Deck 17: Legal and Ethical Issues

Question 1

The Insanity Defense Reform Act shifted the burden of proof onto the

A)defense.
B)prosecution.
C)expert witness.
D)judge.

Answer 1

defense.

Question 2

What is the rationale for laws that provide for legal verdicts of "guilty but mentally ill?"

A)to prevent the truly insane from being treated as criminals.
B)to provide treatment options for convicted criminals while still holding them responsible for their actions.
C)to deal with mentally ill vagrants.
D)to permit consideration of whether the accused could appreciate the wrongfulness of his or her actions.

Answer 2

to provide treatment options for convicted criminals while still holding them responsible for their actions.

Question 3

If an individual is judged to be Guilty but Mentally Ill,he or she

A)is always put in the general prison population.
B)may be committed to a prison hospital or other type of suitable psychiatric facility.
C)is placed in a psychiatric hospital until it is deemed that he or she is ready to reenter society.
D)will receive inpatient psychiatric treatment at a local psychiatric hospital before being moved into the general prison population.

Answer 3

may be committed to a prison hospital or other type of suitable psychiatric facility.

Question 4

Jeffrey Dahmer,the serial killer,was an example of a criminal who was

A)mentally ill but not legally insane.
B)legally insane but not mentally ill.
C)insane according to the rule of knowing right from wrong,but not according to the irresistible impulse rule.
D)neither mentally ill nor legally insane.

Question 5

George killed his two children because he believed he heard voices telling him that if he did not kill them,his neighbor would.His defense attorney argued that due to George's insanity at the time of the crime,George should not be held responsible for the crime and should thus be acquitted of the crime.Which of the following best describes the plea that George's defense attorney made?

A)Not Guilty but Mentally Ill
B)The Durham test
C)Not Guilty by Reason of Insanity
D)Guilty But Mentally Insane

Question 6

Insanity defense trials typically involve

A)considerable flexibility in determining who is most responsible for criminal actions.
B)subjective determinations of competency at the time of a crime.
C)individuals with antisocial personality and no other significant mental disorders.
D)All of the above are correct

Question 7

A primary purpose of the American Law Institute guidelines for defining the insanity defense was to

A)avoid specifying symptoms of mental illness which might later become obsolete.
B)be more specific and informative to lay jurors.
C)allow greater leeway for expert witnesses to define the concept of mental illness.
D)open the defense to the full range of mental illnesses.

Question 8

The Jones v.United States case illustrated which problem with the insanity defense?

A)Mentally ill people may still be guilty of crimes.
B)People deemed to be insane may be treated for longer than they would have been imprisoned.
C)Committed patients have a right to refuse treatment.
D)People may be insane at the time of the crime but still competent to stand trial.

Question 9

According to the American Law Institute guidelines,which of the following mental disorders would not qualify for the insanity defense?

A)paranoid schizophrenia
B)dissociative identity disorder
C)post-traumatic stress disorder
D)antisocial personality disorder

Question 10

Patrick was found guilty of murdering his wife.Psychiatrists testified that Patrick had paranoid schizophrenia and that his delusions led directly to the criminal act.If his state allows the guilty but mentally ill verdict,what sentence would Patrick likely receive?

A)Psychiatric commitment until a psychiatrist determines that he is cured of his mental illness.
B)Psychiatric commitment until a psychiatrist determines that he is no longer dangerous.
C)A criminal sentence but with psychiatric care provided during the incarceration.
D)The same criminal sentence as a non-mentally ill person convicted of murder.

Question 11

Frank suffers from schizophrenia.Allegedly,he has severely beaten another man in the park after an argument.While he is being examined by a psychologist to see if he is fit to stand trial,he is mandated to a mental health institution.This is an example of

A)civil commitment.
B)mandated reporting.
C)criminal commitment.
D)psychiatric commitment.

Question 12

What verdict has been proposed most recently for mentally ill persons who commit crimes?

A)guilty (no allowance made for mental illness)
B)not guilty by reason of insanity
C)not guilty by reason of temporary insanity
D)guilty but mentally ill

Question 13

Criminal and civil commitment can be best distinguished by

A)whether the one being committed is insane.
B)whether a crime has been committed by the individual.
C)the severity of the symptoms and the crime committed.
D)the type of police intervention necessary.

