0
0

Chapter 41. Psychiatry and the Law

Robert I. Simon, M.D.; Daniel W. Shuman, J.D.
DOI: 10.1176/appi.books.9781585623402.337125

Sections

Excerpt

The legal principles applied to the practice of psychiatry do not differ from those applied to medicine in general. Nevertheless, the diagnosis, treatment, and management of patients with psychiatric disorders present unique concerns that may pit the psychiatrist's duty to the patient against the psychiatrist's duty to the community. For instance, the competence of psychiatric patients to make health care decisions is often an issue in psychiatric care, as well as the risks that patients pose to others and how best to reduce those risks. Issues such as informed consent, the duty of confidentiality, the right to treatment, the right to refuse treatment, substitute decision making, and advance directives are commonly confronted by clinicians when treating psychiatric patients.

Your session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

FIGURE 41–1. Psychiatric claims by cause of loss: United States, 1998–2006.The "cause of loss" represents the main allegation made in the claim or lawsuit. In almost all lawsuits, multiple allegations of negligence are asserted. These data are collected based on the chief allegation or complaint. Thus, the category of "incorrect treatment" may be alleged in a lawsuit based on a patient suicide but the main or chief allegation/complaint is stated as "incorrect treatment." Suicide and attempted suicide is the most frequently identifiable cause of loss. The "drug reaction" category used here encompasses all types of drug/medication misadventures, including errors in prescribing, adverse reactions to medications, mismanagement of a patient's medication regime, or other unanticipated outcomes related to medication use. "Other" includes Vicarious Liability "PC", Libel/Slander, Other/Not specific, Third Party (e.g., parents), Administrative, Lack of Informed Consent, Abandonment, Tarasoff, Forensic, Premises Liability, Boundary Violation.Source. The Psychiatrists' Program, managed by Professional Risk Management Services (PRMS; www.prms.com).
Table Reference Number
TABLE 41–1. Recent allegations of malpractice (approximate frequency of claims)
Table Reference Number
TABLE 41–2. Common limitations of testimonial privilege
Table Reference Number
TABLE 41–3. Required minimum standard of care for a somatic treatment of a psychiatric patient
Table Reference Number
TABLE 41–4. Common negligent prescription practices
Table Reference Number
TABLE 41–5. Informed consent: reasonable information to be disclosed
Table Reference Number
TABLE 41–6. Common consent options for patients lacking the mental capacity for health care decisions
Table Reference Number
TABLE 41–7. Indications for seclusion and restraint
Table Reference Number
TABLE 41–8. Contraindications to seclusion and restraint
Table Reference Number
TABLE 41–9. Increased index of suspicion for malingering
Table Reference Number
TABLE 41–10. Collateral sources of information
Table Reference Number
TABLE 41–11. Major factors influencing neuropsychological test findings
Table Reference Number

While the risk of being sued is inherent in the practice of psychiatry, spending time and talking with patients reduces the chances of being sued when things go bad.

Except in an emergency, a psychiatrist must obtain informed consent—intelligent, knowing, and voluntary—from a competent patient before providing treatment. If the patient is not competent, an alternative method of consent (e.g., advance directive, guardianship) must be used.

Patient confidences are sacrosanct and may be disclosed only when authorized in writing by the patient, ordered by the court, or excepted by law (e.g., elder or child abuse).

Although psychiatrists may be competent in many roles, they should avoid conflicting roles such as forensic expert and therapist for the same patient-litigant.

The psychiatrist who remains informed about the legal regulation of psychiatry can more effectively manage complex clinical-legal issues that inevitably arise with patients.

