Legal Liability for a Patient's Suicide

1986 ◽  
Vol 14 (3-4) ◽  
pp. 409-434 ◽  
Author(s):  
Elizabeth V. Swenson
Keyword(s):  
Informed Consent ◽  
Therapeutic Relationship ◽  
Strict Liability ◽  
Standard Of Care ◽  
Legal Liability ◽  
Fiduciary Duty ◽  
Traditional Theory ◽  
Contract Breach

Lawsuits alleging psychotherapist liability for a patient's suicide have increased in number recently. Although the traditional theory of negligence is still popular, issues involving the standard of care and proof of causation are particularly difficult when one of the parties to the therapeutic relationship is not living. These problems have different implications when failure to prevent suicide is alleged than when a psychotherapist is said to have caused the suicide. In the latter, the presence of informed consent and assumption of the risk must be carefully evaluated as defenses. Alternative theoretical bases for these suits include implied contract, breach of fiduciary duty, and strict liability.

Liability Issues in Clinical Practice

2008 ◽  
Vol 18 (1) ◽  
pp. 32-40
Author(s):  
Sharon Griffin Scudder
Keyword(s):  
Clinical Practice ◽  
Informed Consent ◽  
Standard Of Care ◽  
Legal Liability ◽  
Speech Language Pathologists ◽  
Personal Assets

Abstract Legal liability is of concern for speech-language pathologists and audiologists in clinical practice. This paper offers general suggestions designed to help clinicians minimize the risks of liability in clinical practice. Suggestions include knowing and practicing within the standard of care of your profession, obtaining informed consent, being polite and caring with patients, documenting everything, verifying the licensure and certification of clinicians and other employees you hire, and organizing your business to limit your liability from the actions of others within your business and to protect your personal assets. The author recommends that you protect your promising career from being derailed by allegations of malpractice and negligence by continuing to develop your skills and structuring your clinical practice to provide the very best care to your clients and patients.

Electronic Fetal Monitoring: Physician Liability and Informed Consent

1984 ◽  
Vol 10 (1) ◽  
pp. 31-91
Author(s):  
Myra Gerson Gilfix
Keyword(s):  
Informed Consent ◽  
Fetal Monitoring ◽  
Standard Of Care ◽  
Legal Issues ◽  
Standards Of Care ◽  
Monitoring Technique ◽  
Electronic Fetal Monitoring ◽  
Monitoring Procedure ◽  
Practice Standard ◽  
Physician Liability

AbstractElectronic fetal monitoring (EFM) has been criticized as ineffective, unsafe and costly. Despite existing controversy regarding the risks involved in using EFM, this monitoring procedure continues to be widely employed. In many jurisdictions, in fact, the use of EFM during labor may be considered the customary practice. This Article analyzes the medical and legal issues arising from a physician's use of or failure to use EFM. The Author argues that EFM subjects the mother and the fetus to risks which may be avoided if auscultation, a less intrusive monitoring technique, is employed. The ‘customary practice’ standard of care, the ordinary negligence standard of care, and the ‘best judgment’ and ‘duty to keep abreast’ standards of care are compared and applied to the physician's decision to use EFM. The Author contends that physicians who employ auscultation may not be liable for failing to use EFM; however, physicians who use EFM despite the evidence of its risks may be liable for failing to ‘keep abreast’ or to use their ‘best judgment’ or for negligence. Finally, the Author contends that both physicians and their patients are best protected when the physician elicits the mother's informed consent to employ a particular monitoring technique during labor.

scholarly journals Psychotherapy Ethics in Twentieth-Century Literature

2020 ◽  
Author(s):  
Anna Magdalena Elsner
Keyword(s):  
Twentieth Century ◽  
Informed Consent ◽  
Therapeutic Relationship ◽  
Ethical Issues ◽  
Ethical Dilemmas ◽  
Literary Texts ◽  
Twentieth Century Literature ◽  
Ethical Challenges ◽  
Key Characteristics ◽  
Century Literature

Ethical issues arising in the practice of psychotherapy, such as confidentiality, boundaries in the therapeutic relationship, and informed consent, figure prominently in a range of twentieth-century literary texts that portray psychotherapy. This chapter analyzes the portrayal of these conflicts, but also stresses that they are often marginal to the overall plot structures of these narratives and that literary depictions of psychotherapy are often vague or even inaccurate concerning key characteristics of psychotherapeutic practice. Focusing on examples that either illustrate professionalism and the absence of ethical challenges in psychotherapy, or take up the ethical reservations that fueled anti-Freudianism or the anti-psychiatry movement, the chapter proposes that selected literary depictions of psychotherapy can play a key role in sensitizing therapists to the complex make-up of ethical dilemmas as well as illustrating the cultural and historical contexts of these dilemmas.

