Week 5.6 Flashcards
Malpractice is devastating in terms of (2)
Both financial and emotional cost
What are the legal rights of patients/clients (4)
Under the law clients/patients have:
1) The right to psychotherapy in the least restrictive environment
2) The right to exercise informed consent to treatment alternatives
3) The right to treatment that satisfies the highest standards of care
4) The right to expect that their therapist will act ethically
Psychotherapy should be…
Should be open, not restrictive and targeted to only one group, research based
What do clients/patients need to provide?
Need to give informed consent
What does the profession need?
Professions need the best highest standard - if falling short need more training
What does the law need to think about when malpractice suits come up?
When malpractice suits come up, this is what the law is thinking about (if 4 cannot be satisfied)
What 3 important community functions do malpractice laws serve?
Malpractice laws serve three important community functions:
1) It protects the public from professional wrongdoing by providing aversive consequences [professional, financial, personal] for misconduct
2) It transfers the “loss” from one party to another party who is more culpable (need compensation, bad behaviour has cost that person)
3) It distributes the cost of professional negligence across the profession through increased insurance premiums – hence put pressure on professional associations [APS] to self-regulate and self-scrutinize
(profession then has vested interest making sure people are weeded up, because if premiums go up psychologists cannot afford it)
Examples of community functions served
For instance - professional responsibility to report anyone who is breaking ethical codes, professional guidelines or the law
Example of malpractice reporting
For example, former HoD Psychology reporting RMIT to the accreditation board
If malpractice not picked up by the psychology profession,
If not picked up by psychology profession, needs to be picked up by legal profession
Proving malpractice [via the criminal justice system]: (2)
- Legal
(a) Statutes - Federal and state laws [eg mandatory reporting of child abuse]
(b) Case law - previous cases provide precedence by defining the expected standard of psychological care
- Professional
(a) Ethical codes - Professional codes of conduct technically only apply to [APS] members, but in courts of law they are also applied to non-members [who are also psychologists]
(b) Consensus of professionals - courts use expert witnesses to help determine what is the established standard of care
(c) Consensus in the community - standards of care are also judged by the community - general outrage or by the use of juries in such cases
Standards
Standards (legal, psychology) in the community - how general persons expect people to behave professionally
Case Study 1: Ms J is a 37 year old woman who presented with a complaint of headaches that had occurred daily over the past year. The headaches were characterised by a band-like pain encircling the head. She reported no other physical symptoms. She also stated that the headaches were exacerbated by stress and typically got worse over the course of the day. The psychologist diagnosed the case as stress-related muscle-contraction headaches and began psychotherapy. What aspect of malpractice was the person charged with and was the person found guilty?
Which litigation charges were given:
- Failure to communicate
- Failure in duty to protect
- Failure to maintain confidentiality
- Failure to manage risk
- Failure to provide informed consent
- Practising medicine without a license
Litigation 1: Practising medicine without a license and was found guilty
- Psychotherapists should ensure clients/patients do not have existing medical conditions that can explain their psychological problem
- Ensure clients/patients have medical check-up and get medical clearance before therapy begins
- Eg. Ms J’s headaches may have a biological explanation [growth]
- Eg., children with primary nocturnal enuresis need to be cleared of bladder infections
Case Study 2: Client I was referred to psychologist J for a mental status examination. Psychologist J completed the initial interview but did no testing. Therefore, reported some general findings to Psychiatrist U. Consequently, psychiatrist U prescribed medication that “injured” the client. What aspect of malpractice was the person charged with and was the person found guilty?
Which litigation charges were given:
- Failure to communicate
- Failure in duty to protect
- Failure to maintain confidentiality
- Failure to manage risk
- Failure to provide informed consent
- Practising medicine without a license
Litigation 2: Failure to communicate and was found guilty
- Psychotherapists are required to ensure that all communications are clear and transparent
- All communications to psychologists need to be clarified to ensure all requests are clearly understood
- All communications from psychologists should be clear and comprehensive
- Eg. Psychiatrist U clearly requested a mental status assessment to decide on a medical intervention. Psychologist J did not complete the assessment and failed to inform the psychiatrist of this fact. The report used vague statements which implied sound mental health
Issues with communication (3)
- Communication between professionals - psychiatrist expects assessment using tests
- Psychologist did not communicate to professional
- Not necessarily failure to communicate between psychologist and client, can be other professionals