References

American Academy of Psychiatry and the Law: Ethical Guidelines for the Practice of Forensic Psychiatry. Adopted May 1987. Revised October 1989, 1991
 
American Medical Association: Physician-Assisted Suicide. Code of Medical Ethics Reports, Vol 5, No 2. Chicago, IL, American Medical Association, July 1994, pp 269–275
 
American Medical Association: Report of the Council on Scientific Affairs: Evidence-Based Principles of Discharge and Discharge Criteria (CSA Report 4-A-96). Chicago, IL, American Medical Association, 1996
 
American Medical Association: Guide to the Evaluation of Permanent Impairment, 5th Edition. Chicago, IL, American Medical Association, 2001
 
American Psychiatric Association: Child Custody Consultation. Washington, DC, American Psychiatric Association, 1982
 
American Psychiatric Association: The Psychiatric Uses of Seclusion and Restraint (APA Task Force Report No 22). Washington, DC, American Psychiatric Association, 1985
 
American Psychiatric Association: Tardive Dyskinesia: A Task Force Report of the American Psychiatric Association. Washington, DC, American Psychiatric Association, 1992
 
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000
 
American Psychiatric Association: The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging. A Task Force Report of the American Psychiatric Association, 2nd Edition. Edited by Weiner RD. Washington, DC, American Psychiatric Association, 2001a
 
American Psychiatric Association: The Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry. Washington, DC, American Psychiatric Association, 2001b
 
American Psychiatric Association: Practice Guidelines for the Treatment of Psychiatric Disorders. Washington, DC, American Psychiatric Association, 2004
 
Appelbaum PS: Statutes regulating patient–therapist sex. Hosp Community Psychiatry 41:15–16, 1990
[PubMed]
 
Appelbaum PS, Lidz CW, Meisel A: Informed Consent: Legal Theory and Clinical Practice. New York, Oxford University Press, 1987, pp 84–87
 
Appelbaum PS, Zonana H, Bonnie R, et al: Statutory approaches to limiting psychiatrists' liability for their patients' violent acts. Am J Psychiatry 146:821–828, 1989
[PubMed]
 
Baldwin LM, Hart LG, Oshel RG, et al: Hospital peer review and the National Practitioner Data Bank. JAMA 282:349–355, 1999
[PubMed]
 
Baxter P, Beck JC: The violent patient: minimize your risk, in Practicing Psychiatry Without Fear: Guidelines of Liability Prevention. Edited by Lifson LE, Simon RI. Cambridge, MA, Harvard University Press, 1998
 
Beahrs JO, Gutheil TG: Informed consent in psychotherapy. Am J Psychiatry 158:4–10, 2001
[PubMed]
 
Becker B, Kay GG: Neuropsychological consultation in psychiatric practice. Psychiatr Clin North Am 9:255–265, 1986
[PubMed]
 
Benefacts. A Message from the APA-sponsored Professional Liability Insurance Program. Psychiatric News, April 19, 1996, pp 1, 26
 
Billick SB, Kerry CD: Role of the psychiatric evaluator in child custody disputes, in Principles and Practice of Forensic Psychiatry. Edited by Rosner R. New York, Chapman and Hall, 1994, pp 271–281
 
Binder RL: Sexual harassment: issues for forensic psychiatrists. Bull Am Acad Psychiatry Law 20:109–118, 1992
 
Bisbing SB, Jorgenson LM, Sutherland PK: Sexual Abuse by Professionals: A Legal Guide. Charlottesville, VA, Michie, 1995
 
Black HC: Black's Law Dictionary, 6th Edition. St Paul, MN, West Publishing, 1990
 
Blackstone W: Commentaries, Vol 4, 1769, pp 24–25
 
Blinder M: My examination of Dan White. Am J Forensic Psychiatry 2:12–22, 1981–1982
 
Blumer D: Psychiatric Aspects of Epilepsy. Washington, DC, American Psychiatric Press, 1984
 
Brakel SJ, Parry J, Weiner BA: The Mentally Disabled and the Law, 3rd Edition. Chicago, IL, American Bar Foundation, 1985
 
Coke E: Third Institute 6, 6th Edition, 1680
 
Devinsky O, Bear D: Varieties of aggressive behavior in temporal lobe epilepsy. Am J Psychiatry 141:651–656, 1984
[PubMed]
 
