Forensic psychiatrists are often sought by the court of law to provide professional opinion on specific legal matters that have a major impact on the evaluee and possibly society at large. The quality of that opinion and recommendations rely on the quality of the analysis from the assessment results conducted by the psychiatrist. However, the definition and scope of a forensic psychiatric analysis is not clear. While existing literature on forensic psychiatric analysis generally includes organizing information, identifying relevant details, and formulating a set of forensic psychiatric opinions as components, there is no explicit and unified definition of these terms and process. This lack of clarity and guidelines may hinder forensic psychiatry from achieving its goal of providing objective information to the court or other relevant parties. Forensic psychiatric analysis exhibits numerous parallels to clinical reasoning in other fields of medicine. Therefore, this review aims to elaborate forensic psychiatric analysis through the lens of clinical reasoning, which has been developed by incorporating advances in cognitive sciences. We describe forensic psychiatric analysis through three prominent clinical reasoning theories: hypothetico-deductive model, illness script theory, and dual process theory. We expand those theories to elucidate how forensic psychiatrists use clinical reasoning not only to diagnose mental disorders, but also to determine mental capacities as requested by law. Cognitive biases are also described as potential threat to the accuracy of the assessment and analysis. Additionally, situated cognition theory helps elucidate how contextual factors influence risk of errors. Understanding the processes involved in forensic psychiatric analysis and their pitfalls can assist forensic psychiatrists to be aware of and try to mitigate their bias. Debiasing strategies that have been implemented in other fields of medicine to mitigate errors in clinical reasoning can be adapted for forensic psychiatry. This may also shape the training program of general psychiatrists and forensic psychiatrists alike.
The history of smallpox outbreaks had spawned new era in preventing infectious diseases. In the 19 th century, the terms vaccine and vaccination were introduced. Steadily, vaccination became increasingly popular due to its ability to eradicate smallpox and control other infectious diseases. However, the development of vaccines does not always get positive responses. In the midst of society, vocal antivaccination movement was born, voicing dangers of vaccination. Doctors as front-liners in the field of health as well as responsibility bearers of patients play important role to educate patients while avoid involvement with antivaccination propaganda.Kampanye Anti-Vaksin oleh Seorang Dokter, Apakah Melanggar Etik?Abstrak Sejarah terjadinya wabah cacar telah melahirkan era baru dalam upaya pencegahan penyakit infeksi. Pada abad ke-19 mulai diperkenalkan terminologi vaksin dan vaksinasi. Lambat laun, vaksinasi kian populer karena mampu mengeradikasi penyakit cacar dan mampu mengontrol penyakit infeksi lainnya. Namun, perkembangan vaksin tidak serta merta mendapat tanggapan positif. Di tengah masyarakat lahirlah gerakan antivaksinasi yang vokal menyuarakan bahaya dari vaksinasi. Dokter sebagai garda terdepan di bidang kesehatan sekaligus penanggung jawab pasien memegang peran penting untuk mencerdaskan dan tidak terlibat dalam pusaran propaganda antivaksinasi.Vaksin secara biologi merupakan suatu bibit penyakit (virus) yang dilemahkan untuk kemudian menghasilkan kekebalan aktif saat dimasukkan ke dalam tubuh manusia. Vaksin dengan segala kemampuannya untuk mencegah morbiditas dan mortalitas terhadap penyakit infeksi merupakan pencapaian terbesar di bidang kesehatan masyarakat. Perkembangan vaksin tidak serta merta mulus begitu saja. Di saat vaksin semakin populer, maka lahirlah komunitas dan pemahaman yang menolaknya, yaitu kaum antivaksin. Di internet, gerakan antivaksinasi/ imunisasi dalam bentuk apapun cukup mendapat banyak perhatian.3 Banyak peneliti menilai bahwa gerakan baru ini muncul saat vaksinasi cacar mulai diperkenalkan dan terus berlanjut hingga saat ini.3 Metode penyebaran informasinya sudah berubah sejak abad ke-19, namun isu-isu yang disebarkan oleh komunitas antivaksinasi masih mirip hingga sekarang. 3Bila ditelusuri, jumlah situs internet yang membahas antivaksinasi akan jauh lebih banyak daripada situs yang mempromosikan vaksinasi. Kebanyakan kontennya pun mirip, disalin-ulang dari satu situs ke situs lainnya.4 Artikel-artikel itu ditulis seakan-akan memang berdasarkan bukti (evidence based medicine) karena menampilkan nama-nama pakar dengan data dan angka yang sangat meyakinkan. 4 Seiring berjalannya waktu, gerakan antivaksin tidak hanya ramai di internet, tapi hingga diadakannya seminar-seminar di PENDAHULUAN 1
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