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Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label Forensic Evaluation. Show all posts
Showing posts with label Forensic Evaluation. Show all posts

Monday, May 6, 2019

Ethical Considerations Regarding Internet Searches for Patient Information.

Charles C. Dike, Philip Candilis, Barbara Kocsis  and others
Psychiatric Services
Published Online:17 Jan 2019

Abstract

In 2010, the American Medical Association developed policies regarding professionalism in the use of social media, but it did not present specific ethical guidelines on targeted Internet searches for information about a patient or the patient’s family members. The American Psychiatric Association (APA) provided some guidance in 2016 through the Opinions of the Ethics Committee, but published opinions are limited. On behalf of the APA Ethics Committee, the authors developed a resource document describing ethical considerations regarding Internet and social media searches for patient information, from which this article has been adapted. Recommendations include the following. Except in emergencies, it is advisable to obtain a patient’s informed consent before performing such a search. The psychiatrist should be aware of his or her motivations for performing a search and should avoid doing so unless it serves the patient’s best interests. Information obtained through such searches should be handled with sensitivity regarding the patient’s privacy. The psychiatrist should consider how the search might influence the clinician-patient relationship. When interpreted with caution, Internet- and social media–based information may be appropriate to consider in forensic evaluations.

The info is here.

Wednesday, May 30, 2018

Reining It In: Making Ethical Decisions in a Forensic Practice

Donna M. Veraldi and Lorna Veraldi
A Paper Presented to American College of Forensic Psychology
34th Annual Symposium, San Diego, CA

Here is an excerpt:

Ethical dilemmas sometimes require making difficult choices among competing ethical principles and values. This presentation will discuss ethical dilemmas arising from the use of coercion and deception in forensic practice. In a forensic practice, the choice is not as simple as “do no harm” or “tell the truth.” What is and is not acceptable in terms of using various forms of pressure on individuals or of assisting agencies that put pressure on individuals? How much information should forensic psychologists share with individuals about evaluation techniques? What does informed consent
mean in the context of a forensic practice where many of the individuals with whom we interact are not there by choice?

The information is here.

Sunday, March 11, 2018

Cognitive Bias in Forensic Mental Health Assessment: Evaluator Beliefs About Its Nature and Scope

Zapf, P. A., Kukucka, J., Kassin, S. M., & Dror, I. E.
Psychology, Public Policy, & Law

Abstract

Decision-making of mental health professionals is influenced by irrelevant information (e.g., Murrie, Boccaccini, Guarnera, & Rufino, 2013). However, the extent to which mental health evaluators acknowledge the existence of bias, recognize it, and understand the need to guard against it, is unknown. To formally assess beliefs about the scope and nature of cognitive bias, we surveyed 1,099 mental health professionals who conduct forensic evaluations for the courts or other tribunals (and compared these results with a companion survey of 403 forensic examiners, reported in Kukucka, Kassin, Zapf, & Dror, 2017). Most evaluators expressed concern over cognitive bias but held an incorrect view that mere willpower can reduce bias. Evidence was also found for a bias blind spot (Pronin, Lin, & Ross, 2002), with more evaluators acknowledging bias in their peers’ judgments than in their own. Evaluators who had received training about bias were more likely to acknowledge cognitive bias as a cause for concern, whereas evaluators with more experience were less likely to acknowledge cognitive bias as a cause for concern in forensic evaluation as well as in their own judgments. Training efforts should highlight the bias blind spot and the fallibility of introspection or conscious effort as a means of reducing bias. In addition, policies and procedural guidance should be developed in regard to best cognitive practices in forensic evaluations.

