Legal issues of professional negligence in suicide cases

Packman, Wendy; Pennuto, Tracy O'Connor; Bongar, Bruce; Orthwein, Jennifer

doi:10.1002/bsl.613

Cited by 31 publications

(26 citation statements)

References 25 publications

(36 reference statements)

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“…3,4 Studies have identified concerns in working with individuals at risk for suicide ranging from stress and coping with emergency situations, 5 being sued for malpractice, 6 having previous experience with losing a client to suicide, 5,7,8 and possessing adequate technical and personal competence 9 to manage at-risk clients. Given that suicide is an area of great concern, suicide prevention training may be an important area for enhanced knowledge and skill development among healthcare professionals.…”

Section: Introductionmentioning

confidence: 99%

Educational Preferences and Outcomes From Suicide Prevention Training in the Veterans Health Administration: One-Year Follow-Up With Healthcare Employees in Upstate New York

Matthieu¹,

Chen²,

Schohn³

et al. 2009

Military Medicine

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This study identifies training outcomes and educational preferences of employees who work within the Veterans Health Administration (VHA). Using a longitudinal pre-postsurvey design, 71 employees from one geographic region of VHA healthcare facilities participated in an evaluation of a brief standardized gatekeeper program and a needs assessment on training preferences for suicide and suicide prevention. Results indicate significant differences in knowledge and self-efficacy from pre to post (p < 0.001), although only self-efficacy remained significant at 1 year follow-up, (M = 3.01; SD = 0.87) as compared to pretraining (M = 2.50, SD = 1.05) (t = −5.64, p < 0.001). At post-training, 90% of the participants were willing to learn more about suicide, with 88% willing to spend more than 1 hour in future training activities on more advanced topics. This training program can increase the knowledge and abilities of VHA staff to engage, identify, and refer veterans at risk for suicide to appropriate care.

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Section: Introductionmentioning

confidence: 99%

Educational Preferences and Outcomes From Suicide Prevention Training in the Veterans Health Administration: One-Year Follow-Up With Healthcare Employees in Upstate New York

Matthieu¹,

Chen²,

Schohn³

et al. 2009

Military Medicine

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“…31 Physicians are not expected to be infallible in predicting suicide, but to demonstrate a reasonable degree of skill, knowledge, and care that would reasonably be expected of a practitioner of the same experience. 32 Although suicide is a multifaceted, multi-causal product that cannot be predicted reliably, 19,28,33,[34][35][36][37] the law focuses on proximate cause. 38 Mental health professionals are held responsible for identifying potential risks for suicide and preventing suicide, with the rationale that failing to assess for suicidality leads to a failure to implement management plans that could have reduced the risk.…”

Section: Legal Perspectivesmentioning

confidence: 99%

Suicide: Rationality and Responsibility for Life

2014

Can J Psychiatry

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Objectives: Death by suicide is widely held as an undesirable outcome. Most Western countries place emphasis on patient autonomy, a concept of controversy in relation to suicide. This paper explores the tensions between patients' rights and many societies' overarching desire to prevent suicide, while clarifying the relations between mental disorders, mental capacity, and rational suicide.Methods: A literature search was conducted using search terms of suicide and ethics in the PubMed and LexisNexis Academic databases. Article titles and abstracts were reviewed and deemed relevant if the paper addressed topics of rational suicide, patient autonomy or rights, or responsibility for life. Further articles were found from reference lists and by suggestion from preliminary reviewers of this paper.Results: Suicidal behaviour in a person cannot be reliably predicted, yet various associations and organizations have developed standards of care for managing patients exhibiting suicidal behaviour. The responsibility for preventing suicide tends to be placed on the treating clinician. In cases where a person is capable of making treatment decisionsuninfluenced by any mental disorder-there is growing interest in the concept of rational suicide. Conclusions:There is much debate about whether suicide can ever be rational. Designating suicide as an undesirable event that should never occur raises the debate of who is responsible for one's life and runs the risk of erroneously attributing blame for suicide. While upholding patient rights of autonomy in psychiatric care is laudable, cases of suicidality warrant a delicate consideration of clinical judgment, duty of care, and legal obligations. W W W Suicide : rationalité et responsabilité de la vieObjectifs : La mort par suicide est généralement vue comme un résultat indésirable. La plupart des pays occidentaux mettent l'emphase sur l'autonomie du patient, un concept controversé relativement au suicide. Cet article explore les tensions entre les droits des patients et le désir ardent de nombreuses sociétés de prévenir le suicide, tout en clarifiant les relations entre les troubles mentaux, la capacité mentale, et le suicide rationnel.Méthodes : Une recherche de la littérature a été menée à l'aide des mots clés suicide et éthique, dans les bases de données PubMed et LexisNexis Academic. Les titres et résumés d'articles ont été étudiés et jugés pertinents si l'article abordait les sujets du suicide rationnel, de l'autonomie ou des droits des patients, ou de la responsabilité de la vie. D'autres articles ont été repérés dans des bibliographies et par des suggestions des réviseurs préliminaires du présent article. Résultats :Le comportement suicidaire d'une personne ne peut pas être assurément prédit et pourtant, diverses associations et organisations ont mis au point des normes de soins pour prendre en charge les patients présentant un comportement suicidaire. La responsabilité de prévenir le suicide tend à être imposée au clinicien traitant. Dans les cas où une personne est capable ...

