But actually the fact is by interpreting the law the court can make comprehensive changes in the actual implementation and overall maneuver of the law. This can be easily be gathered by analyzing the statutory interpretation made by Indian judiciary and its effect on India and its citizens as a whole.
Benzodiazepines are invaluable therapeutic agents which in varying degrees may produce physiological dependence; moreover, their use may complicate or be complicated by the abuse of other substances. In prescribing these controlled substances, more than with other medications, physicians may be perceived to be acting as agents of the state as well as of the patient, with the potential for ethical conflict that this dual role entails.
In some circumstances it may be unethical to prescribe benzodiazepines; in other circumstances it may be unethical to withhold them, even if prescribing involves risks for the clinician. Benzodiazepines suffer from guilt by association, in that the clinician who treats street-drug users will often see benzodiazepines used to self-medicate the consequences of that abuse.
On the other hand, the clinician who treats a more heterogeneous population may see Valium diazepam misuse, but will not see true addiction, insofar as there is no dose escalation or compulsive use in spite of adverse consequences.
As with insulin and digitalis, drugs needed for long-term therapeutic use may produce dependence, but that is not the same as addiction. The closest that benzodiazepine abuse comes to addiction is as part of a pattern of poly-drug abuse, sometimes with the rationalization that other chemical addictions require, in compensation, increasing dosages of benzodiazepines.
Long-term therapeutic use of benzodiazepines occurs primarily in three groups of patients. The largest group is those with chronic, serious medical illnesses e. It would be cruel to deny to these patients, often well advanced in age, the degree of relief offered by benzodiazepines.
The second group is those with panic disorder. Whether benzodiazepines are more appropriate for such individuals mens rea intention essay help SSRIs or other antidepressants must be decided by weighing therapeutic versus side effects on a case-by-case basis. However, there is no evidence of benzodiazepine abuse in this population, and chronic use tends to result in gradual dose reduction over time.
The third group consists of individuals with chronic psychiatric disorders or repeated instances of acute stress. Here, too, except for those with personality disorders, much chronic benzodiazepine use and pharmacological dependence occur in the context of legitimate treatment.
Typical Dilemmas Disagreements between clinicians concerned mainly with overuse of benzodiazepines and those who focus on underuse are based in part on different perspectives, patient populations, and values. Unfortunately, the salient dimensions of what should be a clinical controversy have all too often been obscured by the misuse of the term "addiction," which has created a false analogy between benzodiazepine dependence and addiction to substances of abuse.
This analogy, in turn, has brought with it irrelevant associations with antisocial behavior. By contrast, the "respectable minority" of psychoanalytically oriented therapists, whose practice has evolved from Freud's, emphasizes the importance of enhancing patient autonomy and authenticity.
These controversies have generated sufficient concern that the American Psychiatric Association issued a task force report on the subject. While such guidelines are useful as checklists for administrative purposes or as reminders for chart review, they are no substitute for the careful review and analysis of risks and benefits on a case-by-case basis which is the hallmark of psychopharmacological decision making.
Special care needs to be taken, therefore, when evaluating and treating a variety of vulnerable populations, including the pregnant patient, [ 14 ] institutionalized populations, such as geriatric residents of nursing homes [ 15 ] and inmates in correctional settings, people who live alone or who have a history of abuse or a disordered family situation, patients being treated with methadone, [ 16 ] and patients who are facing stresses such as examinations or testifying in court.
All of the above is easier said than done, given the increasing time pressures and devaluation of time spent with patients on the part of many managed-care reimbursement schemes. Careful consideration is likewise needed when performing forensic psychiatric evaluations, such as employment evaluations, including applications of the Americans with Disabilities Act ADA[ 18 ] and mental-state evaluations in criminal cases, where the question of diminished capacity resulting from benzodiazepine use or dependency may arise in the determination of competency to stand trial, in the determination of criminal responsibility at trial, or as a mitigating factor in sentencing.
By getting to know the patient over a period of time, the physician can prescribe with a deeper understanding and greater confidence that the patient will work out any resulting problems within rather than outside the alliance.
Managed health care, by putting a premium on short hospital stays, short-term therapies, and the fifteen-minute psychopharmacological or internist patient visit, often precludes long-term alliance building.
Physicians feel compelled not only to prescribe benzodiazepines without adequate knowledge of the patient, but even to use these drugs as substitutes for listening to and talking with patients. Under these conditions, it is sometimes appropriate to build an alliance around the physician's role of advocating for the patient's health-care needs.
On the other hand, this strategy may risk increasing dependency on a therapist who begins to be seen as an omnipotent advocate.A fortnightly summary of HIV research news.
HIV treatment is not a cure, but it is keeping millions of people well. Start learning about it in this section. Just diagnosed In this section we have answered some of the questions you might have if you have just found out you have HIV.
Intention is one of the main forms of mens rea. In almost all criminal offences, the mens rea required is that of intention to cause prohibited result. Murder requires as its mental element intention to kill or cause grievous bodily harm.
Ethical and Legal Dimensions of Benzodiazepine Prescription. by Harold J.
Bursztajn, M.D. and Archie Brodsky, B.A. From the Department of Psychiatry, Harvard Medical. What do great men like Benjamin Franklin, Thomas Jefferson, and Theodore Roosevelt all have in common? They all were proficient in Latin. From the Middle Ages until about the middle of the 20th century, Latin was a central part of a man’s schooling in the West.
The level of mens rea required varies for different crimes, to find the mens rea one must look at the specific definition of a crime. For the purpose of this essay I will first look at Intention and Recklessness and then compare the two as fault terms governing criminal liability.
Mens rea means 'guilty mind ' and refers to the intention element of a crime. It is the state of mind expressly or implicitly required by the definition of the offence charged. It can also be described as the required blameworthy state of mind of the defendant at the time that the actus reus was caused.