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Admissibility of brain scans in criminal trials

Wednesday, October 1, 2014
posted by Rita Handrich

brain normal or murdererIt’s been a while since we’ve done an update on neurolaw issues and we think you’ll want to read the entire article upon which this post is based. The article is published in Court Review: Journal of the American Judges Association (which is probably a journal you would benefit from perusing regularly). The article (authored by a psychiatry professor with both MD and JD degrees) offers a review of past courtroom use of the Positive Emission Tomography (commonly referred to as a PET scan) and their potential admissibility for criminal trials. This is obviously a very contentious topic but one that is essential for trial advocates to monitor.  Here are just a few of the thoughts on (past and future) admissibility of the PET Scan that Dr. Rushing offers to the judges for whom the journal is written.

Pretrial Competency Hearings:

If during pretrial examination, a defendant is found incompetent to stand trial, the examiner offers a diagnosis and a prognosis for when (and how) competency can be restored. If the examiner believes competency cannot be restored, “a PET scan can help illustrate the brain-based abnormality that the examiner detected”.

Guilt Phase of Criminal Trials:

During this phase of a criminal trial the PET can “elucidate damage to areas of the brain that are involved in cognitive functions such as judgment and impulse control”. The author comments that prosecutors may challenge the defense expert’s ability to establish a causal link between the violence and the brain damage (and those challenges have often been successful in excluding PET evidence). However, she says, “PETs colorful imagery of brain damage can be useful during trial or in plea bargaining discussions”.

Penalty Phase of Criminal Trials:

The author comments brain-based deficits are a mitigating factor in cases of both capital and non-capital defendants. She cites 2004 case law mandating the consideration of cognitive and/or neuropsychological limitations even when those limitations have no direct link with homicidal behavior. Thus, she recommends the use of PET scans as mitigating evidence during the sentencing phase of a capital murder trial. This evidence could help a jury understand the limitations of the defendant and thus, they may impose a lesser sentence.

Ineffective Assistance of Counsel Claims for Failure to Explore Brain-Based Abnormalities:

Failure to present evidence on brain damage has been a “factor in overturning death sentences in ineffective-assistance-of-counsel cases”.

Finally, the author opines that the rules of evidence offer clear guidelines regarding “when and for what purposes” evidence such as PET scans can be introduced. She identifies a list of questions for judges to considering at various stages of trial.

Whether you think, as we do, that the colorful PET scans are not yet ready for prime time use in courtrooms around the country or not–when an article is published in a journal directed at judges–it’s probably a good idea to have a look!

Rushing, SE (2014). The admissibility of brain scans in criminal trials: The case of positron emission tomography. Court Review, 50 (2)


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forgiving infidelityAccording to new research, you can’t have both. Inspired by women who told them they “would not vote for Hillary Clinton [in the Presidential primaries a decade later] because she forgave then-President Bill Clinton’s infidelity”, these researchers looked at how male and female observers viewed male and female victims of infidelity based on how they responded to their partner’s behavior.

The researchers did three separate experiments:

The first experiment used 100 male fraternity members (aged 18 to 24 years) who read a story about (ostensibly) a member of their own fraternity whose significant other had posted photos of her infidelity on Facebook. (This is tempting to visualize–what sort of photos do you imagine were purportedly on Facebook?) When confronted, the woman apologized and in response, the fraternity brother either forgave her, broke up with her, or slashed his (ex-)girlfriend’s vehicle tires.

In the second experiment, 114 “female voters” (aged 20 to 79 years) read the story of a woman who was presented as a political candidate. Her spouse of 25 years had an affair with his secretary and when confronted, he apologized. The “female voters” in this study read that the woman either forgave him, divorced him, or slashed his car seats.

In the third experiment, (dare we anticipate the use of a knife again?), 94 male and 131 female undergraduate students (ranging in age from 17 to 55 years of age) participated. Half of them read the story (ostensibly published in their college newspaper) of “Natalie Lewis, a student at a “sister” campus who learned that her male partner, a student body president at another campus and chair of the statewide student senate, was unfaithful”. The other half read a similar scenario but in this case it was a male student leader (“Brandon Thomas”) who learned his female partner had been unfaithful. When confronted, as in the other two experiments, the unfaithful partner apologized. In response to the infidelity, the victim either forgave the partner, broke up with the partner, or (wait for it) posted embarrassing details about the partner’s sexual inadequacy on Facebook. (Well, at least the aggression avoided knife-play!)

