Abstract
Attorneys working in the area of personal injury face complex cases in addition to many potential ethical and practice hazards. They are trained, educated, and have experience in handling and discharging their responsibilities in such cases to the best advantage of their clients, whether plaintiff or defense, while maintaining a professional integrity and appropriate ethical stance. Ideally, personal injury attorneys will practice from a position of virtue, serving their clients in their efforts to recover and regain their quality of life. Nevertheless, factors such as financial and work pressures can intervene, leading to inappropriate conduct that may harm their clients and risk professional alienation and malpractice. In the present article, seven case examples are provided that illustrate how personal injury attorneys working for plaintiffs can act in unethical and harmful ways, ultimately endangering their practice. The article is oriented to attorneys at all phases of their careers and includes recommendations for avoiding the types of harm and unethical practice that have been described. Also, the article presents strategies that psychologists treating these patients can take to remedy further emotional damage to patients.
Similar content being viewed by others
References
American Bar Association. (2007a). Model Rule 1.3. ABA model rules of professional conduct and code of judicial conduct. Available at: http://www.abanet.org/cpr/mrpc/rule_1_3.html. Accessed 2 July 2008.
American Bar Association. (2007b). Model rule 1.2. ABA model rules of professional conduct and code of judicial conduct. Available at: http://www.abanet.org/cpr/mrpc/rule_1_2.html. Accessed 30 June 2008.
American Bar Association. (2007c). Model rule 1.8. ABA model rules of professional conduct and code of judicial conduct. Available at: http://www.abanet.org/cpr/mrpc/rule_1_8.html. Accessed 2 July 2008.
American Bar Association. (2007d). Model rule 8.4. ABA model rules of professional conduct and code of judicial conduct. Available at: http://www.abanet.org/cpr/mrpc/rule_8_4.html. Accessed 2 July 2008.
American Bar Association. (2007e). Model rule 1.16. ABA model rules of professional conduct and code of judicial conduct. Available at: http://www.abanet.org/cpr/mrpc/rule_1_16.html. Accessed 14 July 2008.
American Bar Association/Bureau of National Affairs. (1996). ABA/BNA lawyers’ manual on professional conduct, 31:1201. Washington, DC: American Bar Association/Bureau of National Affairs.
American College of Physicians. (1998). Ethics manual. Annals of Internal Medicine, 128, 576–594.
American Medical Association Council on Ethical and Judicial Affairs. (2006). Code of medical ethics: Current opinions with annotations, 2006–2007. Chicago, IL: American Medical Association.
American Psychological Association. (2002). Ethical principles of psychologists and code of conduct. American Psychologist, 57, 1060–1073.
Aristotle. (1999). Nicomachean ethics (T. Irwin, Translator) (2nd ed.). Indianapolis, Indiana: Hackett.
Avraham, R. (2006). Putting a price on pain-and-suffering damages: A critique of the current approaches and a preliminary proposal for change. Northwestern University Law Review, 100, 87–120.
Barnhizer, D. (2004). Profession deleted: using market and liability forces to regulate the very ordinary business of law practice for profit. The Georgetown Journal of Legal Ethics, 17, 203–266.
Barth, P. S. (2004). Some reflections on the national commission and its legacy. Workers’ Compensation Policy Review, 4(4), 21–27.
Beanlands, H. J., Lipton, J. H., McCay, E. A., Schimmer, A. D., Elliott, M. E., Messner, H. A., et al. (2003). Self-concept as a “BMT patient”, illness intrusiveness, and engulfment in allogeneic bone marrow transplant recipients. Journal of Psychosomatic Research, 55, 419–425.
Beauchamp, T. L., & Childress, J. F. (2001). Principles of biomedical ethics (5th ed.). New York: Oxford University Press.
