Ethical considerations in medicolegal evaluation of neurologic injury and impairment following acquired brain injury

Abstract

Specific training for medicolegal evaluation of persons with neurologic injury or impairment is not always obtained. Most physicians and psychologists acknowledge that they receive insufficient formal training or education with regard to identifying and coping with the various potential ethical conflicts that can arise in this arena. However, increasing guidelines are being issued for managing the disparities between conflicting interests and ethics for distinctly different roles of independent examiner/expert witness versus treating clinician. In the current paper, relevant ethical issues are reviewed in order to illustrate ethical conduct as it relates to many common aspects of medicolegal situations. Although some of the current dilemmas described are unique to the interaction of the American legal and health care systems, most have international relevance. Finally, recommendations are provided toward the goal of promoting standardization of objective and ethical conduct in medical and psychological practice.