致謝 The Death Penalty Project Nigel Eastman Richard Latham Marc Lyall Tim Green 2015 The Death Penalty Project 8/9 Frith Street Soho London W1D 3JB tae

Transcription

1 台灣死刑案件 司法精神鑑定實務手冊 Handbook of Forensic Psychiatric Practice in Capital Cases in Taiwan Nigel Eastman Tim Green 黃致豪 Leon Huang Richard Latham Marc Lyall 合作單位

2 致謝 The Death Penalty Project Nigel Eastman Richard Latham Marc Lyall Tim Green 2015 The Death Penalty Project 8/9 Frith Street Soho London W1D 3JB +886 (0)

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5 索引 Nigel Eastman Richard Latham... vii vs vs vs

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10 / DSM ICD vi

11 前言 Eastman N, Adshead G, Fox S, Latham R, Whyte S 2012 vii

12 Nigel Eastman Richard Latham viii

13 第一章 臨床司法精神醫學 與法制精神醫學 1

14 台灣死刑案件司法精神鑑定實務手冊 clinical forensic psychiatry legal psychiatry forensic psychiatry 2 Oxford Specialist Handbook of Forensic Psychiatry 3 risk assessment first principles 2 2

15 臨床司法精神醫學與法制精神醫學 2 method natural tensions construct responsibility culpability value set 15 1 一 各類法醫資源間的關聯 forensic psychiatry forensic 二 刑事司法與法院資源 forensic professionals 1 Oxford Specialist Handbook of Forensic Psychiatry 3

16 台灣死刑案件司法精神鑑定實務手冊 forensic 三 監所的精神衛生服務 2006 NHS 四 精神病犯戒護療養機構的相關服務 medical psychotherapist 五 特定類別的工作團隊 forensic psychiatrist clinical psychologist 4

17 臨床司法精神醫學與法制精神醫學 forensic psychologist forensic psychotherapist criminologist probation officer 六 中低發展經濟體的法醫資源 5

18 台灣死刑案件司法精神鑑定實務手冊 6

19 第二章 法律與精神醫學 7

20 台灣死刑案件司法精神鑑定實務手冊 一 精神醫學與法律系統的目標 二 精神醫學與法律間的張力 三 不同語境中的詞彙運用問題 constructs methods of inquiry diagnosis mental state conditions schizophrenia bipolar disorder dementia diagnoses thought disorder depressed mood depersonalisation mental state abnormalities conditional disability abnormality of mind insanity disease of the mind responsibility fitness to plead fitness to be sentenced to death fitness to be executed legal artifices mental concepts intention disease of the mind insanity 8

21 法律與精神醫學 discourses mental illness mental disorder psychopathy psychopathic disorder treatment treatment for mental disorder mental terms / 四 探問方式 investigative adversarial restrictive fairness evidence hypothesis testing judging 五 學科衝突的實務問題 adversarial 9

22 台灣死刑案件司法精神鑑定實務手冊 六 重點在於認清脈絡 positive normative / wrong discourse / 七 醫學與精神醫學 vs. 心理學 categorical constructs dimensional ones incongruities incongruous binary 2 八 終極分歧 2 From here on, even though the constructs of medicine, or psychiatry, and psychology are distinct in their nature and derivation, they have sufficient in common at least to be distinguished from mental constructs which occur in law, such that the reader should interpret medicine, or psychiatry, to infer the inclusion of psychology, unless we specify a distinction. 10

23 法律與精神醫學 九 自創性 (Autopoesis) vs. 彈性不同程度的歧異 mental disorder 3 sentencing / autopoesis reflexivity autopoetic sentencing guidelines insanity diminished responsibility fit to plead 十 語境之轉譯 translation 3 proportionality just deserts Justice can mean, from the perspective of the individual, proportionality, or just deserts. There are other meanings attributed to the concept also. 11

24 台灣死刑案件司法精神鑑定實務手冊 十一 將轉譯的失誤降到最低 instructions address the ultimate issue 十二 精神醫學作為司法精神鑑定專業 volition intention 十三 起於目的之構念 (Constructs from Purposes) 的細節 psychosis insanity / diminished responsibility abnormality of mind unfit to plead unfit for execution 12

25 法律與精神醫學 十四 資訊運用 病史 vs. 證據 rules of evidence history standard of proof diagnosis formulation 4 adversarial investigative pattern recognition 4 However, if numerous or significant, they challenge the psychiatrist to question whether the perceived pattern (diagnosis, formulation) is correct, or the whole explanation. 13

26 台灣死刑案件司法精神鑑定實務手冊 十五 收集與選擇資訊的方法 forensic psychiatrist 十六 司法精神醫學專家的意義 court report formulation court proceedings 十七 精神醫學與法律之雙向關係精神醫學與法律的關係是雙邊關係 the worst of the worst beyond reformation 14

27 法律與精神醫學 risk management plan 十八 藉由相互了解保持彼此界線 十九 相互合作但不相互污染 co-operation contamination effecting affect 二十 精神醫學與刑法體系是否有目的混淆的風險? rescue 15

28 台灣死刑案件司法精神鑑定實務手冊 二十一 結論 16

29 第三章 精神疾病與犯罪行為 17

30 台灣死刑案件司法精神鑑定實務手冊 7 5 biography of violence 一 功能性精神疾病 ( 含妄想型思覺失調症 [paranoid schizophrenia]) 二 酒精及藥物濫用與依賴 (Alcohol and drug misuse and dependence) 5 Semple D and Smyth R (2009) Oxford Handbook of Psychiatry, Oxford University Press, Oxford, UK Oxford Specialist Handbook of Forensic Psychiatry 18