Closing statements:

What is clear is that forensic evaluators appear to be aware of the issue of bias in general, but diminishing rates of perceived susceptibility to bias in one’s own judgments and the perception of higher rates of bias in the judgments of others as compared with oneself, underscore that we may not be the most objective evaluators of our own decisions. As with the forensic sciences, implementing procedures and strategies to minimize the impact of bias in forensic evaluation can serve to proactively mitigate against the intrusion of irrelevant information in forensic decision making. This is especially important given the courts’ heavy reliance on evaluators’ opinions (see Zapf, Hubbard, Cooper, Wheeles, & Ronan, 2004), the fact that judges and juries have little choice but to trust the expert’s self-assessment of bias (see Kassin et al., 2013), and the potential for biased opinions and conclusions to cross-contaminate other evidence or testimony (see Dror, Morgan, Rando, & Nakhaeizadeh, 2017). More research is necessary to determine the specific strategies to be used and the various recommended means of implementing those strategies across forensic evaluations, but the time appears to be ripe for further discussion and development of policies and guidelines to acknowledge and attempt to reduce the potential impact of bias in forensic evaluation.

The article is here.

Monday, January 8, 2018

Advocacy group raises concerns about psychological evaluations on hundreds of defendants

Keith L. Alexander
The Washington Post
Originally published December 14, 2017

A District employee who has conducted mental evaluations on hundreds of criminal defendants as a forensic psychologist has been removed from that role after concerns surfaced about her educational qualifications, according to city officials.

Officials with the District’s Department of Health said Reston N. Bell was not qualified to conduct the assessments without the help or review of a supervisor. The city said it had mistakenly granted Bell, who was hired in 2016, a license to practice psychology, but this month the license was downgraded to “psychology associate.”

Although Bell has a master’s degree in psychology and a doctorate in education, she does not have a PhD in psychology, which led to the downgrade.

The article is here.

Sunday, October 22, 2017

A Car Crash And A Mistrial Cast Doubts On Court-Ordered Mental Health Exams

Steve Burger
Side Effect Media: Public Health/Personal Stories
Originally posted September 26, 2017

Here is an excerpt:

Investigating a lie

Fink was often hired by the courts in Indiana, and over the last ten years had performed dozens of these competency evaluations. His scene-of-the-crash confession called into question not only the Loving trial, but every one he ever worked on.

Courts rely on psychologists to assess the mental fitness of defendants, but Fink’s story raises serious questions about how courts determine mental competency in Indiana and what system of oversight is in place to ensure defendants get a valid examination.

The judge declared a mistrial in Caleb Loving’s case, but Fink’s confession prompted a massive months-long investigation in Vanderburgh County.

Hermann led the investigation, working to untangle a mess of nearly 70 cases for which Fink performed exams or testing, determined to discover the extent of the damage he had done.

“A lot of different agencies participated in that investigation,” Herman said. “It was a troubling case, in that someone who was literally hired by the court to come in and testify about something … [was] lying.”

The county auditor’s office provided payment histories of psychologists hired by the courts, and the Evansville Police Department spent hundreds of hours looking through records. The courts helped Hermann get access to the cases that Albert Fink had worked on.

Wednesday, January 20, 2016

Using Internet and Social Media Data as Collateral Sources of Information in Forensic Evaluations

By Pirelli, G., Otto, R.K., and  Estoup, A.
Professional Psychology: Research and Practice, Jan 11 , 2016

Abstract

Increasing use of Internet search engines (e.g., Google), social networking sites (e.g., Facebook), and commentary vehicles (e.g., Twitter) has prompted discussion regarding users’ privacy. Whereas there is a growing professional literature pertaining to the use of data drawn from social media sources in employment, university admissions, and health-care settings, few publications address the use of Internet data in forensic mental health assessment contexts. In this paper, we consider the appropriateness of professionals seeking and incorporating Internet and social media data when conducting forensic psychological evaluations, and we set forth a call for research and additional commentary.

The article is here.

Sunday, December 28, 2014

Psychologists and psychiatrists serving as expert witnesses in court: what do they know about eyewitness memory?

