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Chapter: Essentials of Psychiatry: Law, Ethics and Psychiatry

Overview of Legal Principles

The development of legal principles is the result of the interplay of legislatures that enact laws, executive branches that enforce them and courts that interpret them.

Overview of Legal Principles

 

The development of legal principles is the result of the interplay of legislatures that enact laws, executive branches that enforce them and courts that interpret them. The first level of courts are trial courts, where cases are tried and decided. Appeals courts generally hear arguments by parties who feel that lower courts have made errors of law which require reversal of the lower court decision. The federal and most state court systems have two lev-els of appeals courts (an Appeals Court and a Supreme Court, although terminology varies among jurisdictions). The highest court in the land is the US Supreme Court, which is the final arbi-ter of questions of Federal and Constitutional Law.

 

Cases decided in state courts set the law only for the state in which the case is decided. Although state decisions may ulti-mately influence one another, no state is required to abide by the precedent of a different state’s courts. For instance, the Tarasoff case discussed below set standards in California for a mental health professional’s duty to protect a third party from the danger posed by a client. Although that case only applied to practice in California, it has had a great influence on legal and clinical prac-tice in other states. Similarly, federal Appeals Courts set prec-edent only for the Circuits in which they sit. Only when the US Supreme Court has ruled on a matter of law are all other state and federal courts required to follow the precedent.

 

Each state also has a constitution that may be more protective of individuals’ rights or more limiting of the states’ power than the federal constitution. State courts can make decisions interpreting their own constitutions or the federal constitution. While federal Appeals Courts and ultimately the US Supreme Court can overrule a state court’s interpretation of the federal constitution, the state supreme court has the final word on the state’s constitution, so long as the state constitution does not violate the federal constitution. (For instance, a state constitution may provide greater protection against police searches than the federal constitution, but not less.)

The specific legal rights and principles with which we will concern ourselves are found in the amendments to the US Con-stitution. Of particular interest to psychiatry are the following constitutional amendments: the First Amendment, which embod-ies the right to freedom of speech and religion; the Third and Fourth Amendments, which have been interpreted as implying a right to privacy; the Fifth Amendment, which grants the right to remain silent in a criminal case; the Sixth Amendment, which discusses the rights of defendants to fair and speedy trials; the Eighth Amendment, which proscribes cruel and unusual punish-ment; and the Fourteenth Amendment, which embodies the “due process’’ and “equal protection of the law’’ clauses (Table 6.1).


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