Week 5.7 Flashcards
Case Study 3: Client P was evaluated in a hospital emergency department by psychologist M. There was no long-term relationship between client P and psychologist M. In the evaluation, the question of suicidality was raised. Psychologist M evaluated the client using the gold standard test for suicide risk [B-SAFE] which did not reveal any suicide risk. The client was released from hospital and subsequently committed suicide. The family sued 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 3: Failure to manage risk but found not guilty
- [suicide] risk evaluation should never fall below the appropriate standard of care [failure to diagnose suicidality].
- Suicide threats should be taken seriously [ie. Duty to prevent harm] and psychologists should use the best assessment tools [the gold standard], make correct/consistent diagnoses and intervene appropriately
- All clinical work should be adequately documented
- 20% of psychologists will lose a patient to suicide over their professional careers
- In the above case, while the assessment was brief – the psychologist used the gold standard assessment and recorded his decision-making
Case Study 4: The client [Mr P] told his psychologist [Dr M] that he intended to kill an unnamed but readily identifiable woman [Ms T]. After the session, psychologist M contacted the police and requested that the police observe client P because he may be a danger to himself or others. The police took Mr P into custody but released him after observation noting he was rational but also warning him to stay away from Ms T. Mr P did not return to treatment and subsequently killed Ms T two months later 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 4: Failure in duty to protect and found guilty
- Psychotherapists can be held responsible for protecting the public from violent acts from their patients
- If the member of public [under threat] can be identified, then there are extra requirements from the psychologist [over and above reporting the threat to police]
Psychologists have…
Duty to protect can go wider when get people like pedophile, murder/threaten to hurt someone, is it fantasizing or actual intention
Confidentiality…
Confidentiality doesn’t hold for certain situations - allowed to break confidentiality in this case
Psychologists have what responsibility
Public responsibility because could potentially identify who victim was
Case Study 5: Medical doctor S referred patient B to psychologist F for psychological treatment. In line with Dr S’s protocol, she requested a report from the psychologist. Typically psychologist F would provide a summary report, but in his haste he send a more detailed report that included an extensive family history and the patient’s DSM-5 diagnoses. 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 5: Failure to maintain confidentiality and found guilty
Professionals should not discuss or disclose information about a patient to anyone
There are some/few exceptions including endangerment to others [eg threats of harm or reports regarding child abuse]
Where there are other professionals working with the client/patient limited information [in the best interests of the patient] can be shared
In the above case, a specific report limited to relevant information should have been sent rather than the full case notes
What don’t psychologists do in terms of notes
Don’t hand a lot of notes on because there is confidential material there
Case Study 6: The patient was a 60 year old married man who was referred for psychological screening [regarding his suitability for a penile prosthesis]. For five years the patient had experienced erectile dysfunction [precluding sexual intercourse]. Medical examination showed no physical aetiology]. The psychological evaluation revealed a number of significant marital issues. Further, the patient felt guilty about a past extra-marital affair. The psychologist recommended behaviour sexual dysfunction therapy and marital counselling. Given the psychological report, the surgeon indicated to the patient that he was unsuitable for surgeon. The patient insisted he was not interested in psychotherapy and that he believed the problem was physical. 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 6: Failure to provide informed consent [fully informed about the nature of the evaluation – that is who requested it? and why?]. The psychologist was found guilty
Informed consent requires psychologists to fully disclose to the client/patient all relevant information
Critically, the client should know:
Who is the client? (In this situation the client was the surgeon)
What is the purpose of the assessment?
What are all of the treatment options
The client has the right to decide what treatment [or not] they will have
In the above case, the psychologist failed to disclose that the surgeon was the client, the assessment was solely for the client’s suitability for surgery, and, that the client had the right to refuse being assessed
What do you need to know
Need to ask who was the client
What does psychologist need to do
Not the psychologist’s job to say they would be suitable for this - should just say yes or no as to whether suitable
Beyond what they should do - beyond the client (client is surgeon)
Psychologist’s behaviour is restricted to…
Behaviour is restricted to what person asked for and what client should be given
Other areas of litigation (2)
- Sexual victimisation
- Financial/business arrangements
