Richard Shaw — Direct/Cross/Redirect

RICHARD SHAW: My name is Richard John Shaw.

RICHARD SHAW: I'ma psychiatrist. I went to medical school at the University of London in England. I went straight after high school. That's actually the system in the British medical system. I did two years of pre-clinical training and then three years of clinical care with patients. Following that, I moved to New Zealand to do an internship. It was an internship in neurology, medicine, surgery, and psychiatry. I spent three years in New Zealand and I did a year of psychiatry residency training. Excuse me. And following that, I — excuse me.

RICHARD SHAW: Following that, I moved back I moved here to the United States for the first time and did a residency in adult psychiatry at the Albert O IAM residency in adult psychiatry at the Albert Einstein College of Medicine, which is in New York. That was four years of training in the Bronx, and I also did some subspecialty training in family therapy and couples -- and family therapy in my fourth year. And after that, I moved to California and I have worked at Stanford. I studied at Stanford, I did a fellowship in child and adolescent psychiatry, and I've been at Stanford pretty much since then.

RICHARD SHAW: I'ma professor of psychiatry in the department of psychiatry at Stanford. I also run what's called the psychiatry consult service at the children's hospital at Stanford.

RICHARD SHAW: I have what's called board certification in adults and general psychiatry. I attained that from the American Board of Psychiatry and Neurology in 1991. And then I obtained subspecialty board certification in child PLANE May 24, 2022 and adolescent psychiatry in 1993. `Q Are you a member of any professional organizations in the field of psychiatry?

RICHARD SHAW: Yes,I am. I'ma member of the American Academy of Child and Adolescent Psychiatry. I'm also a member of the Academy of Consultation-Liaison Psychiatry.

RICHARD SHAW: If you include my training in psychiatry residency in the U.S., that will be since 1985.

RICHARD SHAW: Yeah, I think so.

RICHARD SHAW: Approximately three-quarters of my time is working with patients. I work in the pediatric hospital treating a combination of mainly children and adolescent with severe medical conditions, but also working with parents of children who have severe medical conditions. I also consult to the pediatric emergency room and we evaluate patients who show up with suicide attempts and other serious situations.

RICHARD SHAW: Well, as a professor, I have to do a number of academic activities, so I do research, I do a lot of teaching, I give lectures, I supervise residents, medical students and fellows in psychiatry. I do some administrative work. Yeah, so it's a pretty diverse, you know, varying day and week.

RICHARD SHAW: A lot of my research has involved looking at the issue of trauma and PTSD in parents who have medically fragile children. A lot of these parents are naturally really affected by their child's illness and develop trauma symptoms. So, I've developed some interventions to try to help parents, you know, provide support and treatment to reduce their symptoms of trauma.

RICHARD SHAW: Yes, I have. I have published, approximately, 70, probably closer to 80 peer-reviewed manuscripts in different scientific journals. I've also published a number of book chapters on various topics, approximately 30, and I have published three textbooks, one of which has gone into a second edition on topics that are related to my area of expertise, and one of them, actually, is about the treatment of PTSD in parents of premature infants.

RICHARD SHAW: Actually, all. of those books were published through the APA, the American Psychiatric Association. They have a publishing house, and that's been my publishing company.

RICHARD SHAW: The APA, the American Psychiatric Association, not to be confused with the American Psychological Association, is a professional organization that represents psychiatrists in the U.S. The last time I looked at it, I think there was about 37 or 38,000 members, and the APA has many different roles. One of it is advocacy in psychiatry in the U.S. But it also has an important role in terms of education, so they host an annual scientific meeting every year in which psychiatrists will present their research.

RICHARD SHAW: It publishes a number of journals in the field and, well, fairly frequently, it publishes guidelines for professional practice or about ethical guidelines that they hope the members will follow as part of their practice.

RICHARD SHAW: I mentioned the publishing. I also present at the scientific meetings. I last presented in 2021, during COVID, it was virtually, but on the topic of group therapy for parents with trauma symptoms. You know, I follow the APA and their various guidelines, and I think it's a really influential and important institution.

