Thread by @alysanmati

Cross-examination of Dr. Scott Woodside, the Crown's forensic psychiatrist who doesn't think Alek Minassian is not criminally responsible, has begun. Starts with the defence asking about the process of the assessment.

Defence: It's a back and forth conversation?

Woodside: Within certain limits. He could answer as he chose, would ask follow up questions. Let him take the time to say what is important to him. There is structure and areas they need to cover but he has "fair bit of freedom"

Defence: You want build a rapport and get him to talk

Woodside: Within limits, needs to be clear I am not a friend or advocate. Clear from the start that what they tell me could be in the report to the judge.

Defence says he's not saying Minassian ever saw Woodside as a friend, no indication of that. Asks more about the questions Woodside asks -- he could ask all the q's he wanted?

Woodside agrees.

Woodside said nothing Minassian told him was excluded from the report.

Defence points out they spoke for 12 hours, points to the Westphal transcripts. You don't write down everything he says.

Woodside says it's paraphrased or verbatim quotes.

Defence says Woodside's notes are shorter than the report. Your notes are 23 pages, report is about 30 plus a 100 page summary of collateral material.

Woodside agrees, says of course notes would be shorter don't include background etc.

Defence says you don't ask people to pause so you can type question, then answer.

Woodside says he does ask people to pause if they get ahead of him.

Defence asks whether it's possible to tell if the questions are open-ended or a suggestion.

Woodside said you can tell from the responses eg "agreed." He says his notes are not chronological though usually he does start that way. Seems like he grouped areas together.

The notes are mostly chronological order though.

Woodside he "literally writes down" virtually everything someone tells him.

Defence: As Minassian tells you things, you touch type and make grammatical changes or clarifying adds later if needed. He didn't record the interviews (I don't understand this at all, tbh). And that's what ended up in the report.

Woodside: That's correct.

Defence: Harder to cross someone when they don't have handwritten notes/recordings but they just have typed notes that are the same as the report

Woodside said typed notes are much better bc they are actually legible and more accurate.

Defence: Audio recording would be most accurate.

Woodside: If I do I have stipulations. Not responsible if there is an issue with it. And then the recordings are with police so can't accused of tampering. Transcript be prepared before writing the report.

Defence: Did you put an offer to record the interviews in writing?

Woodside: No one asked me to record them, not the judge, defence or Crown.

Defence: You give presentations/lectures about report writing. Do you tell people to make sure their typed notes are the same as the report to make it harder to cross-examine?

Woodside laughs, no. Only different between handwritten notes is that you can actually read my notes.

Defence says typed notes can be changed without anyone knowing.

Woodside says he knows his duties and take them seriously. Says he often only gets other doctor notes at time of trial.

Defence: The reason to review notes is to see if the expert missed something or something else wrong.

Woodside agrees.

Defence: if you watched the westphal videos and picked out an important part, you'd point it out to the Crown. Or from the notes of Dr. Chauhan.

Woodside agrees.

Defence: You do that because you have access to the underlying information, not just trust me, it's in the report

Defence: But you didn't allow anyone to do that in this case

Woodside says his notes are accurate. No part left out of the report. That is his practice.

Defence: I don't know what interview what part of what he said came from or who was present.

Woodside said it is stated re the index offence when the interview took place. Not important when other stuff was said. He says it is stated who was presented at which interviews.

(This is all coming up because Westphal, the defence expert, did video and audio record his interviews and was EXTENSIVELY crossed on what the Crown said he left out/misconstrued/poorly summarized in his report)

Defence asking how he'd know what was said in what interview?

Woodside said you can look at the collateral information summary

Defence: Why not put the dates of the interviews in notes.

Woodside said he has done cumulative notes, where each day's notes were seperate and it

was "enormously confusing" to lawyers and he was accused of repeating things.

Woodside said he has the start and stop times in the report

Defence: Within the body of your report, no heading like "Day 2"

Woodside said different sections of report can take from different interviews. The only time he noted the different days was in relation to the offence because it would matter if he said different things at different times.

