Avoiding Dual Agency in Clinical and Medicolegal Practice

Mental health professionals who provide medicolegal services need to be aware of the very important differences between clinical and retained expert/forensic roles. This column offers a distinction between clinical and forensic roles in terms of responsibilities, objectives, and guiding ethical principles. Existing professional guidelines and other views from the medical literature that discourage the mixing of such roles are reviewed. The conflation of clinical and forensic roles and the attendant risks are considered, in terms of both competing interests and the possible ethical threat associated with assuming a dual role. Knowingly or unwittingly assuming a dual role is potentially harmful to the therapeutic alliance, threatens the expert's objectivity, and may jeopardize a patient's legal case. Guidance is offered as to how to avoid conflating clinical and forensic roles when compelled to provide medicolegal services.