RICHARD SHAW: I've been given a number, several teaching awards at Stanford University, and the American Academy of Child and Adolescent Psychiatry, that J mentioned, honored me with an award for service to my specialty several years ago. I don't remember exactly when.

RICHARD SHAW: Yes, that's part of our work as an academic psychiatrist, is to lecture, to give presentations. So I present fairly frequently at annual scientific meetings, as I mentioned. I've been invited to give grand round presentations at different medical centers, including University of Pennsylvania and Harvard. So that's just part of our goal, is to try to educate our colleagues © about our work.

RICHARD SHAW: Yes, I have.

RICHARD SHAW: I would estimate, in terms of deposition and trial testimony, approximately 50 times in the past 15, 20 years.

RICHARD SHAW: They're pretty varied. So some of them would be medical malpractice. I've also done a number of cases evaluating victims who've been subject to physical/sexual assault or trauma. 12. Q _ What work were you asked to do in this case?

RICHARD SHAW: My role in this case was to give my opinions about the testimony and opinions from — of Dr. Spiegel, who you heard from yesterday morning.

RICHARD SHAW: I was present yesterday in court listening to his testimony. I have viewed his depositions. He had two depositions earlier this year, and I watched those depositions. I've also read a lot of deposition testimony, for example, testimony by Mr. Depp's psychiatrist, Dr. Blaustein, by his physician, Dr. Kipper, and nurse, Debbie Lloyd. I've reviewed depositions by many of the therapists involved in this case, including Dr. Banks, the relationship consultant, Dr. Cowan, who is Ms. Heard's therapist, and I think Dr. Anderson, who, I think, provided some couples' therapy. I've also reviewed the medical records of Dr. Kipper and Dr. Blaustein and some various email communications.

RICHARD SHAW: I think a Jot of the information that has been talked about here.

RICHARD SHAW: That's correct.

RICHARD SHAW: Yes,I do. 17. Q What's your opinion?

RICHARD SHAW: I had a couple of primary opinions. The first is that I - my opinion is that he violated the ethical principles that are outlined in the Goldwater Rule when he gave his opinions about Mr. Depp, specifically with relationship to personality traits and his cognitive abilities. My second primary opinion would be that Dr. Spiegel's opinions were unreliable and that he had insufficient -

RICHARD SHAW: The Goldwater Rule came about in response to an incident that occurred during the 1964 presidential election, when Senator Barry Goldwater was running as a Republican candidate and there was a magazine called Fact magazine that started a campaign to discredit Senator Goldwater. And then obtained a mailing list from the AMA and sent out a single-survey questionnaire to about 12,000 psychiatrists in the U.S., asking if they felt that Senator Goldwater was fit to run for office.

RICHARD SHAW: And about 2,000 psychiatrists responded, a thousand of whom expressed very negative opinions about Senator Goldwater, and made comments such as, for example, he was a megalomaniac, he was a paranoid schizophrenic, that he had narcissistic personality disorder. As a result of that, he was replaced as a candidate and went on to sue Fact magazine for defamation of character. And he was successful in that lawsuit. And in response to this incident, the American Psychiatric Association, that I think was really concerned about how psychiatry was being represented and statements psychiatrists were making about someone they had never met or evaluated, issued the Goldwater Rule.

RICHARD SHAW: And the main premise of the Goldwater Rule is that it was improper for a psychiatrist to render professional opinion about a public figure unless they had personally and closely evaluated them.

RICHARD SHAW: They wanted to make sure that psychiatric illness wasn't being stigmatized. They wanted to ensure that individuals weren't defamed by statements made by a psychiatrist that weren't backed up by medical evidence, and they also wanted to preserve the integrity of the psychiatric profession, since I think the public, in general, and the psychiatrists speaks out publicly and expresses an opinion, a psychiatric opinion, people generally like to take that seriously. And the APA wanted to make sure that those opinions were credible and could be relied upon.

