What does this discussion mean for the practitioner, who must respond to a subpoena, give a deposition or otherwise appear in court? Knowing how to function within the law's minimalist, procedural and rule-driven confines is critical to success in its halls. Grilling one's own attorney on the rules that will be followed is an important starting point. Knowing that set procedures of qualification, direct examination, cross-examination and rebuttal frame one's testimony goes a long way toward calming the anxiety most practitioners experience in court.
Moreover, preparing a script for testimony allows practitioners to fit their expertise into the requirements of the legal setting. The challenge of direct and cross-examination is to express clinical thinking in terms recognizable to the law. Intended as a forum accessible to the layperson, the courtroom does not value jargon and specialized vocabularies. Physicians must fit clinical data into the specific legal language governing the hearing.
It is the jurisdiction's legal definitions that will often determine the relevance of clinical information. Because standards may differ from court to court, clinicians must apply their testimony to the frameworks known to the jurisdiction (e.g., dangerousness, best interests, substituted judgment). This makes for a more seamless transition from the consultation room to the courtroom.
Furthermore, the adversarial legal process challenges psychiatrists to re-think the strengths and weakness of their clinical logic. Because psychiatrists are not used to exposing the collegial clinical ethic to the ethic of adversarial legal procedure, rehearsing responses to potential criticism is useful preparation. It surprises many first-time witnesses to find that criticism of their testimony is often not clinical in tone. Rather, it derives from the understanding of a layperson--an attorney or judge who is not familiar with the clinical meanings practitioners commonly take for granted. For example, merely describing schizophrenia as disorganized thinking and impaired contact with reality disabuses some laypeople of their misunderstanding of the illness as multiple personalities. This description, simplistic to psychiatrists, is more likely to convey information to a court about insanity, a legal concept it is asked to address with clinical information. Being clear in the use of clinical terminology and making it relevant to the operant legal criteria goes a long way toward blunting criticism of one's testimony.
These distinctions notwithstanding, law must have its roots in ethics. It must support the right and the just. It must emanate from the mores and values of the community. From the ancient meaning of these terms, it must draw its strength from society's traditions of what is good. From this starting point, however, the fields diverge. They are distinguishable and distinct. Recognizing the unique qualities of each enriches the experience of any practitioner who must negotiate the path between them.