Prescribing Justice: A Close Examination of Physicians Acting As Expert Witnesses in Saudi Arabia.

INTRODUCTION: An expert witness is a person who provides testimony on issues that the court finds to be outside the scope of their expertise and experience. Any physician who has performed an independent medical evaluation or written medical records can and should expect to be requested as an expert witness. Medical malpractice, workers' compensation, and personal injury are the most prominent areas where medical expert witnesses participate and provide opinions and testimony. To our knowledge, this is the first study to be conducted in Saudi Arabia on physicians acting as expert witnesses. METHODS: This observational descriptive cross-sectional study conducted in Saudi Arabia from November 2022 to July 2023 aimed to assess physicians' experiences, education, training, willingness, self-competency, attitude, and perception as expert witnesses. The study population consisted of physicians working in Saudi Arabia, with at least a specialist level of professional expertise. Participants completed a self-administered online survey, utilizing a researcher-designed questionnaire. RESULTS: In total, 417 participants, with males comprising 51.3% of the sample, responded to the survey. More than half of the physicians (58.3%) had never produced a medical report for the court. Among those who had, the majority had done so one to twice. Similarly, the majority had never testified in court (77.5%), with only a small percentage having done so once or twice. Approximately 80% of participants had no prior education or training as expert witnesses, but among those who did, courses and workshops were the most common forms of education or training. Most participants expressed interest in learning or training for this role (69.1%) and were willing to provide medical reports or court testimony (73.9%). However, half of the participants did not feel competent in writing a medical report for the court, and more than half lacked confidence in giving testimony. CONCLUSION: The findings highlight the need for increased engagement, education, and training among physicians, particularly early and mid-career professionals, to enhance their confidence and competence as expert witnesses and ensure ethical practices in the medicolegal domain in Saudi Arabia.

The semantic structure of accuracy in eyewitness testimony.

In two studies, we examined if correct and incorrect statements in eyewitness testimony differed in semantic content. Testimony statements were obtained from participants who watched staged crime films and were interviewed as eyewitnesses. We analyzed the latent semantic representations of these statements using LSA and BERT. Study 1 showed that the semantic space of correct statements differed from incorrect statements; correct statements were more closely related to a dominance semantic representation, whereas incorrect statements were more closely related to a communion semantic representation. Study 2 only partially replicated these findings, but a mega-analysis of the two datasets showed different semantic representations for correct and incorrect statements, with incorrect statements more closely related to representations of communion and abstractness. Given the critical role of eyewitness testimony in the legal context, and the generally low ability of fact-finders to estimate the accuracy of witness statements, our results strongly call for further research on semantic content in correct and incorrect testimony statements.

The effect of mood on shaping belief and recollection following false feedback.

The current study examined how mood affects the impact of false feedback on belief and recollection. In a three-session experiment, participants first watched 40 neutral mini videos, which were accompanied by music to induce either a positive or negative mood, or no music. Following a recognition test, they received false feedback to reduce belief in the occurrence of the events displayed in some of the videos (Session 2). This was followed by an immediate memory test and a delayed memory assessment one week later (Session 3). The results revealed that participants in negative mood reported higher belief scores compared to those in positive moods, despite an overall decline in belief scores for all groups following the false feedback. Notably, individuals in negative moods exhibited less reduction in their belief scores after encountering challenges, thereby maintaining a higher accuracy in their testimonies. Over time, a reduction in the clarity of participants' memory recall was observed, which correspondingly reduced their testimony accuracy. This study thus indicates that mood states play a role in shaping belief and memory recall under the influence of false feedback.

New Insights on Expert Opinion About Eyewitness Memory Research.

