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Biomedical subjects

L H Roth

Publications and source records attributed to L H Roth.

At least 19 recordsLinked to original sources
PubMed1989

Statutory approaches to limiting psychiatrists' liability for their patients' violent acts.

A consensus has developed among mental health professionals that the legal duty to protect potential victims of their patients' violent acts, as fashioned by the courts, requires modification. To date, 12 states have responded with legislation designed to clarify and limit clinicians' responsibilities. In addition, APA has distributed a model statute as a resource document to aid those psychiatrists interested in stimulating legislative action. This paper examines existing statutes and the APA resource document, considers the variety of ways in which the goals of reform can be achieved, and recommends approaches that balance desires for public safety with the legitimate needs and concerns of the mental health professions.

Forensic Psychiatry↗
PubMed1979

A commitment law for patients, doctors, and lawyers.

The author proposes a model commitment law that balances the sometimes conflicting points of view among patients, doctors, and lawyers about this subject. Paternalism is affirmed, while safeguards are provided. It is argued that absent patient incompetency to consent to or refuse treatment, or absent an emergency, mental patients should not be treated involuntarily. The author believes that a different procedural approach is required depending on whether the patient is committed under the parens patriae or police power of the state.

Commitment of Persons with Psychiatric Disorders↗
PubMed1977

Tests of competency to consent to treatment.

The authors describe the various tests of competency to consent to treatment used today, which include the following: 1)evidencing a choice, 2)"reasonable" outcome of choice, 3)choice based on "rational" reasons, 4)ability to understand, and 5)actual understanding. They analyze the applicability of these tests to patients' decisions to accept or refuse psychiatric treatment and illustrate the problems of ap-lying these tests by citing clinical case examples. They find that the circumstances in which competency becomes an issue determine which elements of which tests are stressed and which are underplayed.

Adult↗
PubMed1977

Toward a model of the legal doctrine of informed consent.

The authors draw together the disparate scholarly and judicial commentaries on consent to medical treatment to develop a model of the components in the decision-making process regarding consent to or refusal of psychiatric treatment. The components consist of the precondition of voluntariness, the provision of information, the patient's competency and understanding, and, finally, consent or refusal. They offer two models of valid consent: the objective model, which focuses on the congruence or lack of it between the patient and a "reasonable" person, and the subjective model, which focuses entirely on the patient's actual understanding.

Civil Rights↗
PubMed1977

Dangerousness, confidentiality, and the duty to warn.

The Tarasoff decision, by imposing on psychiatrists an obligation to warn the intended victim of threats made by a patient, but only under certain vaguely specified circumstances, may stampede psychiatrists into issuing such warnings to avoid possible legal liability no matter how remote the risk of harm may actually be. The authors suggest that the ill effects of such a reaction by psychiatrists--breach of confidentiality and the attendant erosion of trust and harm to the therapeutic alliance--can often be easily avoided by taking less drastic steps, some of which are illustrated by case presentations.

Adult↗