or edition can lessen communication error or misunderstanding.

Confidentiality↗
PubMed1983

The insanity defense: a tale of two cities.

The M'Naghten case and the Hinckley matter are in some ways remarkably similar. The attempted assassination of a ruling figure, the public discomfort with the insanity defense, and problems in the application of the legal rules characterized both. An explosion of media criticism occurred in 1843, as it did in 1982. The English ultimately handled the M'Naghten case in a dispassionate manner that determined Anglo-American law for more than a century and provided the basic law by which Hinckley was tried. Fears expressed in 1843 were never realized; the final chapters of the Hinckley case remain to be written.

District of Columbia↗
PubMed1981

Effect of the Rennie decision on private hospitalization in New Jersey: two case reports.

The Rennie decision in New Jersey on the right to refuse treatment has been extended from public mental health programs to private psychiatric hospitals where conditions are very different from those which engendered the decision. This ripple effect may result in therapeutic delay, increased cost, possible general medical neglect, family turmoil, and misuse or loss of insurance benefits. The two cases described by the author resulted in expenditures of more than $30,000 by the patients and their insurers. The author criticizes the policy of using independent psychiatrists to review treatment in private hospitals. He believes that if the right to refuse treatment is maintained, prompt judicial review without prior restraining orders should be public policy.

Bipolar Disorder↗
PubMed1981

Privilege, confidentiality, and patient privacy: status 1980.

The principle of patient privacy has evolved from the Hippocratic Oath to current medical ethics guidelines and to legal protections for doctor-patient communications. Privilege statutes now abound in the United States with considerable difference from state jurisdiction to state jurisdiction. Recently several bills have been introduced to establish a federal standard for patient privacy. These bills are critically examined--particularly in regard to the conflict between the need to keep doctor-patient interactions private and the demand by law enforcement agencies for information. The federal bills lean towards the latter at the expense of the protection of confidentiality and therefore should not be adopted. The narrowness of the scope of the proposed laws is reflected in a comparison with a proposed model privacy act.

Confidentiality↗
PubMed1980

Liability and electroshock therapy.

The malpractice status of the use of electroshock therapy (electroencephalotherapy) has been reviewed. In about 40 years, there have been relatively few reported cases dealing with EST (EET) and professional liability. Few cases have been won, and those generally for modest amount. However, future successful claims are expected to reflect current inflation. Certainly the limited volume of litigation would seem to raise a question as to the justification for the extent of the surcharges charged for psychiatric malpractice insurance for the administration of EST. Potential liability for EST continues to be a significant threat to the psychiatric practitioner, although drug matters, suicide, and conformance with legal standards seem a more significant area for current litigation. Those who use EST (EET) can minimize liability exposure by (1) obtaining an informed consent from the patient, (2) describing the method of treatment and possible complications to the family or patient and so noting, (3) ensuring legal authority to treat the patient who is incompetent to give consent or for whom special procedures are required, (4) treating in accordance with accepted procedures, (5) avoiding outpatient EST, if possible, (6) paying close attention to patient complaints, (7) keeping good records, and (8) not promising perfection.

Electroconvulsive Therapy↗