Question 14

What is the distinction between insanity and competency to stand trial?

A)Insanity is more serious than incompetency.
B)Competency,but not insanity,concerns persons accused of a crime.
C)Someone found competent to stand trial cannot also be found insane.
D)Insanity and competency concern different points in time during which the person's mental state is being questioned.

Question 15

A major result of the Insanity Defense Reform Act was

A)to require that a documented,preexisting mental condition exist at the time of a crime in order to use an insanity defense.
B)to clarify what specific crimes may be associated with insanity.
C)to restrict the insanity defense to multiple offenders.
D)to eliminate the irresistible impulse as a plausible insanity defense.

Question 16

According to the Insanity Defense Reform Act,a person who is deemed not guilty by reason of insanity

A)must be suffering from at least a moderate mental illness.
B)must be incarcerated for the maximum allowable time for their crime even if their mental health improves to the point where hospitalization is no longer needed.
C)must lack the overall capacity to appreciate the wrongfulness of their behavior.
D)All of the above are correct.

Question 17

In the case of Jones v.United States,Jones was hospitalized after stealing a jacket.His attorneys argued before the court that he was

A)denied effective treatment for his insanity.
B)hospitalized for longer than he would have been imprisoned.
C)legally insane but had no mental illness requiring hospitalization.
D)never proven to be legally insane.

Question 18

The case of Jeffrey Dahmer exemplifies

A)the plea of not guilty by reason of insanity.
B)the distinction between mentally ill and insane.
C)the aggressive behaviors of antisocial personality disorder.
D)how a psychologically healthy person can be temporarily insane.

Question 19

The M'Naghten rule states that the insanity defense is appropriate if a person

A)has an irresistible impulse leading him or her to commit a crime.
B)has a diagnosable mental illness.
C)is not competent to stand trial.
D)does not know right from wrong at the time of the criminal act.

Question 20

If an individual is acquitted with the Not Guilty by Reason of Insanity Plea,he or she

A)is committed to a forensic hospital for an indefinite amount of time.
B)is generally placed in a maximum security prison.
C)is able to walk free,but with strict requirements for outpatient psychiatric treatment.
D)is placed in a psychiatric hospital until it is deemed that he or she is ready to reenter society.

Question 21

The trial of Andrea Yates caused great public debate because

A)the jury found her to be sane.
B)the jury found her to be insane.
C)the defense tried to use the rarely accepted "guilty by reason of insanity" defense.
D)she was taking care of her children while diagnosed with schizophrenia.

Question 22

Mr.J stood near an elementary school with a loaded gun,staring at the children and teachers,every day for a week.Could he be committed,even though he had a license for the gun and had not been seen committing a crime?

A)Yes,since he is clearly a danger to others.
B)Yes,but only if he is found to have a prior record of criminal activity.
C)Yes,but only if he is judged to be mentally ill.
D)No,because this would violate the principle forbidding "preventive detention."

Question 23

Simon has been diagnosed with schizophrenia,paranoid type.He is accused of murder,and his lawyers have suggested that he is not competent to stand trial.He is then administered Haldol,and his symptoms remit significantly,and he stops experiencing paranoid ideas and delusions.What is likely to happen next?

A)He would continue to be considered incompetent to stand trial as the medication produced the effects.
B)He would not be tried in court.
C)His lawyers would have to reconsider their insanity defense.
D)He would be considered competent to stand trial.

Question 24

An informal civil commitment

A)applies only if there is no imminent danger.
B)can be used only if the person agrees.
C)is a short-term emergency procedure that can be accomplished without involving the courts.
D)requires a court order.

Question 25

The prosecution and defense in the trial of Andrea Yates agreed

A)that she knew right from wrong.
B)she was not mentally ill at the time of the murders.
C)that she killed her children.
D)All of the above are correct.

Question 26

Which of the following statements is TRUE regarding the relationship between mental illness and dangerousness?

A)Most mentally ill people are violent at some point during their illness.
B)More crimes are committed by mentally ill people than any other group.
C)Among mentally ill people,violence is most common among those with schizophrenia.
D)People with mental illness who were not substance abusers were no more likely to engage in violence than non-mentally ill people who were not substance abusers.

