Developing a Forensic Practice

Expert Witness Report.

2007

The Bulletin of the American Academy of Psychiatry and the Law

The implications of the definition of forensic psychiatry are explored, with particular reference to the field as a subspecialty of general psychiatry. The allegation of undue moral uncertainty in forensic psychiatry is denied and the moral issues are revealed to be related to the status of the underlying philosophical disputes. An outline for the organization of the forensic psychiatric assessment is presented. The charge that forensic psychiatry is not as "hard" a science as the other forensic sciences is denied. The administrative and political organizational problems facing the subspecialty are explored. The practitioners in the field are encouraged to recognize that forensic psychiatry is a subspecialty and to work for official subspecialty status. Cautious predictions about the future of the field are provided.

The journal of the American Academy of Psychiatry and the Law, 2013

Ethics-related dilemmas arise in forensic psychiatry as in all psychiatric practice. Although most can be resolved by following the AAPL Ethics Guidelines and the AAPL Ethics Questions and Answers, the more complex ones inevitably have no easy solutions. Ethics-based duties can conflict without clear guidance on prioritization. Weighing competing factors necessitates more than merely following a rule, since there are potentially conflicting rules, and ethical practitioners may prioritize them differently. Concerns pertaining to the death penalty and defendants who are victims of discrimination are especially difficult. Such considerations usually are in the realm of aspirational ethics, with conclusions open to debate. They need consideration by most practitioners concerned with determining the most ethical course of action. Much as it is insufficient for an ethical citizen merely to avoid breaking the law, it is not enough to avoid violating any one guideline while remaining blind ...

2006

While general clinicians still conduct most forensic assessments, none of the previously published textbooks targets them. In the Preface, the editors of The American Psychiatric Publishing Textbook of Forensic Psychiatry: The Clinician's Guide acknowledge that their main goal is to create a forensic textbook primarily for the general clinician. The textbook is designed to educate the reader in forensic subjects so that the reader becomes comfortable in case he or she has to "discharge forensic obligations." The book includes 23 chapters with practice guidelines and suggested reading material. Recognized authorities in the field of forensic psychiatry contribute to the text, making it valuable to forensic specialists as well. Chapter 1, "Rediscovering Forensic Psychiatry," by Liza H. Gold, MD, is an overview of the history of forensic psychiatry, the first true subspecialty of medicine. It contains interesting reading about "mad doctors," in charge of "asylums for lunatics." The author describes social, scientific, and cultural dynamics of the English and American society of the 18th and 19th centuries. It includes the first cases that involved the use of the insanity defense and testimony by medical professionals as expert witnesses. The chapter also provides historical facts that are not only fascinating to anyone who has an interest in the field, but also show important historical links with the past. This chapter clarifies how precedents of significant importance, such as James Hadfield's attempt to assassinate King George III in 1800, found its way into today's landmark cases. Not surprisingly, the challenges that psychiatrists of the past experienced remain valid today. Chapter 2, "Introduction to the Legal System" was written by Daniel W. Shuman, JD, and outlines the different roles psychiatrists play in clinical prac

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International Journal of Law and Psychiatry, 2010

This paper examined quality of forensic reports submitted to the Hawaii Judiciary. Hawaii utilizes a three panel system for assessing fitness to proceed, where two psychologists and one psychiatrist submit independent reports to the Court. Utilizing a survey instrument based on previous research and nationallyderived quality standards, 150 competency to stand trial (CST) reports were examined. Reports demonstrated pervasive mediocrity with respect to quality (Mean QC = 68.95, SD = 15.21). One quarter (N = 38) of the reports scored at or above 80% of the maximum possible score. Levels of CST agreement between evaluators and evaluators and judges were high. Report quality did not differ as a function of evaluator professional identity. Full-time employed evaluators submitted a greater number of reports above the quality criterion. For those evaluators who attended the March training, reports demonstrated significantly improved quality. Suggestions for enhancing report quality are offered with a special attention to inclusion of report elements, focus on inclusion of historical elements, and clearly described rationales supporting forensic opinions. (7664 words. Competency to stand trial, inter-rater agreement).

The journal of the American Academy of Psychiatry and the Law, 2014

Psychiatrists who publish case reports are required to seek informed consent from their subjects on the basis of the ethics-related obligation to maintain patient confidentiality. Academic journals have developed editorial standards to fulfill this obligation. Forensic evaluations do not create a doctor-patient relationship in the traditional sense, and information obtained through a forensic evaluation may also be found in the public domain. This public exposure is particularly likely, given the development of open access publishing standards, online journals, and increasing professional involvement in social media. This article outlines the ethics of informed consent in published case reports for general and forensic psychiatry and offers recommendations for forensic case study publishing. The authors suggest changes in the current requirements stated in The Journal for publication of case reports.

Traditional report formats commonly employed to summarize forensic mental health evaluations pose several limitations, including that they implicitly encourage inclusion of irrelevant data and only data that are consistent with one's opinions and discourage writers from explicitly distinguishing between case data, their inferences, and their reasoning. To remedy these issues, we propose a relevancy-focused (RF) report format, which is a findings-based report style developed specifically for use when summarizing results of forensic psychological evaluations. We describe a practical guide to the critical thinking and rhetorical writing embodied in the RF. Public Significance Statement Forensic psychological evaluations play a key role in civil and criminal litigation, as do the reports that summarize them. Reports must accurately and efficiently communicate the assessment process, the data gathered, and the examiner's opinions and underlying reasoning. Described in this article is a structure for forensic report writing that was designed specifically with these important obligations in mind.

Journal of Forensic and Legal Medicine, 2014

When assisting the courts in criminal proceedings, the work of forensic physicians are leaning more towards the preparation of written evidence rather than the giving of oral evidence in person. For this, they may be asked to serve either as professional witnesses or expert witnesses. These 2 roles have nevertheless been a constant source of confusion among forensic physicians. In view of this, the article aims to highlight the similarities and differences between these 2 roles particularly in relation to the preparation of written evidence. It will take a close look at the forms of written evidence which forensic physicians are expected to produce in those distinct capacities and the attending duties, evidentiary rules and legal liabilities. Through this, the work aspires to assist forensic physicians undertake those responsibilities on a more informed footing.