Defence: Looking at a paragraph taken verbatim from notes into the report. Starts "during our second interview" written in the past tense, you are summarizing as you go.

Woodside said he puts all his notes in past tense.

Defence: You wrote the summary of the interview later.

Woodside said this is completely inaccurate

Defence: You consciously convert his words in the moment into the past tense so you can write it into your report?

Woodside says yes.

Defence: Let's talk about Mr. Minassian. When were you first contacted about participating as an assessor in this matter.

Woodside said he thinks it was July of 2018.

Defence agrees likely bc that's when the order for the Bradford assessment was made.

Defence: Clear to you police were aware from the first day that Minassian had some kind of autism diagnosis.

Woodside agrees.

Defence: Clear to you in July 2018 he was someone on the autism spectrum.

Woodside agrees

Defence: That autism was a factor here would have been clear to you from day one. And you have said you are not an expert in autism. You took no steps to bring in such an expert.

Woodside said he didn't know how autism would factor into defence at first.

But yes, didn't get an autism expert.

Defence: You got the court ordered assessment and the "buck stops with you."

Woodside agrees.

Defence: You were asked if you have a specialty in autism, which doesn't exist in psychiatry. Only three specialty areas forensic, child/adolescent and geriatric. But CAMH has different divisions, for example with one for schizophrenia.

Defence: But there are no recognized expert in schizophrenia though by the College.

Woodside agrees but does say there are recognized experts at CAMH in those areas.

Defence also points to areas of specialty in adult neuro-developmental disorders, and child psychiatry.

Woodside agrees and notes there is also an in-patient unit that focuses on autism and intellectual disability.

Defence: Lots of ppl at CAMH with expertise in autism

Defence: You chose not to consult with any of them for this assessment.

Woodside agrees and agrees he could have asked.

Defence going through Woodside's CV and pointing out all the ways he doesn't specialize, write or lecture about autism.

Defence pointing to the sexual behaviour clinic where Woodside said he has worked with people with autism, including high-functioning people.

Defence: You've heard about a number of tests used to determine severity of autism.

Woodside has not taken training in those and doesn't use the ADOS, nor the Vineland or the Empathy Quotient test.

Defence: I don't see you have training in any testing used to diagnose autism severity.

Woodside: Virtually all my training relates to forensic practice (he's done hundreds of psychopathy checklists)

Woodside he sees in-patients with autism who are severely disabled and does see other people with autism through his practice.

Defence: Do you know how many people with autism have serious intellectual and language deficits?

Woodside said it's about a third of everyone with ASD.

Defence: It's a minority

Woodside he usually sees higher-functioning people with autism for risk assessments or competency, or through the sexual behaviours clinic (there are three people in this area). He did not make the diagnosis himself.

But he confirmed the diagnosis. He doesn't think any of those people have undergone specialized autism testing, it's just based on the DSM-5 criteria. All of three have co-morbidities.

Defence: You have never dealt with someone who like Mr. Minassian only has autism spectrum disorder, intact language and intellect.

Woodside said he has in other areas of his practice, not at the sexual behaviour clinic.

Defence: You didn't mention that in exam-in-chief.

Woodside: Regular contact is different with assessment. Has two people in that category. Did a competency assessment for a doctor and another person for risk assessment.

Woodside: Likely more but only two he can think of specifically.

Defence: So the court orders you do to an assessment in a case involving the worst mass killing in Toronto, with autism being raised as a factor, and you didn't get an expert in autism involved.

Woodside said Dr. Wright, the psychologist does have some expertise in autism. Didn't get a non-forensic autism expert involved.

Defence puts up something about forensic psychiatric ethics that says not to go outside areas of expertise and to suggest alternates.

Defence says Woodside has enormous experience with non-autistic people but when he knew this case would deal with autism exclusively, this provision required him to bring in someone with expertise in autism.

Woodside disagrees.

On the lunch break now.

The defence has the section of the DSM-5 about autism spectrum disorder up on the screen.

The defence says Woodside relied on Dr. Wright's testing to come to his conclusions.

Woodside agrees.