Question 27

The difference between "insanity" and "competency" is that insanity

A)involves a person's state at the time of the crime.
B)is a legal,not a mental health,category
C)has less serious consequences.
D)criteria are more clear cut.

Question 28

Most states hold that a person can be involuntarily committed to a mental hospital

A)if found to be mentally ill.
B)if found to be mentally ill and a danger to themselves or others.
C)only if he or she has committed a crime.
D)only if he or she has committed a violent crime.

Question 29

Despite her objections,the police took Elizabeth directly to a mental hospital after they found her in an obviously deranged state attempting to kill herself.What is the procedure the doctors used to keep her in the hospital after she arrived?

A)voluntary commitment
B)criminal commitment
C)formal commitment
D)a two physicians' certificate (2PC)

Question 30

Mike has attacked his wife several times in the past and appears likely to do so again very soon.He can be locked up now (before he attacks her)if

A)someone overhears his threats.
B)she has not been warned.
C)she has a court order.
D)he is deemed mentally ill.

Question 31

What is "synthetic sanity?"

A)Faking of sanity by a deranged person
B)Sanity measured only by psychological tests
C)Sanity induced by psychotropic drugs
D)Appearance of sanity under courtroom stress

Question 32

When someone is determined incompetent to stand trial,what typically happens to them?

A)They are released.
B)They are treated and then tried for the original crime.
C)They are treated and then released.
D)They are treated while serving time in prison for the crime.

Question 33

Eighteen of the 38 U.S.states that allow capital punishment prohibit the execution of people with mental retardation on grounds against

A)trying the mentally ill.
B)cruel and unusual punishment.
C)immoral death.
D)pity.

Question 34

In the Jackson v.Indiana case,it was decided that a person judged incompetent to stand trial could be committed to a prison hospital

A)for an indeterminate period,as long as the accused is still considered a danger to others.
B)for an indeterminate period,as long as the accused is still judged to be insane.
C)only until it is determined whether or not the accused will ever become competent.
D)only if the competence of the accused is dependent on medication ("synthetic sanity.")

Question 35

Saks' argument about dissociative identity disorder as an insanity defense is that

A)the body who commits the crime should be held responsible,regardless of whether the "person" was conscious of the crime being committed.
B)the person,not the body,is responsible for a crime.
C)dissociative identity disorder is usually faked by criminals pleading insanity and thus should not be an allowable defense.
D)since therapy for dissociative identity disorder is not usually effective,confinement to a prison mental hospital is illogical.

Question 36

Which of the following statements is true regarding violence and the mentally ill?

A)Nearly 25% of the violence in the United States is linked to mental illness
B)90% of psychotic patients are non-violent
C)People with mental illnesses who are violent typically lash out in crowded public places
D)None of the above are true.

Question 37

You are an attorney appointed to represent a poor client accused of rape who has a history of mental illness.During your first several meetings,the man is completely incoherent.Which of the following issues should you address first?

A)competency to stand trial
B)possibility of mens rea
C)a possible insanity defense
D)possible civil commitment

Question 38

The competency to stand trial issue is based on the basic legal principle

A)that trials should not occur without the accused being present.
B)that mentally ill persons may not be responsible for their crimes.
C)of innocent until proven guilty.
D)of free will and the knowledge of right and wrong.

Question 39

Corey has been remanded to a psychiatric hospital to determine if he is competent to stand trial.He has been diagnosed with schizophrenia and is responding well to treatment with psychotropic medications.He is less delusional and his speech is more organized.Based on this,he is deemed competent and is scheduled to stand trial.This is an example of

A)synthetic sanity.
B)being guilty but mentally ill.
C)misdiagnosis.
D)temporary insanity.

Question 40

Brian has been diagnosed with schizophrenia.He is accused of stealing from a jewelry store and is currently being treated in a psychiatric hospital to assess his competency.Which of the following are correct regarding Brain's situation?

A)Brian cannot be forced to take Haldol,an antipsychotic medication.
B)Brian can be deemed competent even if his competency is the result of medication alone.
C)The effects of Brian's current antipsychotic medications can be explained to the jury.
D)All of the above are correct

Question 41

Which of the following is true regarding the deinstitutionalization of large numbers of mentally ill persons?

