Notes from the second day of the American Academy of Psychiatry and Law.
The only psychiatric diagnosis not related to an increased risk of
suicide is mental retardation. Poor David Carradine got a mention
during the lecture on autoerotic asphyxia. Menninger talked about the
"three wishes" of suicide: to escape pain, to express rage, and to be
martyred (when provoking others to kill him). Five percent of all
suicides happen in the hospital. The legal idea of "proximate cause"
consists of the "cause in fact" (the poor treatment) and the issue of
foreseeability. HIPAA allows disclosure of information without consent
for purposes of treatment (like to do a risk assessment). HIPAA was
amended in 2002 to allow this. Many states allow disclosure without
consent in emergencies.
Humans and functional MRI are equally poor at predicting human
deception in an experimental poker bluff paradigm.
Georgetown medical school requires all their students to have an
iTouch or iPhone. Dang, that's progress!
The best predictor of competency restoration is the cumulative days of
length of stay. (Longer LOS means less restorable.) Predictors of non-
restorability are older age, mental retardation and a diagnosis of
The forensic sciences sampler is always the most fun and interesting
presentation for me. This year's topic was the investigtion of fires
and bombing. There is a local company, Combustion Science and
Engineering, which does computer modelling of these incidents.
Psychiatrists use psychodynamics, fire investigators use "fire
dynamics" or fire behavior. They consider witness reports, burn
patterns and electrical arc patterns to determine an origin and cause
of the fire. People who die within the compartment of origin tend to
die of heat injuries while outside the compartment they die of carbon
monoxide poisoning. Dr. Doug Ubelaker, a forensic anthropologist from
the Smithsonian Museum of Natural History, talked about human
identification of fire victims. When dry bones burn they get
longitudinal fractures, when flesh-covered bones burn they get
In the early days of the FBI the Smithsonian scientists were routinely
"loaned out" to help investigators.
Fetal kidnapping is when pregnant women are killed for their babies.
Out of 18 reported cases, only one defendant was legally insane.
It's never a good idea for your mistress to die under mysterious
circumstances even if you didn't kill her.