Experimental psychologists investigating eyewitness memory have periodically gathered their thoughts on a variety of eyewitness memory phenomena. Courts and other stakeholders of eyewitness research rely on the expert opinions reflected in these surveys to make informed decisions. However, the last survey of this sort was published more than 20 years ago, and the science of eyewitness memory has developed since that time. Stakeholders need a current database of expert opinions to make informed decisions. In this article, we provide that update. We surveyed 76 scientists for their opinions on eyewitness memory phenomena. We compared these current expert opinions to expert opinions from the past several decades. We found that experts today share many of the same opinions as experts in the past and have more nuanced thoughts about two issues. Experts in the past endorsed the idea that confidence is weakly related to accuracy, but experts today acknowledge the potential diagnostic value of initial confidence collected from a properly administered lineup. In addition, experts in the past may have favored sequential over simultaneous lineup presentation, but experts today are divided on this issue. We believe this new survey will prove useful to the court and to other stakeholders of eyewitness research.

Evaluating layperson interpretation of actuarial sexual violence risk data: A multi-method comparison of risk communication with attention to gender bias.

Forensic clinicians are often called upon to help courts determine the likelihood that someone will continue to commit sexually violent acts in the future. The utility of these evaluations depends largely on how effectively the results are communicated to and understood by the trier of fact. Actuarial results, such as those commonly reported in sexual offense risk assessments, appear particularly challenging for laypersons to understand. Using a representative sample of 206 U.S. adults, this study examines three methods of communicating actuarial risk via simulated expert testimony on participants' ratings of a hypothetical evaluee's risk of sexual re-offending. The results suggested that all participants, regardless of how results were communicated, over-estimated the examinee's risk level relative to the expert's probabilistic findings, but tended to agree with the expert's categorical predictions. Participants who were only shown actuarial data consistently rated the evaluee as more dangerous and likely to commit future sexually violent acts. Additionally, it was found that gender significantly impacted participants' perceptions, such that women found the evaluee more dangerousness and desired greater social distance from him. This study has implications for best practices regarding expert communication of actuarial results in cases involving sexual violence.

Role of psychopathology on children credibility of sexual abuse testimony.

When an alleged victim has a pre-existing psychopathological diagnosis, this can affect the rating of their version of the abuse in terms of credibility. The objective of this work is to analyze the relationship between the assessment of the credibility of the testimony of a CSA victim, the psychological problems that the child may have presented prior to sexual abuse and the possible psychological sequelae that she may present as a result of the abuse. 109 cases were selected in which the credibility of the testimony could be determined. Through forensic interviews and the study of the corresponding professional reports, the following were obtained: sociodemographic data, data on their previous psychological state and data on their psychological state after the reported events. The psychological state of the child after the reported events shows no relation to the forensic evaluation of the credibility of her testimony. The existence of a relationship between the absence of previous psychopathology and the fact that the victim's testimony is valued as a credible account is confirmed. This study reveals that children who presented psychological manifestations prior to their experience of abuse receive a lower credibility rating than those without previous psychopathological symptoms or diagnoses.

Idiosyncratic effects of interviewer behavior on the accuracy of children's responses.

Children are interviewed to provide information about past events in various contexts (e.g., police interviews, court proceedings, therapeutic interviews). During an interview, various factors may influence the accuracy of children's responses to questions about recent events. However, behavioral research in this area is limited. Sparling et al. (2011) showed that children frequently provided inaccurate responses to questions about video clips they just watched depending on the antecedents (i.e., the way a question was asked) and consequences (i.e., the response of the interviewer to their answers). In the current study, we replicated and extended the procedures reported by Sparling et al. and found that two of five children were sensitive to the various antecedents and consequences that we manipulated. Our findings indicate a need for more research in this area to determine the relevant environmental variables that affect children's response accuracy.

Global survey on evaluative reporting on DNA evidence with regard to activity-level propositions.