On the Legal Aspects of Tardive Dyskinesia

1979 ◽  
Vol 7 (3) ◽  
pp. 295-331 ◽  
Author(s):  
Ralph Slovenko
Keyword(s):  
Informed Consent ◽  
Tardive Dyskinesia ◽  
Antipsychotic Medication ◽  
Standard Of Care ◽  
Legal Aspects ◽  
Legal Issues ◽  
Institutionalized Patients ◽  
The Right ◽  
Causal Nexus

Of the various drug therapies, the antipsychotic medication is presenting some novel twists to old issues in law and psychiatry. From what is known, its benefits are high but so are its risks. To wit, the risk of tardive dyskinesia. Presented here for consideration are legal issues of standard of care, informed consent, the right of institutionalized patients to refuse treatment, statute of limitations, and causal nexus.

scholarly journals Medicolegal Aspects of Craniofacial Trauma

2019 ◽  
Vol 35 (06) ◽  
pp. 657-665
Author(s):  
Nima Vahidi ◽  
Weitao Wang ◽  
Thomas Lee ◽  
Jared Inman ◽  
Yadranko Ducic
Keyword(s):  
Informed Consent ◽  
Trauma Surgery ◽  
Standard Of Care ◽  
Scope Of Practice ◽  
Facial Trauma ◽  
Active Labor ◽  
Craniofacial Trauma ◽  
Trauma Surgeons ◽  
Medicolegal Issues

AbstractCharacterization of complications in facial trauma management is of special interest to practitioners of facial trauma surgery. It is important for facial trauma surgeons to not only understand the standard of care, but also the pitfalls that can expose them to litigation. Litigation within the realm of facial trauma surgery often manifests from issues with poor communication, inadequate informed consent processes, and poor surgical management. In this analysis, we comprehensively examine malpractice litigation in facial trauma surgery, and outline important factors for surgeons to consider in the care of this patient population. It is important for facial trauma surgeons to understand medicolegal issues within their scope of practice. These include principles of informed consent, state regulated statutes of limitation, and Emergency Medical Treatment and Active Labor Act laws. This analysis emphasizes the importance of exercising appropriate patient care, understanding the indications for surgery, and seeking counsel when necessary.

Loss of Possession: Concussions, Informed Consent, and Autonomy

2014 ◽  
Vol 42 (3) ◽  
pp. 334-343 ◽  
Author(s):  
Richard Robeson ◽  
Nancy M. P. King
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Fiduciary Duty ◽  
Decision Making Process ◽  
Informed Decision Making ◽  
Research Subjects ◽  
Autonomous Decision ◽  
Duty To Inform ◽  
Fundamental Shift ◽  
Original Concept

The principle of informed consent is so firmly established in bioethics and biomedicine that the term was soon bowdlerized in common practice, such that engaging in the informed decision-making process with patients or research subjects is now often called “consenting” them. This evolution, from the original concept to the rather questionable coinage that makes consent a verb, reveals not only a loss of rhetorical precision but also a fundamental shift in the potential meaning, value, and implementation of the informed consent process. Too often, the sharing of information has been replaced by the mere acquisition of agreement with the authority ostensibly offering a choice.Scholars of informed consent agree that its salience and its legitimacy derive from a fiduciary duty to inform, in order to respect, protect, and promote autonomous decision making by those to whom the duty is owed.

scholarly journals Ethical Considerations during the Informed Consent Process for Acute Ischemic Stroke in International Clinical Trials

2020 ◽  
Author(s):  
Tiffany R. Bellomo ◽  
Jennifer A. Fokas ◽  
Clare Anderson ◽  
Noah Tsao ◽  
Christopher Becker ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Informed Consent ◽  
Acute Ischemic Stroke ◽  
Alternative Treatment ◽  
Standard Of Care ◽  
Informed Consent Process ◽  
Consent Process ◽  
Patient Consent ◽  
Study Team ◽  
The Usa