Annika Melindera & Svein Magnussena
Psychology, Crime & Law
Volume 21, Issue 1, 2015, pp 53-61

Abstract

Expert witnesses have various tasks that frequently include issues of memory. We tested if expert witnesses outperform other practitioners on memory issues of high relevance to clinical practice. We surveyed psychiatrists and psychologists who reported serving as expert witnesses in court (n = 117) about their knowledge and beliefs about human memory. The results were compared to a sample of psychiatrists and psychologists who had never served as expert witnesses (n = 819). Contrary to our expectations, the professionals serving as expert witnesses did not outperform the practitioners who never served. A substantial minority of the respondents harbored scientifically unproven ideas of human memory on issues such as the memory of small children, repression of adult traumatic memories, and recovered traumatic childhood memories. We conclude that the expert witnesses are at risk of offering bad recommendations to the court in trials where reliability of eyewitness memory is at stake.

The entire article is here.

Monday, November 24, 2014

Psychologist paying $550,000 settlement in toddler’s death

By Tom Jackman
The Washington Post
Originally published November 8, 2014

The mother of a 15-month-old boy who died while on a visit to his father in Manassas in 2012 will be paid a $550,000 wrongful death settlement from the psychologist who testified that it was safe to leave the boy with his father, Joaquin Rams.

The settlement was entered in Fairfax Circuit Court on Oct. 17, the same day that Prince William County prosecutors, who are seeking to prove that Rams killed his son, revealed that Virginia’s chief medical examiner had changed the official ruling on the cause of death from drowning to “undetermined.”

The entire article is here.

Wednesday, October 1, 2014

Ethical Principles and the Communication of Forensic Mental Health Assessments

Alfred Allan, Thomas Grisso
Ethics & Behavior 
Vol. 24, Iss. 6, 2014

Abstract
Our premise is that ethics is the essence of good forensic practice and that mental health professionals must adhere to the ethical principles, standards, and guidelines of their professional bodies when they communicate their findings and opinions. We demonstrate that adhering to ethical principles can improve the quality of forensic reports and communications. We demonstrate this by focusing on the most basic principles that underlie professional ethical standards and guidelines, namely, Fidelity and Responsibility, Integrity, Respecting Rights and Dignity of Persons, and Justice and Fairness. For each principle we offer a brief definition and explain its demands. Then we identify ways in which the principle can guide the organization, content, or style of forensic mental health report writing, offering illustrative examples that demonstrate or abuse the principle.

(cut)

Unless they are confronted with a specific ethical problem, many professionals consider the writing of reports an archetypical practical task and might not consider how it is related to the ethical principles of their profession. Yet ethics is the very essence of professional practice. As we seek to demonstrate, almost every facet of report writing is related to an ethical principle. We do not assert that one is practicing unethically if one makes the types of errors in report writing that we have described. Our primary purpose in this article is to demonstrate how forensic report writing can be improved by using professional ethics principles as a guide for report-writing practice.

The entire article is here, behind a paywall.

Wednesday, September 3, 2014

Who Is the Client and Who Controls Release of Records in a Forensic Evaluation?

By Bruce Borkosky
Psychological Injury and Law
August 2014
DOI: 10.1007/s12207-014-9199-6

Abstract

Forensic psychologists often refuse to release evaluation records, especially to the evaluee. One justification for this practice is based on the ethical positions that the referral source “is the client” and “controls release of records” (also found in the Specialty Guidelines for Forensic Psychology). To determine whether these ethical positions are shared by the field of forensic mental health, official documents from forensic mental health organizations were used as a proxy for these views. Thirty-four supporting arguments for either position were identified from the literature; it was postulated that official documents would support both positions and utilize supporting arguments. Fifty-four official documents were discovered, and qualitative analysis was used to construct a 17-category model of official views. Neither position was supported by a majority of documents, and few of the supporting arguments were utilized by supportive documents. The positions are unsupported because official documents espouse a wide diversity of views, there are a number of logical flaws in supporting arguments, and even official APA documents hold conflicting views. Ethical arguments are advanced for contrary positions, and the referral-source-control of records release is contrary to law. A more ethical view is that the psychologist may have multiple, possibly conflicting responsibilities to multiple entities; the psychologist’s roles and responsibilities should be clarified with each entity using an informed consent process. Psychologists should release records at the behest of the evaluee, lest they be subject to licensing discipline, Health Insurance Portability and Accountability Act (HIPAA) complaints, and/or civil sanctions. Recommendations are offered for psychologists, future ethics codes and professional practice guidelines, and test security practices.

