Civil Areas Covered By An Expert Forensic Psychiatrist
Medical Malpractice
Medical malpractice is concerned with the process of seeking to receive monetary damages due to errors in the practice of medicine. The testimony of an Expert Forensic Psychiatrist can be required by all parties of a case, including individual patients, patient families and their attorneys, defendants and their attorneys, insurance companies, government agencies and public health experts and researchers. The common basis of these situations include complaints of negligence such as inappropriate pharmacology, failure to take adequate history, failure to recognize, monitor and treat side effects, inappropriate use of seclusion or restraints, failure to apply or maintain accepted standards of care, negligence in supervision and medical errors. Cases arising out of suicide or attempted suicide are among the most common and most expensive types of professional liability claims. Testimony from a Psychiatric Expert Witness is an essential part of the determination of cases and requires a full command of clinical and legal issues.
Civil Personal Injury And Disability
Expert Forensic Psychiatrists are often called to make psychiatric and personal injury determinations in cases involving Tort Law. Tort law is a body of law that addresses, and provides remedies for, civil wrongs. A person who suffers damages may be able to use tort law to receive compensation from someone who is legally responsible or liable for those injuries. Generally speaking, tort law defines what constitutes a legal injury and establishes the circumstances under which one person may be held liable for another's injury. Torts cover intentional acts and accidents. When a plaintiff claims psychological injury as the result of another’s conduct, the claim is for emotional distress. The testimony of a Psychiatric Expert Witness will not only aid in determining whether or not damages exist, but the extent of them.
Disability Evaluations And Consultation
The 1990 census determined work disability to be the inability to perform work resulting from physical, mental or other health condition for a duration of six months or more. An estimated ten percent of the population had some recent disability from a diagnosable mental disorder. Expert Forensic Psychiatrists must understand cultural, social, biological and psychological components that determine decisions made to seek or change employment, become unemployed, or seek disability status as well as social impairments and psychosocial disorders.
Workers compensation claims are often disputed and brought to trial, which will result in the need of a Psychiatric Expert Witness to assess issues such as whether or not the worker has a disorder, the type and duration of the symptoms, how those symptoms relate to work, prognosis and treatment recommendations, whether vocational evaluation or rehabilitation is indicated and when the maximum medical improvement might be reached.
Sexual Harassment
Sexual harassment has become one of the most controversial issues of today’s world. Landmark cases and media attention to these issues have resulted in dramatic increases in costs and awards. Often both plaintiff and defense attorneys call upon Expert Forensic Psychiatrists to make evaluations of claimants. The ability to understand issues of psychological damage, proximate cause, work impairment, prognosis and treatment in the evaluations is of utmost importance in the handling of these cases. A full knowledge of the specific definitions of sexual harassment and hostile environment law differentiates the Psychiatric Expert Witness from others providing testimony at both trials and settlements hearings.
Toxic Exposure Assessments
Neurotoxicity refers to temporary or permanent changes in the function of the nervous system caused by effects of toxic agents, or the combination of toxic agents. Product liability and neurotoxin exposure to agents such as pesticides, solvents, metals, gases and other toxic agents can bring cases requiring an Expert Forensic Psychiatrist. Knowledge and experience in areas of psychiatry, toxicology, and neuropsychology as well as the law are required.
Trauma Disorders
When psychiatric disorders are alleged in civil cases, the Expert Forensic Psychiatrist must determine whether or not the injury is malingered (imagined or exaggerated) or genuine and the prognosis, extent and nature of the injury.
Post Traumatic Stress Disorder is the most often alleged psychological injury in personal injury cases. PTSD results from complex interactions between the person and many influences residing both inside and outside the individual. The Psychiatric community generally agrees that PTSD and ASD (Acute Stress Disorder) are defined as resulting from an extreme traumatic event. However, what an individual interprets as extreme trauma can vary widely from person to person and factors such as the type of trauma, an individual’s childhood experiences, age, gender, family history and social support affect the impact of the trauma. Perception of an event is influenced by personal life history and personality.
Because there are so many variables and the symptoms depend on the subject’s own reporting, the Expert Forensic Psychiatrist has to be meticulous in his evaluation. In addition, the popularity in alleging Post Traumatic Stress Disorder has provided an incentive to malinger. Proving the presence or absence of the disorder very often depends on the experience and knowledge of the Psychiatric Expert Witness.
Civil Competency
A fundamental human right is the right to make a choice and act on that choice. However, sometimes civil courts become involved in restricting these individual rights because of a person’s competency. The nature of competency is such that they are specific and Expert Forensic Psychiatrists must understand clearly which one is being evaluated. One example of civil competency is testamentary capacity, which is a person’s ability to competently make a will. The evaluation of testamentary capacity usually occurs after the person’s death. Without the ability to personally interview and examine the individual, the Psychiatric Expert Witness must rely on other and important sources of information. Determining whether or not the deceased suffered from insane delusions, experienced lucid intervals while making their will, or suffered from the undue influence of another are key factors in determining if a will is to be contested or carried out as written.
Competency issues also arise in determining guardianship, conservatorships, and whether or not an individual had contractual capacity to enter into agreements.
Legal Aspects Of Death And Dying
Ever since medical technology brought the ability to extend life beyond what many people would deem to be productive or practical, cases developed involving death with dignity. Starting with the Quinlan case in 1976, courts have attempted to outline guidelines for medical conduct in the process of dying.
When a person is no longer capable of vocalizing their decisions regarding their care, the Expert Forensic Psychiatrists may be called upon to evaluate the medical and legal ramifications of issues such as medical intervention and the proximity of death, medical futility and palliative care. More controversial issues arise such as voluntary active euthanasia and physician assisted suicide. Provisions in the law have been made for advance medical directives to provide a patient’s directives through vehicles such as living wills and medical powers of attorney. Psychiatric Expert Witnesses are often consulted to evaluate the competency of the person at the time they make the instructions.
