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Logical Paradoxes and Paradoxical Constellations in Medicolegal Assessment

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Abstract

In medicolegal contexts, the expert is confronted with a number of apparent or seemingly paradox constellations that are mostly not even explicit to the assessor involved, yet when they occur, they may have a profound effect on the shaping of the expert’s opinion and, subsequently, on the outcome of litigation. Because the paradoxes in this forensic work have not been made explicit for the most part in the field, it can be assumed that forensic experts themselves are often unaware of paradoxical situations and logical incoherence to be found in many cases. Difficulties to positively diagnose somatoform and dissociative disorders in disability claimants and compensation-seeking litigants are among the most prominent of these paradoxes. For example, in these diagnoses, presumably unconscious core motives and an involuntarily, unconsciously distorted symptom presentation (both being central for the diagnosis) might contrast with conscious symptom magnification and pursuit of monetary interests on the part of the complainant (external incentives in the form of disability or compensation seeking). Other paradoxes discussed in more detail are linked with symptom validity assessment in forensic psychology. Logical dilemmas and paradoxes, if not placed at the forefront in forensic psychological evaluations, potentially undermine the quality of forensic determinations.

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Notes

  1. Similar paradoxes have been described, such as The paradox of well-being, an inverse relationship between the accumulation of objective health problems with higher age and an increase in subjective well-being (cf. Swift et al., 2014, for a more detailed discussion and analysis), or The lifestyle paradox (Deetjen, 2017). They are certainly interesting in this context but not directly linked to forensic assessment, so they will not be discussed in more detail here.

  2. Notwithstanding the view that giving such a warning in the context of informed consent should be recommended, it would be unacceptable to reveal more detailed information about how validity will be checked. “Although informing examinees that their honesty and effort will be assessed is necessary, informing them how it will be assessed or exactly when it will be assessed is inappropriate” (Bush, 2007, p. 72).

  3. A categorical syllogism is an argument consisting of exactly three categorical terms each of which is used exactly twice. Two premises lead to one conclusion.

  4. The exact legal text reads in the original: “Ausübung von Psychotherapie im Sinne dieses Gesetzes ist jede mittels wissenschaftlich anerkannter psychotherapeutischer Verfahren vorgenommene Tätigkeit zur Feststellung, Heilung oder Linderung von Störungen mit Krankheitswert, bei denen Psychotherapie indiziert ist” (§1 (3), p. 1311).

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  1. Department of Neurology, Vivantes Klinikum im Friedrichshain, Landsberger Allee 49, 10249, Berlin, Germany

    Thomas Merten

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This is the written version of a keynote speech at the Fifth European Symposium on Symptom Validity Assessment, Basel, Switzerland, June 22, 2017.

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Merten, T. Logical Paradoxes and Paradoxical Constellations in Medicolegal Assessment. Psychol. Inj. and Law 10, 264–273 (2017). https://doi.org/10.1007/s12207-017-9297-3

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