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Handbook of Forensic Psychiatric Practice in Capital Cases


Implications for forensic psychiatrists Tese differences have several consequences for forensic psychiatrists.


Clinical data collected by the psychiatrist, and contained within a court report, can have not only medical but also legal relevance, including to guilt or innocence; some of which may be admissible and some not. In order to ascertain what weight to give that evidence should it be disputed, the court will wish to know the expert’s status (e.g. consultant, trainee), post, relevant qualifications and experience, and these should be stated in the report.


For the same reason, the sources of any information used by a psychiatrist should be made clear (patient, informant, records etc.), so that the court can apply its own approach to what it holds to be true.


Tere may be disparity between the information that a psychiatrist would use in determining a diagnosis or formulation and that which is admissible within the relevant legal proceedings (see above). Tis can cause ethical tension for an expert in court, for instance where, s/he is told that certain information cannot be considered by the court. Tere may be information that s/he is aware is inadmissible as evidence, but which may be diagnostically or clinically highly relevant. Reports should make clear how conclusions have been derived, and from which information.


Information contained within court proceedings for example witness statements, can be used as data by the forensic psychiatrist (by analogy with informant information in ordinary clinical practice). However, witness evidence may be contradictory, such that the expert has to make conditional statements (‘if the court believes A then the diagnosis of X is reinforced, if B then it is undermined’).


Information received from the criminal justice system should be given great weight if it has been considered and accepted by a court, because it will have been tested against the rules of evidence and been subjected to attempts by one or more parties to disprove it (so convictions should weigh more heavily in a risk assessment (see Chapter 7) than allegations, for example).


Psychiatry and law as a two-way relationship The relationship between psychiatry and law is bilateral.


Psychiatry is used by law to assist in answering the law’s questions, as when psychiatrists testify as to whether a defendant was capable of forming the requisite intent for a particular crime, or whether he satisfies the legal criteria for the partial defence to murder of diminished responsibility, or whether he comes within one of the two criteria for the imposition of the discretionary death penalty of the worst of the worst, or beyond reformation (see Chapter 12)


Psychiatry itself also uses legal processes to therapeutic ends, as when a psychiatrist decides to recommend detention for treatment under mental health legislation, including sometimes as part of their risk management plan.


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