The entire article is here.

Thursday, June 19, 2014

IQ Cutoff for Death Penalty Struck Down by Supreme Court

By Sara Reardon and Nature News Blog
Scientific American
Originally posted on May 28, 2014

When deciding whether a defendant is too intellectually disabled to receive the death penalty, courts must take into account inherent variability in IQ scores, the US Supreme Court ruled today.

In its 5-4 decision, the court said that it is unconstitutional for states like Florida to use an IQ score of 70 as a cutoff above which a defendant is considered to be intelligent enough to understand the consequences of his or her actions.

The entire article is here.

Tuesday, June 3, 2014

Are Psychologists Violating their Ethics Code by Conducting Death Penalty Evaluations for Defendants with Mental Disabilities?

By Celia Fisher
The Center for Ethics Education
Originally posted on May 17, 2014

Imagine you are a forensic psychologist asked during the sentencing phase of a capital punishment case to assess the mental status of a homeless, African American defendant convicted of murder.  Your evaluation report states that the defendant has an IQ and adaptive living score bordering on a diagnosis of intellectual disability, but the absence of educational and health records from childhood prevents you from definitively stating he fits the Supreme Court’s definition of “mental retardation” which would preclude the jury from recommending the death penalty.  Subsequently the defendant is sentenced for execution.

The entire article is here.

Wednesday, November 6, 2013

Are Forensic Evaluations “Health Care” and Are They Regulated by HIPAA?

By Bruce Borkosky,  Jon M. Pellett, and Mark S. Thomas
Psychological Injury and Law
June 2013

Abstract

Forensic mental health providers (FMHPs) typically do not release records to the examinee. The Health Insurance Portability and Accountability Act (HIPAA) federal regulations might change this position, given that they have created a basic right of access to health care records. This legislation has led to a disagreement regarding whether HIPAA regulates forensic evaluations. The primary argument (and the majority of scholarly citations) has been that such evaluations do not constitute “health care.” Specifically, in this position, the nature and purpose of forensic evaluations are not considered related to treatment (amelioration of psychopathology) of the patient. In addition, it asserts that HIPAA applies solely to treatment services; thus, forensic evaluations are inapplicable to HIPAA. We describe the evidence for and against this argument, the strengths and limitations of the evidence, and recent court decisions related to it. The weakest part of the “HIPAA does not regulate forensics” argument is that HIPAA has no exclusion criteria based on type of services. It only creates an inclusion criteria for providers; once “covered,” all services provided by that provider are thence forward “covered.” Authoritative evidence for patient access can be found in the HIPAA regulations themselves, the US Department of Health and Human Services’ commentaries, additional statements and disciplinary cases, the research literature, other agency opinion, and legal opinion. It appears that the evidence strongly suggests that, for those forensic mental health practitioners who are covered entities, HIPAA does apply to forensic evaluations. The implication is that FMHPs potentially face various federal, state, and civil sanctions for refusing to permit patient access to records.

The article is here.

Monday, September 9, 2013

Vignette 28: Another Point of View

A psychologist who completes evaluations for the Bureau of Disability Determination (BDD) calls you for a consultation.

Earlier in the day, the psychologist evaluated a 48-year-old male with a history of chronic pain.  The only documentation received from BDD was a list of medications, which included an antidepressant and a prescription sleep aid.