A)It occurred after adequate community services were made widely available.
B)It resulted in the discovery that most inpatients appeared insane only because of the negative effects of institutionalization.
C)It has been recognized as harmful;current policy is to reinstitutionalize most of these patients.
D)It created a large population of impoverished,homeless mentally ill.

Question 42

In the case of O'Connor v.Donaldson,Donaldson was involuntarily committed to a psychiatric hospital for 14 years.He sued the hospital psychiatrists,arguing that they had denied his right to

A)live in the least restrictive setting.
B)a fair trial.
C)refuse treatment.
D)treatment.

Question 43

The "right to treatment" refers to the right of

A)all people to affordable health care.
B)professionals to make treatment decisions.
C)committed people to receive adequate care.
D)society to have dangerous people treated.

Question 44

Human subjects committees and institutional review boards for reviewing the ethics of proposed experiments are made up of

A)behavioral scientists.
B)citizens of the community.
C)lawyers.
D)All of the above are correct

Question 45

Issues that have come up after the original Tarasoff ruling have included

A)protection when the threat of harm is implicit,not just when explicit threats have been made.
B)warning family members of harmfulness,not just the one towards whom threats have been made.
C)holding other family members responsible for possible harm.
D)identifying potentially dangerous individuals to newspapers.

Question 46

Fifty years ago,medical research with human subjects

A)was generally more ethical than mental health research.
B)was monitored by review boards in the institutions where the research was being conducted.
C)was used as a way of punishing mentally ill prisoners.
D)frequently led to serious,harmful consequences to participants.

Question 47

The prediction of dangerousness is probably best in which of the following situations?

A)When the person is experiencing hallucinations
B)If violence is in the person's distant past,and it was a single but very serious act.
C)Following extended hospitalizations
D)After a period of relative calm

Question 48

Following civil commitment,patients must be placed in

A)mental hospitals.
B)a setting that provides medication treatment.
C)the most restrictive setting to which the patient will consent voluntarily.
D)the least restrictive setting in which they will be prevented from harming themselves or others.

Question 49

Mental health professionals are constrained by

A)the law.
B)ethical principles.
C)professional guidelines.
D)All of the above

Question 50

In the Wyatt v.Stickney case on the "right to treatment," the court ruled that

A)private mental hospitals must provide a minimal level of care to patients who cannot pay full fees.
B)patients involuntarily committed to a psychiatric hospital must receive treatment.
C)every American should have access to affordable mental health care.
D)therapists cannot refuse treatment to those who request it.

Question 51

What is the emphasis of recent court decisions in involuntary civil commitment cases?

A)holding professionals accountable for predicting dangerousness
B)holding professionals accountable for violating confidentiality
C)protecting the safety of the public
D)protecting the rights of the mentally ill

Question 52

Following an automobile accident,Mike suffered significant head injuries that led to his inability to make sound rational decisions for himself.The doctors treated him according to specific guidelines Mike left before the accident.This is referred to as a(n)

A)living will.
B)advanced directive.
C)treatment plan.
D)premorbid decision tree.

Question 53

Which of the following is true regarding the right to refuse treatment?

A)It does not apply if a person is judged to be at risk for becoming dangerous to others.
B)It does not apply if a person is a danger to themselves or to others.
C)It applies only to those in the least restrictive environment.
D)It applies to criminal commitment but not civil commitment.

Question 54

The most recent extension of the Tarasoff ruling (2004)states

A)that therapists no longer have a duty to warn possible victims except in cases where the patient has explicitly described the means he/she would use to commit the violence.
B)that therapists have a duty to warn a possible victim if the threat is reported by a family member of the patient.
C)the duty to warn only extends to licensed clinical psychologists and not to social workers or other types of mental health workers.
D)that therapists have a duty to warn a possible victim if the threat is reported by a friend or co-worker of the patient.

Question 55

Outpatient commitment

A)is a method of forcibly hospitalizing unwilling people with mental illnesses.
B)seeks to reduce violence in patients discharged from hospitals.
C)allows hospitalized patients to live independently with a case manager who visits the patient every week.
D)is often accompanied by decreased medication compliance.

Question 56

Deinstitutionalization policies have inadvertently led to which of the following outcomes?

A)the release of many dangerous individuals.
B)higher numbers of mentally ill in other institutions,such as jails and nursing homes.
C)insufficient research participants.
D)increased costs of treatment.

