The Boundaries of "Good Behavior" and Judicial Competence: Exploring Responsibilities and Authority Limitations of Cognitive Specialists in the Regulation of Incapacitated Judges.

J Law Med Ethics

Brandon Hamm, M. D., M. S., is psychiatry chief resident at the Cleveland Clinic Department of Psychiatry in Cleveland, OH. He earned his Medical Degree at Southern Illinois University School of Medicine in Springfield, IL and his Master of Science degree in clinical bioethics at Clarkson University/Icahn School of Medicine at Mount Sinai in Schenectady, NY. Bryn S. Esplin, J.D., is an Assistant Professor of Bioethics in the Department of Humanities in Medicine, Texas A&M's Health Science Center School of Medicine. Professor Esplin holds a B.A. in Rhetoric from the University of California, Berkeley, a J.D. from the University of Nevada, Las Vegas, and completed her clinical training as an Advanced Bioethics Fellow at the Cleveland Clinic Foundation in Cleveland, OH.

Published: June 2018

Both law and medicine rely on self-regulation and codes of professionalism to ensure duties are performed in a competent, ethical manner. Unlike physicians, however, judges are lawyers themselves, so judicial oversight is also self-regulation. As previous literature has highlighted, the hesitation to report a cognitively-compromised judge has resulted in an "opensecret" amongst lawyers who face numerous conflicts of interest. Through a case study involving a senior judge with severe cognitive impairment, this article considers the unique ethical dilemmas that cognitive specialists may encounter when navigating duties to patient, society, and the medical profession, without clear legal guidance. Systemic self-regulatory inadequacies in the legal profession are addressed, as well as challenges that arise when trying to preserve the trust and dignity of an incapacitated patient who must fulfill special duties to society. Ultimately, because of their unique neurological expertise and impartial assessments, we submit that allowing cognitive specialists to submit their assessments to an internal judiciary board may act as an additional check and balance to ensure the fair and competent administration of justice.

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http://dx.doi.org/10.1177/1073110518782959DOI Listing

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