In lieu of an abstract, here is a brief excerpt of the content:

THE PHYSICIAN'S DIS-EASE AS AN EXPERT WITNESS: ITS SEMANTIC PATHOLOGY RUSSELL MEYERS, ?.?., ScM., F.A.C.S.* Many ofour youngerpeople have very little interest today in offering themselves as experts in court in view ofthe constrictedframework in which they believe their testimony may be cast, aframework which is considered irrelevant to their areas ofcompetence . . . answers supplied . . . almost constitute aprofessional perjury.—J. Lawrence Kolb, M.D. Many thoughtfulpsychiatrists who have had court experience are so impressed with the difficulties in rendering conscientious service to the courts in the determination of criminal responsibility under existing rules . . . that they have become nihilists.—Manfred GUTTMACHER, M.D. Incidence and Description ofSymptoms These baleful comments, recently made by the director ofthe Psychiatric Institute of New York and by a distinguished academician at the Johns Hopkins Medical School, referred particularly to observable reactions ofpsychiatrists, who from time to time appear as expert witnesses in our courts of law. There is little room to doubt that our confreres in this specialty are more often and perhaps more intensely vexed on the legal scene than the rest of us. But the animadversion to which their spokesmen allude is frequently enough visited upon their colleagues who perforce are intimately involved with the behavioral sciences—neurologists , psychologists, neurosurgeons, anthropologists, sociologists, geneticists , physiatrists, and special educators—and also upon orthopedists, internists, and general practitioners, who, as medical experts, are called upon to mediate with members ofthe legal andjudicial fraternity in and out of court on civil and criminal cases. The symptoms ofthe dis-ease consist essentially in a vague but poignant discomfiture, impatient disquietude, and piqued disenchantment with the court situation, at times bordering upon antipathetic exasperation and * The Highlands Clinic, Williamson, West Virginia. 211 downright resentment. Inasmuch as the malady is increasingly more manifest , it portends (as such restiveness has so often done in man's long history ) an imminent change. The present essay is concerned with this issue—more particularly with elucidating the semantic, etiologic, and pathologic bases of the dis-ease and envisioning a therapeutic course of action which holds some promise that the impending change will be salutary pro bono publico. During a clinical and research career of over thirty years in the behavioral sciences, I have been more than casually exercised over the issues cited. My sensitivities thereto have recently been sharpened incidental to the trial ofa young man in which I appeared as chiefmedical witness for the defense. A synopsis ofthe highlights ofthe case [i] follows. A marine aged twenty-one years, on temporary leave of absence, was mowing his fiancee's lawn. Upon being requested by aneighboring housewifenot to makenoise with the lawnmower lest her napping children be wakened, the soldier strangled and slaughtered the woman, inflicting over fifty stab wounds. He confessed to the crime on the following day and atno timerepudiated this admission. At the trial he pleadnot guilty by reason ofinsanity. The verified antecedent medical history disclosed that several craniocerebral traumas had been incurred during mid-adolescence. Then, on two occasions during the fifteen months preceding the homicide, the marine had experienced complete "blackouts," each of which was heralded by the sudden development of severe headache, stinging paresthesia of the face, profuse perspiration, diplopia, a generalized flushed-and-smothering sensation, and confusion. The first such episode occurred aboard ship while the marine was on watch duty. Sensing something was amiss, he hastily called the corporal of the guard by phone and reported, "I don't know what's happening." Evidently he passed out at this moment, for the corporal who reported on the call could obtain no further response. When fellow marines reached the scene, the victim appeared wholly unresponsive . He was assertedly discovered thrashing wildly about, deranging his clothes and gear, and had to be forcibly restrained. The victim's next awareness was of lying quietly on deck surrounded by his fellows. Helped to sick bay, he was examined by a naval physician who entered a diagnosis of "postural hypotension" and added the comment, "Definitely not a seizure pattern." The second episode, unwitnessed, assertedly occurred a year later. The heralding symptoms were as above described and, upon "coming to," the marine found himself wandering "groggily" on a lonely...

pdf

Share