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PubMed2006

Meadow, Southall, and the General Medical Council of the United kingdom.

In this article we address the recent actions of the General Medical Council in the United Kingdom affecting 2 pediatricians who are major contributors to pediatric knowledge about the intentional suffocation of infants. The General Medical Council struck one of them from the register of licensed medical practitioners, but the decision was appealed successfully. The council restricted the practice of the other pediatrician. After a review of the transcripts of the hearings, we conclude that the opinions given by both doctors were responsible, and the transcripts suggest that the conduct of the hearings was unfair. Licensing boards may have difficulty in competently regulating doctors' expert testimony, at least in cases involving child maltreatment.

Child Abuse↗
PubMed1992

Professional versus personal ethics: methods for system reform?

It has been suggested that changes in, and more vigorous enforcement of, professional ethical codes might lead to significant improvements in the quality of expert testimony by mental health professionals. The author examines the arguments for and against this thesis, and concludes that lack of consensus on controversial issues is likely to impede implementation and enforcement of meaningful ethical codes. He argues that attempts to educate the courts and legislatures through writings, testimony, and interdisciplinary teaching are more likely to be effective for the foreseeable future.

Dangerous Behavior↗
PubMed1977

[Early diagnosis of cardiac insufficiency in patients with ischemic heart disease and hypertension in medical jurisprudence].

Results of a study into the myocardium function in 440 patients with ischemic heart and hypertensive diseases are presented. In the study poly-kineto-apex-cardiography, rheography of the aorta and lungs, ultrasonic cardiography at rest in 123 of 440 patients were used after veloergometric loading. The application of the mentioned methods in conjunction with the veloergometric test helped diagnose a latent cardiac insufficiency that proved most frequent among patients with myocardial infarction in their past history (84.5%) and among those suffering from hypertensive disease with prevalence of the cardiac syndrome. An inference is drawn on the need for a complex investigation of patients at the clinic and especially in the practice of the medical expert testimony on the work capacity.

Adult↗
PubMed1994

Scientists in the courtroom: basic pointers for the expert scientific witness.

The need for expert and unbiased participation in legal proceedings by physicians, industrial hygienists, toxicologists, environmental scientists, regulators, and similar professionals is hampered by lack of familiarity with the requirements of expert testimony and lack of opportunities for professional training in this activity. Drawing on material developed in a continuing education course offered by the University of Washington, we describe the role and process of being an expert witness and provide basic information regarding good professional practices pertaining to the testifying expert role.

Ethics, Professional↗
PubMed1995

The admissibility of hypnotic evidence in U.S. Courts.

For the past two decades, the American judiciary has confronted the admissibility of hypnotic evidence in criminal prosecutions. These courts have uniformly rejected the admissibility of out-of-court statements made while an individual is in hypnosis. In contrast, the courts divided sharply over the admissibility of hypnotically refreshed testimony. Some courts adopted a per se rule of exclusion; these courts, however, also carved out exceptions for testimony based on prehypnotic memory and testimony of the accused. Courts admitting hypnotically refreshed testimony adopted three different positions: (a) a "credibility" approach, which left the reliability issue to the jury; (b) a "discretionary admission" approach, which left the reliability issue to the trial judge; and (c) a "procedural safeguards" approach. In addition, constitutional concerns played an influential role in some of these cases. This diversity in the case law often resulted from a judicial failure to understand the scientific research on hypnosis. Courts have also considered the use of hypnosis as a basis for expert testimony about an accused's mental state. Unless the advantages of hypnotically refreshed testimony are significant, why add more problems?

Criminal Law↗
PubMed1996

[Medical expert assessment in the Anglo-American lawsuit].

The expert testimony in the common law countries is fundamentally different from the one in the continental European countries. According to the anglo-american law, both parties present the evidence to the court. Witnesses are examined and cross-examined. Most important, the expert is not appointed by the court or a helper of the court, but the expert is an expert witness. He is presented by one of the parties, examined and cross examined. Because some of the expert witnesses may be biased, there can be a war of experts.

Clinical Competence↗
PubMed1993

The biases of child sexual abuse experts: believing is seeing.

