Mela Mansfield, Luther Glen, Gutheil Thomas G
Department of Psychiatry, Royal University Hospital, University of Saskatchewan and College of Law, Saskatoon, Saskatchewan
College of Law and Department of Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan.
Can J Psychiatry. 2016 Feb;61(2):112-8. doi: 10.1177/0706743715625943.
To extract the themes pertaining to prudent psychiatric practice from written court judgments in Canada.
We searched the medical and legal literature for cases involving civil litigation against Canadian psychiatrist and reviewed all available written judgments. We completed a thematic analysis of the civil actions against psychiatrists as conveyed by those written court judgments. We classified the cases according to the disposal status and the essential lessons from the decisions on standard of care and practice by Canadian psychiatrists.
Forty such cases were identified as involving psychiatrists over a 45-year period. A subgroup included those dealing with limitation periods and disclosure applications. Thirty of the 40 cases (75%) were decided in favour of the defendant psychiatrists, including 2 dismissed for running over the limitation period. The cases that actually went to trial suggest that documentation and obtaining second opinions are protective against claims of negligence. Inpatient cases resulting in successful litigation against psychiatrists involved fatal outcomes, but not all fatal outcomes led to successful litigation.
The key lessons from these cases are the importance and relevance of regular best clinical practices, such as documentation, obtaining second opinions, following guidelines, and balancing competencies in the expert and manager or advocate roles. Incorporating these practices should allay concerns about litigation against psychiatrists.
从加拿大的书面法庭判决中提取与审慎精神科诊疗相关的主题。
我们在医学和法律文献中搜索涉及对加拿大精神科医生民事诉讼的案例，并审查所有可用的书面判决。我们对这些书面法庭判决所传达的针对精神科医生的民事诉讼进行了主题分析。我们根据处理状态以及加拿大精神科医生关于诊疗标准和实践的判决中的重要经验教训对案例进行分类。
在45年期间，共确定了40起此类涉及精神科医生的案例。一个子类别包括那些涉及诉讼时效和披露申请的案例。40起案例中有30起（75%）判决有利于被告精神科医生，其中2起因超过诉讼时效而被驳回。实际进入审判的案例表明，记录病例和获取第二种意见可防范过失索赔。导致对精神科医生成功诉讼的住院病例涉及致命后果，但并非所有致命后果都导致成功诉讼。
这些案例的关键经验教训是常规最佳临床实践的重要性和相关性，例如记录病例、获取第二种意见、遵循指南以及平衡专家与管理者或辩护人角色的能力。纳入这些实践应能减轻对精神科医生诉讼的担忧。
