Course Description
(This panel is sponsored by AAPL's Judicial Action Committee)
Neurological evidence (neurological diagnoses, neuroimaging, neuropsychological testing, and/or neurological exam findings) is increasingly used in forensic evaluations of defendants, having been introduced in over 8000 criminal cases in the United States in the last 12 decades. While forensic psychiatrists may be asked to opine on neurological evidence or neurological diseases, these opinions are typically outside their expertise unless they have had special training. The panel will present the unique factors and ethics challenges that forensic practitioners should consider when encountering common neurological diseases (e.g., TBI, focal brain lesions, dementia, sleep disorders, seizures, among others) and applying neurological evidence in their opinions. The panel, which includes a forensic neuropsychiatrist, forensic behavioral neurologist, forensic neuropsychologist, as well as general forensic psychiatrists, will use hypothetical and other case examples to illustrate how and when forensic psychiatrists should consult and coordinate their work with forensic neurologists and neuropsychologists. We will discuss the important role of forensic neurologists in relation to forensic psychiatrists despite there being no formal forensic training for neurologists. The panel will emphasize how an interdisciplinary approach to these forensic cases, balancing differing perspectives, approaches, and expertise between the specialties, is the best way to foster truth in these forensic settings.
REFERENCES
Deborah W. Denno, How Experts Have Dominated the Neuroscience Narrative in Criminal Cases for Twelve Decades: a Warning for the Future, 63 Wm. & Mary L. Rev. 1215 (2022), https://scholarship.law.wm.edu/wmlr/vol63/iss4/5
Darby, R. R. (2018). Neuroimaging abnormalities in neurological patients with criminal behavior. Current neurology and neuroscience reports, 18, 1-7.
QUESTIONS AND ANSWERS
1. Which of the following represents an ethics concern for applying neuroimaging and biomarkers for
neurocognitive disorders in forensic evaluations?
A. The trier of fact may overvalue the significance of “objective” tests.
B. Informed consent issues regarding using data for forensic purposes.
C. Possible coercion for evaluees to get these prognostic tests in forensic settings when they would
otherwise wish not to know dementia risk.
D. All of the above
E. None of the above
ANSWER: D
2. It is estimated that between 37-57% of people with which neurological disorder have criminal behavior?
A. Huntington’s disease (HD)
B. Frontotemporal dementia (bvFTD)
C. Epilepsy
D. Traumatic Brain Injury (TBI)
E. REM sleep behavior disorder (RBD)
ANSWER: B
Speakers
William Connor Darby, MD, Los Angeles, CA
Octavio Choi, MD, PhD, Stanford, CA
Robert Weinstock, MD, Los Angeles, CA
R. Ryan Darby, MD, Nashville, TN (I)
Ciaran Considine, PhD, Nashville, TN (I)
Octavio Choi, MD, PhD, Stanford, CA
Robert Weinstock, MD, Los Angeles, CA
R. Ryan Darby, MD, Nashville, TN (I)
Ciaran Considine, PhD, Nashville, TN (I)
Accreditation Statement
The American Academy of Psychiatry and the Law is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The American Academy of Psychiatry and the Law designates this enduring material for a maximum of 2.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Learning Objectives
Describe unique factors to consider when evaluating for common neurological disorders in criminal forensic settings; Describe how to recognize the limits of our qualifications in presenting certain neurological evidence (e.g., neuroimaging) and when it is most appropriate to consult, work in tandem, or refer to a forensic neurologist, neuropsychologist, or forensic neuropsychiatrist; Describe the competing ethics considerations to balance when applying neurological evidence to forensic opinions; Describe ethics and practical challenges to working in an interdisciplinary forensic team; Describe relevant case law pertinent to presenting on neurological evidence
Describe unique factors to consider when evaluating for common neurological disorders in criminal forensic settings; Describe how to recognize the limits of our qualifications in presenting certain neurological evidence (e.g., neuroimaging) and when it is most appropriate to consult, work in tandem, or refer to a forensic neurologist, neuropsychologist, or forensic neuropsychiatrist; Describe the competing ethics considerations to balance when applying neurological evidence to forensic opinions; Describe ethics and practical challenges to working in an interdisciplinary forensic team; Describe relevant case law pertinent to presenting on neurological evidence
Disclosures
All meeting planners, Program and Education Committee Members, in control of content for the meeting have signed disclosures indicating that they have no relevant financial relationships with any ineligible companies.
All presenters of this activity have also signed disclosures indicating that they have no relevant financial relationships with any ineligible companies.
