Am J Psychiatry 1989; 146:176-181
Copyright © 1989 by American Psychiatric Association
Commitment: the consistency of clinicians and the use of legal standards
CW Lidz, EP Mulvey, PS Appelbaum and S Cleveland
University of Pittsburgh Center for Medical Ethics, PA.
The reliability and validity of the application of legal criteria for
commitment were investigated as part of a larger study. Evaluations of 411
patients by 96 different clinicians showed good interrater reliability for
assessment of dangerousness and committability. A strong relationship
between ratings of committability and ratings of dangerousness suggests
that clinicians were conforming to the logic of the commitment law.
Discrepant cases involved patients who desired voluntary admission or whose
commitment was completed elsewhere. Results suggest fair application of
commitment standards but that two issues of statutory interpretation
confused participating clinicians.