31 精神疾病與犯罪行為 intoxication ( ) disinhibition withdrawal states 三 人格違常 (Personality disorder) B PCL-R psychopathy 19

32 台灣死刑案件司法精神鑑定實務手冊 四 躁症 (Mania) Hypersexuality 五 鬱症 (Depression) 六 創傷後壓力症候群 (PTSD) Triggering from flashbacks 20

33 精神疾病與犯罪行為 七 亞斯伯格症及其他類型自閉症 (Asperger s syndrome and other autistic spectrum disorders) 八 學習障礙 (Learning disability) 九 後天大腦損傷 (Acquired brain injury) 21

34 台灣死刑案件司法精神鑑定實務手冊 十 癲癇與睡眠失調 (Epilepsy and sleep disorder) 十一 結論 biography of offending formulation 22

35 第四章 司法精神醫學衡鑑 23

36 台灣死刑案件司法精神鑑定實務手冊 一 概覽 psychosis 11 formulation the causes of behaviour collateral information history 6 leaving no stone unturned 7 6 where the civil liberty effect of a finding of guilt in the absence of mental disorder is high, through imprisonment or execution 7 Within the clinical assessment itself... 24

37 司法精神醫學衡鑑 二 為何應該注意脈絡? 目標不同的影響 死刑案件各階段的差異 characteristics 12 mercy hearings softer fit for execution 關係的差異 25

38 台灣死刑案件司法精神鑑定實務手冊 nonmaleficence 15 / / / / / 8 15 三 接受委託之前 / 8 although this position emphasises the importance of being aware of the potential impact on assessment of one s own values set, in terms of the potential for bias, and of acting honestly 26

39 司法精神醫學衡鑑 acute psychosis 四 死刑案件常見問題 police caution [compliance] [suggestibility] Fitness to plead and stand trial time of offence Diminished responsibility Insanity Automatism the requisite intention conviction / sentence 27

40 台灣死刑案件司法精神鑑定實務手冊 五 面談之前 六 資訊來源 legal representatives childhood disturbances / 28

41 司法精神醫學衡鑑 七 衡鑑 環境 同意 面談 29

42 台灣死刑案件司法精神鑑定實務手冊 index offence index offence ICD-10 DSM-IV DSM Ensure that you have asked any necessary questions at the interface between the clinical assessment and the legal questions to which you know the information will be applied 30

43 司法精神醫學衡鑑 口譯者 筆記 應該寫下詢問的問題 ( 與回答 ) 嗎? 應該見被告一次以上嗎? / 八 間接證據 (Collateral information) 31

44 台灣死刑案件司法精神鑑定實務手冊 九 身體檢查與專門檢查 (Physical examination and investigations) legal automatism EEG MRI CT clinical indication minimum standards 十 人格衡鑑 affective traits Psychopathy Checklist Revised PCL-R psychopathy psychological testing personality psychometrics 32

45 司法精神醫學衡鑑 十一 心理測驗 psychosexual pathology 十二 死刑案件之醫學參與 General Medical Council [legal tests] / 33

46 台灣死刑案件司法精神鑑定實務手冊 34

47 第五章 心理衡鑑 35

48 台灣死刑案件司法精神鑑定實務手冊 一 運用心理測驗心理測驗與其他訊息來源 4 選擇測驗工具 WAIS-IV 36

49 心理衡鑑 二 衡鑑臨床症狀及症候群衡鑑情緒症狀 Beck Anxiety Inventory, BAI Beck Depression Inventory II, BDI-II Hospital Anxiety and Depression Scale HADS 人格衡鑑 Milon Clinical Multi-axial Inventory, MCMI-III Minnesota Multiphasic Personality Inventory MMPI Personality Assessment Inventory PAI 病前智力功能衡鑑 cough gist debt 37

50 台灣死刑案件司法精神鑑定實務手冊 Flynn effect WAIS-IV Pre-Morbid Functioning Test TOPF WAIS WAIS-III Weschler Test of Adult Reading WTAR WAIS WAIS-R National Test of Adult Reading NART 目前智力功能衡鑑 WAIS-IV WMS-IV /BADS /Stroop / Trailmaking 物質誤用 Leeds Dependency Questionnaire, LDQ LDQ Sensation Seeking Scale, SSS 記憶障礙症 / 失智 malingering 38

51 心理衡鑑 transient global amnesia syndrome

52 台灣死刑案件司法精神鑑定實務手冊 詐病 faking good faking bad MCMI-III PAI Paulhus Deception Scale self-deceptive enhancement impression management Millar Forensic Assessment of Symptoms, MFAST Structured Interview of Reported Symptoms, SIMS Structured Inventory of Malingered Symptomatology, SIMS false positive 40

53 心理衡鑑 Tombaugh Test of Memory Malingering, TOMM Ravens Standard Progressive Matrics, RSPM 外傷導致的腦損傷與其對行為的影響 Behavioural Assessment of Dysexecutive Syndrome, BADS Stroop Neuropsychological Screening Test Controlled Oral Word Association Test FAS Reitan Trail Making Test 41

54 台灣死刑案件司法精神鑑定實務手冊 受暗示性與順從性 suggestibility complaince Gudjonsson Suggestibility Scale Gudjonsson Compliance Scale D E 三 心理學與法律問題

55 第六章 精神醫學的診斷與判定 43

56 台灣死刑案件司法精神鑑定實務手冊 formulation 一 診斷過程 corroborating evidence 二 分類 World Health Organization, WHO International Classification of Diseases, 10th edition; ICD-10 Diagnostic and Stastistical Manual, 4th edition; DSM-IV DSM-V inter-rater reliability 44