We think maybe these researchers have some anger issues (and what is it with all these knives and public shaming?), but here is what they found:

The young fraternity brothers in Experiment 1 rated the “brother” who forgave as about the same level of maturity but as less competent than the brother who left the relationship. However, they did see the forgiving brother as violating shared values as to how one should respond to a publicly revealed infidelity. They rated the brother who forgave as more competent and less damaging to their group reputation in comparison to the brother who slashed her tires. (This is reassuring.)

The “female voters” in experiment two rated the forgiving politician as less competent, slightly weaker, and less worthy of support in comparison with the politician who divorced her philandering spouse. The female voters thought the forgiving politician damaged the group’s (presumably all of womankind) power and status and violated their shared values. They did see the car seat slashing politician more negatively than the forgiving politician (which again, is reassuring).

Finally, in the third study which included male and female undergraduates and featured male and female student leaders with unfaithful partners–observers rated the leader who forgave his or her partner as just as mature as the leader who broke up with the partner and as more mature than the one posting scandalous information on Facebook. However, the one who forgave was seen as weaker, less competent and less worth voting for than the student leader who left the relationship. The one who forgave was seen as violating shared group values and damaging the group’s power and status more so than the one who left. Overall, they preferred the leaver to the forgiver, but in one final gesture of reassurance, these undergraduates preferred forgiveness to retaliation.

In other words, even though participants across all three studies agreed that forgiveness can be mature–it also can make the forgiver appear weak and incompetent. In every experiment, the participants preferred the partner who left the relationship (despite the researcher’s insistence on incorporating slashing knives and public shaming into the scenarios) to the one who forgave–although they preferred the one who forgave to the one who retaliated.

From a litigation advocacy perspective, you need to think carefully about how to repair perceptions of competence and strength if your client has chosen to remain in a relationship after a public infidelity. Obviously, this is more often in the news with male politicians publicly apologizing to their constituents and to their spouses who stand (publicly shamed and likely humiliated) behind them. But, regardless of whether your client is male or female–choosing to stay has consequences. Mature but incompetent and weak political candidates are less electable. We’d guess Hillary’s consultants are on this one, and, if not, she can call us.

It would be interesting to see whether there are correlates of these findings for other forms of trust betrayal. What happens if a company finds an employee has used company assets improperly for personal reasons? Or violated confidentiality? Or violated behavioral guidelines (drinking or drugs on the job, or making sexist jokes, or aggressive behavior). Certainly the current controversy about the degree to which domestic violence should result in workplace ramifications is the biggest headline in professional football right now. Is this going to be treated as an anger management problem that calls for treatment, or misogyny and thuggery that is intolerable? This is an intriguing first phase of a research design with huge social ramifications.

J. Smith, H., Goode, C., Balzarini, R., Ryan, D., & Georges, M. (2014). The cost of forgiveness: Observers prefer victims who leave unfaithful romantic partners European Journal of Social Psychology DOI: 10.1002/ejsp.2054


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female in surgical researchMore than two decades after the 1993 Revitalization Act was signed (stating women and minorities must be included in NIH funded research), females are still under-represented in both “basic science and translational surgical research”.

The authors acknowledge that medical research on human subjects is only a small subset of all medical research. However, even those studies using animals and cells have females under-represented. Why? Females, whether cell, animal or human (due to hormonal fluctuations) are harder and more expensive to study and including them may make the research much more complex to analyze. They are simply not as predictable as male cells, animals or humans.

Yet, there is a growing body of research showing “men and women may manifest diseases differently, experience illnesses differently, and benefit from treatments differently”. The authors list disease processes where male and female patients respond differently, including “but not limited to cardiovascular disease, lung cancer, depression, obesity, osteoporosis, thyroid disorders, multiple sclerosis, and Alzheimer’s Disease”. Yet, the authors tell us, in 2014, “all medications except for zolpidem (Ambien) are dosed the same for men and women, including anesthetics and chemotherapeutics, drugs that can be lifesaving”.

This is a fascinating (and disturbing) article to read and we will simply hit the high points (or should that be low points?). The authors looked at the top 5 surgery journals (i.e., Annals of Surgery, American Journal of Surgery, JAMA Surgery, Journal of Surgical Research, and Surgery) from January 2011 through December 2012. Here is some of what they found on medical research:

One-third of all publications using animals or cells did not specify the sex studied, and when they did specify, 80% studied only males.

For research on cells, 76% did not specify the sex of the subject from whom the  cell studied was drawn. When they did specify, 71% studied only males.

