How can we individualize, from the sins of the past, the present complex outcome?

Adjunct Professor Joan Lawrence1,2

1RANZCP Brisbane, Australia, 2Medicolegal Society of Queensland, Brisbane, Australia

This paper will attempt to demonstrate an issue many Forensic Psychiatrists face when compiling reports for civil compensation and will urge those with appropriate ability to address this weakness in our compensatory scheme.

A case report will delineate a set of multiple significant losses/disruptions in development from infancy, throughout childhood and early adolescence, leading inevitably to an ongoing troubled adult life marked by further failures in relationships, employment, finances and wellbeing. One of more of those recent stressors is compensable.

With a litany of stressors throughout his/her development, one is asked to indicate the impairment attributable to stressor L in a list of A to Z.

With current clinical opinion and measurement tools, how can we address validly and reliably this common legal question? There is a need for a new outcome measure that can isolate the individual past trauma contribution in a multi-trauma cumulative present outcome.


Adjunct Professor Joan Lawrence A.M. qualified in Medicine at University of Queensland (1957), and is registered to practice in Australia as a Consultant Psychiatrist (since 1962). She is a Fellow the Royal Australian and New Zealand College of Psychiatrists (FRANZCP) and Fellow the Royal College of Psychiatrists (FRC Psych).  She has been in continuous practice in adult general psychiatry in private and public practice, full time since, continuing presently.  She has extensive forensic experience in both civil and criminal matters increased over this time. Assessments in all areas, including risk assessments under the Dangerous Prisoners (Sexual Offenders) Legislation conducted.  Dr Lawrence is a Foundation Member of the Forensic Faculty of the RANZCP and a Member of the Australian and New Zealand Association for Psychiatry, Psychology and the Law (ANZAPPL).  She has been awarded Honorary Life Membership of the Medico-Legal Society of Queensland in 2005 for her contribution to both professions and was awarded the RANCP Medal of Honour in 1999.  She regularly attends conferences and workshops and often present papers at such meetings, nationally and internationally.  In addition, she has served as an Assisting Psychiatrist to the Mental Health Court 2002-2015, a Member of Q-CAT Panels and a Deputy Chairman of QCOMP Tribunals in Queensland.

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