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Forensic psychiatry is the medical subspecialty, recognized by the American Psychiatric Association since 1991, in which psychiatric expertise is applied to legal issues. The American Board of Psychiatry and Neurology started in 1994 to examine individuals for “added qualifications in forensic psychiatry.” There are about 40 1-year fellowship programs in forensic psychiatry accredited by the Accreditation Council for Graduate Medical Education, USA.

There are four divisions of forensic psychiatry. The first pertains to the legal aspects of general psychiatric practice, such as the civil commitment of involuntary patients, the doctrine of informed consent, the requirement to protect third parties from dangerous patients, and matters of privilege and confidentiality.

The second division of forensic psychiatry covers the assessment of mental disability. This includes the evaluation of individuals who have been injured on the job, the assessment of a plaintiff who claims that he or she was injured and is now seeking compensation from a defendant, and the assessment of the competency of individuals to perform specific acts such as making a will.

The most colorful aspect of forensic psychiatry deals with individuals who have been arrested. This division includes the evaluation of competency to stand trial, the evaluation of a person's competency to waive his or her Miranda rights, the assessment of criminal responsibility, evaluations that relate to sentencing, and the treatment of incarcerated individuals.

The fourth division of forensic psychiatry is forensic child psychiatry, which includes child custody evaluations, the evaluation of children who may have been abused, and consultation regarding minors who are involved with juvenile court.

Goldstein AM (ed):Forensic Psychology. New York: Wiley, 2003.
Gutheil TG,Appelbaum PS:Clinical Handbook of Psychiatry and the Law, 4th edn. Philadelphia: Lippincott Williams & Wilkins, 2006.
Melton GB,Petrila J,Poythress N,Slobogin C:Psychological Evaluations for the Courts, 2nd edn. New York: Guilford Press, 1998.
Rosner R (ed):Principles and Practice of Forensic Psychiatry, 2nd edn. London: Arnold, 2003.
Simon RI,Gold LH (eds):Textbook of Forensic Psychiatry. Washington, DC: American Psychiatric Publishing, 2004.

Professional Liability

Psychiatrists are less likely than other physicians to be sued for professional negligence. However, we live in a litigious society—most psychiatrists will be the subject of at least one professional liability claim during the course of their professional careers.

In a case of professional liability or malpractice, a patient (the plaintiff) sues the psychiatrist (the defendant). In order to prevail legally, the plaintiff must prove each of four elements: (1) The psychiatrist had a duty of care to the patient, (2) there was a breach of the duty to the patient, (3) the patient was injured, and (4) the negligent care was the proximate cause of the patient's injury. That is, if it were not for the negligent act, the injury would not have occurred. At ...

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