Alkol kullanımı ile ilişkili psikiyatrik bozukluklarda ceza sorumluluğunun belirlenmesine yönelik uygulamalar

Öz

Tarih boyunca sosyal ve tıbbi amaçlarla kullanılagelen en yaygın psikoaktif maddelerden biri olan alkol, tüketim tarzındaki kontrolsüzlük ve aşırılık nedeniyle insanların beden ve ruh sağlıklarını olumsuz etkilemenin yanı sıra sosyal ve adli açıdan da pek çok probleme yol açmaktadır. Suç davranışına zemin hazırladığı bilinen alkol kullanımının, alkole bağlı ortaya çıkan ruhsal ve davranışsal klinik tabloların ve bunlarla ilişkili yasal durumların değerlendirilmesinde psikiyatristler önemli ve kaçınılmaz bir rol üstlenmektedir. Psikiyatristlerin bilirkişi olarak yoğunlukla görev aldığı ceza hukuku kapsamındaki ceza sorumluluğunun tespitine yönelik olarak, sanığın davranışlarını yönlendirebilme ve yargılama yetilerini etkileyen, alkol kullanımı ile ilişkili ruhsal ve davranışsal patolojilerin var olup olmadığına dair bilirkişi görüşü adli makamlarca sıkça talep edilmektedir. Bu bağlamda, genel geçer adli psikiyatri ilkelerine göre, yol açtığı klinik tablo ne olursa olsun, istemli olarak kullanılan alkolün etkisiyle işlenen suçlarda kişinin gerçekleştirdiği eylemden sorumluluğu tam kabul edilir. Pek çok ülkenin ceza hukuku sistemi bu görüşü benimsemekle birlikte Anglo-Amerikan ceza hukukunda durumsal istisnaların varlığı da gösterilmiştir. Alkolün istem dışı olarak alınması veya kullanımına bağlı kalıcı ve geri dönüşümsüz bir ruhsal bozukluğun varlığı halinde ise sanığın ceza sorumluluğunu azaltıcı veya kaldırıcı etki söz konusu olmaktadır. Ulusal ve uluslararası literatürden ve kanıta dayalı olarak hazırlanmış adli psikiyatri ve ceza hukuku kitaplarından yararlanılarak hazırlanan bu derleme metninde psikiyatrik yönleriyle alkol kullanım bozuklukları, alkol ve suç ilişkisi, ceza sorumluluğu tespitine yönelik uygulamaların gelişimi ve genel ilkeleri, ceza sorumluluğuna etkisi olduğu tartışılan ve kabul edilen alkol kullanımı ile ilişkili klinik durumlar sunularak tartışılmış olup vaka örnekleri ile pekiştirilmiştir. Yazımızın ulaşmayı amaçladığı ana fikir ise hangi klinik tabloya yol açarsa açsın, diğer tüm ruhsal bozukluklarda olduğu gibi alkol ile ilişkili klinik durumlarda da suça, hastalığa ve olguya özgü şekilde ceza sorumluluğu değerlendirmesinin uygulanması gerektiğidir.

Anahtar Kelimeler

• Alkol kullanım bozuklukları, ceza sorumluluğu, intoksikasyon

Implementations for assessing criminal responsibility in psychiatric disorders related to alcohol use

Öz

Although alcohol is one of the most commonly used psychoactive substances for its recreative and medical aspects throughout the history, uncontrolled and excessive consumption leads to poor physical and mental health conditions. Furthermore, unfavorable consequences constantly arise on both social and legal issues. Alcohol use is a well-known trigger for criminal behavior; therefore, psychiatrists inevitably bear pivotal role in both clinical and forensic assessments of mental and behavioral conditions related to alcohol use. In the context of criminal law, psychiatrists as experts are frequently requested by judicial authorities to evaluate the presence of alcohol-associated mental and behavioral disturbances affecting the suspects’ capacity of judgment and controlling their own actions in order to determine criminal responsibility. In this regard, universal principals of forensic psychiatry warrants to defendant’s full criminal responsibility in the offenses that are committed under the influence of voluntary alcohol intake. Most of the criminal law systems in different countries adopt the afore-mentioned notion, however Anglo-American criminal law demonstrates several conditional exceptions in legal settings. On the other hand, involuntary use of alcohol or presence of alcohol-related permanent or irreversible mental disorders are widely accepted as mitigating or removing conditions on culpability. Inspired by both national and international literature, evidence-based textbooks of forensic psychiatry and criminal law, this review article is presented in the light of conventional wisdom and up-to-date knowledge. The aim of this article is to discuss and reflect different perspectives regarding alcohol use disorders, alcohol-crime relationship, evolution and general principals of criminal responsibility and finally, contradictive and recognized influences of alcohol-related clinical conditions on criminal responsibility supported with case illustrations. The ultimate keynote; this article is intended to provide the readers with the necessity of case-based approach in alcohol-related mental disorders for the assessment of criminal responsibility in forensic settings as it should be in any psychiatric case.