Blanchard, E. B., Hickling, E. J., Freidenberg, B. M., Malta, L. S., Kuhn, E., & Sykes, M. A. (2004). Two studies of psychiatric morbidity among motor vehicle accident survivors 1 year after the crash. Behaviour Research and Therapy, 42, 569–583.
Blumstein, J. F., Bovbjerg, R. R., & Sloan, F. A. (1991). Beyond tort reform: Developing better tools for assessing damages for personal injury. Yale Journal of Regulation, 8, 171–212.
Bramness, J. G., Skurtveit, S., & Morland, J. (2004). Impairment due to intake of carisoprodol. Drug and Alcohol Dependence, 74, 311–318.
Breslau, N. (1998). Epidemiology of trauma and posttraumatic stress disorder. In R. Yehuda (Ed.), Psychological trauma, pp. 1–29. Washington, DC: American Psychiatric Press.
Brickman, L. (1994). On the relevance of admissibility of scientific evidence: Tort system outcomes are principally determined by lawyers’ rates of return. Cardozo Law Review, 15, 1755–1797.
Brickman, L. (1996). ABA regulation of contingency fees: Money talks, ethics walks. Fordham Law Review, 65, 247–335.
Brodsky, S. L. (1999). The expert expert witness: More maxims and guidelines for testifying in court. Washington, DC: American Psychological Association.
Buchanan, D. R. (2008). Autonomy, paternalism, and justice: Ethical priorities in public health. American Journal of Public Health, 98, 15–21.
Burch, E. C. (2004). Unsettling efficiency: When non-class aggregation of mass torts creates second-class settlements. Louisiana Law Review, 65, 157–252.
Burt, D. B., Zembar, M. J., & Niederehe, G. (1995). Depression and memory impairment: A meta-analysis of the association, its pattern, and specificity. Psychological Bulletin, 117, 285–305.
Butcher, J. N., Dahlstrom, W. G., Graham, J. R., Tellegen, A., & Kraemmer, B. (1989). The MMPI-2. Minneapolis, MN: University of Minnesota Press.
Canadian Psychological Association. (2000). Canadian code of ethics for psychologists (3rd ed.). Available at: http://www.cpa.ca/cpasite/userfiles/Documents/Canadian%20Code%20of%20Ethics%20for%20Psycho.pdf. Accessed 18 July 2008.
Cano, A. (2004). Pain catastrophizing and social support in married individuals with chronic pain: The moderating role of pain duration. Pain, 110, 656–664.
Caplan, A. L. (1988). Informed consent and provider–patient relationships in rehabilitation medicine. Archives of Physical Medicine & Rehabilitation, 69, 312–317.
Christensen, B. K., & Segal, Z. V. (2001). Cognitive processing deficits associated with major depression. Psychopathology Research: The Newsletter of the Society for Research in Psychopathology, 11, 4–10.
Côté, P., Cassidy, J. D., Carroll, L., Frank, J. W., & Bombardier, C. (2001). A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature. Spine, 26, E445–458.
Crossley, M. (2008). Neuropsychological rehabilitation in later life: Special considerations, contributions and future directions. In R. Woods & L. Clare (Eds.), Handbook of the Clinical Psychology of Ageing, 2nd ed., pp. 505–522. New York: Wiley.
Dalton, J. E., Pederson, S. L., Blom, B. E., & Besyner, J. K. (1986). Neuropsychological screening for Vietnam veterans with PTSD. VA Practitioner, 3(37), 40–41. 44, 47.
Dougall, A. L., Ursano, R. J., Posluszny, D. M., Fullerton, C. S., & Baum, A. (2001). Predictors of posttraumatic stress among victims of motor vehicle accidents. Psychosomatic Medicine, 63, 402–411.
Ehlers, A., Mayou, R. A., & Bryant, B. (1998). Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents. Journal of Abnormal Psychology, 107, 508–519.
Elzinga, B. M., & Bremner, J. D. (2002). Are the neural substrates of memory the final common pathway to PTSD? Journal of Affective Disorders, 70, 1–17.