RICHARD SHAW: There are exceptions, yeah. And I think Dr. Spiegel had a Jot to say about this yesterday when he was saying that if you couldn't express an opinion without evaluating someone, it sort of made the whole specialty or role of experts in the court sort of null and void. But there are exceptions and situations in which an expert can give testimony in court.

RICHARD SHAW: So one good example would be if there was a medical malpractice case or if there was a case about - that involved a patient who had committed suicide and the courts wanted to find out whether the psychiatrist had followed appropriate practice, the expert can review medical records and can give an opinion based on those records, provided those records have sufficient information, for example, about the diagnoses, about the treatment, about how the patient was responding or not responding to treatment,

RICHARD SHAW: Well, my opinion is that he did not. He expressed a number of professional opinions about Mr. Depp that we heard about yesterday. And, again, he did so without an evaluation, without consent. He did not follow the guidelines of the APA, the 2017 revision, where it was considered important that there be sufficient information obtained by that expert to give an opinion. So I definitely felt that his conduct, unfortunately, did violate the Goldwater Rule.

RICHARD SHAW: Well, I think there were two primary ones. The first that we heard about was that Dr. Spiegel had professional opinions about Mr. Depp's personality, and he talked a lot about how he believed that Mr. Depp had narcissistic personality traits. And he talked about narcissistic personality disorder. So narcissistic personality disorder is a diagnosis in the diagnostic and statistical manual, it's called the DSM-5 for short. It's a diagnostic manual published by the APA.

RICHARD SHAW: Second example that was given was that he was asked to give an example of how Mr. Depp had shown that he was envious of others, 13: which is another criteria for narcissistic personality disorder. And the example is that Dr. Depp was jealous of Ms. Heard because he believed she was having an affair with Mr. Franco. Now, if we look at these two terms, as a psychiatrist, there's a big difference between being envious and being jealous. As a psychiatrist, when I think about envy, I think about somebody wants something that someone else 272 has --

RICHARD SHAW: Sure So the other big category had to do with Dr. Spiegel's evaluation of Mr Depp's cognitive abilities And his general opinion was that Mr Depp had deficits in his memory in his attention in his processing speed in his to May 24 2022 he had word-finding difficulties Again Dr. Spiegel did not evaluate Mr Depp and the information that he relied upon there were two pieces of information the first was that he watched a very long deposition that Mr Depp gave the day after I think he had flown back from London to the East Coast and he made observations about Mr Depp's behavior in that deposition and felt that he could opine or give an opinion about processing speed and other cognitive aspects He also made reference to something you heard about yesterday this thing called a mini-mental status examination this is a brief

RICHARD SHAW: So the mini-mental status, it's a series of about 10 or 11 questions and tasks that someone completes, and you get a score out of 30. What Dr. Spiegel testified was that Mr. Depp could not recall three words after five minutes, and he used that as an example of Mr. Depp having cognitive deficits that he specifically attributed to Mr. Depp's alcohol and substance abuse. And he really did not have sufficient information. I liken a mini-mental status exam, it's like taking someone's temperature.

RICHARD SHAW: It would have to be someone who could conduct the type of neuropsychological testing that I was mentioning. You can't establish the presence of cognitive deficits without —

RICHARD SHAW: You can't establish cognitive deficits without appropriate neuropsychological testing, and that can only be done by a psychologist or neuropsychologist. So, a psychiatrist, like Dr. Spiegel, would be giving an opinion outside of his area of expertise. If he gave an opinion about cognitive deficits which required psychological testing to be further evaluated.

RICHARD SHAW: Yes, I do. 12. Q _ What is forensic psychiatry? 13. A Forensic psychiatry is a specialty of psychiatry that relates to matters on the intersection between psychiatry and the law. So, for example, what we're doing today is forensic psychiatry, where a psychiatrist comes into court and gives an opinion about a matter to help the court make — come to an opinion.

