PT  - JOURNAL ARTICLE
AU  - John O. Beahrs
AU  - Jeffrey L. Rogers
TI  - Appropriate Short-Term Risk in Psychiatry and the Law
DP  - 1993 Mar 01
TA  - Journal of the American Academy of Psychiatry and the Law Online
PG  - 53--67
VI  - 21
IP  - 1
4099  - http://jaapl.org/content/21/1/53.short
4100  - http://jaapl.org/content/21/1/53.full
SO  - J Am Acad Psychiatry Law1993 Mar 01; 21
AB  - Effective treatment decisions sometimes require substantial risk of short-term harm, which can be shown after-the-fact to have been preventable, thereby carrying some liability risk. To err on the side of short-term comfort or safety, however, may greatly increase the overall and long-term risks. For instance, to intrusively restrain a borderline patient from threatened acting out, may (1) fuel a regressive cycle that heightens future risk, (2) deprive the clinician of therapeutic leverage, and/or (3) so disrupt the treatment system that other patients unnecessarily suffer. Long-term thinking is not always convincing to judge or juror, because of less direct causal connections; hence, there is pressing need to develop rational criteria for when it should hold sway. Two competing trends of legal doctrine are relevant: risk-benefit analysis (utilitarian) and absolute values (absolutist). Presumptions of appropriate short-term risk separately weigh five relevant factors, in interaction with one another: imminent safety, long-term risk, voluntariness of other agent, therapeutic boundaries, and social values. Forensic psychiatrists are advised to take a stronger stand in support of short-term risk, when needed to enhance long-term safety and optimal standards of care.