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Handbook of Forensic Psychiatric Practice in Capital Cases


itself be cited verbatim. Te ‘particular occasion’ may be some time in the past, for example at the time of commission of the actus reus if the matter at issue is a psychiatric defence, or currently, if what is at issue is the defendant’s mental condition in regard to sentencing, including to death, or capacity to be executed.


As already advised, any medical terminology necessarily used should be explained in lay terms, conveniently in brackets after first reference to the term, or by way of a glossary provided at the end of the report if multiple terms have to be used.


It is expected by the courts that experts will draw not only on their training and experience in reaching their opinion, but also sometimes from research findings. Any such relevant findings should be included, if necessary with papers attached. Similarly, diagnoses used should be accompanied by a copy of the diagnosis as it appears in either ICD-10 or DSM-IV (see also below).


Possible alternative opinions


Any potentially opposing view is important to present – even if there is no report in the papers that poses it – as are the reasons why you do not hold to it, for example why you think a defendant is not malingering and actually suffers from schizophrenia. If you don’t, others will. Showing that you have considered other viewpoints is evidence of being balanced and fair minded. Conclusions that are reasoned are far more likely to be respected by the court, and by lawyers for both sides.


Diagnosis


Diagnoses should be reached through using the ICD-10 or DSM-IV criteria. However, neither should serve as checklists; sometimes legal representatives will attempt to ‘tick off’ symptoms of a disorder that are present or absent. Both systems operate properly as guidance and should not be seen as substitutes for clinical judgment


In certain reports, for example reports that are prepared pre-trial, basic facts will not have been established. Or facts may, within a trial, be in dispute. Different sets of ‘facts’ might well lead to different medical conclusions, or to different strength of medical conclusion. As already indicated, the good expert will give an opinion expressed in ‘conditional on court findings of fact’ terms. He must not adopt any view on matters of fact open to court determination (see also below).


Medical limits


It is not for experts to usurp the functions of the court. Offering an opinion on guilt or sentence – ‘the ultimate issue’ – is clearly inappropriate. However, some would argue that it is also wrong to give an opinion on, for example, whether a defendant meets the legal test for insanity, as this is also the ultimate issue for the court to determine. Tat is, s/he can describe the defendant’s mental state at the relevant time, and how this might be seen to ‘translate’ into the legal test, but should stop short of saying that it does. Or s/he may write that whether it does, or in what manner, depends upon factual findings by the court, that is, give ‘conditional’ opinions.


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