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Pro & Con: should videotaping of forensic psychiatric examinations be the standard? (Opinion).

YES

The central purpose of the law is to find fact and seek truth using the best evidence. The forensic psychiatrist's role is to aid the court in reaching this central purpose.

No matter how good one's notes are or how good a psychiatrist is at describing his or her examination, there is no better way to obtain and preserve the most accurate record of the forensic psychiatric examination than a video recording.

Audiotaping can capture the verbal exchanges, including tone of voice and inflection, which, in and of itself, is an improvement over simple note taking. But videotaping preserves facial expressions, bodily movements, and other nonverbal personal and interpersonal behaviors that cannot be captured by any other means. Notes are an inherently biased record, since they are filtered through a human being--the psychiatrist. I've seen many cases in which even well-intentioned psychiatrists committed systematic errors in note taking when compared with a videotape record.

I have routinely videotaped my forensic examinations for more than 20 years now Most of the time I don't have to look at the videotape again. But many times, being able to review the interview on the videotape, for example, when a subject speaks very rapidly or when testimony occurs a long time after the examination, has proven invaluable.

Furthermore, videotapes of the examination, far better than notes, can help show a judge and/or a jury the complexity that is human psychology and behavior. Some psychiatrists don't like using videotape because they're concerned that they may look foolish, be criticized for their technique, or challenged about their interpretations of the information.

I like to compare a judge or jury to an analyst. One needs to be totally open so the analyst can have truthful information to be able to develop accurate perceptions and make correct interpretations. Likewise, we psychiatrists need to allow jury members to see what the psychiatrist experienced of the client in the examination, rather than force them to make decisions based only on how psychiatrists have interpreted the examination or shaped their testimony.

Although some raise questions about consent and coercion when questions are raised about the videotaping of forensic examinations, I find that videotaping is actually protective of coercion. The person being examined can be confident that an accurate record exists of the examination.

Finally, I find the use of videotape freeing. I set the video camera up, turn it on, and then focus solely on the interaction with the client. I can conduct a better interview without having to worry about whether I accurately noted what the subject said. I need not worry that I'm going to miss something because I know it's going to be there, one way or another. In fact, I usually have an assistant taking notes. I can review the videotape later, correct or fill in the notes, and critique my own performance. In that way I learn to do better interviews and, hopefully end up providing better service to the courts and the clients I evaluate.

Dr. Stephen Teich is a forensic psychiatrist in private practice in New York.

NO

Videotaping forensic examinations can be useful and extremely valuable for solving certain problems, but we need to be very careful in defining this as the standard of practice.

The problem with using the term "standard" is that any other practice immediately becomes substandard, second best, and possibly even negligent or inadmissible in court.

Calling videotaping a standard will bind us to that practice.

Suppose a subject doesn't consent to videotaping, or there's a legal bar to taping, or there's a mechanical failure. When videotaping is the standard, the psychiatrist will have to justify departing from that standard, even when that departure was outside the psychiatrist's control.

The question of consent is a special concern with videotaping. First of all, some individuals are happy to be examined but will object strenuously to videotaping.

Second, forensic psychiatrists are often called to evaluate an individual's competency We all evaluate individuals who are in altered mental states, such as dissociation or trance. Asking a subject to provide consent to videotaping presupposes competency.

This creates a paradox: In those very situations when videotaping might be most illuminating, the consent to be taped is the most uncertain.

Another problem is that defendants. are not the only individuals forensic psychiatrists must examine.

If videotaping is the standard, does that mean we must videotape interviews with collateral sources such as family members?

Cameras clearly can provoke self-consciousness and even paranoid concerns in the examinee.

This self-consciousness can decrease spontaneity. It will also encourage some people to play to the camera, to assume a role.

They're selling themselves in the interview rather than answering your questions.

And examinees are not the only ones who may become self-conscious.

This can apply to the examiner as well. Many psychiatrists are quite comfortable being videotaped, but some excellent, highly empathetic forensic examiners may feel inhibited by the camera's presence.

Some psychiatrists may become excessively focused on their performance, distracted by how they look and sound, and preoccupied with how they will appear for the ages and not just for the hours of the interview

Such tendencies and behaviors can easily shift one's focus away from the person being examined.

And while high-quality video cameras have come down in price in recent years so that cost is not much of a factor, there's still the inconvenience of having to deal with these devices.

Video cameras are one more thing to think about--one more thing diverting our focus from the individual that is before us.

Dr. Thomas G. Gutheil is professor of psychiatry at Harvard Medical School, Boston.
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Publication:Clinical Psychiatry News
Article Type:Brief Article
Geographic Code:1USA
Date:Feb 1, 2003
Words:940
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