Felstiner, W. L. F., & Pettit, B. (2001). Paternalism, power, and respect in lawyer–client relations. In J. Sanders & V. L. Hamilton (Eds.), Handbook of justice research in law, pp. 135–153. New York: Kluwer Academic/Plenum.
Fordyce, W. E., Fowler, R. S., & DeLateur, B. (1968). An application of behavior modification technique to a problem of chronic pain. Behavior Research and Therapy, 6, 105–107.
Gampel, E. (2006). Does professional autonomy protect medical futility judgments? Bioethics, 20, 92–104.
Gatchel, R. J., Noe, C., Gajraj, N., Vakharia, A. S., Polatin, P. B., Deschner, M. D., et al. (2001). The negative impact on an interdisciplinary pain management program of insurance “treatment carve out” practices. Journal of Workers Compensation, 10, 50–63.
Gatchel, R. J., Kishino, N. D., & Noe, C. (2007). Carving-out services from multidisciplinary chronic pain management programs: Negative impact on therapeutic efficacy. In M. E. Schatman & A. Campbell (Eds.), Chronic pain management: Guidelines for multidisciplinary program development, pp. 39–48. New York: Informa Healthcare.
Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., & Turk, D. C. (2007). The biopsychosocial approach to chronic pain: Scientific advances and future directions. Psychological Bulletin, 133, 581–624.
Giordano, J. (2006a). Moral agency in pain medicine: Philosophy, practice and virtue. Pain Physician, 9, 41–46.
Giordano, J. (2006b). Moral virtue and the pain physician: Agency, intentions and actions. Practical Pain Management, 6, 76–80.
Glass, J. M., & Park, D. C. (2001). Cognitive dysfunction in fibromyalgia. Current Rheumatology Reports, 3, 123–127.
Guthrie, C. (1999). Better settle than sorry: The regret aversion theory of litigation behavior. University of Illinois Law Review, 1, 43–90.
Hamanaka, S., Asukai, N., Kamijo, Y., Hatta, K., Kishimoto, J., & Miyaoka, H. (2006). Acute stress disorder and posttraumatic stress disorder symptoms among patients severely injured in motor vehicle accidents in Japan. General Hospital Psychiatry, 28, 234–241.
Hensler, D. R. (2003). Money talks: Searching for justice through compensation for personal injury and death. DePaul Law Review, 53, 417–455.
Hersch, J. (2006). Demand for a jury trial and the selection of cases for trial. The Journal of Legal Studies, 35, 119–142.
Hibbard, M. R., Uysal, S., Kepler, K., Bogdany, J., & Silver, J. (1998). Axis I psychopathology in individuals with traumatic brain injury. Journal of Head Trauma Rehabilitation, 13(4), 24–39.
Hoberg, I. E. (1955). Personal injury litigation: The duties, privileges, and responsibilities of physicians (Part 1). California Medicine, 83, 446–449.
Holbrook, T. L., Anderson, J. P., Sieber, W. J., Browner, D., & Hoyt, D. B. (1998). Outcome after major trauma: Discharge and 6-month follow-up results from the trauma recovery project. Journal of Trauma-Injury Infection and Critical Care, 45, 315–323.
Hurder, A. J. (1996). Negotiating the lawyer–client relationship: A search for equality and collaboration. Buffalo Law Review, 44, 71–99.
Insurance Research Council. (2004). Auto injury insurance claims: Countrywide patterns in treatment, cost, and compensation. Malvern, PA: Insurance Research Council.
Johnson, G. (1996). Hyperextension soft tissue injuries of the cervical spine—A review. Journal of Accident and Emergency Medicine, 13, 3–8.
Kessels, R. P., Aleman, A., Verhagen, W. I., & van Luijtelaar, E. L. (2000). Cognitive functioning after whiplash injury: A meta-analysis. Journal of the International Neuropsychological Society, 6, 271–278.