RICHARD SHAW: One of the primary organizations that has issued guidelines about the practice of forensic psychiatry is called the American Academy of Psychiatry and the Law. This is an organization that represents forensic psychiatrists. And it has published guidelines about what constitutes an ethical and sound practice of doing a forensic assessment and providing a psychiatric opinion. So this guideline, I think, was published m 2015. Actually, contains many elements that are consistent with the Goldwater Rule.

RICHARD SHAW: So, for example, it states that for a forensic assessment to be done, it has to be informed consent. And there should be a very thorough comprehensive evaluation that would include reviewing past records, past psychiatric history; it would include doing what's called a mental status

RICHARD SHAW: (7004 to 7007) 24, 2022 And the guidelines do state that it is reasonable, or permitted, to provide an opinion without an evaluation. But if you're going to do that, there's some things that you have to really make clear in your opinion when you express that opinion. And the first is that you have to acknowledge the limitations of your opinion and not, like Dr. Spiegel, say that his opinion was held with a degree of medical certainty. You have to explain what's missing, what data you did not have that you were not able to rely upon in coming to that opinion.

RICHARD SHAW: You also have to talk about what additional information you would need to come to that opinion. And even though these guidelines say that it's permissible to do this, the text is still, I think, not fully in support of psychiatrists doing this. So their statements are that opinions rendered without a proper database, which is what we psychiatrists rely upon to make diagnoses and give opinions, professional opinions, is questionable and not generally recommended.

RICHARD SHAW: Yes, I did.

RICHARD SHAW: Well, my opinion is that he did not follow those guidelines. So, for example, he did not have consent. He did not do even a basic evaluation of Mr. Depp. When he gave his opinions, as I just mentioned, he said they were opinions that he had to a degree of medical certainty, and he did not make any statements about what other additional information he would have wanted to make that opinion. So, for example, when asked about shouldn't psychological testing be performed, he said most patients don't have access to that, which is actually not at all true.

RICHARD SHAW: Every medical school has neuropsychologists that can do testing. So I think that was an unfortunate statement. So, I think those are the primary reasons which the Goldwater Rule was violated and the practice guidelines were not adhered to.

RICHARD SHAW: Allright.

RICHARD SHAW: Yes. So the difference between a correlation and causation, correlation is a statistical analysis of a relationship between two different factors. So in Dr. Spiegel's testimony, he talked about, you know, there being a correlation between opinions he had about Mr. Depp, his narcissistic personality traits, his substance abuse, things of that nature. So a correlation doesn't say anything about whether or not these factors caused that, you know, the behavior he was discussing.

RICHARD SHAW: Perhaps one of the easiest ways I could describe the difference between correlation and causation is if we look at the issue of measles, if you'll bear with me. There's a correlation between being young and catching measles. Now, we know that measles is not caused by being young, measles is caused by a virus. But young children have not been exposed to the virus, they don't have the immunity, so they have a high rate of measles. So to the difference statistically - or the difference between causation and correlation is illustrated by that example. So on the other end, put this as if, you know, if we had a hundred people in the room, just bringing it back to the issue of IPV that Dr. Spiegel was testifying about. Let's say we had 76 people who had all the risk factors for IPV and 30 people who had no risk factors for IPV. So what can we say about those 70 people? We can't say that any single one of those people has perpetrated IPV, even though they may have all the risk factors.

RICHARD SHAW: And if you look at the 30 people who have no risk factor, you also can't say whether or not they have perpetrated IPV. So the actual presence of risks factors for IPV that Dr. Spiegel was talking about, they say absolutely nothing about what happened in this case.

RICHARD SHAW: Good afternoon.

RICHARD SHAW: That's correct.

RICHARD SHAW: That's correct.

RICHARD SHAW: I have not.

RICHARD SHAW: I have not.

RICHARD SHAW: Yes.

RICHARD SHAW: I'm aware of that.

RICHARD SHAW: Yes.

RICHARD SHAW: Yes.

RICHARD SHAW: Yes.

RICHARD SHAW: I do, yes.

RICHARD SHAW: Yes.

RICHARD SHAW: I heard that yesterday in testimony, yes.