Anahtar Kelimeler

• Alcohol use disorders, criminal responsibility, intoxication

Kaynakça

1. Uluğ B, Öztürk MO. Mental Disorders Due to Psychoactive Sub- stance Use. In: Öztürk MO, Uluşahin A, eds. Mental Health and Disorders 13th Edition [In Turkish]. Ankara: Nobel, 2015: 511–55.
2. Tosun M, Çetin A, N K. Forensic Psychiatric Aspects of Alcohol and Substance Dependence [in Turkish]. Turkiye Klin J Psychia- try-Special Top 2011;4 1 :81–90.
3. Connor JP, Haber PS, Hall WD. Alcohol use disorders. Lancet ;387:988-98.
4. World Health Organization. Global status report on alcohol and health 2014. Available at: http://www.who.int/substance_abuse/ publications/global_alcohol_report/en/. cited: 10 April 2017 .
5. O’Brien CP, Crowley TJ. Substance-Related and Addictive Dis- orders. In: American Psychiatric Association, ed. Diagnostic and Statistical Manual of Mental Disorders DSM 5th Edition. Wash- ington DC: American Psychiatric Association, 2013:481–590.
6. Golonka AD. Effects of alcohol on the offender’s sanity-Issues of criminal law and psychiatry in light of findings of research. Int J Law Psychiatry 2016;46:68-73.
7. Slovenko R. Psychiatry in Law / Law in Psychiatry 2nd Edition. London: Routledge, 2009: p.198-199.
8. Gunn J, Taylor PJ. Forensic Psychiatry: Clinial, Legal and Ethical Issues 2nd Edition. New York: CRC Press, 2014: p.34-444.