For many criminal cases, the source of who deposited the DNA is not what the prosecutor and the defense are trying to dispute. In court, the question may be how the DNA was deposited at the crime scene rather than who the DNA came from. Although laboratories in many countries have begun to evaluate DNA evidence given formal activity-level propositions (ALPs), it is unknown how much other forensic practitioners know and what they think about activity-level evaluative reporting (ALR). To collect this information, a survey with 21 questions was submitted to international forensic science organizations across Europe, Australia, South America, Canada, Asia, and Africa. The survey combined open-ended and multiple-choice questions and received 162 responses. Responses revealed a wide range of knowledge on the topic. Overall, most respondents were somewhat knowledgeable about ALR, ALP, and current practices in court and expressed their support of the concept. A majority of participants identified gaps and obstacles regarding ALR they would like to see addressed. Examples include (1) need for more education/training at all stakeholder levels, (2) need for more DNA evidence-related data under realistic case scenarios, (3) need to internally implement and validate a formalized and objective approach for reporting, and (4) in some countries the need to achieve court admissibility. This global survey gathered the current concerns of forensic DNA practitioners and outlined several operational concerns. The information can be used to advance the implementation of ALR in laboratories and court testimony worldwide.

Deference or critical engagement: how should healthcare practitioners use clinical ethics guidance?

Healthcare practitioners have access to a range of ethical guidance. However, the normative role of this guidance in ethical decision-making is underexplored. This paper considers two ways that healthcare practitioners could approach ethics guidance. We first outline the idea of deference to ethics guidance, showing how an attitude of deference raises three key problems: moral value; moral understanding; and moral error. Drawing on philosophical literature, we then advocate an alternative framing of ethics guidance as a form of moral testimony by colleagues and suggest that a more promising attitude to ethics guidance is to approach it in the spirit of 'critical engagement' rather than deference.

Giving Consent to the Ineffable.

A psychedelic renaissance is currently taking place in mental healthcare. The number of psychedelic-assisted therapy trials is growing steadily, and some countries already grant psychiatrists special permission to use psychedelics in non-research contexts under certain conditions. These clinical advances must be accompanied by ethical inquiry. One pressing ethical question involves whether patients can even give informed consent to psychedelic-assisted therapy: the treatment's transformative nature seems to block its assessment, suggesting that patients are unable to understand what undergoing psychedelic-assisted therapy actually means for them and whether it aligns with their values. The present paper argues that patients often have sufficient knowledge to give informed consent because they know that they want to change their negative status quo and that psychedelic-assisted therapy offers an effective way to do so. Accordingly, patients can understand what the transformative nature of psychedelic-assisted therapy means for them and a make a value-aligned choice even if they are unable to anticipate the manifestation of a psychedelic experience.

["Thanks to all this good care, we progressed quickly"]. / « Grâce à tous ces bons soins, nous avons vite progressé ¼.

Sohane and Sélenn are twins and will soon be 6 years old. They had a birth journey often described as unusual, because they were born far too early, at 31 weeks of amenorrhea. Through the pen of their father, they share their testimony with us, looking back on this complicated period of which they were able to keep memories thanks to the photographs and stories of their parents.

No verbal overshadowing in aphantasia: The role of visual imagery for the verbal overshadowing effect.

The verbal overshadowing effect refers to the phenomenon that the verbal description of a past complex stimulus impairs its subsequent recognition. Theoretical explanations range from interference between different mental representations to the activation of different processing orientations or a provoked shift in the recognition criterion. In our study, 61 participants with aphantasia (= lack of mental imagery) and 70 controls participated in a verbal overshadowing paradigm. The verbal overshadowing effect did not occur in people with aphantasia, although the effect was replicated in controls. We speculate that this is either due to the lack of visual representations in people with aphantasia that verbal descriptions could interfere with, or to the absence of a shift in processing orientation during verbalisation. To rule out criterion-based explanations, further research is needed to distinguish between discriminability and response bias in people with aphantasia. Finally, data indicated that the verbal overshadowing effect may even be reversed in individuals with aphantasia, partly due to a lower memory performance in the no verbalisation condition. Effects of further variables are discussed, such as mental strategies, memory confidence, and difficulty, quantity and quality of verbalisation.