Droba M, Whybrow PC: Endocrine and metabolic disorders, in Comprehensive Textbook of Psychiatry/V, Vol 2, 5th Edition. Edited by Kaplan HI, Sadock BJ. Baltimore, MD, Williams & Wilkins, 1989, pp 1209–1221
 
Elliott FA: Neurological aspects of antisocial behavior, in The Psychopath: A Comprehensive Study of Antisocial Disorders and Behaviors. Edited by Reid WH. New York, Brunner/Mazel, 1978, pp 146–189
 
Elliott FA: Neurological findings in adult minimal brain dysfunction and the dyscontrol syndrome. J Nerv Ment Dis 170:680–687, 1982
[PubMed]
 
Emanuel EJ, Emanuel LL: Proxy decision making for incompetent patients: an ethical and empirical analysis. JAMA 267:2067–2071, 1992
[PubMed]
 
Felthous AR: The duty to warn or protect to prevent automobile accidents, in American Psychiatric Press Review of Clinical Psychiatry and the Law, Vol 1. Edited by Simon RI. Washington, DC, American Psychiatric Press, 1990, pp 221–238
 
Gold LH: Sexual Harassment: Psychiatric Assessment in Employment Litigation. Washington, DC, American Psychiatric Publishing, 2004
 
Greenberg SA, Shuman DW: Irreconcilable conflict between therapeutic and forensic roles. Journal of Professional Psychology: Research and Practice 28:50–56, 1997
 
Greenberg SA, Shuman DW, Meyer RG: Unmasking forensic diagnosis. Int J Law Psychiatry 27:1–15, 2004
[PubMed]
 
Grisso T: Evaluating Competencies: Forensic Assessments and Instruments. New York, Plenum, 1986
 
Grisso T, Appelbaum PS: Comparison of standards for assessing patients' capacities to make treatment decisions. Am J Psychiatry 152:1033–1037, 1995a
 
Grisso T, Appelbaum PS: The MacArthur treatment competence study, III: abilities of patients to consent to psychiatric and medical treatments. Law Hum Behav 19:149–174, 1995b
 
Gutheil TG, Appelbaum PS: Substituted judgement and the physician's ethical dilemma: with special reference to the problem of the psychiatric patient. J Clin Psychiatry 41:303–305, 1980
[PubMed]
 
Gutheil TG, Simon RI: Risk management principles in recovered memory cases: the importance of the clinical foundation. Psychiatr Serv 48:1403–1407, 1997
[PubMed]
 
Hoge SK, Jorgenson L, Goldstein N, et al: APA resource document: legal sanctions for mental health professional–patient sexual misconduct. Bull Am Acad Psychiatry Law 23:433–448, 1995
[PubMed]
 
Johnson ID: Reports to the National Practitioner Data Bank. JAMA 265:407–411, 1991
[PubMed]
 
Joint Commission on Accreditation of Healthcare Organizations: Comprehensive Accreditation Manual for Behavioral Healthcare Hospital Accreditation Standards PC 13.50. Oak Brook Terrace, IL, Joint Commission on Accreditation of Healthcare Organizations, 2006a
 
Joint Commission on Accreditation of Healthcare Organizations: Comprehensive Accreditation Manual for Behavioral Healthcare Restraint and Seclusion Standards for Behavioral Health. Oak Brook Terrace, IL, Joint Commission Accreditation of Healthcare Organizations, 2006b
 
Kane JM, Weinhold P, Kinon B, et al: Prevalence of abnormal involuntary movements ("spontaneous dyskinesia") in the normal elderly. Psychopharmacology (Berl) 77:105–108, 1982
[PubMed]
 
Klawans HL, Barr A: Prevalence of spontaneous lingual-facial-buccal dyskinesia in the elderly. Neurology 32:558–559, 1982
[PubMed]
 
