The journal of the American Academy of Psychiatry and the Law
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J. Am. Acad. Psychiatry Law · Jan 2010
Solitary confinement and mental illness in U.S. prisons: a challenge for medical ethics.
In recent years, prison officials have increasingly turned to solitary confinement as a way to manage difficult or dangerous prisoners. Many of the prisoners subjected to isolation, which can extend for years, have serious mental illness, and the conditions of solitary confinement can exacerbate their symptoms or provoke recurrence. Prison rules for isolated prisoners, however, greatly restrict the nature and quantity of mental health services that they can receive. ⋯ S. courts and human rights experts. We then address the challenges and human rights responsibilities of physicians confronting this prison practice. We conclude by urging professional organizations to adopt formal positions against the prolonged isolation of prisoners with serious mental illness.
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Psychiatrists and attorneys often find collaboration difficult, even when working toward mutually beneficial goals. In this commentary, a young psychiatrist reflects upon the mismatch between physicians and attorneys. Differences in medical and legal training, as well as different personality styles and approaches to problem solving, may contribute to conflict. However, psychiatrists can benefit and learn from the attorneys' approach and apply it to situations in which advocacy for good patient care and the fundamental values of medicine is necessary.
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J. Am. Acad. Psychiatry Law · Jan 2010
Disparities in justice and care: persons with severe mental illnesses in the U.S. immigration detention system.
As the total number of persons held within the U. S. immigration detention system has grown, the number of detained persons with severe mental illnesses has grown correspondingly. Reports issued by the government, legal and human rights advocates, and the media have brought to light a problematic and growing detention system with pervasive legal and mental health care disparities. ⋯ S. immigration detention system. Attention is given to the paucity of legal protections for immigration detainees with severe mental illnesses, such as no right to appointed legal counsel and no requirement for mental competence before undergoing deportation proceedings. A case example and discussion of potential alternatives to detention highlight the need for wide-ranging reform.
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Collaboration between physicians and attorneys seems inherently unnatural because of the traditionally disparate aspects of the human condition that each addresses, with the health of mind and body the domain of Medicine, and the preservation of rights and property the considered realm of Law. At a time when it was not en vogue for physicians and attorneys to work together, Howard Zonana recognized the value of this partnership and fostered a model of collaboration from which society has greatly benefited.