Swedish interpreters' views and experiences of interpreting child forensic interviews.

BACKGROUND: Child forensic interviewers have expressed concerns regarding the quality of interpreter-mediated child forensic interviews. However, research on interpreters' perspectives on these interviews is scarce and specialized education for interpreters limited. OBJECTIVE: This mixed-methods study aimed to explore interpreters' experiences and knowledge of interpreting child forensic interviews. PARTICIPANTS AND SETTING: A total of 130 Swedish interpreters with different authorization statuses responded to a digital survey about interpreting child forensic interviews. METHODS: Qualitative data were analyzed with reflexive thematic analysis and content analysis, and quantitative data with descriptive and inferential statistics. RESULTS: Interpreters reported challenges concerning children's limited language skills, the emotional effects of interpreting child forensic interviews, the limited access to information before interviews, and the complex balance between following interpreters' ethical guidelines and adjusting for situational demands. Regarding practical conditions, interpreters preferred interpreting in person instead of via telephone. Interpreters' general knowledge of child forensic interviewing did not differ between interpreters with different authorization statuses (F(2,108) = 0.80, ω2 = -0.002, p = .45), except from views on using leading questions (H(2) = 17.34, η2 = 0.14, p < .001) and whether interpreters may clarify terms to child interviewees (H(2) = 8.02, η2 = 0.06, p = .02). CONCLUSIONS: It is crucial to consider interpreters' perspectives when striving to improve the quality of interpreter-mediated child forensic interviews. Interpreters should be provided sufficient information to prepare and assess their suitability. Interpreters should also be offered education in interpreting child forensic interviews and given appropriate service structures to support their wellbeing.

Testimony and observation of statistical evidence interact in adults' and children's category-based induction.

Hearing generic or other kind-relevant claims can influence the use of information from direct observations in category learning. In the current study, we ask how both adults and children integrate their observations with testimony when learning about the causal property of a novel category. Participants were randomly assigned to hear one of four types of testimony: generic, quantified "all", specific, or only labels. In Study 1, adults (N = 1249) then observed that some proportion of objects (10%-100%) possessed a causal property. In Study 2, children (N = 123, Mage = 5.06 years, SD = 0.61 years, range 4.01-5.99 years) observed a sample where 30% of the objects had the causal property. Generic and quantified "all" claims led both adults and children to generalize the causal property beyond what was observed. Adults and children diverged, however, in their overall trust in testimony that could be verified by observations: adults were more skeptical of inaccurate quantified claims, whereas children were more accepting. Additional memory probes suggest that children's trust in unverified claims may have been due to misremembering what they saw in favor of what they heard. The current findings demonstrate that both child and adult learners integrate information from both sources, offering insights into the mechanisms by which language frames first-hand experience.

Forensic Interview Techniques in Child Sexual Abuse Cases: A Scoping Review.

Child sexual abuse (CSA) is widely recognized as a global public health problem with negative consequences for victims, their families, and society. The child's testimony is essential to the case outcome, given the frequent absence of physical or biological evidence of the abusive acts. Thus, the child forensic interview plays a decisive role in criminal investigation. The present scoping review aims to identify and describe the judicial procedures for collecting CSA victims' testimony using an evidence-based approach and a structured methodology. The review followed Preferred Reporting Items of Systematic Reviews and Meta-Analysis-Scoping Review guidelines. Studies were identified through manual reference checking and in four electronic databases: PsycARTICLES, PubMed, SCOPUS, and Web of Science. In all, 146 studies were identified according to the defined inclusion criteria, that is, empirical studies identifying judicial procedures to collect CSA victims' testimony, published in English or Portuguese. In total, 30 different forensic interview procedures to collect the child victim's testimony were found. The National Institute for Child Health and Human Development investigative interview protocol was the most frequently mentioned. Despite the variety of protocols, it was possible to conclude that they have a similar general structure. This review also identified gaps in interviewing practices with CSA victims. The scoping review corroborates the importance of forensic interviews with CSA victims, stating its implications for criminal investigation, the legal system, and the child's recovery process.

