By Paul S. Appelbaum and Thomas Gutheil. 4th edition. Philadelphia, PA: Lippincott Williams & Wilkins, 2007. 332 pp. $99.00.
Eight years after the publication of the last version, the fourth edition of Clinical Handbook of Psychiatry and the Law lives up to the reputation established in prior renderings. Authored by AAPL Past Presidents and past Guttmacher Award winners Paul S. Appelbaum and Thomas Gutheil, this book is a reference designed to assist its readers in competently navigating the evolving terrain that is psychiatry and the law. Much like before, this update strives to adhere to the commitment made paramount in earlier editions: to provide an accessible reference that brings “clinicians the most up-to-date guidance possible on how law affects clinical practice, and how psychiatry can contribute to the law.” The text accomplishes this goal while still utilizing the presentation format of the first edition.
The book's eight chapters cover the following subjects: confidentiality and privilege, emergency psychiatry, inpatient psychiatry, malpractice and other forms of liability, competence and medical decision-making, forensic evaluations, clinicians and lawyers, and the clinician in court. Each chapter is further divided into seven sections. These sections uniformly begin with relevant case examples designed to underscore and illustrate the legal concepts associated with the chapter. These well-written and often poignant clinical case scenarios help prepare the reader to examine the sections that follow on legal concepts, clinical concerns, and pitfalls. The pitfalls section is designed to assist clinicians in negotiating potentially conflicting agency roles that can, at times, pit legal interests against clinical ones. Each chapter's concluding three sections consist of case example epilogues that provide follow-up to the introductory vignettes, an action guide, and suggested readings. The up-to-date references are arranged by subject headings that reflect the themes of the corresponding chapter sections. Thus, the last two sections of each chapter serve to review and to reinforce material presented in that chapter.
The Handbook's defining feature continues to be its organizational structure. While this format is no longer a novel one, the framework supports the introduction of new material quite effectively. The continued inclusion of historical perspectives, from which modern statutes and standards have evolved, aids in making this work more comprehensive and useful. One such example is the elucidation of problems affecting confidentiality in today's technological age. The authors examine legal concerns involving clinical use of electronic equipment, including computerized records, faxes, e-mail, answering machines, cell phones, and wireless phones.
As psychiatrists are increasingly called upon to provide legal testimony, the chapters that focus on clinicians' appearing in court and working with lawyers are standouts. These portions of the text assist the reader with navigating through potentially stressful clinical situations within an inherently adversarial arena. Whether as fact witness or expert witness, the reader is kept mindful of the discordant orientations that exist between the medical and legal worlds. This reality can be a challenge for practitioners at any level.
The text is especially useful for professionals who invariably find that their current practice trends have been influenced and shaped by legal developments. While the book is not a how-to manual for forensic psychiatric practice, it provides a conceptual framework for establishing and maintaining a competent psychiatric practice that is up to date and reflective of current medicolegal standards. This award-winning book, with its well-organized chapters and user-friendly format, will be a welcome addition to the reference collections of clinicians and forensic psychiatrists, including those practitioners who are familiar with previous editions.
- American Academy of Psychiatry and the Law