Psychiatry and the Law - Basic Principles (Mar 30, 2024)_(3031525884)_(Springer)

This book is designed to help new psychiatrists and other medical professionals confront the complicated legal and ethical issues that arise at the intersection of the mental health and judicial systems. The law provides the boundaries in which clinical care operates. Appreciating these boundaries is particularly important when working with individuals whose rights may already be curtailed (forensic settings, for example). Understanding how psychiatry and the law interface provides students and trainees with a foundation for building their skills and attitudes through training and beyond. This text can guide or supplement education on the legal regulation of psychiatry, the use of psychiatry to answer legal questions, and the treatment of individuals with criminal justice involvement. In the second edition of this text, the editors have updated several chapters with new information and added chapters covering topics not addressed in the first edition. Each chapter begins with a clinical case vignette that brings the topic to life through a clinical encounter, the majority of which are based on landmark legal cases that set a historical precedent. The text presents details of the legal case, historical significance, and the precedent it set before discussing the core principles of the subject area. Each chapter reviews the existing literature and reinforces the most salient points. Topics include risk assessment, substance misuse and the law, legal issues within child and adolescent psychiatry, involuntary medication considerations, and other challenges that are often not sufficiently addressed in training. Psychiatry and the Law: Basic Principles covers a wide range of topics that would be suitable for use as the basis of a course in forensic psychiatry for psychiatry residents and is an excellent resource for new psychiatrists, psychologists, social workers, students, and other professionals navigating medical and legal boundaries in clinical practice. Contents Editors and Contributors About the Editors Contributors 1: Introduction: Why Understanding the Law Matters Connecting the Law to Clinical Work Case Example Initial Presentation Hospital Course Preparing for Discharge How to Make Use of This Book References 2: Understanding the Law and Legal System Clinical Vignette Historical Case: Marbury V. Madison, 5 US 137 (1803) Understanding the Law and Legal System The Law and Legal System in Practice: Where Do Laws Come From? [3] The Law and Legal System in Practice: Once Law Is Made, How are Legal Disputes Resolved [5] The Law and Legal System in Practice: Once a Dispute Is in the Correct Court, How Is It Actually Settled? Judge or Jury? Standard of Proof “Beyond a Reasonable Doubt” “More Likely than Not” “Clear and Convincing” The Law and Legal System in Practice: Summary—Jurisdiction, Finders of Fact and Standards of Proof The Law and Legal System in Practice: Application to the Facts of the Vignette The Law and Legal System in Practice: Take Away Points References 3: Confidentiality and Privilege Clinical Vignette History of the Real Case and Its Significance: What Really Happened Jaffee v. Redmond, US Supreme Court, 1996 [1, 2] Core Principles in Understanding Confidentiality Distinguishing Confidentiality vs. Privilege Common Exceptions to Confidentiality Mandatory Reporting Duties Child Abuse and Neglect Abuse and Neglect of Older and Disabled Persons Other Vulnerable Populations Public Health Conditions HIPAA SAMHSA’s CFR 42: Part 2 Conclusion References 4: Duties to Third Parties Clinical Vignette What Really Happened? Tarasoff v. The Regents of the University of California, Supreme Court of California 1974 Tarasoff v. The Regents of the University of California, Supreme Court of California 1976 (“Tarasoff II”) Duties to Third Parties: Introduction Trends in Duties to Third Parties Duties to Third Parties: Concerns and Controversy Assessing Threats Responding to Threats Warnings State-by-State Variation Discharging a Tarasoff Duty Given All This Confusion, What Do You Actually Do to Fulfill Your Professional Duty? Risk Assessment Risk Management Warnings Documentation Liability Conclusion References 5: Informed Consent Clinical Vignette History of the Case: Cruzan v. Director, Missouri Department of Health, 110 SCt 2841 (1990) Basics of Informed Consent Core Principles of Cruzan Cruzan Affirmed Competent Decision-Making Treatment Decisions of Incompetent Patients Should Be Based on Previously Expressed Preferences Be Familiar with Relevant Statutes and Institutional Policies Cruzan Defined Artificial Nutrition and Hydration as Medical Treatment Cruzan and the Potential for Defensive Medicine Conclusion References 6: Voluntary and Involuntary Psychiatric Hospitalization Clinical Vignette History of the Real Legal Case Introduction Voluntary Hospitalization Involuntary Hospitalization Brief History of Involuntary Commitment Laws in the United States Practical Aspects of Contemporary Commitment Processes Emergency Commitment Civil Commitment Involuntary Outpatient Commitment Involuntary Commitment of Minors Conclusion References 7: Involuntary Medications Clinical Vignette Historical Case: Washington v. Harper, US Supreme Court, 1990 [1] Core Considerations History of Involuntary Medications: From the Beneficence Model to the Autonomy Model of Care Involuntary Medications for Civilly Committed Patients Involuntary Medications in Criminal Proceedings Considerations Regarding Involuntary Treatment with Medications Emergency Versus Non-Emergency Situations