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Malingering pain in the medicolegal context

George Mendelson1, Danuta Mendelson

  • 1Department of Psychological Medicine, Monash University, Caulfield Pain Management and Research Centre, Caulfield, Victoria, Australia. george.mendelson@med.monash.edu.au

The Clinical Journal of Pain
|October 27, 2004
PubMed

Insights

Malingering, the fake or exaggerated illness for gain, is common in pain complaints. Currently, no valid clinical methods exist to detect malingered pain, leaving veracity to the courts.

Area of Science:

  • Forensic Psychology
  • Clinical Medicine
  • Legal Medicine

Background:

  • Malingering, defined as the willful feigning or exaggeration of illness, historically served to evade military duty.
  • In contemporary settings, malingering is often linked to avoiding legal consequences or obtaining benefits like compensation.
  • Legal contexts may use "malingering" for those under military regulations, while other instances are treated as fraud, potentially leading to perjury or criminal charges.

Observation:

  • Assertions of malingering frequently arise in clinical practice, especially with subjective complaints lacking objective organic findings.
  • This is particularly noted in pain complaints where individuals may be eligible for pain-contingent compensation or are involved in litigation.
  • The article reviews literature on pain and malingering, exploring detection method development.

Findings:

  • Despite attempts, no scientifically validated clinical assessment methods are available for detecting malingered pain.
  • The subjective nature of pain complaints complicates objective evaluation for malingering.

Implications:

  • Healthcare professionals should avoid using terms like "malingerer" in legal reports.
  • The determination of a plaintiff's veracity in malingering claims ultimately rests with the court system.
  • This highlights a gap in clinical assessment tools for subjective pain complaints with potential legal ramifications.

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