57 精神醫學的診斷與判定 DSM-IV DSM-5 DSM ICD DSM ICD 三 效度與分類 ICD-10 Schedules for Clinical Assessment in Neuropsychiatry, SCAN DSM-IV DSM-V Structured Clinical Interview for DSM,SCID ICD DSM ICD-10 ( ) DSM-IV DSM-V 45

58 台灣死刑案件司法精神鑑定實務手冊 四 精神醫學診斷 行為與犯行 五 診斷死刑案件當事人的特定考量智力失能 (intellectual disability) DSM-IV DSM-V 46

59 精神醫學的診斷與判定 六 精神醫學上的 判定 七 詳述精神醫學判定 47

60 台灣死刑案件司法精神鑑定實務手冊 / / / 48

61 第七章 風險評估 49

62 台灣死刑案件司法精神鑑定實務手冊 一 重視實務過程不著墨理論 二 以法律目的為導向的風險評估 三 風險評估本身就有倫理問題 四 定義 50

63 風險評估 五 風險評估概述 intrinsic factors 六 清楚自己所進行的事 七 一切都可能發生, 但發生預期結果的或然率有多高? probability possibility 51

64 台灣死刑案件司法精神鑑定實務手冊 八 幾種不同類型的衡鑑方式 / 資料蒐集方法 acturial predictive validity certainty evidence-based practice practice-based evidence 九 精算式的評估 statistical mapping community study 52

65 風險評估 base rate Violence Risk Appraisal Guide, VRAG Risk Matrix 2000, RM 2000 T D Y X T Y X D 十 結構式的臨床判斷 HCR- 20 RSVP 暴力史 53

66 台灣死刑案件司法精神鑑定實務手冊 精神醫學因素? 物質誤用 頭部外傷 心理因素 54

67 風險評估 情境因素 十一 比較精算式與臨床式評估的方法 sensitivity specificity HCR-20 RSVP 55

68 台灣死刑案件司法精神鑑定實務手冊 十二 暴力風險 : 觀點與判斷 十三 靜態與動態風險 十四 保護因子 Short-term Assessment of Risk and Treatability, START 十五 對暴力行為的 判定 (formulation) 56

69 風險評估 1 57

70 台灣死刑案件司法精神鑑定實務手冊 圖 1: 判定圖表示例 易感因素 locus of control 環境 / 誘發因素 disinhibted 問題 維持因子 implicit theory 保護因子 填入心裡測驗相關資訊 穩定的動態因子 intimacy deficit self-regulation 急性的動態因子 建議 / 未來再犯風險 58

71 風險評估 十六 結論... 59

72 台灣死刑案件司法精神鑑定實務手冊 60

73 第八章 報告撰寫 針對報告撰寫的詳盡建議 請參考 Oxford Handbook of Forensic Psychiatry 61

74 台灣死刑案件司法精神鑑定實務手冊 一 目標 I impartiality independence integrity 二 一般建議要促成上述目標, 報告架構就是關鍵 X A Y B 62

75 報告撰寫 三 報告架構 四 引言 63

76 台灣死刑案件司法精神鑑定實務手冊 五 被告晤談 formal thought disorder A... A... 六 心智 / 精神狀態檢驗 七 從晤談以外管道獲得的資料 64

77 報告撰寫 八 個人見解 65

78 台灣死刑案件司法精神鑑定實務手冊 ICD-10 DSM-IV DSM-V 其他可能見解 診斷 ICD-10 DSM-IV( DSM-V) 醫學的極限 66

79 報告撰寫 九 對報告架構的建議 67

80 台灣死刑案件司法精神鑑定實務手冊 十 內容揭露 十一 報告增修 legal privilege 十二 需要留意的問題 68

81 報告撰寫 第九章 出庭作證 針對出庭作證的詳盡建議 請參考 Oxford Handbook of Forensic Psychiatry 譯註 本處有關出庭作證之內容 原則上仍依照手冊原文以 英國法為依據之內容進行翻譯 僅於必要處適當補充台灣的相關法令 惟精神衛生專業人員適用本手冊時仍請務必注意 實務上對於精神衛生 專業人員擔任鑑定人進行鑑定過程以及出庭報告 包括書面與口頭報告 之要求 可能較之本章所論內容更加嚴謹 本章所提供有關台灣法令 之補述部分 僅供一般性準備參考用 仍不應用以取代台灣法律專家之實際判斷與認定 69

82 台灣死刑案件司法精神鑑定實務手冊 一 開庭時間點 / / 二 準備出庭 70

83 出庭作證 8 / / 71

84 台灣死刑案件司法精神鑑定實務手冊 三 開庭程序 一般建議... 72

85 出庭作證 開庭之前 affirmation / 主詰問 73

86 台灣死刑案件司法精神鑑定實務手冊 反詰問 74

87 出庭作證 再次交互詰問覆主詰問 覆反詰問 75

88 台灣死刑案件司法精神鑑定實務手冊 詰問專家證人的規則 / / 76

89 第十章 審前衡鑑與報告相關議題 77

90 台灣死刑案件司法精神鑑定實務手冊 caution mental condition defences 一 審前衡鑑的原則應運用衡鑑相關總則 ( 見前章 ): suggestibility compliance 二 了解警方警告之能力 vulnerability psychosis 78

