Homicide and dementia: An investigation of legal, ethical, and clinical factors of Australian legal cases

Baird, Amee; Kennett, Jeanette; Schier, E

doi:10.1016/j.ijlp.2020.101578

Cited by 2 publications

(27 citation statements)

References 35 publications

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“…Figure 1 details the PRISMA flowchart for study selection. Thirteen studies met the inclusion criteria [5,16,[22][23][24][25][26][27][28][29][30][31][32]. The study information and key findings are further outlined in Table 1.…”

Section: Assessment Of Qualitymentioning

confidence: 99%

“…Most offenders were male (132/153, 86%). From those sampled in the community, the victim was a spouse in 62% of cases (79/128) [5,22,24,25,[27][28][29][30][31][32]. For those in institutional settings, two case reports described the victim as another male resident [23,26], while the retrospective cohort study found that risk of death from resident-resident aggression was twice as high for male residents compared with female (p = 0.05), despite victims of aggression being slightly more likely to be female (15/25, 53.6%) [16].…”

Section: Assessment Of Qualitymentioning

confidence: 99%

“…The type of dementia was not always specified or the method of diagnosis. However, ten studies utilized clinician assessment to make the dementia diagnosis [5,22,[24][25][26][27][28][29][30]32], with six including details of neuroimaging performed [22, 25-27, 29, 30]. The diagnosis of dementia was made postmortem in only one case [31].…”

Section: Assessment Of Qualitymentioning

confidence: 99%

“…Common factors emerged in these homicide offenders, including the type of dementia with the presence of dysexecutive syndrome, psychosis, alcohol use, personality pathology, victim vulnerability, and delirium. Given the nature of underlying comorbidity in homicide offenders with dementia, several studies highlighted the need for specialized assessment [5,16,22,24,25,27,28,34] and care settings [5,16,22,24,26,27]. [22] had a separately reported dataset [33], and was thus counted as one study.…”

Section: Assessment Of Qualitymentioning

confidence: 99%

“…Given the nature of underlying comorbidity in homicide offenders with dementia, several studies highlighted the need for specialized assessment [5,16,22,24,25,27,28,34] and care settings [5,16,22,24,26,27]. [22] had a separately reported dataset [33], and was thus counted as one study.…”

Section: Assessment Of Qualitymentioning

confidence: 99%

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Homicide and Dementia: A Systematic Review

Sundakov-Krumins

Lubbe

Wand

2022

Dement Geriatr Cogn Disord

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Background: Homicide by older offenders is rare and devastating. It likely occurs due to a complex interaction of personal, social, and environmental factors. Dementia is a progressive neurological condition which may amplify behavioural disturbances such as aggression. This systematic review aims to evaluate the factors associated with homicide committed by people with dementia in order to inform clinical practice. Summary: MEDLINE, PsychINFO, Embase, and PubMed databases were searched in accordance with PRISMA guidelines for empirical studies examining the characteristics and circumstances of people with dementia who committed homicides. Data on factors associated with the homicide were extracted and the quality of each study rated using standardized criteria. A total of 499 papers were screened and thirteen studies met the inclusion criteria. Study design included case reports (seven studies), case series (four studies), and two retrospective cohort studies, indicative of low levels of evidence. Sample sizes were 1–70. Study findings were predominantly descriptive. Quality ratings ranged from 50 to 100%. Factors associated with disinhibition such as dysexecutive syndrome, alcohol use, and delirium may predispose to severe impulsive aggression. Psychosis and personality pathology appeared to influence targeted assaults resulting in homicide by people with dementia. Victim vulnerability was also a key element. Key Messages: The current evidence examining risk factors for homicide committed by people with dementia is limited. However, there are common characteristics reported in these descriptive studies including psychiatric factors and cognitive states causing disinhibition. Recommendations for clinical practice include early assessment of older people with dementia and changed behaviours to allow management of comorbidities and reversible risk factors, alongside education, and advice to carers (who may be targets of aggression). Specialized geriatric forensic psychiatry services and care settings should be developed.

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Section: Assessment Of Qualitymentioning

confidence: 99%

Section: Assessment Of Qualitymentioning

confidence: 99%

Section: Assessment Of Qualitymentioning

confidence: 99%

Section: Assessment Of Qualitymentioning

confidence: 99%

Section: Assessment Of Qualitymentioning

confidence: 99%

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Homicide and Dementia: A Systematic Review

Sundakov-Krumins

Lubbe

Wand

2022

Dement Geriatr Cogn Disord

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A Scoping Review of Ethical and Legal Issues in Behavioural Variant Frontotemporal Dementia

2023

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Behavioural variant frontotemporal dementia (bvFTD) is a subtype of frontotemporal dementia characterized by changes in personality, social behaviour, and cognition. Although neural abnormalities cause bvFTD patients to struggle with inhibiting problematic behaviour, they are generally considered fully autonomous individuals. Subsequently, bvFTD patients demonstrate understanding of right and wrong but are unable to act in accordance with moral norms. To investigate the ethical, legal, and social issues associated with bvFTD, we conducted a scoping review of academic literature with inclusion & exclusion criteria and codes derived from our prior work. Among our final sample of fifty-six articles, four mentioned bvFTD patient-offenders as unfit to stand trial by insanity, and sixteen mentioned the use of dementia evidence in a court of law to better understand the autonomy of bvFTD patients. Additional emergent issues that were discovered include: training police officers to handle situations involving bvFTD patients and educating healthcare providers on how to help caregivers navigate bvFTD. The current literature highlights the inadequacy of traditional applications of medico-legal categories such as autonomy, capacity and competence, in informing cognitive capacity assessments in clinical and legal settings and deserves consideration by neuroethicists.

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Homicide and dementia: An investigation of legal, ethical, and clinical factors of Australian legal cases

Cited by 2 publications

References 35 publications

Homicide and Dementia: A Systematic Review

Homicide and Dementia: A Systematic Review

A Scoping Review of Ethical and Legal Issues in Behavioural Variant Frontotemporal Dementia

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