9. Balcıoğlu İ, Çitken A, Doksat MK. Legal Aspect of Substance Dependence [in Turkish]. NYS 2008;46 1 :3-8.
10. Beckson M, Bartzokis G, Weinstock R. Substance Abuse and Addiction. In: Principles and Practice of Forensic Psychiatry 2nd Edition. London: Arnold Press, 2003:672-83.
11. Haggård-Grann U, Hallqvist J, Långström N, Möller J. The role of alcohol and drugs in triggering criminal violence: A case- crossover study. Addiction 2006;101 1 :100-8.
12. McClelland GM, Teplin LA. Alcohol intoxication and vio- lent crime: Implications for public health policy. Am J Addict ;10 suppl :70-85.
13. Fergusson DM, Lynskey MT, Horwood LJ. Alcohol misuse and juvenile offending in adolescence. Addiction 1996;91 4 :483-94.
14. Evans JR, Schreiber Compo N, Russano MB. Intoxicated wit- nesses and suspects: Procedures and prevalence according to law enforcement. Psychol Public Policy, Law 2009;15 3 :194-221.
15. Karasov AO, Ostacher MJ. Alcohol and the law. Handb Clin Neurol 2014;125:649–57.
16. Resnick PJ, Noffsinger S. Competency to Stand Trial and the Insanity Defense. In: Simon RI, Gold LH, eds. The American Psy- chiatric Publishing Textbook of Forensic Psychiatry. Washington DC: American Psychiatric Publishing, 2004: 329-47.
17. Sadock BJ, Sadock VA, Ruiz P. Forensic Psychiatry and Ethics in Psychiatry. In: Sadock BJ, Sadock VA, Ruiz P, eds. Kaplan & Sa- dock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psy- chiatry 11th Edition. Philedelphia: Wolters Kluwer, 2015: 1381-99.
18. Schouten R, Brendel RW. The Role of Psychiatrists in the Criminal Justice System. In: Stern TA, Fava M, Wilens TE, Rosen- baum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry 2nd Edition. London: Elsevier, 2016: 921–8.
19. Cin H, Akgündüz A. History of Turkish Law [in Turkish]. İstanbul: Ottoman Research Foundation, 2011: p.71-75.
20. Aydın MA. History of Turkish Law 10th Edition [in Turkish]. İstanbul: Beta, 2013: p.175.
21. Kocar Y. Culpability, the grounds of elimination or mitigation of the culpability Unpublished Thesis [in Turkish]. Institute of So- cial Sciences, Ankara University, 2007.
22. Demirbaş T. Penal Code General Provisions 4th Edition [In Turkish]. Ankara: Seckin Publishing, 2006: p.332-3.
23. Demirel ÖF, Balcıoğlu İ. Criminal liability and legal capac- ity of alcohol and substance dependence [in Turkish]. NYS ;53 1 :27-33. Clark K, Rooprai DS. Practical Forensic Psychiatry. London: Hodder Arnold, 2011: p.262-3.
24. Morse SJ. Good Enough Reason: Addiction, Agency and Crimi- nal Responsibility. Faculty Scholarship Unpublished Thesis . Law School, University of Pennsylvania, Pennsylvania, 2013.
25. Puri BK, Brown RA, McKee HJ, Treasaden IH. Mental Health Law: A Practical Guide 2nd Edition. London: Hodder Arnold, 2012: p.88-9.
26. Watterson RT. Just say no to the charges against you: alcohol intoxication, mental capacity, and criminal responsibility. Bull Am Acad Psychiatry Law 1991;19 3 :277–90.
27. Marlowe DB, Lambert JB, Thompson RG. Voluntary intoxica- tion and criminal responsibility. Vol. 17, Behavioral Sciences and the Law. 1999: 195–217.
28. Stone JH, Roberts M, O’Grady J, Taylor A V, O’Shea K. Faulk’s Basic Forensic Psychiatry 3rd Edition. Oxford: Blackwell Science, : p.177-180.
29. Tiffany LP, Tiffany M. Nosologic objections to the criminal de- fense of pathological intoxication: What do the doubters doubt? Int J Law Psychiatry 1990;13 1–2 :49-75.
30. Parwatikar SD, Holcomb WR, Menninger KA. The detection of malingered amnesia in accused murderers. Bull Am Acad Psy- chiatry Law 1985;13 1 :97-103.
31. Pressman MR, Caudill DS. Alcohol-induced blackout as a criminal defense or mitigating factor: An evidence-based re- view and admissibility as scientific evidence. J Forensic Sci ;58 4 :932-40.
32. Cima M, Nijman H, Merckelbach H, Kremer K, Hollnack S. Claims of crime-related amnesia in forensic patients. Int J Law Psychiatry 2004;27 3 :215-21.
33. Van Oorsouw K, Merckelbach H, Ravelli D, Nijman H, Mekking- Pompen I. Alcoholic blackout for criminally relevant behavior. J Am Acad Psychiatry Law 2004;32 4 :364-70.
34. Goodwin DW. Alcohol amnesia. Addiction 1995;90 3 :315–7.
35. Perry PJ, Argo TR, Barnett MJ, Liesveld JL, Liskow B, Hernan JM, Trnka MG, Brabson MA. The association of alcohol-induced blackouts and grayouts to blood alcohol concentrations. J Foren- sic Sci 2006;51 4 :896-9.
36. Merikangas J. Commentary: Alcoholic blackout--does it re- move mens rea? J Am Acad Psychiatry Law 2004;32 4 :375-7.
37. Sweeney DF, Liston RA. The alcohol blackout. Santa Barbara: Mnemosyne Press, 2003: p.190.
38. McClary DC. Police arrest Conner M. Schierman for the mur- der of two women and two children in Kirkland on July 17, 2006. Available at: http://www.historylink.org/File/10070. cited 14 April 2017 .
39. Öncü F, Sercan M. Assessment of Criminal Responsibility. In: Uygur N, ed. Forensic Psychiatry Practical Guide 2nd Edition, Psy- chiatric Association of Turkey [in Turkish]. Ankara: Pelin, 2014: 72.
40. Sadock BJ, Sadock VA, Ruiz P. Substance Use and Addictive Disorders. In: Sadock BJ, Sadock VA, Ruiz P, eds. Kaplan & Sa- dock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psy- chiatry 11th Edition. Philedelphia: Wolters Kluwer, 2015: 616-93.
41. Musalek M, Scheibenbogen O, Schuster A. Alcohol-Induced Psychotic Disorders. In: Stanghellini G, Aragona M, eds. An Expe- riential Approach to Psychopathology. Berlin: Springer Interna- tional Publishing, 2016: 149-61.