Independent medical evaluations
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* Derryck H. Smith

I have conducted several thousand independent medical examinations, and from time to time, as pointed out by Ebrahim1 in his *CMAJ* commentary, the examinee has a serious medical problem. In my view, our obligation to the individual demands that we take some type of definitive action when the litigant being examined has a serious medical problem. On one occasion, I certified and sent an examinee directly to hospital by ambulance, because I believed the examinee was actively suicidal.

In less serious situations, on four or five occasions, I have called the legal counsel who engaged me and expressed my concern about the examinee. I have sought permission from legal counsel to call the examinee’s family physician or treating specialist to express my concern. On all occasions, legal counsel was happy to have me do so.

To ensure that examinees understand the purpose of the assessment, I always have them sign a full consent form. The form outlines the purpose of the examination, points out that there is no doctor–patient relationship and indicates that I will not be giving them any advice regarding treatment.

## Reference

1.  Ebrahim S, Sava H, Kunz R, et al. Ethics and legalities associated with independent medical evaluations. CMAJ 2014;186: 248–9.
    
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