91 審前衡鑑與報告相關議題 intoxication 三 接受偵訊之合適性 admissions 12 四 自白的可靠性 voluntary false confession 12 Again, there is a need to give an opinion on the likely mental state of the defendant at the time of any interview, and then to consider the likely impact of this on their ability to have participated in an interview, and nature of that participation. 79

92 台灣死刑案件司法精神鑑定實務手冊 coerced-compliant confession coerced-internalised confession oppressive 與自白有關的心理衡鑑 acquiescence compliance suggestibility confabulation psychometric tests 80

93 審前衡鑑與報告相關議題 五 審判時心神喪失 / / 81

94 台灣死刑案件司法精神鑑定實務手冊 competency tools formulation 審判時心神喪失之精神醫學衡鑑 IQ 六 結論 82

95 第十一章 衡鑑與報告 以精神狀態異常為 由進行抗辯 83

96 台灣死刑案件司法精神鑑定實務手冊 一 引言 10 二 心神喪失

97 衡鑑與報告 : 以精神狀態異常為由進行抗辯 臨床衡鑑 functional ability 三 神經性的疾病 85

98 台灣死刑案件司法精神鑑定實務手冊 四 減輕 ( 刑事 ) 責任 五 失憶 失憶 - 臨床議題 5 86

99 衡鑑與報告 : 以精神狀態異常為由進行抗辯 (depersonalisation) (derealisation) 六 酒精或藥物中毒 19 3 七 本章摘要 87

100 台灣死刑案件司法精神鑑定實務手冊 88

101 第十二章 量刑相關的衡鑑與報告 89

102 台灣死刑案件司法精神鑑定實務手冊 一 引言 二 刑罰的減輕因素

103 量刑相關的衡鑑與報告 三 精神疾病對量刑的影響

104 台灣死刑案件司法精神鑑定實務手冊 四 量刑相關的衡鑑 ICD-10 DSM-V ICD-10 DSM-V 7 92

105 量刑相關的衡鑑與報告 10 五 從輕量刑所需的報告 ADHD 93

106 台灣死刑案件司法精神鑑定實務手冊 六 危險性與風險 7 7 風險評估 94

107 量刑相關的衡鑑與報告 報告

108 台灣死刑案件司法精神鑑定實務手冊 七 惡行重大至極 與 已無教化可能 Edward Fitzgerald Keir Starmer The Death Penalty Project 2007 The Guide to Sentencing in Capital Cases research-publications/giode-to-sentencing-in-capital-cases/. 八 悛悔 九 結論 96

109 第十三章 特赦聽證的相關鑑定與報告撰寫 97

110 台灣死刑案件司法精神鑑定實務手冊 40 一 精神 / 心智疾患的性質 Edward Fitzgerald Keir Starmer Death Penalty Project 2007 A Guide to Sentencing capital Cases 二 臨床鑑定 三 針對減刑聽證的報告 98

111 報告撰寫 第十四章 死刑受刑能力之衡鑑與報告 99

112 台灣死刑案件司法精神鑑定實務手冊 relapsing and remitting mental disorders 一 關於 恢復死刑受刑能力 之治療的建議 impossible question

113 第十五章 死刑案件中司法精神醫學與 心理鑑定之倫理議題 101

114 台灣死刑案件司法精神鑑定實務手冊 一 何謂臨床倫理? a justifiable answer four principles utilitarian 二 責任衝突與雙重角色 102

115 死刑案件中司法精神醫學與心理鑑定之倫理議題 三 原則 autonomy beneficence nonmaleficence respect justice first amongst equals unusual nature partial solution remoteness whilst giving evidence towards determining whether a mental condition defence is available to a defendant in a capital trial might reasonably be seen as more remote from execution per se than the former two stages, but less remote than medical involvement in a capital sentencing hearing, or in assessing for fitness for execution. less more 103

116 台灣死刑案件司法精神鑑定實務手冊 四 專業性 五 倫理準則 World Psychiatric Association American Psychiatric Association General Medical Council American Academy of Psychiatry and the Law 六 價值觀 偏見與客觀 unseen 104

117 死刑案件中司法精神醫學與心理鑑定之倫理議題 七 與被告的關係 [forensicist] 八 知情同意 九 醫師或司法鑑識人員 forensicist alibi 105

118 台灣死刑案件司法精神鑑定實務手冊 十 與死刑執行的距離 判決 / 12 / 12 減刑 死刑受刑能力 106

119 死刑案件中司法精神醫學與心理鑑定之倫理議題 十一 治療以恢復死刑受刑能力 almost impossible resolution 十二 結論 107

120 台灣死刑案件司法精神鑑定實務手冊 108

121 附錄 109

122 台灣死刑案件司法精神鑑定實務手冊 附錄 1: 精神衡鑑量表簡表 所衡量的精神 / 心智面向 精神量表 ( 英 ) 精神量表 ( 中譯 ) / Weschler Adult Intelligence Scale IV (WAIS-IV) Ravens Progressive Matrices National Test of Adult Reading (NART) Schonell Graded Reading Test Weschler Test of Adult Reading (WTAR) Weschler Test of Pre-morbid Functioning (TOPF) Weschler Memory Scale (WMS-IV) Rey-Ostreith COmplex Figure Test Behavioural Assessment of Dysexecutive Syndrome (BADS) Controlled Oral Word Association Test (FAS) Reitan Trailmaking Test Haying and Brixton tests Stroop Neuropsychological Screening Test British Picture Vocabulary Scale (II) Graded Naming test Gudjonsson Suggestibility Scale (I/II) Gudjonsson Compliance Scale Beck Anxiety Inventory (BAI) Beck Depression Inventory II (BDI-II) Hospital Anxiety and Depression Scale (HADS) State/Trait Anger Expression Scale (staxi) Millon Clinical Multiaxial Inventory III (MCMI-III) Minnesota Multiphasic Personality Inventory (MMPI) Personlity assessment inventory (PAI) Leeds dependence Questionnaire (LDQ) Sensation Seeking Scale (SSS) Dissociative Experience Scale (DES) Tombaugh Test of Memory Malingering (TOMM) Raven's Standard Progressive Matrices Miller Forensic Assessment of Symptoms Test (MFAST) Structured Interview of Reported Symptoms (SIRS) Structured Inventory of Malingered Symptomatology (SIMS) Paulhus Deception Scales (PDS) ( 4 ) ( 4 ) Haying Brixton D E 2 / * 110