Experts in clinical evaluations of child sexual abuse were studied using a paradigm that requested them to estimate the likelihood of a 3-year-old child having been sexually molested by her father, as alleged by her mother, when she was two years old. All of the experts claimed special qualifications and experience in the field of diagnosing and treating child sexual abuse victims. Expert-respondents provided two estimates of the likelihood that the child had been molested, the first following a detailed presentation of the clinical case by the actual evaluator of the child (the presentation included opportunities to ask questions ad libitum beyond the presentation material), the second following an extensive discussion of the clinical material with other child experts present. The range of estimated likelihoods that the child had been molested was extreme among the expert respondents. The clinical conference format that was used seemed to provide the experts with no apparent means for eliminating or reducing differences in their clinical opinions. Recommendations concerning how the supervising court should regulate further child-father contacts were similarly varied. The implications of these findings for judicial acceptance of expert testimony in cases of alleged child sexual abuse are discussed.

Adult↗
PubMed2005

Do jurors "know" what isn't so about child witnesses?

Are expert witnesses needed in child sexual abuse cases to educate jurors about children's memory, suggestibility, and reactions to abuse, or do jurors already know what such experts could tell them? To cast light on this question, we surveyed jurors and jury-eligible college students and compared their beliefs with what is known via scientific research regarding children's memory and ability to testify, reactions to interrogation, and reactions to sexual abuse. We also asked participants to infer results of four widely cited studies of children's suggestibility. Participants' beliefs were consistent with findings from research on some issues (e.g., that children can be led to claim that false events occurred) but diverged from the scientific consensus on other issues (e.g., whether children can remember painful events in infancy). Similarly, participants sometimes overestimated and sometimes underestimated the level of suggestibility observed in empirical studies. Individual differences in accuracy were related to participants' gender, education and ethnicity, and there was considerable disagreement among participants on many questions. Implications of findings for the admissibility of expert testimony in child abuse cases are discussed.

Adult↗
PubMed1991

The role of the psychiatrist in dangerous offender hearings.

The current Canadian legislation regarding dangerous offenders is reviewed, with specific emphasis on the role of the required psychiatric testimony. It is suggested that, although this legislation as it is currently formulated could be viewed as an attempt to broaden the insanity defence, and permit the diversion of mentally ill offenders from a punitive to a therapeutic milieu, it enables the preventive detention of recidivist offenders. Some fundamental ethical issues which follow from this are identified, together with the issues which have dominated expert testimony in hearings held in British Columbia during the past 13 years.

Antisocial Personality Disorder↗
PubMed1994

Posttraumatic stress disorder among battered women: analysis of legal implications.

The diagnosis of posttraumatic stress disorder (PTSD) has recently been applied to the psychological experiences of victims of intimate violence, including physical and sexual assault. The use of trauma theory to explain battered women's responses to violence has laid a foundation for expert testimony on PTSD, where relevant, within more general testimony concerning partner violence. This article discusses the relevance of the PTSD diagnosis within the legal context for explaining battered women's responses to violence.

Battered Women↗
PubMed2006

Gender differences in attitudes toward psychopathic sexual offenders.

Although a considerable amount of research has been conducted examining the validity of psychopathy as a psychological construct, relatively few studies have focused on the effects of using this disorder in "real-world" settings to influence the attitudes of laypersons who are making life-altering decisions about offenders. This study attempted to replicate and extend earlier findings (Guy & Edens, 2003) suggesting that there are gender differences in the impact of expert testimony regarding psychopathy. A sample of 599 undergraduates reviewed case facts regarding a hypothetical Sexually Violent Predator trial in which the type of risk assessment testimony provided (clinical opinion, actuarial scale, psychopathy evaluation) and the age of the victims (adult versus child) were manipulated. Consistent with prior research, despite overall high rates of support for commitment in the adult victim condition, men were less prone than women to support civil commitment when the defendant was described as "a psychopath" (62.5 versus 86.5%). No such gender differences were noted in the clinical opinion or actuarial conditions. When the victims were identified as children, type of testimony had no impact because support for commitment was almost unilateral. Finally, ratings of how psychopathic the defendant was perceived to be (regardless of the testimony provided) were significantly associated with support for commitment across most conditions.

Adolescent↗
PubMed1994

[Neurologic-psychiatric expert assessment in 1989 to 1991 social law].

With 100 Social Court proceedings instituted in Germany (according to the territory of 1989), there could be shown the law-suits not being based on substantial arguments in two thirds and, therefore not having chances of success in foro. Among medical expert testimonies concerning with psychiatric matters female plaintiffs predominated; in contrast, neurologic testimonies were predominantly requested for males. The proportion of foreigners amounted to 5-15% depending from the matter on which testimony was requested. Mean age of the plaintiffs was approximately 50 years, they had been retired from business life on an average of 3 years before. Two thirds of the plaintiffs briefed an attorney or a representation of interests for instituting legal proceedings; the latter did not result in charges to the plaintiffs. Medical examinations to elaborate the testimony included tests employing technical measures such as neuroimaging in about one third of the cases. Relating to the latter, there is an increasing tendency obviously.

