This article provides a guide for psychiatrists facing the stressful situation of being subpoenaed to a coronial inquiry, offering practical advice and emphasising the importance of support and preparation.
Help, I’ve been subpoenaed!
Being subpoenaed to provide evidence in a coronial inquiry can be a daunting experience for any psychiatrist. This guide aims to navigate through this challenging process, offering practical advice and emotional support to those who find themselves in this stressful situation.
Understanding the Context
A coronial inquiry is a legal investigation into the causes and circumstances of a death, particularly those that are sudden, unexplained, or suspicious. When a psychiatrist is subpoenaed to such an inquiry, it is typically to serve as a witness of fact rather than an expert witness. Although this scenario is rare in a psychiatrist’s career, it can occur following adverse outcomes, some of which may be fatal.
Emotional Impact and Anxiety Levels
The level of anxiety experienced by a psychiatrist in this situation often depends on their relationship with the patient involved:
- Minimal Anxiety: When the psychiatrist had no direct involvement with the patient but is asked to provide general comments.
- Moderate Anxiety: When the psychiatrist had some involvement with the patient but was not their primary treating psychiatrist.
- Extreme Anxiety: When the psychiatrist was directly responsible for the patient’s care.
In such stressful circumstances, it is crucial for the psychiatrist to avoid isolation and seek support from various sources.
Immediate Steps to Take
- Contact Your Medical Defence Organisation: Inform them immediately upon being subpoenaed. These organisations provide invaluable support and guidance throughout the process.
- Inform a Close Colleague: Share your situation with a trusted colleague who can offer support and understanding. While some colleagues may hesitate to get involved, others will provide the compassionate care you need.
- Inform Family Members: Keep your spouse or close family members informed about the situation. Their support can be crucial during this time.
- Consult Your General Practitioner: Discuss the situation with your GP. They can offer medical advice, emotional support, or referrals for professional help if needed.
Preparing Your Statement
You will be required to submit a statement before giving evidence in court. This statement is crucial as it will guide your examination as a witness and may be read aloud in court. Here are some key points to remember:
- Factual Accuracy: Ensure your statement is as accurate and factual as possible. Review all relevant documents and records related to the case.
- Review by Medical Defence Organisation: Have your statement reviewed by your medical defence organisation before submission to ensure it is thorough and accurate.
- Clarity and Conciseness: Write your statement in clear, concise, and professional terms. This helps in presenting your narrative effectively.
Court Procedures and Testimony Preparation
Understanding the nature of coronial court procedures can alleviate some anxiety. Coronial inquiries are inquisitorial rather than adversarial, focusing on uncovering facts to prevent future occurrences rather than assigning blame.
- Review Case Details: Thoroughly review the case and relevant documents to prepare your testimony.
- Anticipate Questions: Consider possible questions from barristers and the judge, and prepare your responses.
- Professional Demeanour: Maintain a professional and empathetic demeanour throughout the proceedings, even when provoked.
Approach to Family and Friends of Patients
- Often in these cases the relatives of the deceased patient will be present, and one wonders whether you should speak to the family and make statements such as saying that you are sorry about what happened. Saying “sorry” is not going to be taken as an admission of guilt but rather as an empathetic statement to those that have been so sadly affected.
Emotional and Professional Support
Do not underestimate the emotional toll this process can take. Feelings of guilt, grief, and anxiety are common. It’s important to:
- Avoid Isolation: Stay connected with colleagues, family, and your GP.
- Acknowledge Your Feelings: Recognise feelings of responsibility, guilt, anger, or shame, but do not let them prevent you from seeking support.
- Substance Misuse and Mental Health: Be aware of the risks of substance misuse, anxiety, and depression. Seek help if needed.
Post-Inquiry Debriefing
After the inquiry, it’s essential to debrief:
- Medical Defence Organisation: Meet with the staff who supported you to discuss what you’ve learned and how you’ve coped.
- Close Colleagues and Family: Continue to discuss your experience with trusted colleagues and family members.
- Ongoing Support: Understand that debriefing and emotional recovery may take time and require ongoing support.
Conclusion
While being subpoenaed to a coronial inquiry is undoubtedly stressful, it is a process that can be navigated with proper preparation and support. By staying connected with your support network and preparing thoroughly, you can manage the emotional and professional challenges effectively. Ultimately, these experiences can contribute to your growth as a professional and enhance your resilience.
Prof Philip Morris AM
MBBS BSc(med) PhD FRANZCP FAChAM(RACP) ABPN