123 附錄 附錄 2: 心理衡鑑工具建議清單 Weschler Adult Intelligence Scale IV (WAIS-IV) 魏氏成人智力量表 ( 第 4 版 ) 4 Weschler Memory Scale (WMS-IV) 魏氏記憶量表 ( 第 4 版 ) 4 Controlled Oral Word Association Test (FAS) 控制性口語詞彙聯想測驗 (bedside test) Millon Clinical Multiaxial Inventory III (MCMI-III) 米隆臨床多軸量表第 3 版 3 Coin in the hand test 銅板在哪一手記憶測驗 10 Beck Depression Inventory II (BDI-II) 貝克憂鬱量表 ( 第 2 版 ) 2 21 Tests of Attitudes Towards Violence - Maudsley Violence Questionnaire (MVQ) 莫斯里暴力問卷 Stroop Neuropsychological Screening Test 史楚普神經心理篩檢測驗 111

124 台灣死刑案件司法精神鑑定實務手冊 Reitan Trailmaking Test 雷氏路徑描繪測驗 A B 1 A 2 B... Rey-Ostreith Complex Figure Test 雷歐氏複雜圖形測驗 45 Raven s Progressive Matrices 瑞文氏推理測驗 Test of Effort 投入度測驗 Test of Memory Malingering (TOMM) 記憶偽裝測驗 TOMM 50 Gudjonsson Suggestibility Scale (I/II) 谷鐘森暗示感受性量表 ( 第 1 或 2 版 ) Gudjonsson Compliance Scale Form D 谷鐘森順從性量表 -D 表

125 Paulhus Deception Scales (PDS) 包琥斯欺騙量表 40 PDS Dissociative Experience Scale (DES) 解離經驗量表 DES State/Trait Anger Expression Inventory-2 (STAXI-2) 情境 / 特質憤怒量表第 2 版 STAXI-2 57 Leeds dependence Questionnaire (LDQ) 里茲依賴量表 LDQ Sensation Seeking Scale (SSS) 刺激尋求量表 113

126 台灣死刑案件司法精神鑑定實務手冊 附錄 3: 診斷分類 - 參照 DSM 與 ICD 10 (ICD-10) (APA ) (Diagnostic and Statistical Manual, DSM-IV-TR ) 4 DSM-IV-TR ICD-10 DSM DSM DSM-IV-TR DSM DSM ICD10 code DSM code Diagnosis F00-F09 Organic mental disorders 器質性精神 [ 心智 ] 疾患 F Dementia in Alzheimer s disease with early onset F Dementia in Alzheimer s disease with late onset F Dementia in Alzheimer s disease, atypical or mixed type F Dementia in Alzheimer s disease, unspecified F Vascular dementia of acute onset F Multi-infarct dementia F Subcortical vascular dementia F Mixed cortical and subcortical vascular dementia F Other vascular dementia F Vascular dementia, unspecified F Dementia in Pick s disease F Dementia in Creutzfeldt-Jakob disease F Dementia in Huntington s disease F Dementia in Parkinson s disease F Dementia in human immunodeficiency virus [HIV] disease F Dementia in other specified diseases classified elsewhere F Unspecified dementia 5.x0 Without additional symptoms.x1 Other symptoms, predominantly delusional.x2 Other symptoms, predominantly hallucinatory.x3 Other symptoms, predominantly depressive.x4 Other mixed symptoms F Organic amnesic syndrome, not substance-induced F Delirium, not superimposed on dementia, so described F Delirium, superimposed on dementia F Other delirium F Delirium, unspecified F Organic hallucinosis F Organic catatonic disorder 114

127 附錄 F Organic delusional [schizophrenia-like] disorder F Organic mood [affective] disorders F Organic manic disorder F Organic bipolar affective disorder F Organic depressive disorder F Organic mixed affective disorder F Organic anxiety disorder F Organic dissociative disorder F Organic emotionally labile [asthenic] disorder F Mild cognitive disorder F Other specified mental disorders due to brain damage etc. F Unspecified mental disorder due to brain damage etc. F Organic personality disorder F Postencephalitic syndrome F Postconcussional syndrome F Other organic personality and behavioural disorder F Unspecified organic or symptomatic mental disorder F10-19 Mental/behavioural disorders due to substance use [ ] F Acute alcohol intoxication uncomplicated -- F Acute alcohol intoxication with bodily trauma or injury F Acute alcohol intoxication with other medical complications F Acute alcohol intoxication with delirium F Acute alcohol intoxication with perceptual distortions F Acute alcohol intoxication with coma F Acute alcohol intoxication with convulsions F Acute alcohol intoxication pathological intoxication F Harmful alcohol use F Alcohol dependence currently abstinent F Alcohol dependence abstinent in a protected environment F Alcohol dependence on a maintenance/replacement regime F Alcohol dependence abstinent, receiving drug treatment F Alcohol dependence currently using alcohol F Alcohol dependence continuous use F Alcohol dependence episodic use (dipsomania) F Alcohol withdrawal uncomplicated F Alcohol withdrawal with convulsions F Alcohol withdrawal with delirium but without convulsions F Alcohol withdrawal with delirium and convulsions F Alcohol-induced psychosis schizophrenia-like F Alcohol-induced psychosis, predominantly delusional F Alcohol-induced psychosis, predominantly hallucinatory F Alcohol-induced psychosis, predominantly polymorphic F Alcohol-induced psychosis, predominantly depressive F Alcohol-induced psychosis, predominantly manic 115