Adult↗
PubMed2002

[Continuous mental disorder as a prerequisite for the loss of legal capacity].

German civil law differentiates between continuous and temporary mental disorder. Loss of legal capacity can only be ascertained if a continuous mental disorder is evident. Considering the far-reaching consequences of the loss of legal capacity, careful distinction between these two groups of disorders is necessary, but clear legal guidelines and unequivocal psychiatric statements are still lacking. The solution given here can assure the quality of expert testimony by taking into account the current diagnostic conventions of ICD-10 research criteria as well as relevant knowledge about clinical course and therapy of psychiatric disorders.

Disability Evaluation↗
PubMed2004

[Regulation on preventive detention according to section sign 66 of the German Penal Code. Principles and differential indication compared with the regulation according to section sign 63 of the German Penal code].

Preventive detention is imposed by court order if a dangerous criminal shows a disposition to relapse. The negative criminal prognosis should be given by a psychiatric expert based on considerations about the criminal's personality traits. Matters of preventive detention are important for forensic psychiatry, but so far have rarely been discussed. This article presents related problems and offers-under special consideration of problematic personality traits or personality disorders-practical guidelines for expert testimony. Our considerations should serve as a thought-provoking stimulus for further psychiatric discussions about this topic.

Antisocial Personality Disorder↗
PubMed1995

[Psychiatric anamnesis, psychiatric findings and their relevance for legal questions in psychiatric assessment before the social court].

Psychiatric expertise in court implies specific requirements with regard to the formal aspects. On the one hand, they are determined by psychiatry as a branch of medical research and on the other by the fact that the expert testimony serves as a piece of evidence in court. Up to now psychiatrists have focused on the legal consequences of different kinds of diseases rather than on the formal aspects of expertise testimony. In this paper, we try to reconcile the specific requirements of psychiatric exploration with the requirements that have to be fulfilled in order to convince the court.

Persons with Disabilities↗
PubMed1979

Medicolegal aspects of paternity testing.

Blood group testing has achieved wide acceptance by the courts as a major scientific determinant in paternity proceedings. Other tests, including H-LA types and hemoglobin determinations, are also being used with increasing frequency; however, there are legal safeguards which must be met to satisfy the court's need to ensure the validity of the tests and their interpretation. In order for the results of paternity testing to be admitted into testimony (evidence) the following should be established: 1) proof that proper persons provided the blood samples; 2) consent to the tests and permission for release of information regarding test results; 3) proof that the speciment was correctly labeled and transported; 4) documented accuracy of the testing procedures; 5) fact testimony regarding the test results; and 6) expert testimony explaining the exclusion principle. In the future, laboratory personnel can expect wider application of these and other laboratory results to legal proceedings. For determinations derived from any laboratory testing to be admissable as evidence, the courts will apply the above safeguards.

Blood Group Antigens↗
PubMed1994

The pitfalls of making a categorical diagnosis of post traumatic stress disorder in personal injury litigation.

Since it first became possible to diagnose Post Traumatic Stress Disorder (PTSD) categorically with the advent of DSM-III (American Psychiatric Association, 1980), its use in the American Courts to substantiate civil claims has burgeoned. This situation may be set to repeat itself in the UK. Mental health professionals need to be aware that there is a substantial body of evidence supporting the validity of the concept of a DSM diagnosis of PTSD. However, the reliability of such a diagnosis can be called into question. There are legal and ethical issues involved in assessing and interpreting the DSM criteria, some of which may lead the expert witness to make authoritative pronouncements that are outside his legitimate field of expertise. There is a danger that the legal profession will adopt the DSM as a 'gold standard' against which to judge expert testimony. The multiaxial classification of the DSM can be a useful framework for presenting a diagnosis of PTSD, but over-rigid adherence to the criteria at the expense of clinical judgement and experience should be avoided.

Expert Testimony↗
PubMed1995

Battered woman syndrome defense in Canadian courts.

As a result of a 1990 Supreme Court of Canada decision, battered woman syndrome defense is now accepted as a legitimate extension of self-defense in Canadian courts. This defense hinges on the expert testimony that a battered woman who is accused of murder or aggravated assault suffers from the psychological sequelae of abuse and that this psychological distress contributes to her apprehension of danger and ultimately her apprehension of death during a particular battering episode. The authors present a brief overview of the history of battered woman syndrome defense, the role of the expert in assessing the applicability of this defense in any particular situation, and the pitfalls of using battered woman syndrome defense.

Adult↗