The disability applicant arrived late for the evaluation, reporting that his pain prevented him from being on time.  He shuffled his feet, walked in a hunched manner, used a cane, shifted in his seat frequently, and groaned throughout the evaluation.  He described rather significant cognitive and vegetative symptoms of depression.  He began to cry softly at one point when discussing the negative consequences of chronic pain.  When asked about outpatient psychological treatment, the disability applicant explained he did not know that psychotherapy could help, and he would be anxious to try therapy.

At the end of the evaluation, the patient left, shuffling and making muffled groans as he left the office and the waiting room.  When the psychologist returned to his office, he remembered a lunch date for which he was late.  As he was leaving the office building, the psychologist saw the disability applicant in the parking lot laughing with another person.  He twirled his cane with one hand.  He stood upright and seemed genuinely happy.  When the disability applicant met the psychologist’s gaze, the applicant immediately hunched over, grabbed his back, groaned loudly, and used the cane to steady himself.  The psychologist hopped in his car for lunch without any discussion with the applicant.

Knowing that BDD evaluations are used within a legal context (in that lawyers, other psychologists, and administrative law judges will see this report), the psychologist asks the following questions:

1. What are the psychologist's ethical duties to the BDD?

2. What are the psychologist's ethical duties to the applicant?

3. Is the psychologist permitted to use any of his observations outside of the office as part of his report? If so, why?  If not, why not?

4. If so, should it be included as an addendum or as part of the body of the report?

5. In either case, how do these observations influence the psychologist’s rating of truthfulness or veracity during the evaluation?

6. Does the psychologist have any obligation to clarify what happened in the parking lot with the disability applicant by phone?

7. If not, how should the psychologist respond if the disability applicant calls him to discuss the evaluation or the interaction in the parking lot?

8. Is it appropriate to use the term “malingering” in the report, given that there is such a small sample of behavior?

Wednesday, August 7, 2013

Jodi Arias Trial: The Importance of Forensic Psychology Guidelines

By MICHAEL J. PERROTTI, PHD
World of Psychology Blogs

I have served as a clinical and forensic neuropsychologist expert witness for over twenty years. It is of utmost importance that an even playing field be created in adversarial proceedings.

What is conducive to this is use of forensic guidelines as standards by all experts involved in a case.

The Jodi Arias trial depicts apparent omissions of important standards that could influence outcome of assessment. There was a lack of collateral interviews, which the Reference Manual for Scientific Evidence (RMSE) addresses.

In addition, there were other omissions that I believe are important to the outcome of the Jodi Arias trial.

The entire blog post can be found here.

Jodi Arias Trial: Teachable Moments in Forensic Psychology can be found on the Video Resources page of this blog

APA's Forensic Guidelines can be found on the Guides and Guidelines page of this site

Thursday, June 13, 2013

Suspect in Colorado Killings Enters Insanity Plea

By Jack Healy
The New York Times
Originally posted on June 4, 2013

James E. Holmes, the former neuroscience student charged with killing 12 people inside a Colorado movie theater last July, changed his plea on Tuesday to not guilty by reason of insanity.

It was an expected shift in Mr. Holmes’s defense, formalized during a court hearing in this Denver suburb. As the judge read a lengthy document describing the legal consequences and psychiatric examinations that would follow the plea, Mr. Holmes, shackled and dressed in a red jail uniform, appeared to follow along on a copy, gazing down as one of his lawyers flipped the pages.

The entire story is here.

Wednesday, June 12, 2013

An Ethical Prohibition that Isn’t — And Never Really Was

By Robert E. Erard, Ph.D.
The National Psychologist
March 11, 2013

A decade after the 2002 APA Ethics Code and the HIPAA Privacy Rule should have settled the matter many psychologists continue to believe fervently that they have some special ethical duty to resist all formal requests for their raw test data, even when these requests are accompanied by releases from the test taker and even by subpoenas or court orders.

