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Practical aspects of clinical risk assessment and management

Published online by Cambridge University Press:  06 August 2018

Peter Snowden*
Affiliation:
Prestwich Hospital, Bury New Road, Prestwich, Manchester M25 7BL

Extract

It is debatable whether the notion of dangerousness now has any utilitarian value for psychiatry. The presence or absence of dangerousness is very much in the eye of the beholder. It is an all or nothing term – you either have it or you do not! While there is usually little disagreement about the few very violent individuals “who, for 24 hours a day, and in any situation, are likely to cause harm to others” (Chiswick, 1995), most patients are not in this category and “little bit dangerous” is unlikely to be of much comfort to clinical staff. It is unhelpful to deny that dangerousness is any more than an adjective which has been elevated into a pseudoscientific construct whose definitions (Scott, 1977; Walker, 1978; Home Office & DHSS, 1975) amount to little more than “past harm predicts future behaviour”.

Type
Research Article
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

Chiswick, D. (1995) Dangerousness. In Seminars in Practical Forensic Psychiatry (eds D. Chiswick & R. Cope), pp. 210242. London: Gaskell.Google Scholar
Gunn, J. (1994) Dangerousness. In Forensic Psychiatry: Clinical Legal and Ethical Issues (eds J. Gunn & P. J. Taylor), pp. 624645. Oxford: Butter worth-Heinemann.Google Scholar
Home Office & Department of Health and Social Security (1975) Report of the Committee on Mentally Abnormal Offenders (Butler Report). Cmnd 6344. London: HMSO.Google Scholar
Lancet (1990) Taking risks in general practice. Editorial. Lancet, ii, 541.Google Scholar
Lindgren, O. (1992) Clinical risk management in the health service: a valuable tool for doctors and managers. The Clinician in Management, 1, 68.Google Scholar
McIntyre, N. & Popper, K. (1983) The critical attitude in medicine: the need for a new ethics. British Medical Journal, 287, 19191923.Google Scholar
Mathews, R. (1992) Healthcare risk management in dental practice. Healthcare Risk Management Bulletin, 4, 78.Google Scholar
Monahan, J. (1993) Limiting therapist exposure to Tarassof liability: guidelines for risk containment. American Psychologist, 48, 242250.Google Scholar
North East Thames and South East Thames Regional Health Authorities (1994) Report of the Inquiry into the Care and Treatment of Christopher Clunis. London: HMSO.Google Scholar
Roberts, G. (1992) Planned risk management and patient care. Healthcare Risk Management Bulletin, 4, 57.Google Scholar
Scott, P. (1977) Assessing dangerousness in criminals. British Journal of Psychiatry, 131, 127142.Google Scholar
Snowden, P. (1977) Risk taking. Journal of Forensic Psychiatry, 4, 198200.CrossRefGoogle Scholar
Walker, N. (1978) Dangerous people. International Journal of Law and Psychiatry, 11, 3750.Google Scholar
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