The Royal Australian & New Zealand College of Psychiatrists (RANZCP) recently released Professional Practice Guideline 11 (the Guideline). The Guideline’s goal is to provide a basic standard of practice and to assist psychiatrists in observing their professional obligations, especially in relationship to reports and conducting independent medical examinations in medico-legal settings.
Clarity must be sought by the psychiatrist as to whether the individual understands that the examination is happening because a request has been made by a third party (usually the lawyer of a party to litigation) or because orders have been made by a Court, Tribunal or other body.
- Psychiatrists are to inform the individual that their primary role is to provide a report to enable decision-making by the referrer or other relevant body (such as a Court or Tribunal).
- The Guidelines specify that psychiatrists should explain the purpose of the consultation, form of the interview, arrangements made for the individual’s privacy and the availability of breaks and/or refreshments.
- Importantly, psychiatrists should explain the limits of confidentiality regarding the examination and report and that the outcomes may be presented to the referrer and/or another relevant body.
Interactions with Patients
When it comes to a psychiatrist’s interaction with individuals to be assessed, they must carefully consider:
- Their duties of confidentiality to both the individual and the referrer, including disclosing any conflicts of interest and minimising harm.
- If an individual has been referred to a psychiatrist for the purposes of an independent medical examination and report, the psychiatrist should not offer to provide routine and ongoing treatment for that individual.
- If emergency treatment is required, it should only be provided where no reasonable alternative exists, and the individual should then immediately be referred to a treating health professional for ongoing care.
- From time to time, an individual may request a support person be present for the examination. Psychiatrists should consider these requests on a case-by-case basis and balance their decision on the individual’s desire and the requirements of the examination. In any event, if a support person is present, then this must be disclosed within the report.
- Sometimes referrers have obtained surveillance footage of the individual to assist in determining their capacity and impacts of their injury on everyday life. If surveillance footage/reports are included in the letter of request, psychiatrists need to ensure that the individual is aware of those. If footage is provided, then a psychiatrist may view it, but this must be in the presence of the individual.
- If an individual requests that the examination is recorded, the psychiatrist should refer to the laws in the relevant jurisdiction. If in doubt, the psychiatrist should seek to clarify the legality of the recording before commencing the examination and are free to decline the request.
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This publication is general in nature and is not comprehensive or constitutes legal or medical advice. You should seek legal, medical or other professional advice before relying on any content, and practice proper clinical decision making with regard to individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgment or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Tego Insurance Pty Ltd is not responsible to you or anyone else for any loss suffered in connection with the use of this information. All content on this page has been written in a generic way, and has not been presented with any knowledge of your personal objectives or financial needs.