Weinstock R, Garrick T
West Los Angeles Veterans Affairs Medical Center, CA 90073, USA.
Bull Am Acad Psychiatry Law. 1995;23(2):183-93.
Forensic psychiatrists are not as vulnerable to liability as general psychiatrists. The absence of a traditional physician-patient relationship and judicial and quasijudicial immunity are all protective against malpractice actions. Although the absence of a doctor-patient relationship removes an essential element of malpractice, other types of liability such as defamation and ordinary negligence are possible and may not be covered by malpractice insurance. A model is proposed for forensic psychiatry of a partial secondary doctor-patient relationship out-weighted in most circumstances by duties to truth and/or the hiring attorney. Such a model seems most consistent with conflicting duties currently forced on all psychiatrists. This model has advantages of a duty, a violation of which is likely to be covered by malpractice insurance. Rather than deemphasizing partial secondary physician-patient responsibilities, it is advised to stress the important protection provided by judicial and quasijudicial immunity.
法医精神病学家不像普通精神病学家那样容易承担责任。不存在传统的医患关系以及司法和准司法豁免权都能保护他们免受医疗事故诉讼。虽然不存在医患关系消除了医疗事故的一个基本要素,但其他类型的责任,如诽谤和一般过失是可能存在的,而且可能不在医疗事故保险范围内。本文提出了一种法医精神病学的模式,即在大多数情况下,部分次要医患关系被对真相和/或聘请律师的责任所压倒。这样一种模式似乎最符合目前所有精神病学家所面临的相互冲突的责任。这种模式具有一种责任的优势,违反该责任可能会被医疗事故保险所涵盖。与其淡化部分次要的医生-患者责任,建议强调司法和准司法豁免权所提供的重要保护。