When asked for their test data, some psychologists claim paternalistically that nobody could ever understand what these mysterious numbers mean without being a licensed psychologist. They seem to ignore the fact that we ourselves have an ethical duty (Ethical Standard 9.10; APA, 2002) to provide test feedback (i.e., explaining those numbers), not to mention that most test publishers routinely sell test forms and computerized test interpretations to psychiatrists, social workers, counselors and others.

Other psychologists contend that either test copyrights or licensing agreements with test publishers prevent them from complying with these requests. They overlook the fact that the Fair Use Doctrine under the Copyright Act of 1976 (2011), the legal rights of test takers to their health care information and discovery rules governing the bases for experts’ opinions in forensic matters have consistently trumped these arguments when they have been put to the test (e.g., see Carpenter v. Yamaha, 2006).

The entire story is here.

Monday, May 20, 2013

Mental Evaluations Endorse Insanity Plea in Colorado Shootings, Defense Says

By Jack Healy
The New York Times
Published May 13, 2013

Mental health experts who evaluated the man accused of killing 12 people in a Colorado movie theater last year have offered a diagnosis that bolsters an insanity plea in the case, his lawyers said at a hearing here on Monday.

“We now have a diagnosis that’s complete,” Daniel King, a defense lawyer for the suspect, James E. Holmes, said in court. “We now have an opinion by qualified professionals.”

Mr. Holmes, 25, a former graduate student in neuroscience, faces 166 counts of murder, attempted murder and weapons charges in the July 20 shooting during a midnight premiere of the Batman movie “The Dark Knight Rises” at an Aurora movie theater. Officials say he slipped out of an emergency exit shortly after the movie began, sheathed himself in commando-style gear and then returned through the same door to spray the sold-out crowd with gunfire.

Mr. Holmes’s lawyers made a long-expected move on Monday to change his plea to not guilty by reason of insanity. At an arraignment in March, a judge entered a straightforward not guilty plea on Mr. Holmes’s behalf after his lawyers said they were not ready to enter a plea.

The entire story is here.

Monday, April 29, 2013

Jodi Arias Trial - Teachable Moments

Dr. Samuels's Testimony on his evaluation of Jodi Arias. Witness for the Defense


Dr. DeMarte's Testimony on her evaluation of Jodi Arias.  Witness for the Prosecution.



The YouTube video can be found here.

There are quite a few teachable moments in both of these videos.

Thanks to Gary Schoener for these links.

Saturday, April 13, 2013

Mental Illness Is No Guarantee Insanity Defense Will Succeed

By RUSS BUETTNER
The New York Times
Published: April 3, 2013

Here are some excerpts:

Throughout his adult life, Mr. Tarloff, 45, has been prescribed antipsychotic medication to alleviate delusions and hallucinations. He has received a diagnosis of schizophrenia and been hospitalized against his will numerous times. And three months after one such commitment, Mr. Tarloff entered an Upper East Side medical office on Feb. 12, 2008, and killed Kathryn Faughey, a psychologist, with a mallet and a knife.

Yet a lifetime of being crazy hardly makes an insanity defense a sure thing. Mr. Tarloff’s lawyers must convince jurors, who will begin deliberations Wednesday, that he was so sick that day that he did not understand the consequences of his actions: that pounding and stabbing Dr. Faughey could kill her, or that the attack was wrong.

The standard is so difficult to meet that few defendants using the insanity defense in New York win at trial. Of 5,910 murder cases completed in the last decade statewide, only seven defendants have been found at trial to be not responsible by reason of mental disease or defect, according to the state Division of Criminal Justice Services.

The state does not track how often the defense is raised. But failed attempts at the insanity defense regularly receive public attention, including Andrew Goldstein, a schizophrenic who in 1999 pushed Kendra Webdale to her death in front of a subway train, and Renato Seabra, a Portuguese fashion model who in 2011 murdered and mutilated his lover in a Times Square hotel. Both were found criminally responsible for murder.

The entire story is here.