Klein J, Onek J, Macbeth J: Seminar on Law in the Practice of Psychiatry. Washington, DC, Onek, Klein and Farr, 1983
 
LaPuma J, Orentlicher D, Moss RJ: Advance directives on admission: clinical implications and analysis of the Patient Self-Determination Act of 1990. JAMA 266:402–405, 1991
 
Lazarus JA, Sharfstein SS: Changes in the economics and ethics of health and mental health care, in American Psychiatric Press Review of Psychiatry, Vol 13. Edited by Oldham JM, Riba MB. Washington, DC, American Psychiatric Press, 1994, pp 389–413
 
Leong GB, Eth S, Silva JA: The psychotherapist as witness for the prosecution: the criminalization of Tarasoff. Am J Psychiatry 149:1011–1015, 1992
[PubMed]
 
Levinson W, Roter DL, Mullooly JP, et al: Physician–patient communication: the relationship with malpractice claims among primary care physicians and surgeons. JAMA 227:553–559, 1997
 
Lieberman DZ, Resnik HL, Holder-Perkins V: Environmental risk factors in hospital suicide. Suicide Life Threat Behav 34:448–453, 2004
[PubMed]
 
Link BG, Stueve A: Psychotic symptoms and the violent/illegal behavior of mental patients compared to community controls, in Violence and Mental Disorder: Developments in Risk Assessment. Edited by Monahan J, Steadman H. Chicago, IL, University of Chicago Press, 1994, pp 137–159
 
Lohr JB, Wisniewski A, Jeste DV: Neurological aspects of tardive dyskinesia, in Handbook of Schizophrenia, Vol 1: Neurology of Schizophrenia. Edited by Nasrallah H, Weinberger DR. Amsterdam, The Netherlands, Elsevier, 1986, pp 97–119
 
Low P, Jeffries J, Bonnie R: Criminal Law: Cases and Materials. Mineola, NY, The Foundation Press, 1982, pp 152–154
 
Monahan J, Steadman HJ, Silver E, et al: Rethinking Risk Assessment: The MacArthur Study of Mental Disorder and Violence. New York, Oxford University Press, 2001
 
Malcolm JG: Informed consent in the practice of psychiatry, in American Psychiatric Press Review of Clinical Psychiatry and the Law, Vol 3. Edited by Simon RI. Washington, DC, American Psychiatric Press, 1992, pp 223–281
 
McGarry AL: Pathological gambling: a new insanity defense. Bull Am Acad Psychiatry Law 11:301–308, 1983
[PubMed]
 
Melton GB, Petrila J, Poythress NG, et al: Psychological Evaluations for the Courts: A Handbook for Mental Health Professionals and Lawyers, 2nd Edition. New York, Guilford, 1997
 
Meyer DJ, Simon RI: Split treatment: clarity between psychiatrists and psychotherapists. Psychiatr Ann 29:241–245, 327–332, 1999
 
Mill JS: On liberty (1859), in The World in Literature. Atlanta, GA, Scott, Foresman and Company, 1951, pp 316–333
 
Mishkin B: Decisions in Hospice. Arlington, VA, The National Hospice Organization, 1985
 
Mishkin B: Determining the capacity for making health care decisions, in Issues in Geriatric Psychiatry (Advances in Psychosomatic Medicine, Vol 19). Edited by Billig N, Rabins PV. Basel, Switzerland, S Karger, 1989, pp 151–166
 
Monahan J, Steadman H (eds): Violence and Mental Disorder: Developments in Risk Assessment. Chicago, IL, University of Chicago Press, 1994
 
The National Practitioner Data Bank and MCOs, in Psychiatric Practice and Managed Care, Vol 5, No 5. Washington, DC, American Psychiatric Association, 1999, pp 1, 9–10
 
Orentlicher D: The illusion of patient choice in end-of-life decisions. JAMA 267:2101–2104, 1992
[PubMed]
 
