By Marcopulos B, Welner M, Campbell K In: Sanders K Physician’s Field Guide to Neuropsychology: Collaboration Through Case Example Springer 2019, pp 495-506
Intro: Physicians may encounter forensic issues when treating and evaluating their patients. The decisions made in the clinical care environment are used to guide treatment planning, social services, or hospital discharge disposition, but deliberations regarding civil capacity in treatment settings, such as informed consent to treatment and competency to refuse treatment and guardianship, are difficult for patients and their families. The physician may be the first to broach the need for a guardian for finances, after their patient suffered a stroke, TBI, or other brain disease affecting cognition, putting them at potential risk for abuse or exploitation. A physician may also be the entry point for consideration of whether their patient is competent to sign a contract or to give sexual consent. Capacity issues such as these require relatively intact cognitive functioning, and physicians may enlist the help of a neuropsychologist to perform a more detailed assessment. Physicians and neuropsychologists can collaborate to ensure careful documentation of medical conditions and cognitive abilities affecting these treatment decisions and legal implications. Also, a patient may have committed a crime, and their medical status and cognitive functioning may be seen as relevant to their culpability. Physicians and neuropsychologists can work well together to address legal matters that arise during routine patient care or from attorney referrals once a matter becomes a legal dispute in civil or criminal court. This chapter will provide a brief overview of the various civil and criminal legal proceedings that patients may face and how these legal matters can be addressed with collaboration between physicians and neuropsychologists. The literature on forensic issues in medical practice and psychology and neuropsychology is much too extensive to be adequately covered in this chapter. The reader is encouraged to consult with current texts and journal articles for a more in-depth discussion.