ABSTRACTIntroductionObtaining informed consent from acute ischemic stroke patients poses many challenges, especially in the context of a research setting. Specifically, consenting for alternative acute ischemic stroke treatments to the standard of care, Tissue Plasminogen Activator (tPA), can cause delays leading to increased time to reperfusion and worse outcomes.ObjectivesWe sought to investigate the experiences of researchers in existing active-control trials in acute ischemic stroke comparing investigational therapy to tPA in order to identify the approaches and challenges in obtaining informed consent in this unique patient population.MethodsOut of 401 articles evaluated, 14 trials met inclusion criteria of patients receiving IV tPA vs alternative treatment within 4.5 hours of onset of symptoms for acute ischemic stroke. Trial representatives were emailed by the study team with a request for a copy of their patient consent form, other documents related to informed consent, and to complete a survey concerning aspects of the consent process.ResultsOf the 6 trials conducted across 6 continents that completed the survey in its entirety, 2 were ongoing, 4 were published between 2009 and 2016, and the median NIHSS for each published trial was at least an 8. All published trials in the sample stated that informed consent was obtained, but only half reported involvement of a research ethics committee. Although 3 trials performed in Europe or Asia reported directly consenting 75-100% of enrolled patients, the median NIHSS for these trials represented a moderate stroke. Trials with 75-100% of patients directly consented had shorter door to treatment (DTT) times than trials that directly consented less than 50% of enrolled patients. 5 trials allowed consent by proxy, but only 2 of those trials also required patient assent. 4 trials had translators available and translated consent documents, and these trials had longer DTT times. All trials relied on experienced providers or dedicated research coordinators to obtain informed consent; however, only 2 of 6 trials mentioned specific training with regards to informed consent skills.ConclusionsThe current informed consent process is not transparent and poses challenges to investigators in the USA directly comparing tPA to an alternative treatment. International differences in the standards of informed consent, such as deferred consent, may have allowed more patients with moderate strokes to provide direct consent after treatment administration without delaying DTT time. While targeted and innovative approaches for informed consent are needed to improve patient outcomes, we must balance protecting the autonomy of individuals whose willing involvement enables such pivotal discoveries. The stroke community must aim for efficiency, transparency, and inclusion of patients of diverse backgrounds in the informed consent process so that therapeutic advances are possible.

Recent insights into decision-making and their implications for informed consent

2018 ◽  
Vol 44 (11) ◽  
pp. 734-738 ◽  
Author(s):  
Irene M L Vos ◽  
Maartje H N Schermer ◽  
Ineke L L E Bolt
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Rational Choice ◽  
Medical Practice ◽  
Real World ◽  
Ethical Principle ◽  
Traditional Theory ◽  
Choice Behaviour ◽  
Autonomous Decision ◽  
Behavioural Sciences

Research from behavioural sciences shows that people reach decisions in a much less rational and well-considered way than was often assumed. The doctrine of informed consent, which is an important ethical principle and legal requirement in medical practice, is being challenged by these insights into decision-making and real-world choice behaviour. This article discusses the implications of recent insights of research on decision-making behaviour for the informed consent doctrine. It concludes that there is a significant tension between the often non-rational choice behaviour and the traditional theory of informed consent. Responsible ways of dealing with or solving these problems are considered. To this end, patient decisions aids (PDAs) are discussed as suitable interventions to support autonomous decision-making. However, current PDAs demand certain improvements in order to protect and promote autonomous decision-making. Based on a conception of autonomy, we will argue which type of improvements are needed.

Comparative analysis of medical malpractice law

2019 ◽  
Vol 10 (2) ◽  
Author(s):  
Thi Bao Anh Nguyen
Keyword(s):  
Comparative Analysis ◽  
Medical Malpractice ◽  
Strict Liability ◽  
Medical Practitioner ◽  
Standard Of Care ◽  
The Other ◽  
European Countries ◽  
Future Directions ◽  
Malpractice Law

Abstract This research presents the background of medical malpractice law, the tort of negligence with fault, tor of negligence without fault and wrongdoer’s in Vietnam in comparison with medical malpractice laws of some European countries. Vietnamese medical malpractice law has some similarities and noticeable differences to the other European countries. In particular, Vietnam has faced the lack of very important regulations in accurately determining the misconduct of medical practitioner such as standard of care, loss of chance, and strict liability. We propose future directions of possible amendments in the Vietnamese medical malpractice law.

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