Peter Ash - Malpractice and Liability in Psychiatry

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The goal of Malpractice and Liability in Psychiatry is to provide a comprehensive view of malpractice and liability issues in the practice of psychiatry. Psychiatrists are understandably concerned about being sued for malpractice. To help clinicians avoid claims, many chapters emphasize ways of preventing complaints from arising. When thinking of a title, we wondered if a suitable subtitle might be A How Not-To Guide. If prevention fails, and a suit is filed, the psychiatrist then enters into the unfamiliar world of legal process. Although defendant psychiatrists ultimately win most of the cases filed against them, the process can still be quite stressful, and this book details what the psychiatrist might reasonably expect. The practice of psychiatry may give rise to other complaints as well: ethics complaints, complaints to administrative agencies, medical boards, and complaints posted online. This book tries to provide useful guidance for managing those difficult situations as well.

The idea for this book grew out of prior work of the Group for the Advancement of Psychiatry (GAP). Several years ago, one of the editors (P.A.) was invited to guest edit an issue of Focus: The Journal of Lifelong Learning in Psychiatry. The Committee on Law and Psychiatry of GAP accepted his invitation to write articles for a journal issue on malpractice and risk management, and committee members authored the articles for the Fall 2019 issue of Focus titled Forensic Psychiatry: Focus on Malpractice and Risk Management. One journal issue could only cover a limited number of topics, which led to the idea of writing a more comprehensive work, an idea that was reinforced when we discovered there were no current comprehensive texts on this subject. Some of the conceptualization in chapters in this volume were previously presented in articles in the Focus issue (see acknowledgments in Chaps. ).

To provide a comprehensive discussion of malpractice and liability in psychiatric practice, different sections of this book approach these issues from different perspectives. The first section focuses on malpractice law its principles and history. The second section discusses the process of litigation, from the time shortly after an adverse event through the course of a lawsuit, and discusses the perspectives and roles of the different players, from the defendant doctor to the plaintiffs attorney, defense attorney, and expert witnesses. The third section focuses on the most common allegations in malpractice litigation, with an eye to alerting the clinician to areas of risk, and with tips on preventive strategies and documentation without practicing overly defensive medicine. Although patient management receives considerable discussion, it should be emphasized that this book does not attempt to define the standard of care for any psychiatric condition and should not be construed as doing so. The section on practice areas also covers areas of risk and management, but does so from the perspective of different practice settings, such as inpatient and outpatient psychiatry, rather than focusing on types of allegations. While there is some overlap in content with the allegations section, the practice areas section highlights those issues that will be of particular interest to a clinician practicing in that specific arena. The section on special topics addresses variants of practice that cut across all practice areas: telepsychiatry, the Internet, and practicing under unusual conditions such as a pandemic or natural disaster. While most of the book has a focus on issues that give rise to malpractice litigation, the final section details special issues that arise from complaints against psychiatrists in other contexts.

While this book focuses on the practice of psychiatry, most of the chapters are also relevant to other practitioners (e.g., psychologists, social workers, licensed counsellors) who provide treatment for mental health conditions. Each of the chapter authors brings a wealth of knowledge and experience to their subject. We hope you find their writings useful.