Defence: Are you aware/did you research anything that shows ability to work things out on a standardized test is applicable to real world situations.

Woodside says not specifically, though it's mentioned in the DSM 5.

Woodside has a 98-page appendix to his report that goes through all the background material he reviewed.

Defence says none refers to any academic research or articles

Woodside said that's not the purpose of the appendix, it's just a factual review.

Defence: Also no reference in report to academic research.

Woodside agrees other than him citing a article cited by Wright.

Also no bibliography as Dr. Bradford did.

Did send one article he did look at recently.

The defence sent him some articles to review and he read them.

The first one is about the Vineland and the Ados test. It's called "Social and communication abilities and disabilities in higher-functioning individuals with ASD."

The article appears to find that more abled individuals don't actually present with fewer symptoms. Woodside does accept that high IQ/verbal ability doesn't mean that social/communication abilities aren't impaired.

Article says there has been lots of focus re intervention on verbal intelligence and not as much for non-verbal processing. Summarizes another theory that while some can use compensatory strategies to score well on standardized testing but don't draw on those skills in life.

More research needs to be done on what factors can truly predict real-world success.

Defence says Woodside described Minassian's combination of abilities is associated with the "best outcome" for persons with autism. But still faces a number of challenges.

Woodside said this is true, but neurotypical people can still face challenges like social anxiety etc.

Woodside saw Minassian 1.5years after the mass killing. Defence says Minassian was meeting a chaplain, discussing ethics and had spoken to other doctors about the offences.

Defence: What a person says about morals, ethics, perspectives can be shaped by those types of conversations.

Woodside agrees.

Defence: He saw certain things on tv about the case. He got some civil lawsuit documentation. That could have some influence on how one sees things in hindsight

Woodside agrees.

Defence: When you ask about the impact on his family, he shows very little insight.

Woodside: He said he knew they'd be shocked.

Minassian said he could see "a look of sadness" on their faces at some of their few visits. But Woodside said he otherwise showed no insight on the impact on his family.

Minassian said he knew the families of his victims were "very upset." And might apologize in a courtroom, but wasn't sure if he was sorry and that he'd by lying if he said he had regrets. When asked if he'd change anything, would try for higher kill count.

Felt guilty seeing his dad on tv and knew his parents would be saddened and disappointed.

Defence: That's all he said about this.

(To Woodside). Woodside agrees, though hasn't checked the report.

Defence: Speaking to family is important. Woodside didn't speak to them directly, a social worker who works with them did.

Sorry, who works with him (Woodside).

Defence: You didn't go back to Minassian after you got the social worker's report and corroborate that information with him.

Woodside said he did not.

Back from a break. Defence is going through Woodside's report's references to what Minassian said about the impact on his parents.

Defence points out that Minassian seemed to use stronger terms to describe his parents being disappointed after he got fired from a job vs the impact of the mass killing.

Woodside says Minassian did make many other comments regarding how people might view his actions from a moral perspective.

Woodside did say Minassian has real trouble describing his own emotional and emotional state of others. Defence says this is in contrast with his high verbal skills.

Woodside: It's different, he has trouble putting this aspect into words

Defence says it was clear from the police video that the applicable issue would be the moral wrongfulness issue.

Woodside agrees that was most likely.

Bradford came to that conclusion re the NCR test as well.

Woodside said Bradford "hypothesized" about a pathway but that Minassian didn't meet the NCR test in a conventional way.

Defence: Seems like the moral wrongfulness area would be the one to focus on.

Woodside agrees.

Defence: In the 37 pages of your report, you only have one discussion about moral wrongfulness with Minassian.

Woodside says will take defence's word for it.

Woodside said they did discuss his motivations which is linked to moral wrongfulness even if the actual word not used.

Woodside disagrees with defence assessment that he only spoke about it this in a limited way. Points out Minassian said people would think it was "despicable."

Defence says most of it is not in quotes. Didn't note the question.

Defence: Why didn't you quote the whole sentence so we'd know exactly what he said.

Woodside says it would not have added much.

Woodside said Minassian used the words morally wrong and unjustifiable. Says this isn't controversial, he'd said other things like this.