Barriers and solutions for the management of severe hypoglycaemia in people with diabetes in Spain: A Delphi survey.

BACKGROUND AND OBJECTIVE: Severe hypoglycaemia (SH) imposes a significant burden for people with diabetes (PwD), their caregivers (CGs), and the healthcare system. The study aimed to identify barriers and solutions in the management of SH in PwD in Spain, gathering consensus from physicians and nurses. MATERIAL AND METHODS: Expert opinion from physicians and nurses who manage PwD was collected via a 2-round online Delphi method. Consensus was predefined as ≥ 70% of the panellists agreeing or disagreeing with the statement. RESULTS: Physicians (n = 25) and nurses (n = 17) reached ≥ 90% consensus on the following barriers for the management of SH: absence of symptoms, cost to the health system, lack of implementation of glucose monitoring devices, lack of patient training to identify and manage SH, and the fear of SH in children and CGs. Main solutions, identified with ≥ 70% consensus, included training, education, and psychological support using diabetes nurse educators and the use of new glucose monitoring technologies and applications. CONCLUSIONS: This study provides valuable insights on the barriers and solutions in the management of SH in Spain. Structured self-management training, the support of diabetes educators, and the use of insulin delivery devices and glucose monitoring technologies is required for the management of SH.

Homicide or suicide? A probabilistic approach for the evaluation of the manner of death in sharp force fatalities.

The role of forensic science can be defined as providing relevant opinions to assist investigators and courts of law in answering questions. The Likelihood Ratio (LR) provides a quantitative and logical approach to communicating the strength of expert evidence. We reviewed existing forensic literature on sharp force fatalities, focusing on studies reporting the manner of death and the frequency of some characteristics that are traditionally assessed. Four studies were included, resulting in a database of 173 suicides and 354 homicides. The LR of each of the characteristic under both hypotheses (suicide and homicide) was obtained. Subsequently, the LR was computed in six fatalities with known manner of death, three suicides and three homicides, by multiplying the corresponding LR of each individual characteristic. LR ranged from 115 to 140,250 in suicidal cases and from 9 to 2728 in homicidal cases. Compared to other fields of forensic science where LR is used extensively, the values obtained in our cases of sharp force fatalities is low. However, in forensic pathology there is evidence that is outside the expert's opinion, and it is for the trier of fact, such as the judge or jury, to draw conclusions. Nevertheless, the LR serves as a tool for interpreting and weighing evidence while maintaining the distinct roles of the trier of fact and the expert. To comprehensively apply the LR in the field of sharp force deaths, it will be necessary to standardize the methodology of investigation and data collection in descriptive studies.

Naïve information aggregation in human social learning.

To glean accurate information from social networks, people should distinguish evidence from hearsay. For example, when testimony depends on others' beliefs as much as on first-hand information, there is a danger of evidence becoming inflated or ignored as it passes from person to person. We compare human inferences with an idealized rational account that anticipates and adjusts for these dependencies by evaluating peers' communications with respect to the underlying communication pathways. We report on three multi-player experiments examining the dynamics of both mixed human-artificial and all-human social networks. Our analyses suggest that most human inferences are best described by a naïve learning account that is insensitive to known or inferred dependencies between network peers. Consequently, we find that simulated social learners that assume their peers behave rationally make systematic judgment errors when reasoning on the basis of actual human communications. We suggest human groups learn collectively through naïve signaling and aggregation that is computationally efficient and surprisingly robust. Overall, our results challenge the idea that everyday social inference is well captured by idealized rational accounts and provide insight into the conditions under which collective wisdom can emerge from social interactions.