By Robert I Simon
Sufferer suicide is an unavoidable occupational chance of psychiatric perform. certainly, it's the infrequent clinician who doesn't fight, even fret, over the advanced job of assessing and dealing with the danger of suicide in sufferers. sufferer suicides account for the best variety of malpractice matches filed opposed to psychiatrists and for the best variety of settlements and verdicts coated via expert legal responsibility insurers. during this booklet, written through a clinician for clinicians, Dr. Simon, a longtime specialist in psychiatry and legislation, deals -A strong, easy-to-understand evaluation of the way clinical malpractice legislations applies to sufferer suicides. He discusses the factors of care physicians needs to meet, the stipulations linked to malpractice legal responsibility, and the way top to reduce hazards of litigation. -Extensive references to peer-reviewed literature on suicide and up to date malpractice instances, together with these caused through sufferer suicides, which offer perception into the newest advancements in either the clinical group and the courts. -Much-needed sensible recommendation, together with recommendation on operating with suicide hazard tests and suicide prevention contracts, on treating suicidal sufferers in numerous settings (outpatient, inpatient, collaborative, and emergency), and on dealing with concerns coming up within the aftermath of a patient's suicide (documentation, confidentiality, and survivor care). -Clearly outlined danger administration directions that may aid clinicians stay away from litigation or identify a legitimate criminal protection if sued for malpractice. -Numerous case examples that make the theoretical discussions and clinically established threat administration instructions that persist with come alive. wealthy in suggestion that pulls at the author's greater than forty years of scientific event, this booklet serves as a necessary relief to clinicians.
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Extra resources for Assessing and Managing Suicide Risk: Guidelines for Clinically Based Risk Management
Suicide and Malpractice Litigation 15 Table 1–3. Legal defenses in malpractice litigation of suicide cases • Exercise of reasonable professional judgment and compliance with the standard of care • Determination of suicide not foreseeable • Justified allowance of movement (“open-door policy”) • Least restrictive alternative • Superseding, intervening acts • Government immunity • Statute of limitations expiration • Contributory negligence • Othera a Depending on fact-specific case pattern. The time within which a lawsuit can be filed is governed by the laws of the state where the suit is being brought (King 1986).
OTHER LEGAL ACTIONS Although civil claims typically arise because of negligence, they may also result from a breach of contract or from an intentional tort. A breach of contract can occur if a patient undertakes treatment based on an agreement in which the psychiatrist promises some result but then fails to produce it. , treating patients without their consent). , discriminatory treatment practices against institutionalized patients). Psychiatrists can also become embroiled in administrative, licensure, and ethics proceedings.
Therefore, just asking the patient at suicide risk about the presence of suicidal ideation, intent, and plan and receiving a denial cannot be relied on by itself. Even 38 Assessing and Managing Suicide Risk when the patient is telling the truth, it is unwise to equate the patient’s denial of suicidal ideation with an absence of suicide risk. If possible, family members or significant others should be consulted. The Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry (American Psychiatric Association 2001) states, “Psychiatrists at times may find it necessary, in order to protect the patient or community from imminent danger, to reveal confidential information disclosed by the patient” (Section 4, Annotation 8).
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