Although a larger percentage of publications now state sex of the animal or cell studied than they did one and two decades ago, more male-only studies are being published. The authors say this reflects the sex disparity in basic research is growing rather than decreasing over time.

Thyroid and cardiovascular disease are female-prevalent disorders and so we might expect more female subjects in those articles. Only 12% of those publications studied females or both sexes.

The authors offer several memorable quotes:

“With robust and surmounting evidence that women are clearly different from men with respect to cardiovascular mortality, it is unacceptable that less than 25% of current cardiovascular trials are designed without apparent regard to sex in terms of trial design, patient selection, and analytic processes.”

“Furthermore, recent population-based outcome studies show that even as mortality has decreased in most counties in the United States from 1992 to 2006, female mortality increased in 42.8% of these counties.”

This, say the authors, is not simply a problem of surgical research, but rather, based on recent review articles, “sex disparity is pervasive across all disciplines for biomedical and clinical research, with most studies showing no improvements over time”.

The good news is that several of the surgical journals revised their requirements after receiving this information from the authors. Now all authors are required to state the sex of the animal or cell used and if they did not use both sexes, they need to give a rationale. It’s a good first step, but certainly not a solution to such a significant problem in medical research. This article does not address whether minorities also remain under-represented, but we’d take a wild guess they may be as well.

From a litigation advocacy perspective, it is worth considering whether this work applies to a personal injury Plaintiff. If there are known differences between how male and female patients respond to a particular disease or surgical procedure or medication–check to see if their treatment was appropriate for their gender or if a female patient was treated “like a man”. These authors (some of them surgeons) cite a 2005 study showing “only one in five physicians across multiple specialties was aware that more women than men die from cardiovascular disease each year, and most of these physicians did not rate themselves as effective in treating sex-tailored cardiovascular disease”. Similarly, product liability cases involving medical products or medicines could be informed by this research as well.

What should they have known?

What should they have considered?

What would it have cost them to use both male and female research participants?

Yoon DY, Mansukhani NA, Stubbs VC, Helenowski IB, Woodruff TK, & Kibbe MR (2014). Sex bias exists in basic science and translational surgical research. Surgery, 156 (3), 508-516 PMID: 25175501



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“Smart people ask for (my) advice!”

Monday, September 15, 2014
posted by Douglas Keene

smart people ask for adviceWe are often wary of asking for advice for fear of looking dumb or appearing incompetent. Oddly enough, our fears may be unfounded based on some new research out of Harvard Business School. According to the researchers, asking for advice does not make you appear either dumb or incompetent. Instead, asking for advice makes you seem more capable.

While initially this may seem unlikely, think about how much people love to give advice. When someone is asked for advice, they experience a boost in self-confidence, which, say the researchers, in turn enhances their opinion of the person seeking advice. It is, in truth, a win-win situation. The person asking for advice gets some feedback and they are seen as more competent while the person being asked for advice feels better about themselves (and about the person asking for advice).

The researchers (we’ve covered some of their earlier work here) conducted 5 separate experiments and here is what they found:

Asking for advice actually increases other’s perceptions of your competence.

When the task is difficult, asking for advice causes the person seeking advice to appear more competent than when the task is not difficult. However, even when the task is easy, seeking advice did not lower perceptions of the person’s competence!

When someone is asked for their specific advice, they see the asker as more competent. However, if they see the person asking someone else for advice, they do not see the advice seeker as more competent. The researchers believe there is a “direct flattery” component involved here since “being asked for advice caused advisors to feel more self-confident, and, in turn, to view the advice seeker more positively”.

Finally, the advice-giver needs to believe themselves competent and experienced in the area in which they are asked for advice. [Of course, a lot of people have an inflated sense of the scope of their qualifications…] If the advice seeker asks for guidance in an area of the advisor’s expertise, the advisor sees the seeker as more competent. However, if the advisor is obviously not experienced in the area, “then the advice seeker seems less competent than if s/he had not asked for advice” at all.

The researchers say our fears about appearing incompetent by asking for advice are unfounded and that, in truth, there are benefits to both being the advice-seeker and being the advisor. They believe that organizations benefit from encouraging advice-seeking as it will help spread useful information and improve relationships between colleagues and co-workers. The dilemma is that if you educate your employees on the advantages of advice-seeking to both the advice-seeker and the advice-giver–you run the risk of the advice-giver feeling manipulated and the advice-seeker wanting to “not be that guy/gal”. The authors do not offer advice to the manager looking for ways to build this dynamic into their office culture–they simply say it would be a positive and productive thing. (See the full text of the paper here.)

