title: The treating psychiatrist as expert in the courts: is it necessary or possible to separate the roles of physician and expert?
abstract: BACKGROUND
  Certified medical specialists, including forensic psychiatrists, from the 27 member states of the European Union (EU) may practise in each other's countries, but there are professional and legal differences between them. One may lie in whether a patient's treating doctor/clinician may give expert evidence about that person in court.
  
  
  OBJECTIVE
  To examine similarities and differences between EU jurisdictions in law and practice in combining or separating such roles and to review the evidence in support of either position.
  
  
  METHODS
  A psychiatrist with court experience was contacted in each EU country about law, practice and guidance on division of clinician-expert roles. Published literature was searched for an evidence base for practice in the field. Additional material is from discussion at a residential meeting of practising forensic psychiatrists from Austria, Belgium, Denmark, Germany, Hungary, the Netherlands, Switzerland and the UK.
  
  
  RESULTS
  All acknowledge that a treating clinician can never be an independent expert in that case, but the 22 (of 27) EU countries responding vary in law and practice on whether the dual role may be assumed. There has been almost no research interest in factors relevant to separation of roles. International discussion revealed that ethical and practice issues are not straightforward.
  
  
  CONCLUSIONS
  On current evidence, either separation or combination of clinical and expert roles in a particular case may be acceptable. Insofar as there are national legal or professional guidelines on this issue, anyone practising in that country must follow them and may safely do so, regardless of practice in their native country. The most important ethical issue lies in clarity for all parties on the nature and extent of roles in the case. This paper has additional material online.
authors.affiliation: School of Medicine, Cardiff University, Cardiff, UK. taylorpj2@cardiff.ac.uk
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Taylor
authors.forename: Marc
authors.initials: M
authors.lastname: Graf
authors.forename: Hans
authors.initials: H
authors.lastname: Schanda
authors.forename: Birgit
authors.initials: B
authors.lastname: Völlm
mesh_terms: D003416:Criminal Law; D005060:Europe; D005104:Expert Testimony / Q000331:legislation & jurisprudence*; D005555:Forensic Psychiatry / Q000331:legislation & jurisprudence*; D006801:Humans; D010820:Physicians