Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Forensic medicine


Elyse Watkins


Purpose: Clinicians rely on patients honestly disclosing their history and symptoms to guide diagnostic and treatment decisions. However, patients sometimes deliberately misrepresent their condition to achieve a personal benefit separate from health, thus complicating the healthcare encounter, particularly in cases of forensic importance. This article explores the concepts of clinical deception and counterdeception in the context of forensic medicine and proposes strategies for integrating clinical counterdeception techniques into clinical practice.

Methodology: A descriptive review of literature within the fields of intelligence analysis and medicine was conducted leveraging PubMed and Google Scholar focused on the concepts of risk analysis and management, deception, malingering, counterdeception, disclosure, and forensic medicine.

Results: A sampling of papers describing deception and associated concepts were holistically reviewed from which definitions of clinical deception and counterdeception and supporting concepts were derived. While several tools exist for identifying undisclosed victimization in specific contexts, no tools were identified for assessing clinical deception risk that are applicable to all types of forensic patients, including those implementing deception for personal gain.

Conclusion: Definitions for clinical deception and clinical counterdeception with supporting concepts and a framework for assessing clinical deception risk are proposed. Strategies for managing deception risk are discussed. Directions for future work are proposed.


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