King, J. H., Jr. (2004). Pain and suffering, noneconomic damages, and the goals of tort law. SMU Law Review, 47, 163–209.
Koren, D., Arnon, I., & Klein, E. (1999). Acute stress response and posttraumatic stress disorder in traffic accident victims: A one-year prospective, follow-up study. American Journal of Psychiatry, 156, 367–373.
Kritzer, H. M. (1998). Contingent fee lawyers and their clients: Settlement expectations, settlement realities, and issues of control in the lawyer–client relationship. Law & Social Inquiry, 23, 795–821.
Kritzer, H. M. (2002). Litigation in a free society: Seven dogged myths concerning contingency fees. Washington University Law Quarterly, 80, 739–794.
Larson, L. K., & Larson, A. (2000). Workers’ compensation law: Cases, materials and text (3rd ed.). New York: Matthew Bender & Company.
Lewin, H. (1968). Rehabilitation after head injury. British Medical Journal, 1(5590), 465–470.
Lind, E. A. (1994). Procedural justice and culture: Evidence for ubiquitous process concerns. Zeitschift für Rechtssoziologie, 15, 24–36.
Ling, J., Campbell, C., Heffernan, T. M., & Greenough, C. G. (2007). Short-term prospective memory deficits in chronic back pain patients. Psychosomatic Medicine, 69, 144–148.
Lind, E. A., MacCoun, R. J., Ebener, P. A., Felstiner, W. L. F., Hensler, D. R., Resnick, J., et al. (1990). In the eye of the beholder: Tort litigants’ evaluations of their experiences in the civil justice system. Law and Society Review, 24, 953–996.
Lyles, J. (2003). The buying of justice: Perversion of the legal system through interest groups’ involvement with the partisan election of judges. Law & Psychology Review, 27, 121–133.
MacLeod, C. (1991). Clinical anxiety and the selective encoding of threatening information. International Review of Psychiatry, 3, 279–292.
MacLeod, C., Mathews, A., & Tata, P. (1986). Attentional bias in emotional disorders. Journal of Abnormal Psychology, 95, 15–20.
Madeira, J. L. (2006). Lashing reason to the mast: Understanding judicial constraints on emotion in personal injury litigation. U.C. Davis Law Review, 40, 137–198.
Main, C. J. (1999). Medicolegal aspects of pain: The nature of psychological opinion in cases of personal injury. In R. J. Gatchel & D. C. Turk (Eds.), Psychosocial factors in pain: Critical perspectives, pp. 132–147. New York: Guilford.
Martin, R., Kuzniecky, R., Ho, S., Hetherington, H., Pan, J., Sinclair, K., et al. (1999). Cognitive effects of topiramate, gabapentin, and lamotrigine in healthy young adults. Neurology, 52, 321–327.
Mason, S., Wardrope, J., Turpin, G., & Rowlands, A. (2002). The psychological burden of injury: An 18 month prospective cohort study. Emergency Medicine Journal, 19, 400–404.
Mayou, R. A., Bryant, B., & Duthie, R. (1993). Psychiatric consequences of road traffic accidents. BMJ, 307, 647–651.
Mayou, R. A., Bryant, B., & Ehlers, A. (2001). Prediction of psychological outcomes one year after a motor vehicle accident. American Journal of Psychiatry, 158, 1231–1238.
McCoun, R. J., Lind, E. A., & Tyler, T. R. (1992). Alternative dispute resolution in trial and appellate courts. In D. K. Kagehiro & W. S. Laufer (Eds.), The handbook of psychology and law, pp. 95–118. New York: Springer.
Mendelson, G. (1995). Compensation “neurosis” revisited: Outcome studies of the effects of litigation. Journal of Psychosomatic Research, 39, 695–706.
Michaels, A. J., Michaels, C. E., Smith, J. S., Moon, C. H., Peterson, C., & Long, W. B. (2000). Outcome from injury: General health, work status, and satisfaction 12 months after trauma. Journal of Trauma-Injury Infection and Critical Care, 48, 841–848. discussion 848–850.
