Harnessing the power of fusion? A valiant but flawed effort to obviate the need for a distinct mental health law

When it comes to involuntary interventions, the notion that people with mental disorders should be treated identically to persons with general medical disorders has an undoubted appeal. As Dawson and Szmukler have argued previously, principles of fairness and non-discrimination would appear to be well served by basing involuntary hospitalization and treatment in both contexts on incapacity to provide consent. In this commentary, I take note of some of the intellectual forebears of the Szmukler, Daw, and Dawson proposal, and ask why – despite the formidable intellects that have lined up behind similar approaches in the past – they have not been adopted. I also consider some aspects of the current proposal itself, including the unresolved tensions between equal and differential treatment of persons with mental disorders, and the potential practical consequences, especially for persons with general medical disorders. I conclude that the rationale for fusing two disparate bodies of law may itself be irremediably flawed, and the undesirable consequences significant. 

Constructing Competence: Formulating Standards of Legal Competence to Make Medical Decisions

A young woman twenty-six weeks pregnant and dying from cancer lies heavily sedated and attached to a respirator. Is she competent to determine what life-prolonging measures should be taken, or to consent to an emergency cesarean section that may save her fetus but will probably shorten her life? A quadriplegic young man wishes to end his life and requests a court order granting immunity for the medical staff who will unhook his respirator and administer sedatives. Is he competent to choose to die? A person\u27s competence will have implications for whether he or she is allowed to decide what type of treatment, if any, is received; whether treatment is discontinued, including life-sustaining treatment; and whether medical professionals implementing decisions are exposed to civil or criminal liability

Behavioural Genetics in Criminal Cases: Past, Present and Future

Researchers studying human behavioral genetics have made significant scientific progress in enhancing our understanding of the relative contributions of genetics and the environment in observed variations in human behavior. Quickly outpacing the advances in the science are its applications in the criminal justice system. Already, human behavioral genetics research has been introduced in the U.S. criminal justice system, and its use will only become more prevalent. This essay discusses the recent historical use of behavioral genetics in criminal cases, recent advances in two gene variants of particular interest in the criminal law, MAOA and SLC6A4, the recent expert testimony on behalf of criminal defendants with respect to these two gene variants, and the future direction of behavioral genetics evidence in criminal cases

The Psychology of Competence and Informed Consent: Understanding Decision-Making with Regard to Clinical Research

This Article examines the importance of patient autonomy and competence in medical decision making and how questions of competence affect informed consent. The author explores three hypothetical cases which outline the parameters of \u27competence\u27 by illustrating the methodologies used in making [determinations of competence], distinguishing between ethical and legal issues in the assessment of competence, and reviewing the procedures for surrogate decision making when competence is deemed impaired. The cases present questions on when to respect patient autonomy and when it may be appropriate to allow a surrogate to take over decision making