By Paul S. Appelbaum MD, Thomas G. Gutheil MD
Thoroughly up to date for its Fourth variation, this award-winning instruction manual provides psychological future health execs authoritative suggestions on how the legislation impacts their scientific perform. every one bankruptcy provides case examples of felony matters that come up in perform, essentially explains the governing felony principles, their motive, and their medical impression, and provides concrete motion courses to navigating clinico-legal dilemmas. This variation addresses an important fresh advancements together with new federal principles retaining sufferers' privateness, laws minimizing use of seclusion and discretion, legal responsibility hazards linked to more recent psychiatric medicines, malpractice dangers in forensic psychiatry, and new dependent evaluate instruments for violence probability, suicidality, and decisional capacity.
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Extra info for Clinical Handbook of Psychiatry and the Law (CLINICAL HANDBOOK OF PSYCHIATRY & THE LAW
INAPPROPRIATE SECRECY Appropriate attention to confidentiality may be confused with a patient’s counter-therapeutic demand for secrecy. Inappropriate secrets in the milieu of the inpatient ward can be very destructive. For example, the patient may ask a new staff member not to reveal her plan for suicide or escape because that would violate the patient’s trust and confidentiality. This loaded secret leaves the staff member in an impossible, no-win position. Either the staff member loses the alliance and trust of the patient, or may lose the patient herself.
A court psychiatrist, for example, may owe disclosure to the court concerning material relevant to the purpose for which the evaluation is being performed; in some jurisdictions the extent of the disclosure may be limited by statute. A military psychiatrist may be obliged to report on whether a soldier is a security risk, for example, but may keep other material confidential. (See also Chap. ) d. Confusion of agency. It is important to realize that confidentiality should work only one way; that is to say, with the exceptions noted above, nothing should be told about the patient (or family or group) to the outside world.
Emergencies Emergencies in general constitute exceptions to the usual rules governing confidentiality, including under HIPAA. , risk of suicide or impending assault), confidentiality may—and in certain circumstances, must—be breached without consent (as noted in Sec. II-A-5-a). For example, the therapist may tell the patient’s spouse that the patient is suicidal and may urge that the police be called, thus breaking the confidentiality of the therapist-patient relationship. In such situations, the alliance has been temporarily abandoned.