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Full Description
As President of the American Academy of Psychiatry and the Law (AAPL), it is my pleasure to provide this Foreword for the third volume of Critical Issues in American Psychiatry and the Law. Through Dr. Richard Rosner's creativity and effort, the first volume of the series was pub lished in 1982. It represented the first major publishing activity of the AAPL other than the Bulletin and the Newsletter. Dr. Rosner carefully nurtured the project and the second volume, once again addressing a broad range of forensic issues, was published in 1985. The appearance of the third volume brings two major changes to the series. Dr. Rosner shares editorship of this volume with Harold I. Schwartz, and this is the first of the series to be devoted entirely to one area in forensic psychiatry, the elderly. This is a priority subject. As the baby boom ages and technology for extending life increases, the profile of our population is maturing. The aging of the nation brings with it problems of chronic care, the dementias, the fear of prolonging dying rather than extending meaningful life, the social question of increasing health care costs, and the medical and human question of legal and ethical protection of the elderly patient. This volume could not be more timely. As Bernice Neugarten has pointed out, we must avoid stereotyping the elderly.l Many individuals bring to older age a rich repertoire of interests, abilities, and insights. Among the elderly are the young-old.
Contents
Section I Fundamentals.- 1. Geriatric Psychiatry: Legal and Forensic Issues.- Section II Competency and Informed Consent.- 2. Competency and Informed Consent in Geriatric Psychiatry.- 3. The Elderly, Incompetence, and Treatment Decisions: The New York Experience.- 4. Informed Consent and Competence Issues in the Elderly.- Section III the End of Life.- 5. Psychiatric Assessment of Competence to Choose to Die: Proposed Criteria.- 6. Do-Not-Resuscitate Orders: The Impact of Guidelines on Clinical Practice.- 7. Withholding Life Support from the Elderly, or Learning to Live with High-Tech Death.- 8. Euthanasia and Living Wills: The Rights of Patients to Participate in Their Deaths.- 9. Determining When or If a New York Patient May Be Allowed to Die: Navigating between the Perils of Scylla and Charybdis.- Section IV Diagnostic and Clinical Factors.- 10. Biological and Clinical Considerations in Geriatric Medicine.- 11. Depressive Illness in the Elderly: Legal and Ethical Issues.- 12. Neuropsychiatric Assessment of Dementia: Inadequacy of Test Protocols.- Section V Administrative and Social Policy Issues.- 13. Administrative and Forensic Considerations in the Operation of a Geriatric Psychiatry Service.- 14. Abuse of the Elderly: An Overview of the Problem and Solutions.- 15. Divorce and the Elderly.- 16.Non Compos Mentis: The Psychiatrist's Role in Guardianship and Conservatorship Proceedings Involving the Elderly.- 17. Rights of Nursing Home Residents.- 18. An Overview of the Elderly in the Criminal Justice System: Mental Health Perspectives.- 19. Ethical Considerations in Geriatric Forensic Psychiatry.- Section VI Ethnic Considerations: Overcoming Potential Bias.- 20. Issues in the Psychiatric-Legal Evaluation of the Black Elderly.- 21. Special Considerations in thePsychiatric-Legal Evaluation of the Hispanic Elderly.
