Am J Psychiatry 1988; 145:779-785
Copyright © 1988 by American Psychiatric Association
The new preventive detention: psychiatry's problematic responsibility for the control of violence
PS Appelbaum
Department of Psychiatry, University of Massachusetts Medical School, Worcester 01605.
The legal doctrine of the duty to protect potential victims of patients'
violent acts has created problems beyond those usually discussed, which
involve breach of patients' confidentiality. Fear of liability has led some
psychiatrists to hospitalize, solely for the purpose of preventing
violence, patients who do not otherwise require inpatient care. The result
has been the creation of a de facto system of preventive detention that
consumes psychiatric resources intended to serve therapeutic ends and
compels psychiatrists to share the social control responsibilities of the
criminal justice system. The author explores the costs and benefits of
various means of removing the burden of preventive detention from
psychiatry.
