This is a decision of the French Cour de cassation of October 22, 2019, but whose reasoning could perfectly well be applied to Swiss law.
In 2008, a schizophrenic in a psychiatric hospital obtained permission to go out in the hospital grounds. He uses the opportunity to escape, then buys himself a knife with which he then stabs a young man to death.
Deemed irresponsible, the schizophrenic will not be punished. It’s hard to stop there for the victim’s loved ones. There must be someone responsible, someone to blame, in other words someone who has committed a fault and must be punished.
The person responsible will therefore be the psychiatrist who was treating the schizophrenic and who – wrongly – let him go out into the park unsupervised. The psychiatrist will therefore be prosecuted for involuntary manslaughter, the equivalent of negligent homicide under Swiss law (art. 117 CP), and convicted.
The psychiatrist appealed against the Court of Appeal’s 18-month suspended prison sentence (equivalent to a criminal appeal to the Federal Court under Swiss law). The French Supreme Court rejected his appeal and upheld the conviction.
In essence, according to media reports on the French Court of Cassation’s decision:
“(The psychiatrist) committed characterized fault consisting of having refrained, prior to any decision relating to the implementation or maintenance of an unsupervised exit permit (…) in the unenclosed grounds of the establishment, fromdeepening the patient journeyof take a psychiatric history and carry out one or more in-depth examinations “.
To uphold the psychiatrist’s criminal guilt, the Cour de cassation also considered that there was a causal link between the doctor’s fault and the homicide.
We will publish the Cour de cassation ruling as soon as it is available online, as this issue is not limited to French law.
At this stage, however, we can already wonder about the consequences of such a decision on the practice of psychiatrists confronted with schizophrenic patients in particular. In all likelihood – and this is perfectly understandable – few will be prepared to assume criminal responsibility for offences committed by their patients. The natural tendency, therefore, should be towards a quest for zero risk (for the community, of course, but also for psychiatrists from now on), which will inevitably be to the detriment of patients and their rights.
Indeed, insofar as it exists, what is zero risk in psychiatry? Confinement, massive medication, …
Any other ideas?
