Reflections on coaching by attorneys.

There are two potential contaminants of the psychiatric examination in a medicolegal context. One is the malingering of forensically significant mental illness; the second is attorneys’ coaching of litigants in an attempt to influence the litigants’ behavior and demeanor in the examination and thus to affect the outcome. Coaching represents both a forensic and an ethics problem, but the exact nature and the occurrence of coaching itself are not always unambiguous. For completeness, consider that defendants today are surrounded by “coaching influences” from friends, family, other inmates, jailhouse lawyers, the media, and the Internet. I focus here only on the attorney-client interaction. Relatively little has been written about this problem, although there are anecdotal reports heard in practice. For instance, experts tell of litigants appearing at examinations bearing the appropriate pages of the Diagnostic and Statistical Manual. The pages have been supplied by their attorneys, with the ostensible goal of helping the client understand his or her problem, the better to explain it, or other specious rationalizations. Most attorneys, of course, practice at a higher standard of ethics than that in this example. This editorial is intended to open the topic and to address the essential difficulty of distinguishing valid advice from venal coaching. Although little can be done by the forensic psychiatrist to affect or correct the latter, the expert’s awareness of the problem may assist in maintaining the desired objectivity, accuracy, and validity of the forensic assessment. Indeed, the forensic expert’s objectivity intrinsically contrasts with the attorney’s legitimate partisanship in the adversary model and places each discipline on a different ethics track. I will review a range of attorney-client interactions depicted in a variety of sources, realistic and fictional, ranging from overt and unabashed coaching to highly ambiguous examples.