Leo Sher, M.D. 

Suicide is one of the leading causes of liability against a psychiatrist. Suicide may also be a cause of liability against a non-psychiatric physician. Decreasing the risk of liability requires knowing the phenomenology of suicide, suicide risk assessment, understanding how malpractice cases develop, exploring the issues of foreseeability and risk evaluation, and developing a proactive risk management tactic. Several years ago, I published an overview related to suicide risk, assessment, and liability (1). A summary of my article entitled “Suicide medical malpractice: an educational overview” is below:

“A malpractice lawsuit is in the legal category of an action in tort, which is a demand for compensation for the damages that have occurred. For a physician to be found liable to a patient for malpractice, four essential elements must be proved to sustain an assertion of malpractice: duty, negligence, harm, and causation. The incidence of malpractice litigation in the field of psychiatry is increasing. The most common malpractice claim related to psychiatric practice is the failure to provide reasonable protection to patients from killing themselves. A psychiatrist should be able to evaluate suicide risk on the basis of all available information, including patient responses to direct and indirect questions, known risk factors, information on how the patient behaved under similar circumstances in the past, and collateral information. Reasonable care necessitates that a patient who is either thought of being or established to be suicidal must be the subject of some precautions. A failure either to soundly assess a patient’s suicide risk or to employ an appropriate safety plan after the suicide potential becomes foreseeable is likely to make a physician liable if the patient is harmed because of a suicide event. It is imperative for a psychiatric office or facility to have a good documentation. Careful documentation of evaluations and treatment interventions with a description of changes related to the patient’s clinical condition indicates clinically and legally appropriate psychiatric care.”

Reference:

1. Sher L. Suicide medical malpractice: an educational overview. Int J Adolesc Med Health. 2015 May;27(2):203-6. doi: 10.1515/ijamh-2015-5012.