This explains why one of our favorite strategies for both debriefing mock jurors and conducting voir dire are so productive. At mock trials and focus groups, I introduce the process by sharing with the mock jurors my hope that through their collective wisdom we can tell the disputing parties and their lawyers what ‘real people’ think about the issues, and guide a resolution that doesn’t require a trial. It elevates them from being there for a couple hundred dollars to being there to solve a problem. They really like it. At trial, asking the venire questions framed in terms of “help me understand” and “Is that important to you?” makes them feel that you are seeking their perspective, not quizzing them or boxing them in. It credits them with having a contribution to make, that they are smart enough to have a valid opinion, and that you recognize the validity of their point of view. It’s not about you or your client at that point, it’s about the jurors. And that can’t hurt.

Brooks, AW, Gino, F, & Schweitzer, ME (2014). Smart people ask for (my) advice: Seeking advice boosts perceptions of competence. Harvard Business School Working Papers


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TJE_logoThe August issue of The Jury Expert is up and we think you’re going to want to see this. Here’s a rundown of the articles you’ll find at the website.

Demographic Roulette: What was once a bad idea has gotten worse. Authored by Doug Keene and Rita Handrich with a response from Paul Begala, this article takes a look at how the country has changed over the past 2 decades and our old definitions of Democrat or Republican and conservative or liberal are simply no longer useful. What does that mean for voir dire? What should it mean for voir dire? Two very good questions those.

If it feels bad to me, it’s wrong for you: The role of emotions in evaluating harmful acts. Authored by Ivar Hannikainen, Ryan Miller and Fiery Cushman with responses from Ken Broda-Bahm and Alison Bennett, this article has a lesson for us all. It isn’t what that terrible, awful defendant did that makes me want to punish, it’s how I think I would feel if I did that sort of terrible, horrible awful thing. That’s what makes me want to punish you. It’s an interesting perspective when we consider what makes jurors determine lesser or greater punishment.

Neuroimagery and the Jury. Authored by Jillian M. Ware, Jessica L. Jones, and Nick Schweitzer with responses from Ekaterina Pivovarova and Stanley L. Brodsky, Adam Shniderman, and Ron Bullis. Remember how fearful everyone was about the CSI Effect when the research on the ‘pretty pictures’ of neuroimagery came out? In the past few years, several pieces of research have sought to replicate and extend the early findings. These studies, however, failed to find support for the idea that neuroimages unduly influence jurors. This overview catches us up on the literature with provocative ideas as to where neurolaw is now.

Predicting Jurors’ Verdict Preference from Behavioral Mimicry. Authored by Matthew Groebe, Garold Stasser, and Kevin-Khristián Cosgriff-Hernandez, this paper gives insight into how jurors may be leaning in support of one side or the other at various points during the trial. This is a project completed using data from actual mock trials (and not the ubiquitous undergraduate).

Our Favorite Thing. We often have a Favorite Thing in The Jury Expert. A Favorite Thing is something low-cost or free that is just fabulous. This issue, Brian Patterson shares the idea of mind mapping and several ways (both low-tech and high-tech) to make it happen.

The Ubiquitous Practice of “Prehabilitation” Leads Prospective Jurors to Conceal Their Biases. Authored by Mykol C. Hamilton, Emily Lindon, Madeline Pitt, and Emily K. Robbins, with responses from Charli Morris and Diane Wiley, this article looks at how to not “prehabilitate” your jurors and offers ideas about alternate ways of asking the question rather than the tired, old “can you be fair and unbiased?”.

Novel Defenses in the Courtroom. Authored by Shelby Forsythe and Monica K. Miller, with a response from Richard Gabriel. This article examines the reactions of research participants to a number of novel defenses (Amnesia, Post-Traumatic Stress Disorder (PTSD), Battered Women Syndrome (BWS), Multiple Personality Disorder (MPD), Post-Partum Depression (PPD), and Gay Panic Defense) and makes recommendations on how (as well as whether or not) to use these defenses.

On The Application of Game Theory in Jury Selection. Authored by David M. Caditz with responses from Roy Futterman and Edward Schwartz. Suppose there was a more predictable, accurate and efficient way of exercising your peremptory strikes? Like using a computer model based on game theory? In this article, a physicist presents his thoughts on making those final decisions more logical and rational and based on the moves opposing counsel is likely to make.


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