Forensic psychiatric issues in intellectual disability.

Forensic psychiatrists and neuropsychiatrists are likely to encounter individuals with intellectual disability as they are over-represented in the judicial system. These individuals may have the full range of mental illnesses and comorbid conditions, including physical infirmity, sensory deficits, language impairment, and maladaptive behaviors. They are frequently disadvantaged in the judicial system due to lack of comprehension, lack of accommodations, and stigmatization. Decision making capacity may need to be assessed for health care, sexual autonomy, marriage, financial management, making a will, and need for guardianship. The usual approach to conducting an evaluation needs adaptation to fit the unique characteristics and circumstances of the individual with intellectual disability. The forensic consultant can assist attorneys, defendants, and victims in recommending accommodations and the expert witness can provide education to juries.

Medical and Legal Uncertainties and Controversies in "Shaken Baby Syndrome" or Infant "Abusive Head Trauma".

Uncertainties and controversies surround "shaken baby syndrome" or infant "abusive head trauma". We explore Vinaccia v The Queen (2022) 70 VR 36; [2022] VSCA 107 and other selected cases from Australia, the United Kingdom and the United States. On expert opinion alone, a "triad" of clinical signs (severe retinal haemorrhages, subdural haematoma and encephalopathy) is dogmatically attributed diagnostically to severe deliberate shaking with or without head trauma. However, the evidence for this mechanism is of the lowest scientific level and of low to very low quality and therefore unreliable. Consequently, expert opinion should not determine legal outcomes in prosecuted cases. Expert witnesses should reveal the basis of their opinions and the uncertainties and controversies of the diagnosis. Further, the reliability of admissions of guilt while in custody should be considered cautiously. We suggest abandonment of the inherently inculpatory diagnostic terms "shaken baby syndrome" and "abusive head trauma" and their appropriate replacement with "infantile retinodural haemorrhage".

[Legal and forensic medical problems of postmortem donation]. / Pravovye i sudebno-meditsinskie problemy posmertnogo donorstva.

The article is devoted to legal and forensic medical problems of postmortem donation. The substantive provisions of postmortem donation, as well as normative legal documents regulating the processes of organs harvesting from deceased persons for subsequent transplantation and governing the work of transplantologists and forensic medical experts have been considered. The practical examples illustrating the essence and nature of the problem of postmortem forensic medical expertise of persons with absent organs has been given and the importance of the participation of a forensic medical expert involved in the decision-making process on possibility (or impossibility) of the corpse's organs and tissues explantation without prejudice to the further expert examination has been emphasized. The authors pay particular attention to the inadequacy of the legal framework, including the lack of a clear understanding of the legal status of the person holding the position of forensic medical expert, who provides an expert opinion on the organs' explantation.

The Litigation Complexity of Posttraumatic Headaches.

PURPOSE OF REVIEW: This review explores the workings of the legal process in posttraumatic headache (PTH) claims by discussing representative court cases, the approaches taken by both plaintiff and defense attorneys in evaluating a client with PTH, and the role of the expert witness. This discussion also examines the question of whether or not litigation prolongs the symptoms of PTH and concussion, looking at the issues of malingering and the psychological effect of litigation. RECENT FINDINGS: Litigation prolongs recovery of PTH, primarily not from malingering but rather due to the psychological mindset of the plaintiff as created by the litigation process. Just as the medical community struggles with PTH diagnosis, mechanism, and treatment, the legal system grapples with identifying valid claims for PTH. Psychological support is an important component for PTH recovery to more effectively deal with the psychological impact of litigation and the concept of perceived injustice.

Lessons for the courtroom from the study of Flashbulb memory: an integrative review.

In legal proceedings, when no corroboration is possible with external sources of evidence, judges and jurors derive from their own experience the criteria to ascertain if a memory report is accurate and a witness credible. These legal criteria closely resemble the aspects traditionally investigated by literature on Flashbulb memory (i.e., consistency, confidence, quantity), but have failed to obtain a generalised consensus within the scientific community. Drawing up a set of univocal rules upon which to base a conclusion regarding witnesses' credibility is a difficult task, from both legal and scientific points of view. Respectful cooperation between cognitive science and criminal law will encompass both technical support by expert witnesses, and updating guidelines for fact-finders. This cooperation would prevent the risk of common sense fallacies in the legal process, preserving the legal autonomy to evaluate witness credibility.

Mock jurors' evaluation of firearm examiner testimony.