128 台灣死刑案件司法精神鑑定實務手冊 F Alcohol-induced psychosis, mixed F Alcohol-induced amnesic syndrome F Alcohol-induced residual disorder- flashbacks F residual disorder personality or behaviour disorder F residual disorder residual affective disorder F residual disorder dementia F residual disorder other persisting cognitive impairment F residual disorder late-onset psychotic disorder F Other mental/behavioural disorder related to alcohol use [ ]/ F Unspecified mental /behavioural disorder related to alcohol use [ ]/ DSM x ICD Abuse / Dependence / Mental/behavioral disorders due to substance use x= Opioids x= Cannabinoids x= Sedatives or hypnotics x= Cocaine x= Other stimulants, including caffeine x= Hallucinogens x= Tobacco x= Volatile solvents x= Multiple drugs or other substances F1x Acute intoxication uncomplicated -- F1x Acute intoxication with trauma or other bodily injury F1x Acute intoxication with other medical complications F1x Acute intoxication with delirium F1x Acute intoxication with perceptual distortions F1x Acute intoxication with coma F1x Acute intoxication with convulsions F1x Acute intoxication - pathological intoxication F1x.1 above Harmful use F1x.20 above Dependence currently abstinent F1x.21 above Dependence abstinent in a protected environment F1x.22 above Dependence on a maintenance/replacement regime / F1x.23 above Dependence abstinent, receiving drug treatment F1x.24 above Dependence currently using the substance F1x.25 above Dependence continuous use F1x.26 above Dependence episodic use F1x Withdrawal state uncomplicated F1x Withdrawal state with convulsions 116

129 附錄 F1x Withdrawal state with delirium but without convulsions F1x Withdrawal state with delirium and convulsions F1x Substance-induced psychosis, schizophrenia-like F1x Substance-induced psychosis, predominantly delusional F1x Substance-induced psychosis, predominantly hallucinatory F1x Substance-induced psychosis, predominantly polymorphic F1x Substance-induced psychosis, predominantly depressive F1x Substance-induced psychosis, predominantly manic F1x Substance-induced psychosis, mixed F1x Substance-induced amnesic syndrome F1x Substance-induced residual disorder- flashbacks F1x residual disorder personality or behaviour disorder F1x residual disorder residual affective disorder F1x residual disorder dementia F1x residual disorder other persisting cognitive impairment F1x residual disorder late-onset psychotic disorder F1x Other substance-related mental/behavioural disorders [ ]/ F1x Unspecified substance-related mental/behavioural disorder [ ]/ F20-29 Schizophrenia, schizotypal and delusional disorders F Paranoid schizophrenia F Hebephrenic schizophrenia F Catatonic schizophrenia F Undifferentiated schizophrenia F Post-schizophrenic depression F Residual schizophrenia F Simple schizophrenia F Other schizophrenia F Schizophrenia, unspecified.x0 Continuous.x1 Episodic with progressive deficit.x2 Episodic with stable deficit.x3 Episodic remittent.x4 Incomplete remission.x5 Complete remission.x6 Other.x9 Course uncertain, period of observation too short F Schizotypal disorder 117

130 台灣死刑案件司法精神鑑定實務手冊 F Delusional disorder F Other persistent delusional disorders F Persistent delusional disorder, unspecified F Acute non-schizophreniform polymorphic psychotic disorder F Acute schizophreniform polymorphic psychotic disorder F Acute schizophrenia-like psychotic disorder F Other acute predominantly delusional psychotic disorders F Other acute and transient psychotic disorders / F Acute/transient psychotic disorder with acute stress / F Acute/transient psychotic disorder without acute stress / F Induced delusional disorder F Schizoaffective disorder, manic type F Schizoaffective disorder, depressive type F Schizoaffective disorder, mixed type F Other schizoaffective disorders F Schizoaffective disorder, unspecified F Other nonorganic psychotic disorders F Unspecified nonorganic psychosis F30-39 Mood [affective] disorders [ ] F Hypomania F Mania without psychotic symptoms F Mania with psychotic symptoms F Other manic episodes F Manic episode, unspecified F Bipolar disorder, current episode hypomanic F Bipolar disorder, manic without psychotic symptoms F Bipolar disorder, manic with psychotic symptoms F Bipolar disorder, mild or moderate non-somatic depression F Bipolar disorder, mild or moderate somatic depression F Bipolar disorder, severe non-psychotic depression F Bipolar disorder, severe psychotic depression F Bipolar disorder, current episode mixed F Bipolar disorder, currently in remission F Other bipolar affective disorders F Bipolar affective disorder, unspecified F Mild depressive episode without somatic syndrome F Mild depressive episode with somatic syndrome F Moderate depressive episode without somatic syndrome F Moderate depressive episode with somatic syndrome F Severe depressive episode without psychotic symptoms F Severe depressive episode with psychotic symptoms F Other depressive episodes F Depressive episode, unspecified 118

