Friday, November 6, 2009

Avoiding Suicide Lawsuits

No utterance below has any scientific validation. If he ever testifies to such for a plaintiff, I would appreciate learning about it, so that I may legally act upon him. I request that future publications quoting Resnick allow a rebuttal section to balance his garbage utterances. From Phillip J. Resnick, MD, professor of psychiatry and director of forensic psychiatry at Case Western Reserve University in Cleveland,

"Careful documentation of suicide risk factors—including prior attempts and feelings of hopelessness—is the most important means of avoiding a malpractice suit, according to Dr Resnick. It’s not enough to state simply that a patient denies having suicidal ideas. Also take into account input from family and objective signs of patient behavior before discharging a patient from the hospital...

Inpatient Suicide
Liability risk rises when a psychiatric inpatient commits suicide. According to Dr Resnick, there are 2 major considerations in the eyes of the law when determining whether a psychiatrist has failed to protect a patient: foreseeability and precautions taken after the suicide risk is identified, such as frequent monitoring. Suicide is difficult to predict, and the law recognizes this. “However, once the psychiatrist is aware that a patient is at risk for suicide, he or she is expected to take certain reasonable precautions,” Resnick said.

Before discharging an inpatient, be sure to document objective signs of improvement, such as better appetite, better sleeping, group therapy attendance, and brighter affect. This information should be included in the clinical notes. “When I review a malpractice case involving a patient who killed himself or herself shortly after discharge, I look to see whether the doctor recorded any objective evidence of improvement,” said Resnick...

Resnick also strongly recommends involving the patient’s family. “This is crucial,” he notes, “because a patient who is saying his final goodbye before killing himself has a 60% chance of saying goodbye to his spouse but only an 18% chance of notifying his therapist.3” If a patient or a family member reports that the patient has a suicide plan, increased scrutiny is critical: 3 of 4 of these patients go on to attempt suicide.4 Hospitalization or increased treatment should be considered."