6. Legal Issues in Psychiatric Practice

  1. Allan Tasman Professor Chair2,
  2. Jerald Kay Professor Chair3,
  3. Jeffrey A. Lieberman Lawrence Kolb Professor Chairman Director Psychiatrist in Chief4,5,6,
  4. Michael B. First Professor of Clinical Psychiatry4,5,7 and
  5. Mario Maj Professor Chair8
  1. David M. Benedek and
  2. Thomas A. Grieger

Published Online: 8 AUG 2008

DOI: 10.1002/9780470515167.ch6

Psychiatry, Third Edition

Psychiatry, Third Edition

How to Cite

Benedek, D. M. and Grieger, T. A. (2008) Legal Issues in Psychiatric Practice, in Psychiatry, Third Edition (eds A. Tasman, J. Kay, J. A. Lieberman, M. B. First and M. Maj), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470515167.ch6

Editor Information

  1. 2

    Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA

  2. 3

    Department of Psychiatry, Wright State University Boonshoft School of Medicine, Dayton, OH, USA

  3. 4

    Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA

  4. 5

    New York State Psychiatric Institute, New York, NY, USA

  5. 6

    Columbia University Medical Center, New York – Presbyterian Hospital, New York, NY, USA

  6. 7

    Department of Psychiatry, Columbia University Medical Center, New York, NY, USA

  7. 8

    Department of Psychiatry, University of Naples, Naples, Italy

Author Information

  1. Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

Publication History

  1. Published Online: 8 AUG 2008
  2. Published Print: 16 APR 2008

ISBN Information

Print ISBN: 9780470065716

Online ISBN: 9780470515167



  • agency;
  • automatism;
  • duty;
  • mental health law;
  • civil commitment;
  • civil law;
  • criminal law;
  • competency;
  • criminal responsibility;
  • informed consent;
  • insanity;
  • malpractice;
  • negligence;
  • tort law;
  • standard of care;
  • specific intent;
  • suicide;
  • risk assessment


In medical practice, conflicts arise when patients refuse treatment, when patients are considered dangerous to themselves or others, or when bad outcomes occur. The course of action for the psychiatrist in any of these situations is guided by clinical judgment and skill, knowledge, training, and professional guidelines. Ultimately, however, the resolution of these conflicts may be governed by civil and criminal law. Psychiatrists may be called upon to assist legal decision makers in determinations of mental health related impairment and occupational disability, with questions of competency to make medical or other decisions, and with issues surrounding accountability or culpability for behavior. Although special expertise in issues related to the psychiatric–legal interface is the purview of forensic psychiatrists, the practice of all psychiatrists is subject to legal regulation and all psychiatrists will participate in proceedings or procedures at the medico–legal interface. This chapter outlines legal issues—both civil and criminal—with which psychiatrists should be comfortable and familiar in order to deliver appropriate care.