to get as detailed a history as possible. One is only as good as one’s information in Psychiatry, and this helps to prepare a comprehensive report. Time is also important for the reason that claimants will have suffered trauma of some type. Their lives may have been turned upside down through no fault of their own. They may be seeking justice, but they also need to be heard. A listening ear is therapeutic. As well the examination of the claimant, one, of course, needs to go through the documentation relating to the case with a fine-tooth comb, looking for relevant information to be factored into the report. Once it has been dictated and typed, I check the report for any errors and reflect upon whether the solicitor’s instructions have been fully addressed. When I am happy with it, the report is sent off to the instructing party. How do you maintain confidentiality and professionalism while dealing with sensitive mental health information in your practice? As doctors, the importance of confidentiality is drilled into us repeatedly during our long years of medical training, and rightly so. As Psychiatrists, we are in a very privileged position, one in which patients, in their most vulnerable states, open up to us about the most intimate and sensitive things that they may have never told anyone else. This can only happen if we are trusted by our patients, and maintaining confidentiality is at the core of building trust. Empathy is also important during Psychiatric consultations as it helps to build rapport and shows that active listening is taking place. Consultations take place where privacy can be assured. It also goes without saying that all written documentation is dealt with in accordance with GDPR Regulations, with confidential data being disposed of appropriately at the end of a legal case. Lastly, could you share any standout experiences or cases that have particularly shaped your career as a Consultant Psychiatrist and Expert Witness? About eight years ago, I was instructed on a tragic case in Northern Ireland in which a lady of a professional background had smothered her newborn baby son to death. I was instructed by her solicitor to examine her and provide a Psychiatric opinion on her state of mind at the time of the fatal incident. I travelled to Belfast to examine her, where she had been imprisoned. It was very clear to me that the lady had suffered from Postpartum Psychosis, a rare but devastating sudden-onset Psychiatric disorder that occurs within six weeks of childbirth. In this case, it had been characterised by a severely depressed mood and delusional thinking, the lady having been convinced that she needed to ‘save’ her child from the very evil world he had been born into. When it went to court, my independent evidence was factored into the sentencing as the Judge’s verdict, in the end, was one of manslaughter as opposed to murder. For me personally, this was a landmark case in my Medico-legal career as up until then, I had only ever been instructed on General Adult Psychiatric cases, not on Perinatal ones. I have since been instructed on numerous perinatal claims, particularly clinical negligence, and continue to receive instructions on a regular basis. In terms of experiences that have helped to shape my Expert Witness career, I would say that invitations to present to the legal community have been very important. It has been an honour to be invited by lawyers to speak at their meetings as well as by charities such as Action against Medical Accidents (AvMA). I presented a webinar entitled ‘Medico-legal issues in Perinatal Psychiatric Injury’ for AvMA in 2020, which was aimed at Clinical Negligence lawyers. It was very rewarding to offer a specialist Psychiatric perspective on medico-legal issues at the interface between Medicine and Law, two great professions of the world. It offered me an excellent networking opportunity too. “They may be seeking justice, but they also need to be heard. A listening ear is therapeutic.” 18 United Kingdom
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