131 附錄 F Recurrent depression, mild without somatic syndrome F Recurrent depression, mild with somatic syndrome F Recurrent depression, moderate without somatic syndrome F Recurrent depression, moderate with somatic syndrome F Recurrent depression, current episode severe nonpsychotic F Recurrent depression, current episode severe psychotic F Recurrent depression, currently in remission F Other recurrent depressive disorders F Recurrent depressive disorder, unspecified F Cyclothymia F Dysthymia F Other persistent mood [affective] disorders F Persistent mood [affective] disorder, unspecified F Mixed affective episode F Recurrent brief depressive disorder F Other specified mood [affective] disorders F Unspecified mood [affective] disorder F40-49 Neurotic, stress-related and somatoform disorders F Agoraphobia without panic disorder F Agoraphobia with panic disorder F Social phobias F Specific (isolated) phobias ( ) F Other phobic anxiety disorders F Phobic anxiety disorder, unspecified F Panic disorder [episodic paroxysmal anxiety] [ ] F Generalized anxiety disorder F Mixed anxiety and depressive disorder F Other mixed anxiety disorders F Other specified anxiety disorders F Anxiety disorder, unspecified F Predominantly obsessional thoughts or ruminations [ ] F Predominantly compulsive acts [obsessional rituals] [ ] F Mixed obsessional thoughts and acts F Other obsessive compulsive disorders F Obsessive compulsive disorder, unspecified F Acute stress reaction F Post-traumatic stress disorder F Brief depressive reaction F Prolonged depressive reaction F Mixed anxiety and depressive reaction F With predominant disturbance of other emotions F With predominant disturbance of conduct F With mixed disturbance of emotions and conduct 119

132 台灣死刑案件司法精神鑑定實務手冊 F With other specified predominant symptoms F Other reactions to severe stress F Reaction to severe stress, unspecified F Dissociative amnesia F Dissociative fugue F Dissociative stupor F Trance and possession disorders F Dissociative motor disorders F Dissociative convulsions F Dissociative anaesthesia and sensory loss F Mixed dissociative [conversion] disorders [ ] F Ganser s syndrome F Multiple personality disorder F Transient childhood/adolescent dissociative disorders / F Other specified dissociative [conversion] disorders [ ] F Dissociative [conversion] disorder, unspecified [ ] F Somatisation disorder F Undifferentiated somatoform disorder F Hypochondriacal disorder F Somatoform autonomic dysfunction cardiovascular system F Somatoform autonomic dysfunction upper GI tract F Somatoform autonomic dysfunction lower GI tract F Somatoform autonomic dysfunction respiratory system F Somatoform autonomic dysfunction genitourinary system F Somatoform autonomic dysfunction other organ or system F Persistent somatoform pain disorder F Other somatoform disorders F Somatoform disorder, unspecified F Neurasthenia F Depersonalization derealisation syndrome F Other specified neurotic disorders F Neurotic disorder, unspecified F50-59 Behavioural syndromes associated with physical factors F Anorexia nervosa F Atypical anorexia nervosa F Bulimia nervosa F Atypical bulimia nervosa F Overeating associated with other psychological disturbances F Vomiting associated with other psychological disturbances F Other eating disorders F Eating disorder, unspecified F Nonorganic insomnia F Nonorganic hypersomnia F Nonorganic disorder of the sleep-wake schedule 120

133 附錄 F Sleepwalking [somnambulism] F Sleep terrors [night terrors] F Nightmares F Other nonorganic sleep disorders F Nonorganic sleep disorder, unspecified F Lack or loss of sexual desire F Sexual aversion F Lack of sexual enjoyment F Failure of genital response F Orgasmic dysfunction F Premature ejaculation F Nonorganic vaginismus F Nonorganic dyspareunia F Excessive sexual drive F Other sexual dysfunction, not caused by organic disorders F Unspecified non-organic sexual dysfunction F Mild puerperal mental and behavioural disorders F Severe puerperal mental and behavioural disorders F Other puerperal mental and behavioural disorders F Puerperal mental disorder, unspecified F Psychological /behavioural factors of other disorders F Abuse of non-dependence-producing antidepressants F Abuse of non-dependence-producing laxatives F Abuse of non-dependence-producing analgesics F Abuse of non-dependence-producing antacids F Abuse of non-dependence-producing vitamins F Abuse of non-dependence-producing steroids or hormones F Abuse of non-dependence-producing herbal or folk remedies F Abuse of other non-dependence-producing substances F Abuse of unspecified non-dependence-producing substances F Unspecified behaviour syndromes with physiological disturbances F60-69 Disorders of adult personality and behaviour F Paranoid personality disorder F Schizoid personality disorder F Dissocial personality disorder F Emotionally unstable personality disorder, impulsive type F Emotionally unstable personality disorder, borderline type F Histrionic personality disorder F Anankastic [obsessive-compulsive] personality disorder F Anxious [avoidant] personality disorder [ ] F Dependent personality disorder F Narcissistic personality disorder F Other specific personality disorders F Personality disorder, unspecified 121