Overman W Jr, Stoudemire A: Guidelines for legal and financial counseling of Alzheimer's disease patients and their families. Am J Psychiatry 145:1495–1500, 1988
[PubMed]
 
Parry BL, Berga SL: Neuroendocrine correlates of behavior during the menstrual cycle, in Psychiatry, Vol 3. Edited by Cavenar JO. Philadelphia, PA, JB Lippincott, 1991, pp 1–22
 
Perlin ML: Mental Disability Law: Civil and Criminal, Vol 3. Charlottesville, VA, Michie, 1989
 
Perr IN: The clinical considerations of medication refusal. Legal Aspects of Psychiatric Practice 1:5–8, 1984
 
President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research: Making Health Care Decisions, Vol 1: A Report on the Ethical and Legal Implications of Informed Consent in the Patient–Practitioner Relationship. Washington, DC, U.S. Government Printing Office, October 1982
 
Regan M: Protective services for the elderly: commitment, guardianship, and alternatives. William Mary Law Rev 13:569–573, 1972
 
Reich J, Wells J: Psychiatric diagnosis and competency to stand trial. Compr Psychiatry 26:421–432, 1985
[PubMed]
 
Robertson ED: Is "substituted judgment" a valid legal concept? Issues Law Med 5:197–214, 1989
[PubMed]
 
Robertson JD: The trial of a suicide case, in American Psychiatric Press Review of Clinical Psychiatry and the Law, Vol 2. Edited by Simon RI. Washington, DC, American Psychiatric Press, 1991, pp 423–441
 
Rogers R, Shuman DW: Fundamentals of Forensic Practice: Mental Health and Criminal Law. New York, Springer, 2005
 
Rosenthal RJ, Lorenz VC: The pathological gambler as criminal offender: comments on the evaluation and treatment. Psychiatr Clin North Am 15:647–660, 1992
[PubMed]
 
Roth LH: Informed consent and its applicability for psychiatry, in Psychiatry, Vol 3. Edited by Cavenar JO. Philadelphia, PA, JB Lippincott, 1985, pp 1–17
 
Rutter P: Sex in the Forbidden Zone: When Therapists, Doctors, Clergy, Teachers and Other Men in Power Betray Women's Trust. Los Angeles, CA, JP Tarcher, 1989
 
Sale B, Powell DM, Van Duizend R: Disabled Persons and the Law: State Legislative Issues. New York, Plenum, 1982, p 461
 
Schoener GR, Milgrom JH, Gonsiorek JC, et al: Psychotherapists' Sexual Involvement With Clients. Minneapolis, MN, Walk-In Counseling Center, 1989
 
Schreiber J, Roesch R, Golding S: An evaluation of procedures for assessing competency to stand trial. Bull Am Acad Psychiatry Law 155:187–203, 1987
 
Sederer LI, Ellison J, Keyes C: Guidelines for prescribing psychiatrists in consultative, collaborative, and supervisory relationships. Psychiatr Serv 49:1197–1202, 1998
[PubMed]
 
Shuman DW: Expertise in law, medicine, and health care. J Health Polit Policy Law 26:267–290, 2001
[PubMed]
 
Shuman DW, Greenberg SA: Expert witnesses, the adversary system, and the voice of reason: reconciling impartiality and advocacy. Professional Psychology: Research and Practice. 34:219–224, 2003
 
Shuman DW, Weiner MF: The psychotherapist-patient privilege: a critical examination. Springfield, IL, Charles C Thomas, 1987
 
Simon RI: The psychiatrist as a fiduciary: avoiding the double agent role. Psychiatr Ann 17:622–626, 1987
 
Simon RI: Sexual exploitation of patients: how it begins before it happens. Psychiatr Ann 19:104–112, 1989
 
Simon RI: Psychological injury caused by boundary violation precursors to therapist–patient sex. Psychiatr Ann 21:614–619, 1991
 