OBJECTIVES: Firearms experts traditionally have testified that a weapon leaves "unique" toolmarks, so bullets or cartridge casings can be visually examined and conclusively matched to a particular firearm. Recently, due to scientific critiques, Department of Justice policy, and judges' rulings, firearms experts have tempered their conclusions. In two experiments, we tested whether this ostensibly more cautious language has its intended effect on jurors (Experiment 1), and whether cross-examination impacts jurors' perception of firearm testimony (Experiment 2). HYPOTHESES: Four hypotheses were tested. First, jurors will accord significant weight to firearm testimony that declares a "match" compared to testimony that does not (Experiments 1 and 2). Second, variations to "match" language will not affect guilty verdicts (Experiment 1). Third, only the most cautious language ("cannot exclude the gun") would lower guilty verdicts (Experiment 1). Fourth, cross-examination will reduce guilty verdicts depending on specific language used (Experiment 2). METHOD: In two preregistered, high-powered experiments with 200 mock jurors per cell, participants recruited from Qualtrics Panels were presented with a criminal case containing firearms evidence, which varied the wording of the examiner's conclusion and whether cross-examination was present. These variations include conclusion language used by practitioners, language advised by government organizations, and language required by judges in several cases. Participants gave a verdict, rated the evidence and expert in all conditions. RESULTS: Guilty verdicts significantly increased when a match was declared compared to when a match was not declared. Variation in conclusion language did not affect guilty verdicts nor did it affect jurors' estimates of the likelihood the defendant's gun fired the bullet recovered at the crime scene. In contrast, however, a more cautious conclusion that an examiner "cannot exclude the defendant's gun" did significantly reduce guilty verdicts and likelihood estimates alike. The presence of cross-examination did not affect these findings. CONCLUSION: Apart from the most limited language ("cannot exclude the defendant's gun"), judicial intervention to limit firearms conclusion language is not likely to produce its intended effect. Moreover, cross-examination does not appear to affect perceptions or individual juror verdicts. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Shortage of paediatric radiologists acting as an expert witness: position statement from the British Society of Paediatric Radiology (BSPR) National Working Group on Imaging in Suspected Physical Abuse (SPA).

One of the most challenging areas of radiological imaging in children is the diagnosis of physical abuse. There is a dearth of paediatric radiologists willing to act as expert witnesses, particularly in the family courts. There are a number of reasons why radiologists may not be interested or willing to put themselves forward to work as expert witnesses in this field. A group of imaging experts recently formed the "British Society of Paediatric Radiology (BSPR) Working Group on Imaging in Suspected Physical Abuse (SPA)". The group comprises radiologists and neuroradiologists with current or previous experience of providing expert witness reports to the court in cases of SPA. The group met in January 2019 to explore pragmatic solutions to the chronic inefficiencies in both medical and legal practices and the challenges that arise from working in a legal arena with different structures, goals, and assessment criteria. Key issues concerned organisational inefficiencies, variable support from National Health Service Trusts and the Royal College of Radiologists to conduct this work, and the risk/benefit of involvement. This work is important for the patient, parents, and society in general, and highly rewarding for clinical practitioners who are involved, but there are several issues with current practices that discourage active participation. With several members of the group either retired or close to retirement, the shortage of experts is becoming a pressing issue within the UK, which requires an engaged multidisciplinary group to come up with creative solutions. Here, the group provide a consensus opinion highlighting the current barriers and potential facilitators to increasing the number of radiologists willing to provide opinions to the court.

Applying statistics to the gatekeeping of expert evidence: Introducing the Structured Statistical Judgement (SSJ).

Daubert required judges to base their decisions about the admissibility of expert witness testimony in large part on the reliability and validity of empirical observations. Because judges have a wide array of duties and may not be equipped to understand the complexities of statistical analysis, some jurists have recommended that court-appointed experts assist judges in their gatekeeping function. To assist such experts in scrutinizing empirical papers, we propose a Structured Statistical Judgement (SSJ) that takes advantage of advances in the various statistical methods - such as effect sizes that adjust for error - which have allowed researchers to report increasingly more reliable and valid observations. We also include supplementary materials that court-appointed experts can use both as a codebook to operationalize the SSJ and as a quick reference that will aid consultation with judges. An initial application of the SSJ examined all 93 empirical articles published in Psychology, Public Policy, and Law and Law and Human Behavior in 2015 and resulted in excellent interrater reliability (π = 0.83; π = 0.95; π = 0.97), at the same time it indicated that a majority of the articles fail to include the comprehensive and transparent statistical analysis that would be most useful to courts.

Clinician testimony in suicide litigation: A cause to be uneasy.

This is an illustrative article rather than a research study. We offer opinions and recommendations about what we view as unfortunate clinician testimony in suicide-related malpractice cases, testimony that - inadvertently or not - supports or encourages inadequate care of suicidal patients. The principles apply to both psychiatrists and non-psychiatrists, although the former appear more often in our work. We particularly consider the roles and testimony, in court or at deposition, of psychiatrists, whether as defendants, expert witnesses, or fact witnesses. We cite examples of what we view as poor, disingenuous, dishonest and even dangerous testimony that we believe moves the profession toward unsafe patient care. The examples illustrate what we (and sometimes others) describe as normalization of deviance, pre-suit puffery, self-serving defendant testimony, expert pride supplanting testimonial responsibility, expert arrogance, expert parroting of attorney suggestions, witness ignorance and avoiding facts, unconscious expert bias, inexperience thwarting justice, misleading use of terms such as "predictability," and expert witnesses who lack the direct-care experience that jurisdictions often require in order to opine about defendant clinicians' day-to-day patient care. The examples often reveal concerns beyond the category chosen, and should not be expected to convey all of the facts of a particular case.

