Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

16. Addiction and the Law 355PSYCHIATRY AND THE LAWAny psychiatrist may, willingly or not, become involved in legal issues. Theuninitiated must become familiar with general knowledge on the law and psychiatry(Group for the Advancement of Psychiatry, 1991; Gutheil, 1998;Rosner, 2003). Some universals should be stated. First, in the United States,“local rules” matter. Every jurisdiction has its own laws, rules, case law, andadministrative regulations under which medicine and psychiatry are practiced,and these should be reviewed by the psychiatrist before addressing the facts.Second, in the United States, administrative, criminal, and civil cases areset in an adversarial system in which one side is pitted against the other. Theadversarial system can create situations in which the expert is attacked by theopposing side, and such attacks have gone as far as complaints to professional orethical boards, but experts very rarely have been accused of perjury (Binder,2002). Thus, maintaining a professional stance is vital. The forensic expert isalways better served in the position of friend to the Court (as is the case in DrugCourts), rather than to one of the parties.Third, it is important to be aware that there is an opprobrium against “junkscience.” The psychiatrist who serves as an expert witness under oath should beprepared for his or her ideas to be questioned, perhaps in great detail and incomparison with the general knowledge of the field. Until recently, the Federalstandard was that created by the Frye case, otherwise known as the “generalacceptance test,” but Daubert v. Merrell Dow and subsequent cases established anew precedent with which experts should be familiar (Gutheil & Stein, 2000)in order to be ethical and effective.ADDICTION AND THE LAWThere are areas of psychiatry and addiction testimony that are contested, evenif clinically valid and important. Therefore, some guidance into what is saidabout addictions and substances in court may be useful.“Addiction”: A Courtroom Definition“Addiction” is a powerful word, and it should not be misused. Its meaning carriesbiological, behavioral, and social connotations. Among physicians, it hasbeen interchangeable with “substance dependence,” and this has been linked todemonstrable alterations in neural activity. However, the medical communityalso has come to consider food, gambling, and sex as “addictions,” and attorneys,clients, and some doctors may wish to apply the suffix “-ism” to anybehavior they wish to portray as compulsive or uncontrollable. There has beena backlash to the expanding application of this word and, so far, courts have