By Robert I Simon
Sufferer suicide is an unavoidable occupational danger of psychiatric perform. certainly, it's the infrequent clinician who doesn't fight, even be troubled, over the complicated job of assessing and dealing with the chance of suicide in sufferers. sufferer suicides account for the best variety of malpractice fits filed opposed to psychiatrists and for the best variety of settlements and verdicts lined by way of specialist legal responsibility insurers. during this ebook, written via a clinician for clinicians, Dr. Simon, a longtime specialist in psychiatry and legislation, deals -A strong, easy-to-understand evaluate of the way clinical malpractice legislation applies to sufferer suicides. He discusses the criteria of care physicians needs to meet, the stipulations linked to malpractice legal responsibility, and the way top to reduce hazards of litigation. -Extensive references to peer-reviewed literature on suicide and up to date malpractice circumstances, together with these prompted by way of sufferer suicides, which offer perception into the newest advancements in either the medical group and the courts. -Much-needed useful suggestion, together with suggestion on operating with suicide chance checks and suicide prevention contracts, on treating suicidal sufferers in numerous settings (outpatient, inpatient, collaborative, and emergency), and on dealing with concerns bobbing up within the aftermath of a patient's suicide (documentation, confidentiality, and survivor care). -Clearly outlined probability administration guidance that may aid clinicians keep away from litigation or identify a legitimate felony security if sued for malpractice. -Numerous case examples that make the theoretical discussions and clinically dependent threat administration guidance that stick to come alive. wealthy in suggestion that attracts at the author's greater than forty years of medical event, this e-book serves as an important relief to clinicians.
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Additional info for Assessing and Managing Suicide Risk: Guidelines for Clinically Based Risk Management
1992). Most depressed patients do not kill themselves. 6 per 100,000 (Silverman 2003). The suicide rate or absolute risk of suicide for individuals having bipolar disorder is estimated to be 193 per 100,000, a relative risk 18 times that of the general population (Baldessarini et al. 2003). Turning this statistic around, 99,807 patients with such a disorder do not commit suicide in a given year. Thus, on a statistical basis alone, the vast majority of bipolar patients will not commit suicide. The same statistical analysis can be applied to other psychiatric disorders.
The Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry (American Psychiatric Association 2001) states, “Psychiatrists at times may find it necessary, in order to protect the patient or community from imminent danger, to reveal confidential information disclosed by the patient” (Section 4, Annotation 8). , to obtain vital information, to administer and monitor medications, to remove lethal weapons, to assist in hospitalization). Statutory waiver of confidential information is provided in some states when a patient seriously threatens self-harm (Simon 1992).
In recent years, a more liberal, open-door policy has evolved in the treatment and management of suicidal patients. The open-door policy is one aspect of the greater autonomy accorded all patients, but especially psychiatric patients. Some courts have not imposed liability because of the reasonableness of the decision to implement 16 Assessing and Managing Suicide Risk the open-door policy with certain patients. These courts have viewed the open-door policy, when reasonably used, as an extension of professional judgment and a viable treatment approach.