Medication Classes and Formulations Approaches to Involuntary Treatment: Treatment-Driven Versus Rights-Driven Consequences for Inappropriately Administered Treatment Professional Ethics Complaints Criminal Charges Malpractice Suits Civil Rights Violations Summary References 8: Decision-Making Capacity Clinical Vignette: Part One Questions to Consider Based on Part One Clinical Vignette: Part Two History of the Real-Life Legal Case Clinical Discussion Medical Capacity Assessment of Capacity Capacity Restoration and Conflict Resolution When to Proceed with a Proxy or Substitute Decision-Maker Considerations with Regard to Jehovah’s Witness Patients Conclusions References 9: Psychiatric Evaluations Intended for Third Parties Case Vignette What Actually Happened: Lambley v. Kameny, 682N.E.2d 907 (Mass. App. Ct. 1997) Conclusion Third-Party Evaluations: General Principles Roles and Their Responsibilities Treating Psychiatrist Independent Medical Examiners Witness Physicians as Fact Witnesses Physicians as Expert Witnesses Specific Evaluations Social Security Disability Programs Workers’ Compensation Private Disability Insurance Emotional Support Animals/Service Animals Summary References 10: Ethics Clinical Vignette What Really Happened? Lessons from the Case: Ethics, Morality, Law, and the Medical Profession Principles of Medical Ethics as Applicable to Psychiatry The Physician-Patient Relationship Psychiatrists’ Relationship with Other Providers and Third Parties Other Duties of the Ethical Psychiatrist Ethical Guidelines for the Practice of Forensic Psychiatry Dual Agency Informed Consent and Confidentiality Honesty and Striving for Objectivity Other Ethical Issues Pertinent to Forensic Psychiatry References 11: Social Justice and Health Equity Clinical Vignette Interrogating the Neutrality of Normative Knowledges Deterrents from Detecting Racism in Real-Time: Aversive and Colorblind Racism Forensic Psychiatry and Increased Vulnerability to Aversive and Colorblind Racism Accessing Health Equity Knowledges in Facilitated Learning Environments Clinical Vignette Continued Seeing Ourselves as Members of a Fundamentally Flawed System Combatting Racism at the Intersection of Psychiatry and the Law Conclusion References 12: Malpractice The Scenario What Really Happened Thompson v. Patton, Supreme Court of Alabama, 2008 [1] Discussion Requirements for Malpractice Duty Dereliction of Duty Damages Direct Causation Common Claims of Malpractice in Psychiatry Suicide Malpractice Medication Malpractice Sexual Misconduct Malpractice Malpractice Defense Considerations for the Forensic Expert Witness Conclusions References 13: Suicide Risk Assessment Clinical Vignette Introduction Therapeutic Risk Management Clinical Evaluation Exploring Past Suicidality Exploring Suicidality: Ideation, Intent, Plan, and Means Warning Signs, Risk Factors, and Protective Factors Warning Signs Risk Factors and Protective Factors Protective Factors Structured Instruments Stratifying Risk Acute Risk for Suicide Chronic Risk for Suicide High Chronic Risk Moderate Chronic Risk Safety Planning Environmental Safety and Access to Lethal Means Medications for Suicide Prevention Pharmacological Strategies for Depression and Suicide Conclusion References 14: Violence Risk Assessment Clinical Vignette History of the Real Case and Its Significance Core Principles of the Topic Introduction Approaches to Risk Assessment Risk Factors for Violence Risk Assessment Instruments HCR-20 PCL-R LSI-R ICT Reconsideration of the Clinical Vignette and Actual Case Summary and Recommendations References 15: Substance Use Disorders and the Law Clinical Vignette Core Principles Addiction as a Disease or Choice Diagnoses and Terminology Legal Precedents Civil Commitment and Involuntary Treatment Criminal Defenses, Drug Courts, and Correctional Settings Substance Use and Criminal Responsibility Drug Courts and Diversion Substance Use Treatment in Correctional Settings Clinical Considerations SUDs, Violence, and Crime Practitioner Laws and Regulations Future Directions Conclusion/Key Points References 16: Child and Adolescent Forensic Psychiatry Clinical Vignette Landeros v. Flood, California Supreme Court, 1976 [1] Introduction Mandatory Reporting of Suspected Abuse or Neglect Differences Between Minors and Adults in the Judicial System Juvenile Culpability The Supreme Court and Juvenile Sentencing Conclusion References 17: Geriatric Forensic Psychiatry Introduction Testamentary Capacity Clinical Vignette Historical Case: Banks v. Goodfellow, Court of Queen’s Bench, 1870 [5] Core Principles of Testamentary Capacity The Forensic Evaluation What Is Undue Influence? Guardianship Clinical Vignette Legal Process of Guardianship Guardianship Assessment Risk Factors for Elder Abuse and Mistreatment Summary References 18: Competence to Stand Trial and the Insanity Defense Introduction Competence to Stand Trial Clinical Vignette What Really Happened Core Principles of Competence to Stand Trial Core Principles of the Competency Evaluation Conclusions Not Guilty by Reason of Insanity Clinical Vignette What Really Happened Core Principles of the Insanity Defense Core Principles of the Insanity Evaluation Conclusions Summary References 19: Working with Patients with Criminal Justice Involvement Clinical Vignette Bowring v. Godwin 551 F.2d 44 (4th Cir. 1977) Background/Facts Process and Outcome Legal Principle Vignette Review: The Reality Standard of Care Clinical Vignette: Rewind The Sequential Intercept Model: A Conceptual Framework Conclusion References 20: Conclusion: How to Learn More About Forensic Psychiatry References Index