Variations in reliability and validity do not influence judge, attorney, and mock juror decisions about psychological expert evidence.

OBJECTIVE: We tested whether the reliability and validity of psychological testing underlying an expert's opinion influenced judgments made by judges, attorneys, and mock jurors. HYPOTHESES: We predicted that the participants would judge the expert's evidence more positively when it had high validity and high reliability. METHOD: In Experiment 1, judges (N = 111) and attorneys (N = 95) read a summary of case facts and proffer of expert testimony on the intelligence of a litigant. The psychological testing varied in scientific quality; either there was (a) blind administration (i.e., the psychologist did not have an expectation for the test result) of a highly reliable test, (b) nonblind administration (i.e., the psychologist did have an expectation for the test result) of a highly reliable test, or (c) blind administration of a test with low reliability. In a trial simulation (Experiment 2), we varied the scientific quality of the intelligence test and whether the cross-examination addressed the scientific quality of the test. RESULTS: The variations in scientific quality did not influence judges' admissibility decisions nor their ratings of scientific quality nor did it influence attorneys' decisions about whether to move to exclude the evidence. Attorneys' ratings of scientific quality were sensitive to variations in reliability but not the testing conditions. Scientifically informed cross-examinations did not help mock jurors (N = 192) evaluate the validity or the reliability of a psychological test. CONCLUSION: Cross-examination was an ineffective method for educating jurors about problems associated with nonblind testing and reliability, which highlights the importance of training judges to evaluate the quality of expert evidence. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Expert opinions in dermatology.

Apart from their medical responsibilities relating to the diagnosis, treatment and prevention of skin diseases, dermatologists may also be asked to provide expert medical opinions. In their role as medical experts, dermatologists provide their services not only to public institutions and courts but also to private clients. Expert dermatological opinions involve the application of medical knowledge and experience to an individual case as regards a specific legal question. The dermatological expert thus becomes an "assistant" to administrative and public agencies or courts. In addition to providing the required expert knowledge, the expert must maintain strict neutrality and avoid any bias. Expert opinions play a significant role in the field of occupational dermatology. In this context, it is important to make a distinction between scientific expert opinions - commissioned to determine whether the criteria for an occupational skin disease are met or to assess the degree of reduction in earning capacity - and the much more common "small expert opinions" relating to disease prevention ("dermatologist's procedure"). Moreover, expert medical opinions have become increasingly important with respect to medical malpractice issues, both in court proceedings and for investigations conducted by State Medical Chambers. For quality assurance of expert dermatological opinions, the Working Group for Occupational and Environmental Dermatology in particular offers certification courses. The same group also provides guidelines for expert opinions in occupational dermatology (Bamberg Recommendations).

Interpreting Evidence of Torture.

The Istanbul Protocol provides a scheme for giving evidence of signs of torture. This scheme does not conform with the principles of logical inference, revolving as it does round the concept of 'consistency'. The shortcomings of the Protocol are explained using the evidence given in the recent case of KV(Sri Lanka) and the logical approach to such evidence explained.

Memory development: implications for adults recalling childhood experiences in the courtroom.

Adults frequently provide compelling, detailed accounts of early childhood experiences in the courtroom. Judges and jurors are asked to decide guilt or innocence based solely on these decades-old memories using 'common sense' notions about memory. However, these notions are not in agreement with findings from neuroscientific and behavioural studies of memory development. Without expert guidance, judges and jurors may have difficulty in properly adjudicating the weight of memory evidence in cases involving adult recollections of childhood experiences.

Neuroscientists in court.

Neuroscientific evidence is increasingly being offered in court cases. Consequently, the legal system needs neuroscientists to act as expert witnesses who can explain the limitations and interpretations of neuroscientific findings so that judges and jurors can make informed and appropriate inferences. The growing role of neuroscientists in court means that neuroscientists should be aware of important differences between the scientific and legal fields, and, especially, how scientific facts can be easily misunderstood by non-scientists, including judges and jurors.

Epidermis and Enamel: Insights Into Gnawing Criticisms of Human Bitemark Evidence.

Critics describe forensic dentists' management of bitemark evidence as junk science with poor sensitivity and specificity and state that linkages to a biter are unfounded. Those vocal critics, supported by certain media, characterize odontologists' previous errors as egregious and petition government agencies to render bitemark evidence inadmissible. Odontologists acknowledge that some practitioners have made past mistakes. However, it does not logically follow that the errors of a few identify a systemic failure of bitemark analysis. Scrutiny of the contentious cases shows that most occurred 20 to 40 years ago. Since then, research has been ongoing and more conservative guidelines, standards, and terminology have been adopted so that past errors are no longer reflective of current safeguards. The authors recommend a comprehensive root analysis of problem cases to be used to determine all the factors that contributed to those previous problems. The legal community also shares responsibility for some of the past erroneous convictions. Currently, most proffered bitemark cases referred to odontologists do not reach courts because those forensic dentists dismiss them as unacceptable or insufficient for analysis. Most bitemark evidence cases have been properly managed by odontologists. Bitemark evidence and testimony remain relevant and have made significant contributions in the justice system.