Psychiatry and Law for Clinicians: Concise Guide

Psychiatrists are feeling the chilling effects of increased malpractice liability. Today’s changing health care marketplace—exacerbated by the escalating conflict between patient advocacy and cost-cutting policies inherent in managed care—leaves psychiatrists more vulnerable to lawsuits while also undermining their relationships with their patients.

This third edition of the Concise Guide to Psychiatry and Law for Clinicians arms psychiatrists, psychiatric residents, and other mental health care professionals with a thorough knowledge of the clinical management of legal issues in psychiatry. Its author, a recognized forensic educator and practicing psychiatrist, encourages psychiatrists to transform the law from adversary to working partner—a partnership that can be turned to clinical account for the benefit of patients.

Beginning with an overview of clinical psychiatry and the law (including the basics of malpractice litigation and how crucial it is that psychiatrists maintain adequate clinical records), this pocket guide covers every essential aspect of how law affects the practice of psychiatry today:

• The doctor-patient relationship, including the effects of the Tarasoff doctrine, patient billing, abandonment, and proper termination, and confidentiality and testimonial privilege, including a sample authorization for the release of information form, exceptions, and subpoenas
• Informed consent, including competency, information, and voluntariness, and the right to refuse treatment, including common consent and review options for patients lacking mental capacity for health care decisions
• Psychiatric treatment, including psychopharmacology, electroconvulsive therapy, prevention and management of tardive dyskinesia, and recovered memories of sexual abuse
• Seclusion and restraint, including legal guidelines and due-process procedures, indications, and contraindications, and involuntary hospitalization, including rationale, criteria, procedures, standards, and current trends
• The suicidal patient, including risk assessment, treatment plans, inpatient and outpatient liability, and physician-assisted suicide, and the potentially violent patient, including psychiatrists’ increased liability due to Tarasoff, risk-benefit assessment, the patient with HIV, treatment refusal, and self-harm
• Therapist-patient sex, including legal and ethical consequences, legal defenses, psychological consequences for patients, characteristics of vulnerable patients and "typical" sexually involved therapists, malpractice insurance, and prevention

Clinicians will find this wealth of knowledge immediately practical and reassuring, psychiatric residents will find it invaluable as preparation for the real world, and lawyers will appreciate its in-depth treatment of complex psychiatric issues. With its glossary of legal terms, case studies, detailed charts, and extensive references, this clear, authoritative guide reminds us afresh why it deserves its place among the top legal references for mental health professionals.

Robert I. Simon, M.D., is Clinical Professor of Psychiatry and Director of the Program in Psychiatry and Law at Georgetown University School of Medicine in Washington, D.C.