Because of the unique nature of the psychiatrist-patient relationship and the complexities of dealing with patient’s minds instead of their bodies, psychiatrists are at great risk for being named in a malpractice lawsuit. For many years, courts have recognized that psychiatry is not an exact science and that decisions with respect to the treatment often involve a calculated risk and disagreement among experts as to whether the risk was warranted or in accord with accepted principles. Psychiatrists owe their patients the type of care that would be rendered by a reasonable psychiatrist faced with the same or similar circumstances. However, many courts have adopted the professional judgment theory. Under the theory, if a psychiatrist chooses a course of treatment for a patient, within a range of medically accepted choices, the theory of professional medical judgment will insulate the psychiatrist from malpractice liability. However, before the theory will apply to protect a psychiatrist, the psychiatrist must have properly examined and evaluated the patient. Likewise, a psychiatrist will only be exempt from liability under the professional judgment theory if reasonable psychiatric minds could differ as to what the proper course of treatment should be.
Confidentiality of a patient’s records and dealings is essential to the success of the psychiatrist-patient relationship. However, when dealing with potentially dangerous patients, psychiatrists sometimes have to weigh the benefit of maintaining the patient’s confidentiality against the risk of harm if the patient’s dangerousness is not revealed. Thus, a psychiatrist may have a duty to warn the police if he or she learns that a patient intends to commit a crime. Likewise, a psychiatrist generally has a legal duty to report child abuse. Thus, if a patient reveals that he or she is abusing a child, the psychiatrist would have a duty to breach patient confidentiality in order to report the abuse.
Some examples of psychiatric malpractice are as follows:
* Sexual abuse of a patient: Because of the confidential nature of the psychiatrist-patient relationship, sexual contact between a psychiatrist and his or patient is seen as extremely grievous and nearly always would constitute malpractice.
* Negligent release of a mental patient: If a psychiatrist made a decision that a particular patient was fit to be discharged from the hospital, and the patient subsequently killed him or herself and/or others, the psychiatrist may be held liable for malpractice.
* Failure to warn of a patient’s dangerousness: In certain instances, psychiatrists have been held liable for failing to warn third parties, such as a mental patient’s family and friends, of the patient’s stated intention to hurt the third party. The duty to warn third parties and its conflict with confidentiality issues varies from state to state.
* Ordering Electro-convulsive treatment: The decision of whether to order patients to undergo electro-convulsive treatment is controversial in the field of psychiatry. In some cases, a psychiatrist has been held liable for malpractice when electro-convulsive treatment resulted in permanent memory loss.
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