Simon RI: Clinical Psychiatry and the Law, 2nd Edition. Washington, DC, American Psychiatric Press, 1992a
 
Simon RI: Clinical risk management of suicidal patients: assessing the unpredictable, in American Psychiatric Press Review of Clinical Psychiatry and the Law, Vol 3. Edited by Simon RI. Washington, DC, American Psychiatric Press, 1992b, pp 3–63
 
Simon RI: Treatment boundary violations: clinical, ethical, and legal considerations. Bull Am Acad Psychiatry Law 20:269–288, 1992c
 
Simon RI: Innovative Psychiatric Therapies and Legal Uncertainty: A Survival Guide for Clinicians. Psychiatr Ann 23:473–479, 1993
 
Simon RI: Treatment boundaries in psychiatric practice, in Forensic Psychiatry: A Comprehensive Textbook. Edited by Rosner R. New York, Van Nostrand Reinhold, 1994
 
Simon RI: The credible forensic psychiatric evaluation in sexual harassment litigation. Psychiatr Ann 26:139–148, 1996
 
Simon RI: Clinical risk management of the rapid cycling bipolar patient. Harv Rev Psychiatry 4:245–254, 1997
[PubMed]
 
Simon RI: Psychiatrists' duties in discharging sicker and potentially violent patients in the managed care era. Psychiatr Serv 49:62–67, 1998
[PubMed]
 
Simon RI: The suicide prevention contract: clinical, legal and risk management issues. J Am Acad Psychiatry Law 27:445–450, 1999
[PubMed]
 
Simon RI: Concise Guide to Psychiatry and the Law for Clinicians, 3rd Edition. Washington, DC, American Psychiatric Publishing, 2001
 
Simon RI: Suicide risk assessment: what is the standard of care? J Am Acad Psychiatry Law 30:340–344, 2002
[PubMed]
 
Simon RI (ed): Posttraumatic Stress Disorder in Litigation: Guidelines for Forensic Assessment, 2nd Edition. Washington, DC, American Psychiatric Publishing, 2003
 
Simon RI: Assessing and Managing Suicide Risk: Guidelines for Clinically Based Risk Management. Washington, DC, American Psychiatric Publishing, 2004
 
Simon RJ: The myth of "imminent" violence in psychiatry and the law. University of Cincinnati Law Review 75:631–644, 2006
 
Simon RI, Hales RE (eds): American Psychiatric Publishing Textbook of Suicide Assessment and Management. Washington, DC, American Psychiatric Publishing, 2006
 
Simon RI, Shuman DW (eds): Retrospective Assessment of Mental States in Litigation: Predicting the Past. Washington, DC, American Psychiatric Publishing, 2002
 
Simon RI, Wettstein RM: Toward the development of guidelines for the conduct of forensic psychiatric examinations. J Am Acad Psychiatry Law 25:17–30, 1997
[PubMed]
 
Slovenko R: Assessing competency to stand trial. Psychiatr Ann 26:392–393, 397, 1995
 
Slovenko R: Psychotherapy and Confidentiality: Testimonial Privileged Communication, Breach of Confidentiality, and Reporting Duties. Springfield, IL, Charles C Thomas, 1998
 
Smith JT: Medical Malpractice: Psychiatric Care. Colorado Springs, CO, Shepard's/McGraw-Hill, 1986
 
Solnick PB: Proxy consent for incompetent nonterminally ill adult patients. J Leg Med 6:1–49, 1985
[PubMed]
 
Sparr LF: Legal aspects of posttraumatic stress disorder: uses and abuses, in Posttraumatic Stress Disorder: Etiology, Phenomenology, and Treatment. Edited by Wolf ME, Mosnaim AD. Washington, DC, American Psychiatric Press, 1990, pp 22–34
 
Stone AA: Posttraumatic stress disorder and the law: critical review of the new frontier. Bull Am Acad Psychiatry Law 21:23–36, 1993
[PubMed]
 