Question 57

The Tarasoff case led to the ruling that a therapist who learns that a client is threatening to harm someone must

A)take steps to have the person committed.
B)physically detain the client.
C)warn the intended victim of the client's threat.
D)break confidentiality and notify police or other authorities that the person is dangerous.

Question 58

When subjects in research studies are told about the potential risks and are free to decline participation,it is called

A)informed consent.
B)freedom of choice.
C)parens patriae.
D)mens rea.

Question 59

Deinstitutionalization has been described as an improper label because

A)most patients end up in treatment in outpatient clinics,thus visiting other institutions.
B)most patients who are deinstitutionalized remain mentally ill.
C)patients typically end up in other institutions such as nursing homes,prisons,and mental health departments of nonpsychiatric hospitals.
D)few patients are actually discharged from the hospital.

Question 60

The argument against patients' right to refuse treatment has been typically based upon the notion that

A)untreated patients may become dangerous.
B)involuntarily committed patients should not have a say in their treatment,since they are usually guilty of a crime.
C)patients may be too disturbed to make sound judgments about their treatment.
D)the type of treatment prescribed should be determined by the courts,not the patient.

Question 61

Discuss the different types of insanity pleas.

Question 62

Discuss the effects of the Tarasoff case on psychologists.What areas of clinical practice has it touched and how has this case changed the way psychologists practice?

Question 63

Discuss three factors that have been involved in the development of the insanity defense.

Question 64

How has human research changed in recent years to conform to ethical guidelines?

Question 65

Confidentiality is based on ____________,whereas a privileged communication is ___________.

A)state law;decided on by the individual therapist.
B)the ethical code of a profession;based on law.
C)the therapist's obligation not to disclose information;the client's obligation not to disclose opinions about the therapist.
D)verbal report in therapy;a written report of the therapist's impression of a client.

Question 66

How does civil and criminal commitment differ,and under what conditions would each be utilized?

Question 67

A child in a residential treatment center is refusing to participate in treatment.The director of the center tells the child's therapist that unless the child's aggressive behavior improves,the child will be discharged.What ethical dilemma is raised here?

A)conflict about who is the client
B)It is not clear what choice of techniques is appropriate.
C)informed consent
D)confidentiality

Question 68

All of the following people may refuse to be a subject in a research project EXCEPT

A)a patient involuntarily committed to a psychiatric hospital after being found not guilty by reason of insanity.
B)a prisoner convicted of a felony.
C)a college student required to participate in research as part of a psychology class.
D)All of the above may refuse to participate in research

Question 69

Audrey agreed to participate in a research experiment being conducted by a professor in psychology.She was told that the experiment would last two hours and would be somewhat boring but was not expected to be harmful in any way.After one hour,Audrey got tired of the tasks she was asked to do and told the experimenter she had changed her mind and wanted to quit.Can the experimenter tell her she has to continue?

A)Yes,because Audrey used one hour of the experimenter's time which will be wasted if she quits now.
B)Yes,since Audrey agreed to participate knowing that the experiment would be boring.
C)No,because Audrey has the right to stop at any time for any reason.
D)No,because the experimenter failed to obtain informed consent.

Question 70

Which of the following does the text identify as a common problem in obtaining informed consent from research participants?

A)Being informed may change their behavior during the study
B)Researchers may withhold critical information.
C)The benefits may not justify the risks.
D)Participants may not understand what they are told.

Question 71

When is someone considered competent to stand trial? What are the consequences for being judged incompetent to stand trial?

Question 72

Discuss the factors that are considered in preventive detention.Include a discussion of our current ability to accurately predict dangerousness.

Question 73

What is the difference between being mentally ill and being insane?

Question 74

Which of the following relationships does not typically involve privileged communication?

A)medical doctor - patient
B)pastor - confessor
C)friend - confidante
D)husband - wife

Question 75

Which of the following is most likely to raise the ethical dilemma of "Who is the client"?

A)treating drug problems in a college counseling center.
B)training job skills to industrial supervisors.
C)evaluating hyperactive children for pediatricians.
D)counseling anxious adults in private practice.

Question 76

Discuss the factors that determine a defendant's competency to stand trial.

Question 77

Which of the following rights of clients has a legal (not just ethical)basis?

A)confidentiality
B)informed consent
C)privileged communication
D)choice of goals