When the law influences medical practice: Potential impact of the Bouchard-Lebrun ruling on the forensic unit of the Malartic Psychiatric Hospital in Northern Quebec, Canada.

Autor: Laliberté V; Psychiatrist, Department of Psychiatry, Jewish General Hospital, 3755 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1E2, Canada. Electronic address: vincent.laliberte@mail.mcgill.ca., Aird M; Resident in Psychiatry, Université de Montréal, Faculté de Médecine, Roger-Gaudry Building, 2900 Edouard Montpetit Blvd, Montréal, QC H3T 1J4, Canada., Gilbert Tremblay U; PhD in Law and Philosophy, Université de Montréal, Faculté de droit, Pavillon Maximilien-Caron, 3101 chemin de la Tour, Montréal QC H3T 1J7, Canada., Gendron S; Forensic Psychiatrist, Hôpital Psychiatrique de Malartic, 1141 Rue Royale, Malartic, QC J0Y 1Z0, Canada.
Jazyk: angličtina
Zdroj: International journal of law and psychiatry [Int J Law Psychiatry] 2021 May-Jun; Vol. 76, pp. 101686. Date of Electronic Publication: 2021 Apr 28.
DOI: 10.1016/j.ijlp.2021.101686
Abstrakt: The attribution of criminal responsibility in the context of substance intoxication is a matter of controversy in forensic psychiatry. In 2011, the Supreme Court of Canada ruled that Tommy Bouchard-Lebrun was guilty in the straightforward case of a crime committed while in a state of substance-induced psychosis by an individual without a history of mental disorder. However, the ruling may since have served as a precedent also for settling cases where an offence is committed while in a certain state of intoxication and where there is much more diagnostic uncertainty. The goal of our research was to study the impact of the Bouchard-Lebrun Supreme Court decision on rates of criminal responsibility judgements and toxic psychosis diagnosis in the context of such cases. Applying a time-trend ecological study design, we conducted a chart review of every patient treated at the forensic unit of the Malartic Psychiatric Hospital in northern Quebec in the short periods pre- and post-ruling. We then determined the proportion of patients judged not criminally responsible and the proportion diagnosed with substance-induced psychosis. We ran chi-squared tests on the two sets of dichotomous variables. In the period following the Bouchard-Lebrun ruling, a statistically significant decrease was observed in the proportion of individuals judged not criminally responsible, as was a statistically significant increase in the proportion of individuals diagnosed with substance-induced psychosis. The findings suggest that the Bouchard-Lebrun ruling may have had an impact on subsequent forensic psychiatry decision-making and treatment at the Malartic Hospital.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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