Legal Concerns in Psychosomatic Medicine

Abstract

In the practice of psychosomatic medicine, the psychiatric consultant is likely to be confronted with questions at the interface of psychiatry and law. These issues generally emerge around questions of confidentiality and exceptions to confidentiality, assessments of a patient's ability to consent to and refuse treatment, and concerns about malpractice liability. Overall, psychiatrists should approach the care of patients clinically, while understanding the applicable laws and regulations of the jurisdictions in which they practice. In addition, clinicians should be aware of the legal and risk management resources available to them should a complex situation arise. Finally, the psychiatric consultant should make use of consultation when complex issues emerge at the interface of psychiatry and law.

Evaluation of the Capacity to Appoint a Healthcare Proxy

“…The assessment of healthcare consent capacity considers the patient’s process of choosing what is done to his or her own body and is typically based on an assessment of the patient’s understanding, appreciation of, and reasoning about diagnostic information and treatment options, as well as the patient’s ability to express a stable choice. 4,9–11 Consent capacity is diminished in dementia and other neurocognitive conditions associated with impaired cognitive functions and more variably in neuropsychiatric conditions. 12–17 …”