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PSYCHIATRY & THE LAW

Forensic psychiatry is the medical subspecialty, recognized by the American Psychiatric Association since 1991, in which psychiatric expertise is applied to legal issues. The American Board of Psychiatry and Neurology began in 1994 to examine individuals for "added qualifications in forensic psychiatry." There are about 40 1-year fellowship programs in forensic psychiatry accredited by the Accreditation Council for Graduate Medical Education, USA. Several major textbooks of forensic psychology and psychiatry are listed at the end of this section.

There are four divisions of forensic psychiatry. The first pertains to the legal aspects of general psychiatric practice, such as the civil commitment of involuntary patients, the doctrine of informed consent, the requirement to protect third parties from dangerous patients, and matters of privilege and confidentiality.

The second division of forensic psychiatry covers the assessment of mental disability. This includes the evaluation of individuals who have been injured on the job, the assessment of a plaintiff who claims that he or she was injured and is now seeking compensation from a defendant, and the assessment of the competency of individuals to perform specific acts such as making a will.

The third and most colorful aspect of forensic psychiatry deals with individuals who have been arrested. This division includes the evaluation of competency to stand trial, the evaluation of a person's competency to waive his or her Miranda rights, the assessment of criminal responsibility, evaluations that relate to sentencing, and the treatment of incarcerated individuals.

The fourth division of forensic psychiatry is forensic child psychiatry, which includes child custody evaluations, the evaluation of children who may have been abused, and consultation regarding minors who are involved with juvenile court.

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Goldstein  AM, ed. Forensic Psychology: Emerging Topics and Expanding Roles. New York: Wiley; 2006.
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Gutheil  TG, Appelbaum  PS. Clinical Handbook of Psychiatry and the Law. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2006.
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Melton  GB, Petrila  J, Poythress  NG, Slobogin  C. Psychological Evaluations for the Courts: A Handbook for Mental Health Professionals and Lawyers. 3rd ed. New York: Guilford Press; 2007.
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Rosner  R, ed. Principles and Practice of Forensic Psychiatry. 2nd ed. London: Arnold; 2003.
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Simon  RI, Gold  LH, eds. Textbook of Forensic Psychiatry. 2nd ed. Washington, DC: American Psychiatric Publishing; 2010.

LEGAL ASPECTS OF PSYCHIATRIC PRACTICE

Professional Liability

Psychiatrists are less likely than other physicians to be sued for professional negligence. However, we live in a litigious society—most psychiatrists will be the subject of at least one professional liability claim during the course of their professional careers.

In a case of professional liability or malpractice, a patient (the plaintiff) sues the psychiatrist (the defendant). In order to prevail legally, the plaintiff must prove each of four elements: (1) The psychiatrist had a ...

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