Medicine,Science and the Law

Consecutive series of individuals for whom psychiatric reports were requested by the courts in the context of criminal proceedings were studied in six countries: Brazil, Denmark, Egypt, Swaziland, Switzerland, Thailand. A total sample of 96 cases was obtained. Careful study of the court records and psychiatric reports revealed three types of situation which could trigger a request for such a report; an ‘offence-oriented’ response where the offence itself is seen as indicative of mental morbidity, a ‘patient-oriented’ response in which the patient's previous contact with the mental health system serves as trigger and a ‘behaviour-oriented’ response in which the patient's disturbed behaviour in detention or in court arouses concern. The majority of the individuals were first offenders (60 per cent), while a similar proportion had had previous psychiatric treatment.

Attention is focused on the effect of violence which leaves little or no trace in those too young to complain: three illustrative cases are described.

One of the problems that faces pathologists, is to rate the information obtained at a post mortem at its true value. Changing the facts, knowingly or unknowingly, often springs from the weakness of the human mind which needs to ignore or even deny unpleasant experiences, especially if these experiences are linked to medical work that can be considered questionable.

In this article such weakness is illustrated with some examples of forceps deliveries.

Hamsters and rats exposed to single doses of CS were retained for up to 32 months, together with appropriate controls. Survival was unaffected and in no case was the incidence of histological changes significantly higher in the test animals than corresponding control animals. The overall incidence of neoplastic disease was similar in test and control animals. A high incidence of pituitary acidophil adenomas was detected in the female rats: these tumours were present both in control and test rats and it was concluded that they were probably the result of ad libitum feeding.

It was concluded that single doses of CS of 28 800 mg min m⁻³ administered during 1 hour or 18 000 mg min m⁻³ administered over 2 hours produced no long-term adverse effects in the two species studied.

The case of Mrs May Clarke, whose verdict of guilty to a shoplifting charge was quashed by the Appeal Court, is quoted together with others to illustrate the clinical findings of short-lived periods of confused thinking in patients suffering from depression.

The opinion is expressed that shoplifting is a suicide-equivalent in these cases, and it is urged that the proposal of the Butler Committee to introduce a verdict of ‘not guilty on evidence of mental disorder’ should be extended to lesser offences such as shoplifting.

A retrospective study was carried out on 78 men without previous convictions, who had had at least one admission to a psychiatric hospital of not less than 3 months before the age of 30. The subsequent conviction rate of these men was determined and found to be comparable to that of men of the same age in the general population. The significance of these findings is discussed.