Strasburger LH: "Crudely, without any finesse": the defendant hears his psychiatric evaluation. Bull Am Acad Psychiatry Law 15:229–233, 1987
[PubMed]
 
Strasburger LH, Jorgenson L, Randles R: Criminalization of psychotherapist–patient sex. Am J Psychiatry 148:859–863, 1991
[PubMed]
 
Strasburger LH, Gutheil TG, Brodsky A: On wearing two hats: role conflict in serving as both psychotherapist and expert witness. Am J Psychiatry 154:448–456, 1997
[PubMed]
 
Strub RL, Black FW: The Mental Status Examination in Neurology, 2nd Edition. Philadelphia, PA, FA Davis, 1985
 
Tardiff K: The past as prologue: assessment of future violence in individuals with a history of past violence, in Retrospective Assessment of Mental States in Litigation: Predicting the Past. Edited by Simon RI, Shuman DW. Washington, DC, American Psychiatric Publishing, 2002
 
Tischler GL: Utilization management of mental health services by private third parties. Am J Psychiatry 147:967–973, 1990
[PubMed]
 
Tranel D: Functional neuroanatomy: neuropsychological correlates of cortical and subcortical damage, in The American Psychiatric Press Textbook of Neuropsychiatry, 2nd Edition. Edited by Yudofsky SC, Hales RE. Washington, DC, American Psychiatric Press, 1992, pp 70–75
 
U.S. Department of Health and Human Services: The Legal Status of Adolescents 1980. Washington, DC, U.S. Department of Health and Human Services, 1981
 
Walzer RS: Impaired physicians: an overview and update of legal issues. J Leg Med 11:131–198, 1990
[PubMed]
 
Weir RF, Gostin L: Decisions to abate life-sustaining treatment for nonautonomous patients: ethical standards and legal liability for physicians after Cruzan. JAMA 264:1846–1853, 1990
[PubMed]
 
Why Are Liability Premiums Rising? Psychiatric News, June 21, 1996, pp 1, 24–25
 
Wickizer TM, Lessler D, Travis KM: Controlling inpatient psychiatric utilization through managed care. Am J Psychiatry 153:339–345, 1996
[PubMed]
 
Widiger TA, Trull TJ: Personality disorders and violence, in Violence and Mental Disorder: Developments in Risk Assessment. Edited by Monahan J, Steadman H. Chicago, IL, University of Chicago Press, 1994, pp 203–226
 
Woodward B, Duckworth K, Gutheil TG: The pharmacotherapist-psychotherapist collaboration, in Annual Review of Psychiatry, Vol 12. Edited by Oldham J. Washington, DC, American Psychiatric Press, 1993
 
Zeldow PB, Taub HA: Evaluating psychiatric discharge and aftercare in a VA medical center. Hosp Community Psychiatry 32:57–58, 1981
[PubMed]
 
+

CME Activity

Add a subscription to complete this activity and earn CME credit.
Sample questions:
1.
"Competency" in the legal sense and "capacity" in the clinical sense are overlapping constructs that are commonly encountered in clinical practice. Which of the following is not true?
2.
Standards for determination of competency in decision making include all of the following except
3.
In Sell v. United States, the Supreme Court set forth standards governing the administration of antipsychotic drugs to render a nonconsenting defendant competent to stand trial. The requirements established in this decision included all of the following except
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Related Content
Articles
Books
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 43.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 65.  >
The American Psychiatric Publishing Textbook of Psychiatry, 6th Edition > Chapter 6.  >
Topic Collections
Psychiatric News
PubMed Articles
Shifting toward defined contributions--predicting the effects. N Engl J Med 2014;370(26):2462-5.doi:10.1056/NEJMp1314391.
Electronic cigarettes and history. Lancet 2014;383(9936):2204-5.
 
  • Print
  • PDF
  • E-mail
  • Chapter Alerts
  • Get Citation