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1.
Behav Sci Law ; 37(3): 313-328, 2019 May.
Article in English | MEDLINE | ID: mdl-31157923

ABSTRACT

This is an illustrative article rather than a research study. We offer opinions and recommendations about what we view as unfortunate clinician testimony in suicide-related malpractice cases, testimony that - inadvertently or not - supports or encourages inadequate care of suicidal patients. The principles apply to both psychiatrists and non-psychiatrists, although the former appear more often in our work. We particularly consider the roles and testimony, in court or at deposition, of psychiatrists, whether as defendants, expert witnesses, or fact witnesses. We cite examples of what we view as poor, disingenuous, dishonest and even dangerous testimony that we believe moves the profession toward unsafe patient care. The examples illustrate what we (and sometimes others) describe as normalization of deviance, pre-suit puffery, self-serving defendant testimony, expert pride supplanting testimonial responsibility, expert arrogance, expert parroting of attorney suggestions, witness ignorance and avoiding facts, unconscious expert bias, inexperience thwarting justice, misleading use of terms such as "predictability," and expert witnesses who lack the direct-care experience that jurisdictions often require in order to opine about defendant clinicians' day-to-day patient care. The examples often reveal concerns beyond the category chosen, and should not be expected to convey all of the facts of a particular case.


Subject(s)
Expert Testimony/legislation & jurisprudence , Malpractice/legislation & jurisprudence , Suicide/legislation & jurisprudence , Dangerous Behavior , Humans , Referral and Consultation/legislation & jurisprudence
2.
Behav Sci Law ; 37(3): 304-312, 2019 May.
Article in English | MEDLINE | ID: mdl-31063254

ABSTRACT

Few clinical practices are as important for simultaneously augmenting patient safety and mitigating legal risk as the judicious evaluation and stratification of a patient's risk for suicide, proportionate clinical actions based thereon taken by the healthcare provider, and contemporaneous documentation of the foregoing. In this article, we draw from our combined decades of multidisciplinary experience as a clinical psychologist, forensic psychiatrist, medical malpractice attorney, and clinical psychology trainee to discuss the documentation of suicide risk assessment and management as a conduit to patient safety and legal risk mitigation. We additionally highlight documentation as a core clinical competency across disciplines and note areas of improvement, such as increased training, to bolster documentation practices.


Subject(s)
Documentation/standards , Patient Safety/legislation & jurisprudence , Risk Assessment/legislation & jurisprudence , Suicide/legislation & jurisprudence , Clinical Competence/legislation & jurisprudence , Forensic Psychiatry/legislation & jurisprudence , Humans , Interdisciplinary Communication , Intersectoral Collaboration , Male , Malpractice/legislation & jurisprudence , Middle Aged , Suicidal Ideation , Suicide Prevention
3.
J Psychiatr Pract ; 24(4): 274-278, 2018 Jul.
Article in English | MEDLINE | ID: mdl-30427811

ABSTRACT

Separate research groups have independently argued the need for a suicide-specific diagnosis within the psychiatric diagnostic nomenclature. Although a suicide-specific diagnosis could possibly enhance clinical care and improve patient safety, some clinicians have expressed concerns regarding the legal risk of utilizing a suicide-specific diagnosis. In this column, the first of a 2-part series exploring the potential risks and benefits of a suicide-specific diagnosis, the authors draw from their decades of experience in clinical work, legal consulting, as well as the litigation of suicide and wrongful death lawsuits and contend that the bona fide use of a suicide-specific diagnosis would mitigate legal liability to clinicians.


Subject(s)
Mental Disorders/diagnosis , Suicide Prevention , Suicide/legislation & jurisprudence , Adult , Diagnostic and Statistical Manual of Mental Disorders , Humans , Mental Disorders/classification , Risk Assessment
4.
Suicide Life Threat Behav ; 42(3): 292-304, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22494118

ABSTRACT

There are twice as many suicides as homicides in the United States, and the suicide rate is rising. Suicides increased 12% between 1999 and 2009. Mental health professionals often treat suicidal patients, and suicide occurs even among patients who are seeking treatment or are currently in treatment. Despite these facts, training of most mental health professionals in the assessment and management of suicidal patients is surprisingly limited. The extant literature regarding the frequency with which mental health professionals encounter suicidal patients is reviewed, as is the prevalence of training in suicide risk assessment and management. Most importantly, six recommendations are made to address the longstanding insufficient training within the mental health professions regarding the assessment and management of suicidal patients.


Subject(s)
Advisory Committees , Mental Health/education , Risk Assessment , Suicide Prevention , Curriculum , Humans , Professional Competence , Risk Assessment/methods , Societies , United States
5.
J Am Acad Psychiatry Law ; 34(4): 518-22, 2006.
Article in English | MEDLINE | ID: mdl-17185482

ABSTRACT

As part of an impeachment attempt on cross-examination of opposing expert witnesses in trial or deposition, the cross-examining attorney may request the complete tax records of the expert. It is widely believed that expert witnesses may be expected to express opinions that favor the parties who engage them and who pay their fees. Theoretically, the purpose of this request is an attempt to paint the expert as a "hired gun" whose major source of income is forensic work. The different issues, statutes, and case law citations that bear on requests for tax records are reviewed, and the strategies for coping with this tactic are suggested.


Subject(s)
Conflict of Interest/legislation & jurisprudence , Expert Testimony/legislation & jurisprudence , Income Tax/legislation & jurisprudence , Lawyers , Criminal Law/ethics , Criminal Law/legislation & jurisprudence , Ethics, Medical , Expert Testimony/ethics , Humans , Privacy/legislation & jurisprudence , United States
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