LEGAL ISSUES IN TREATING PERPETRATORS AND VICTIMS OF VIOLENCE
Section snippets
MALPRACTICE LIABILITY
Psychiatrists are subject to being sued for malpractice after a patient commits a violent act or a victim of child abuse is diagnosed incorrectly. In a malpractice action, a plaintiff attempts to recover monetary damages by proving in a court of law that the psychiatrist was negligent.58 Ordinarily, a successful malpractice suit requires a plaintiff's expert psychiatric opinion that the defendant psychiatrist practiced below the standard of care. The only exception is in cases of res ipsa
Assessment of Risk for Violence
Although psychiatrists often are asked to predict violent behavior, they have not demonstrated the ability to do this well.39 They typically overpredict violence by 40% to 95% (false positives). The tendency to overpredict is due in part to clinicians' fear of liability for the violent acts of their patients.29 Rather than attempting to predict violent acts, psychiatrists should simply assess the risk for violence.71
Because a psychiatrist is much more likely to be sued successfully for an
Child Abuse
Child abuse encompasses physical abuse, sexual abuse, emotional abuse, and neglect. In 1994, more than 3 million children were reported to child protective service agencies in the United States as victims of child abuse and neglect. More than 1 million of these cases were substantiated as victims of maltreatment. Physical abuse was involved in 21% of these confirmed cases, sexual abuse in 11%, neglect in 49%, and other forms of maltreatment in 19%.43 Nearly 90% of deaths from child abuse or
SUMMARY
Psychiatrists are faced increasingly with the difficult responsibility of evaluating perpetrators and victims of violence. The following guidelines will help the clinician avoid legal difficulty:
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Become knowledgeable about your state statutes regarding civil commitment and duty to third parties.
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Document thoroughly your risk assessment and the factors you considered in reaching your judgment.
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Consider obtaining a second opinion in difficult cases.
- 4
Follow hospital policies regarding seclusion,
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2003, Indian Journal of GastroenterologyThe duty to protect
2003, Principles and Practice of Forensic Psychiatry, 2Ed
Address reprint requests to Phillip J. Resnick, MD, University Hospitals, Cleveland, OH 44106