Nelson, M. B. (2001). When clients become “ex-clients”: The duties owed after discharge. The Journal of the Legal Profession, 26, 233–241.
New Hampshire Bar Association. (2001). The New Hampshire lawyer professionalism creed. Available at: http://www.nhbar.org/legal-links/nh-professionalism-creed.asp. Accessed 14 June 2008.
Nicholson, K., & Martelli, M. F. (2007). Section III. Malingering in psychological injury: TBI, chronic pain, and PTSD. In G. Young, A. W. Kane & K. Nicholson (Eds.), Causality of psychological injury: Presenting evidence in court, pp. 374–514. New York: Springer.
Nixon, M. (2005). Lawyers encouraged to stand against predatory members. (July 23). St. Louis Daily Record & St. Louis Countian. Available at: http://findarticles.com/p/articles/mi_qn4185/is_20050723/ai_n14806510.
O’Donnell, M. L., Creamer, M., & Pattison, P. (2004). Posttraumatic stress disorder and depression following trauma: Understanding comorbidity. American Journal of Psychiatry, 161, 1390–1396.
Pennsylvania Department of Labor and Industries Workers’ Compensation. (2007). Bureau of workers’ compensation information, section 442. Available at: http://www.dli.state.pa.us/landi/lib/landi/laws-regulations/wc/wcact.pdf. Accessed 16 July 2008.
Peolsson, A., & Kjellman, G. (2007). Neck muscle endurance in nonspecific patients with neck pain and in patients after anterior cervical decompression and fusion. Journal of Manipulative and Physiological Therapeutics, 30, 343–350.
Perel, P., Edwards, P., Wentz, R., & Roberts, I. (2006). Systematic review of prognostic models in traumatic brain injury. BMC Medical Informatics and Decision Making, 6, 38.
Phipps, M. J. (2001). Attorney referral for medical treatment: A wolf in disguise? St Mary’s Law Journal, 32, 383–423.
Polatin, P. B., Kinney, R. K., Gatchel, R. J., Lillo, E., & Mayer, T. G. (1993). Psychiatric illness and chronic low-back pain. The mind and the spine—Which goes first? Spine, 18, 66–71.
Ponsford, J., Hill, B., Karamitsios, M., & Bahar-Fuchs, A. (2008). Factors influencing outcome after orthopedic trauma. Journal of Trauma, 64, 1001–1009.
Pryor, E. S. (2003). Rehabilitating tort compensation. Georgetown Law Journal, 91, 659–694.
Radin, M. J. (1993). Compensation and commensurability. Duke Law Journal, 43, 56–86.
Relis, T. (2007). “It’s not about the money!”: A theory on misconceptions of plaintiffs’ litigation aims. University of Pittsburgh Law Review, 68, 701–746.
Robbins, H., Gatchel, R. J., Noe, C., Gajraj, N., Polatin, P., & Deschner, M. (2003). A prospective one-year outcome study of interdisciplinary chronic pain management: Compromising its efficacy by managed care policies. Anesthesia & Analgesia, 97, 156–162.
Schatman, M. E. (2006). The demise of multidisciplinary pain clinics? Practical Pain Management, 6, 30–41.
Schatman, M. E. (2007). The demise of the multidisciplinary chronic pain management clinic: Bioethical perspectives on providing optimal treatment when ethical principles collide. In M. E. Schatman (Ed.), Ethical issues in chronic pain management, pp. 43–62. New York: Informa Healthcare.
Schatman, M. E. (2009a). Psychological assessment of maldynic pain: The need for a phenomenological approach. In J. Giordano (Ed.), Maldynia: Inter-disciplinary perspectives on the illness of chronic pain. New York: Informa Healthcare. in press.
