13.3 Basic principles of conducting a forensic psychiatric examination in a civil procedure

In recent years, the rights of persons with mental disorders have been significantly expanded, and the legal and ethical aspects of providing them with medical care have been optimized. The most important step in modern legislation has been the introduction into psychiatry of legal principles aimed at protecting human rights.

In accordance with the general principles of providing psychiatric care, the basic ethical standards to be followed by expert doctors conducting forensic psychiatric examinations are to maximally respect the interests of people with mental disorders for the purpose of their social rehabilitation. The ethical meaning of an expert psychiatrist is to promote justice in the administration of justice by establishing medical truth about the subject's mental health. At the same time, the involvement of an expert in civil proceedings is determined by the humane task of justice - to ensure that the mentally ill can be protected and helped. The examination should be carried out in accordance with the ethical principles and norms of general psychiatry, taking into account the specific conditions.

The purpose of forensic psychiatric examinations in a civil procedure is to establish not only the fact that a person has a mental disorder, but also the compliance of a medical criterion with a legal one. It is necessary to take into account the totality of clinical, psychological and social factors affecting the state of the subject and the prognosis of his disease.

Expert criteria used in making expert forensic psychiatric opinions in civil cases, are divided into three main groups:

1. Criteria of the first rank - the clinical characteristics of the test person. These include the leading psychopathological syndrome, detected either for the period of the survey, or at the time of the commission of a legally significant action (with a retrospective assessment), or when conducting an examination of cases of disability and disability in a prognostic aspect. The most important aspect in determining the criteria of the first rank is the assessment of the nature and depth of the identified mental disorders, which determines the legal qualification of the mental state in a legally significant situation. This takes into account the intellectual component - the ability to understand the meaning of their actions, i.e. the ability to adequately comprehend the situation, the safety of mnestic and critical functions, and a volitional component - the ability to control one’s actions, i.e. the ability to volitional regulation of their behavior.

2. Criteria of the second rank - social factors. These include the social status of the test person, his ability to work and employment, family status and relationships in the family, stable relationships in the microenvironment, a tendency to abuse alcohol or other psychoactive substances, the presence or absence of antisocial tendencies, the propensity to commit unlawful acts. Analyzed social and labor attitudes, the real ability to adapt, the adequacy of behavior.

3. Criteria of the third rank - psychological factors. These include the attitude to the performed legally significant action, the critical understanding of the essence of his act, legal and legal consequences, the logical nature of the transaction, its expediency in terms of property and moral interests.

A comprehensive analysis of all these factors makes it possible to judge the immutability or changes in the core of the personality, the main characteristics of thinking (consistency, focus, productivity), the degree of preservation of intellectual-mnestic functions, the organization of daily activities in accordance with the needs of practical life and the adequacy of motivation.