Defence says he didn't have the other reports at the time.

Defence trying to point out that Woodside summarized what Minassian said. Nothing in report that Minassian made a rational decision. In the notes re use of term "consciously" but not in the report.

Defence says the pedophile analogy is not in the report. Doesn't use the word compartmentalize either.

Defence: Difference between cognitive and emotional empathy?

Woodside says yes.

Now distinguishing between psychopath and people with autism re empathy. Woodside said psychopaths can read other people's feelings or are likely to feel and can take perspective. "They know the words but not the music." Know societal view of what is expected but disagree.

Woodside agrees Minassian has problems in both cognitive and emotional empathy. He does have some difficulties in perspective-taking. Not as innate skill for him but he can correctly identify how people will respond through an intellectual process. Has to work at it.

Woodside said he didn't take notes about Minassian's demeanour but it didn't change.

Defence: He expressed no pleasure in the attack

Woodside: Didn't show any emotion about anything.

Defence: You asked him how it felt to kill people and he said essentially it felt like nothing. Felt "blank"

Woodside said he said he was focused on what he doing and not feeling much.

Defence: Minassian describes things in the first person, from his own perspective not about what other people were doing, feeling. Says he broke the law. Doesn't say I have just become a murderer or caused great pain and devastation.

Woodside said he did say he just hit people, which amounts to the same thing. No going back at that point.

Defence: Minassian saying "did I really do that" was about police now coming to get him

Woodside: Recognition that he broke the law.

Defence: Minassian never said he was happy about the way he got the city to almost close down. Never said he was proud about getting all the emotions flowing in the city.

Woodside: he was proud of the media attention.

Defence: All he told you he was looking for, was thinking about was how to kill the most people.

Woodside: That wasn't the end. It was to become infamous. That was the goal. He referenced building a cool app as one other way.

Defence: The part about moral outrage...he thought there would also be people who would praise him, the fringe groups.

Woodside: Yes. But bigger goal was for him name to live on.

Defence: He never said about anything about wanting to cause pain and suffering

Woodside: Didn't say anything about torture or sadistic enjoyment of suffering (does say he didn't think about the most painless way either).

Defence: You gave the example re moral reasoning re stopping at a red light. About following the law not about bigger moral conflict. For a neurotypical person, that's not how you think of things. If you are driving down a main city street with traffic moving fast...

As you come up to a light about to change, you don't think about getting a ticket. You think, if I drive into this intersection I might kill someone or they might kill me. You have innate ability to think about this.

Woodside said he thinks it's automatic.

Woodside said his example is better thought about a 3 a.m., where there are no cars but you still stop at the red light.

Defence says another person might roll through a stop sign if there is no one around, taking into account all those factors.

Woodside said we teach all children right or wrong. We teach them rules. Rules make life easier, you don't HAVE to think about it. Doesn't reflect more complex actions. Much of what we do is automatic.

Most people with ASD are really good at following rules, as was Minassian until this incident.

Woodside says there is nothing about ASD that means you can't learn kids can suddenly run into the road in a school zone, which is why we drive slower in school zones.

Woodside accepts it is different and more difficult for people with ASD to use cognitive empathy and they have to use other strategies to compensate.

Defence: moral reasoning and theory of mind are not the same thing, do you agree?

Woodside does. Says cognitive empathy/theory of mind is part of moral reasoning.

The defence is talking about a journal article shared by Woodside about moral reasoning (about the level at which most people function). He asks if he knew it was from a "predatory" journal, which U of T helped uncover. Woodside was not aware of this.

Before we get into this more the judge says is it really needed, the article is not part of the evidence. Defence says it is a bit because he mentioned it.

Woodside talking about risk of suicide. Suicide attempts do sometimes arise in the context of murders.

Defence says research around suicide attempts shows the difficulty of the final step. In movies we see people appealing to the emotions of someone standing on a ledge

Defence: Is this a thing that happens in real life?

Woodside said he only once tried to help talk someone down in a public setting as an advisor to police. More common that it would happen in private, or be disclosed after or before.