Patient suicide is an unavoidable occupational hazard of psychiatric practice. Indeed, it is the rare clinician who does not struggle, even agonize, over the complex task of assessing and managing the risk of suicide in patients. Patient suicides account for the greatest number of malpractice suits filed against psychiatrists and for the greatest number of settlements and verdicts covered by professional liability insurers. In this book, written by a clinician for clinicians, Dr. Simon, an established expert in psychiatry and law, offers -A solid, easy-to-understand review of how medical malpractice law applies to patient suicides. He discusses the standards of care physicians must meet, the conditions associated with malpractice liability, and how best to minimize risks of litigation. -Extensive references to peer-reviewed literature on suicide and recent malpractice cases, including those triggered by patient suicides, which give insight into the latest developments in both the scientific community and the courts. -Much-needed practical advice, including advice on working with suicide risk assessments and suicide prevention contracts, on treating suicidal patients in various settings (outpatient, inpatient, collaborative, and emergency), and on coping with issues arising in the aftermath of a patient's suicide (documentation, confidentiality, and survivor care). -Clearly defined risk management guidelines that will help clinicians avoid litigation or establish a sound legal defense if sued for malpractice. -Numerous case examples that make the theoretical discussions and clinically based risk management guidelines that follow come alive. Rich in advice that draws on the author's more than 40 years of clinical experience, this book serves as an essential aid to clinicians.
Author(s): Robert I. Simon
Edition: 1
Year: 2003
Language: English
Pages: 256
Contents......Page 10
Foreword......Page 14
Preface......Page 18
Introduction......Page 22
Duty of Care......Page 24
Standard of Care......Page 26
Respected-Minority Rule......Page 28
Direct Causation......Page 29
Damage......Page 30
"Volitional Acts" of Suicide......Page 32
Defenses to a Malpractice Claim......Page 35
National Practitioner Data Bank......Page 38
Importance of Clinically Based Risk Management......Page 39
Clinically Based Risk Management......Page 41
References......Page 42
Introduction......Page 46
Case Example......Page 50
Standard of Care......Page 56
Systematic Suicide Risk Assessment......Page 58
Suicide Risk Factors......Page 62
Suicide Risk Assessment Methodology......Page 70
Managed-Care Settings......Page 74
Clinically Based Risk Management......Page 75
References......Page 76
Introduction......Page 82
Case Example......Page 83
Alliance Versus Contract......Page 88
Other Viewpoints......Page 92
Clinical-Legal Issues......Page 94
Clinically Based Risk Management......Page 96
References......Page 98
Introduction......Page 100
Case Example......Page 102
Evaluation......Page 105
Treatment......Page 108
Personality Disorders......Page 110
Management......Page 111
Suicide Warnings......Page 117
Partial Hospitalization Programs and Intensive Outpatient Programs......Page 119
Clinically Based Risk Management......Page 120
References......Page 122
Introduction......Page 126
Case Example......Page 127
Discussion......Page 130
Competence, Licensure, and Insurance......Page 132
Confidentiality......Page 133
Treatment Roles......Page 134
Medication Management......Page 136
Patient Suitability......Page 139
Clinically Based Risk Management......Page 140
References......Page 142
Appendix: Sample Letter From the Psychiatrist to a Psychotherapist......Page 144
Introduction......Page 146
Case Example......Page 148
Complete Psychiatric Examination......Page 153
Suicide Risk Assessment......Page 156
Treatment......Page 161
Safety Management......Page 166
Discharge and Aftercare......Page 174
Documentation......Page 185
Clinically Based Risk Management......Page 186
References......Page 189
Introduction......Page 194
Case Example......Page 195
Assessment......Page 198
Management......Page 204
Clinically Based Risk Management......Page 208
References......Page 209
Introduction......Page 212
Case Example......Page 213
Discussion......Page 214
Documentation......Page 215
Confidentiality......Page 219
Patient Records......Page 225
Suicide Aftermath......Page 227
Aftercare for Suicide Survivors......Page 230
Clinically Based Risk Management......Page 232
References......Page 234
G......Page 238
R......Page 239
W......Page 240
A......Page 242
C......Page 243
D......Page 244
E......Page 245
H......Page 246
I......Page 247
M......Page 248
P......Page 250
R......Page 252
S......Page 253
T......Page 254
Y......Page 255