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“…It seems relatively straightforward that a mental health professional does have a duty to prevent the suicide of one of his/her clients. Indeed, this theory is supported by Kockelman v. Segal (1998), in which the California Court of Appeals held that psychiatrists have a duty to attempt to prevent suicide, and this duty holds even for outpatient psychiatrists (Packman, Pennuto, Bongar, & Orthwein, 2004). However, the actions required by that duty depend on the foreseeability of the suicide.…”

Section: The Role Of Impulsivity In the Foreseeability Of Suicidementioning

confidence: 99%

“…The court ruled that the psychiatrist was not responsible for this suicide because as an outpatient, the suicide victim could not be directly monitored and kept under his therapist's control. Still, there is indication that the number of lawsuits against outpatient providers is increasing (Packman, Pennuto, Bongar, & Orthwein, 2004), and some plaintiffs are successful in proving liability. In Bellah v. Greenson (1978, California Court of Appeals), an outpatient died by suicide via overdose.…”

Section: The Role Of Impulsivity In the Foreseeability Of Suicidementioning

confidence: 99%

Revisiting impulsivity in suicide: Implications for civil liability of third parties

Smith

Witte

Teale

et al. 2008

Behavioral Sci & The Law

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Previous research and popular conceptualizations of suicide have posited that many suicides are the result of impulsive, "on a whim" decisions. However, recent research demonstrates that most suicides are not attempted impulsively, and in fact involve a plan. Legally, suicide has historically been considered to be a superseding intervening cause of death that exonerates other parties from liability, but currently there are two general exceptions to this view. Specifically, another party may be found responsible for a suicide if that party either caused the suicide or failed in its duty to prevent the suicide from occurring. Both of these exceptions assume that the resulting suicide was foreseeable. Given that recent research has indicated that most suicides are planned, and thereby foreseeable to a certain extent under many circumstances, this article discusses issues of foreseeability as they pertain to litigation involving third party liability for the suicide of university students, prison inmates, and mental health patients. The authors contend that the surest way for universities, prison staff, and mental health practitioners to avoid being held liable for a suicide is to appropriately assess for suicidal intent.Suicide is the third leading cause of death for people aged 15 to 24 and the 11 th leading cause of death overall (Centers for Disease Control [CDC], 2004). Approximately 30,000 people die by suicide every year in the U.S. Moreover, four times that many people are hospitalized due to injuries sustained while attempting suicide (CDC, 2004). For the purposes of this paper we will use Silverman and colleagues ' (Silverman, Berman, Sanddal, O'Carroll, & Joiner, 2007) definition of a "suicide attempt," which is "a self-inflicted, potentially injurious behavior with a nonfatal outcome for which there is evidence (either explicit or implicit) of intent to die." Suicide is thus a serious mental health issue and public health problem. In the wake of a suicide, loved ones are often left looking for answers. When family members or friends feel something more should have been done for the decedent, they may ultimately try to settle things in a court of law. In fact, the most common type of lawsuit brought against psychiatrists is in regard to patient suicide (Simon, 2002). Furthermore, records from the American Psychological Association's Insurance Trust indicate that of claims closed by 1990, patient suicide was the second most costly claim for psychiatrists and psychologists insured by the company (Bongar, Maris, Berman, & Litman, 1998). As our society has become more litigious, the number of malpractice suits filed against therapists has risen dramatically and will likely continue to rise (Berman, 1986).Although the causes of suicide are complex, they are not mysterious, and in fact are becoming better understood thanks to decades of scientific research. One comprehensive (Van Orden, et al., 2008). According to this theory three proximal, jointly necessary, and sufficient causes must be present befo...

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Legal issues of professional negligence in suicide cases

Cited by 31 publications

References 25 publications

Educational Preferences and Outcomes From Suicide Prevention Training in the Veterans Health Administration: One-Year Follow-Up With Healthcare Employees in Upstate New York

Educational Preferences and Outcomes From Suicide Prevention Training in the Veterans Health Administration: One-Year Follow-Up With Healthcare Employees in Upstate New York

Suicide: Rationality and Responsibility for Life

Revisiting impulsivity in suicide: Implications for civil liability of third parties

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