Schatman, M. E. (2009b). Interdisciplinary chronic pain management: Perspectives on history, current status, and future viability. In J. C. Ballantyne, J. P. Rathmell & S. M. Fishman (Eds.), Bonica’s management of pain (4th ed.). Philadelphia: Lippincott, Williams & Wilkins. in press.
Schnyder, U., Moergeli, H., Klaghofer, R., & Buddeberg, C. (2001). Incidence and prediction of posttraumatic stress disorder symptoms in severely injured accident victims. American Journal of Psychiatry, 158, 594–599.
Schreiber, S., & Galai-Gat, T. (1993). Uncontrolled pain following physical injury as the core-trauma in the post-traumatic stress disorder. Pain, 54, 107–110.
Sjogren, P., Thomsen, A. B., & Olsen, A. K. (2000). Impaired neuropsychological performance in chronic nonmalignant pain patients receiving long-term oral opioid therapy. Journal of Pain and Symptom Management, 19, 100–108.
Sloan, J. B. (1992). Quantum meruit: Residual equity in law. DePaul Law Review, 42, 399–439.
Tang, N. K., Salkovskis, P. M., & Hanna, M. (2007). Mental defeat in chronic pain: Initial exploration of the concept. Clinical Journal of Pain, 23, 222–232.
Teachman, B. A. (2005). Information processing and anxiety sensitivity: Cognitive vulnerability to panic reflected in interpretation and memory biases. Cognitive Therapy and Research, 29, 479–499.
Terry, P. B. (2007). Informed consent in clinical medicine. Chest, 131, 563–568.
Torrey, D. B. (2001). Lump sum settlement of workers’ compensation cases: Background and unanswered questions under section 449 of the Pennsylvania Act. Pennsylvania Bar Association Quarterly, 72, 23–36.
Torrey, D. B. (2005). Statistics (and comments) on C&R’s, fiscal year 2004–2005. Pennsylvania Bar Association Workers’ Compensation Section Newsletter, n.p.
Torrey, D. B. (2007). Compromise settlements under state workers’ compensation acts: Law, policy, practice, and ten years of the Pennsylvania experience. Widener Law Journal, 16, 199–469.
Turner, D. S., & Cox, H. (2004). Facilitating post traumatic growth. Health and Quality of Life Outcomes, 2, 34.
Tyler, T., & Lind, E. A. (1992). A relational model of authority in groups. Advances in Experimental Social Psychology, 25, 115–191.
Vasterling, J. J., Root, L., Brailey, K., Uddo, M., & Sutker, P. B. (1994). Attention and memory performances in post-traumatic stress disorder. Paper presented at the 22nd Annual Meeting of the International Neuropsychological Society, Cincinnati, OH.
Watzlawick, P., Beavin, J. H., & Jackson, D. D. (1967). Some tentative axioms of communication. In Pragmatics of human communication: A study of interactional patterns, pathologies, and paradoxes (pp. 48–71). New York, NY: W. W. Norton & Company.
Weingartner, H., Cohen, R. M., Murphy, D. L., MarteUo, J., & Gerdt, C. (1981). Cognitive processes in depression. Archives of General Psychiatry, 38, 42–47.
Wu, L. R., Parkerson, G. R., Jr., & Doraiswamy, P. M. (2002). Health perception, pain, and disability as correlates of anxiety and depression symptoms in primary care patients. Journal of the American Board of Family Practice, 15, 183–190.
Zatzick, D. F., Jurkovich, G. J., Gentilello, L., Wisner, D., & Rivara, F. P. (2002). Posttraumatic stress, problem drinking, and functional outcomes after injury. Archives of Surgery, 137, 200–205.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Schatman, M.E. Working to Avoid Collateral Emotional Harm to Clients: Cases and Recommendations for the Personal Injury Attorney. Psychol. Inj. and Law 2, 149–166 (2009). https://doi.org/10.1007/s12207-009-9047-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12207-009-9047-2