Psych · Forensic psychiatry — civil
Civil forensic psychiatry
Also known as Civil forensic psychiatry · Medico-legal psychiatry civil · Testamentary capacity · Financial capacity · Psychiatric disability evaluation · Independent medical examination psychiatry · Fitness for work psychiatry · Fitness for duty psychiatry · Personal injury psychiatry · Guardianship assessment psychiatry
Exam-exhaustive fellowship reference on civil forensic psychiatry: testamentary and financial capacity (Banks v Goodfellow principles; functional domains), guardianship and substitute decision-making principles, personal-injury and psychiatric disability evaluation (AAPL disability guideline), fitness for work/duty, symptom validity, dual-role ethics, and civil report structure. Jurisdiction principles only — no invented statute section numbers. FRANZCP-primary, globally tagged.
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Red flags
- Equating a psychiatric diagnosis with legal incapacity, disability, or automatic work unfitness
- Inventing statute section numbers, tribunal form codes, or universal impairment percentages
- Confusing testamentary incapacity with undue influence (they can coexist but are not identical)
- Retrospective will opinions without reconstructing contemporaneous evidence
- Dual-role confusion: treating psychiatrist writing as if a neutral court expert without disclosure
- Ignoring symptom/performance validity in personal-injury and disability claims
- Deathbed will assessment without considering delirium and fluctuation
- Opining beyond expertise or beyond the referral questions
Meet the file
An 84-year-old man signed a new will eleven days before he died on a surgical ward, leaving his estate to the carer who had moved in six months earlier and nothing to the two daughters named in the previous will. He had mild dementia, a urinary infection, and an opioid infusion.[9][15][16]
The solicitor's file note reads: "Client seemed well and knew what he wanted." The nursing notes for the same afternoon record him as drowsy and disoriented to place.[14][16]
Three separate questions live in that file and they must be answered separately: did he have testamentary capacity at that moment; was he delirious; and was he unduly influenced? They can all be true, all false, or any combination.[7][15][16]
References22ShowHide
- [1]Samuels AH Civil forensic psychiatry - Part 1: an overview Australas Psychiatry, 2018.PMID 29400548
- [2]Samuels AH Civil forensic psychiatry - Part 2: specific issues Australas Psychiatry, 2018.PMID 29457475
- [3]Samuels AH Civil Forensic Psychiatry - part 3: practical aspects of managing a medico-legal practice Australas Psychiatry, 2018.PMID 29457467
- [4]Gold LH, Anfang SA, Drukteinis AM, et al. AAPL Practice Guideline for the Forensic Evaluation of Psychiatric Disability J Am Acad Psychiatry Law, 2008.PMID 19092058
- [5]Anfang SA, Gold LH, Meyer DJ AAPL Practice Resource for the Forensic Evaluation of Psychiatric Disability J Am Acad Psychiatry Law, 2018.PMID 29752290
- [6]Glancy GD, Ash P, Bath EP, et al. AAPL Practice Guideline for the Forensic Assessment J Am Acad Psychiatry Law, 2015.PMID 26054704
- [7]Aravind H, Taylor M, Gill N Evaluation of testamentary capacity: A systematic review Int J Law Psychiatry, 2024.PMID 38422563
- [8]Jakubek A, Montag T, Hull IM, et al. The Medico-Legal Approach to the Assessment of Testamentary Capacity: A Systematic Review Am J Geriatr Psychiatry, 2025.PMID 39690101
- [9]Shulman K, Herrmann N, Peglar H, et al. The Role of the Medical Expert in the Retrospective Assessment of Testamentary Capacity Can J Psychiatry, 2021.PMID 32233933
- [10]Roof JG Testamentary capacity and guardianship assessments Psychiatr Clin North Am, 2012.PMID 23107570
- [11]Sousa LB, Simões MR, Firmino H, et al. Financial and testamentary capacity evaluations: procedures and assessment instruments underneath a functional approach Int Psychogeriatr, 2014.PMID 24229806
- [12]Mart EG Neuropsychological Assessment of Testamentary Capacity and Undue Influence Arch Clin Neuropsychol, 2016.PMID 27480988
- [13]Sudo FK, Laks J Financial capacity in dementia: a systematic review Aging Ment Health, 2017.PMID 27647045
- [14]Shulman KI, Peisah C, Jacoby R, et al. Contemporaneous assessment of testamentary capacity Int Psychogeriatr, 2009.PMID 19323871
- [15]Peisah C, Finkel S, Shulman K, et al. The wills of older people: risk factors for undue influence Int Psychogeriatr, 2009.PMID 19040788
- [16]Liptzin B, Peisah C, Shulman K, et al. Testamentary capacity and delirium Int Psychogeriatr, 2010.PMID 20594383
- [17]Kunz R, von Allmen DY, Marelli R, et al. The reproducibility of psychiatric evaluations of work disability: two reliability and agreement studies BMC Psychiatry, 2019.PMID 31266488
- [18]Ciccone JR, Fisher J, Jones JCW Forensic neuropsychiatric evaluation of a personal injury case Behav Sci Law, 2024.PMID 38145476
- [19]Sweet JJ, Heilbronner RL, Morgan JE, et al. American Academy of Clinical Neuropsychology (AACN) 2021 consensus statement on validity assessment Clin Neuropsychol, 2021.PMID 33823750
- [20]Grisso T, Appelbaum PS, Hill-Fotouhi C The MacCAT-T: a clinical tool to assess patients' capacities to make treatment decisions Psychiatr Serv, 1997.PMID 9355168
- [21]Grisso T, Appelbaum PS Comparison of standards for assessing patients' capacities to make treatment decisions Am J Psychiatry, 1995.PMID 7793439
- [22]Wygant DB, Tylicki JL, Disney LF, et al. Structured Interview of Reported Symptoms-2nd Edition (SIRS-2): Use and Admissibility in Forensic Mental Health Assessment J Pers Assess, 2022.PMID 34871131