134 台灣死刑案件司法精神鑑定實務手冊 F Mixed personality disorders F Troublesome personality changes F Enduring personality change after catastrophic experience F Enduring personality change after psychiatric illness F Other enduring personality changes F Enduring personality change, unspecified F Pathological gambling F Pathological fire-setting [pyromania] F Pathological stealing [kleptomania] F Trichotillomania F Other habit and impulse disorders F Habit and impulse disorder, unspecified F Transsexualism F Dual-role transvestism F Gender identity disorder of childhood F Other gender identity disorders F Gender identity disorder, unspecified F Fetishism F Fetishistic transvestism F Exhibitionism F Voyeurism F Paedophilia F Sadomasochism F Multiple disorders of sexual preference F Other disorders of sexual preference F Disorder of sexual preference, unspecified F Sexual maturation disorder F Egodystonic sexual orientation F Sexual relationship disorder F Other psychosexual development disorders F Psychosexual development disorder, unspecified F Psychosexual development disorder, homosexual F Psychosexual development disorder, bisexual F Psychosexual development disorder, other incl. prepubertal F Elaboration of physical symptoms for psychological reasons F Factitious disorder F Other specified disorders of adult personality and behaviour F Unspecified disorder of adult personality and behaviour F70-79 Mental retardation [learning disability] F Mild mental retardation F Moderate mental retardation F Severe mental retardation F Profound mental retardation F Other mental retardation F Unspecified mental retardation 122

135 附錄 F70-F7 4 F7x.0 No, or minimal, impairment of behaviour F7x.1 Significant behavioural impairment requiring treatment F7x.8 Other impairments of behaviour F7x.9 Without mention of impairment of behaviour F80-89 Disorders of psychological development F Specific speech articulation disorder F Expressive language disorder F Receptive language disorder F Acquired aphasia with epilepsy [Landau-Kleffner syndrome] [ ] F Other developmental disorders of speech and language F Developmental disorder of speech and language, unspecified F Specific reading disorder F Specific spelling disorder F Specific disorder of arithmetical skills F Mixed disorder of scholastic skills F Other developmental disorders of scholastic skills F Developmental disorder of scholastic skills, unspecified F Specific developmental disorder of motor function F Mixed specific developmental disorders F Childhood autism F Atypical autism F Rett s syndrome F Other childhood disintegrative disorder F Overactive disorder of MR [LD], with stereotyped movements F Asperger s syndrome F Other pervasive developmental disorders F Pervasive developmental disorder, unspecified F Other disorders of psychological development F Unspecified disorder of psychological development F90-98 Childhood/adolescent behavioural and emotional disorders F Disturbance of activity and attention F Hyperkinetic conduct disorder F Other hyperkinetic disorders F Hyperkinetic disorder, unspecified F Conduct disorder confined to the family context F Unsocialised conduct disorder F Socialized conduct disorder F Oppositional defiant disorder F Other conduct disorders F Conduct disorder, unspecified F Depressive conduct disorder F Other mixed disorders of conduct and emotions 123

136 台灣死刑案件司法精神鑑定實務手冊 F Mixed disorder of conduct and emotions, unspecified F Separation anxiety disorder of childhood F Phobic anxiety disorder of childhood F Social anxiety disorder of childhood F93.3 V61.8 Sibling rivalry disorder F Other childhood disorders of social functioning F Childhood disorder of social functioning, unspecified F Elective mutism F Reactive attachment disorder of childhood F Disinhibited attachment disorder of childhood F Other childhood disorders of social functioning F Childhood disorder of social functioning, unspecified F Transient tic disorder F Chronic motor or vocal tic disorder F de la Tourette s syndrome F Other tic disorders F Tic disorder, unspecified F Nonorganic enuresis F Nonorganic encopresis F Feeding disorder of infancy and childhood F Pica of infancy and childhood F Stereotyped movement disorders F Stuttering [stammering] F Cluttering F Other specified childhood/adolescent disorders F Unspecified childhood/adolescent disorders F99 Unspecified mental disorder F mental disorder, not otherwise specified 124

137 附錄 附錄 4: 倫理規範 英國醫師公會 (General Medical Council) 優良醫療執業 (2006 年版 ) Confidentiality: Protecting and providing information 英國皇家精神醫學院 (Royal College of Psychiatrist) 優良精神醫療執業 (2009 年公布 第 3 版 ) 125

138 台灣死刑案件司法精神鑑定實務手冊 優良精神醫療執業 - 保密與資訊分享 Care Programme Approach Multi-Agency Public Protection Arrangements 126

139 附錄 美國精神病學與法律協會 (American Academy of Psychiatry and the Law) 精神醫學執業倫理指南 (Ethical Guidelines for the Practice of Forensic Psychiatry)... 保密 同意

140 台灣死刑案件司法精神鑑定實務手冊 誠實與力求客觀... 資格 128

141 附錄 世界精神醫學會馬德里宣言 (World Psychiatric Association Declaration of Madrid)

142 台灣死刑案件司法精神鑑定實務手冊 本書作者 Nigel Eastman Eastman ( Judicial Committee of the Privy Council, JCPC) Eastman (Law Commission) ( Judicial Studies Board, JSB) murder ticket judges Eastman (Forensic Psychiatry Chambers) Tim Green South London and Maudsley NHS Trust 黃致豪 (NYU) BA / Richard Latham Mental Health Law Latham Marc Lyall Lyall 130

143 附錄 關於 英國司法精神醫學會 (Forensic Psychiatry Chambers) ( Judicial Committee of the Privy Council, JCPC) 關於 台灣廢除死刑推動聯盟

144 台灣死刑案件司法精神鑑定實務手冊 關於 死刑專案 The Death Penalty Project Roger Hood Maiko Tagusari David Johnson Mai Sato 132

145 NOTE 附錄 133

146 台灣死刑案件司法精神鑑定實務手冊 NOTE 134

147 NOTE 附錄 135

148 台灣死刑案件司法精神鑑定實務手冊 透視 1984 the Safeguards Guaranteeing the Protection of the Rights of those Facing the Death Penalty Saul Lehrfreund Parvais Jabbar 合作單位 136