Prof. P.D. According to Swiss law, the forensic expert must be a qualified physician. At the CHUV Expertise Centre, each expertise is systematically assigned to an expert and a co-expert. The mandate is never carried out alone. The pair of experts consists of a physician-psychiatrist and a psychologist or two physician-psychiatrists. Once the expertise mandate has been received, the pair can access a person’s criminal record and request to meet. The meeting is conducted either in a prison facility or in an expertise centre’s office. The two or three meetings are conducted by one of the experts for one to two hours. With the person’s consent, medical records can also be accessed to do the important work of collecting information. When this is complete, the two experts attend the results review, which is led by the expert who had thus far not been in attendance. In “this clinical setting”, the relationship dynamics are evaluated and the clinical process is enriched. The proceedings then begin, with the objective of the two experts agreeing with the diagnosis, risk assessment, and the person’s responsibility.
A number of instruments are used: risk assessment tools, specifically “actuarials” or “structured professional judgments”. The instruments are chosen according to the type of violence identified. There are specific instruments for sexual violence, for example. On the other hand, there are very few instruments available for non-violent acts, such as cases of fraud or property damage. The instruments may vary, but the method of expertise remains consistent.
The report must then be defended at the hearing. Unfortunately, this is not routinely carried out in the Vaud region, and I regret that. This can be somewhat uncomfortable for expert-psychiatrists who often dread confrontation. Nevertheless, it is an opportunity to explain a person’s actions, a pathology, or to clear up misunderstandings. In my opinion, this is valuable discussion time between lawyers and psychiatrists, which is usually useful.