Clinical Manual of Psychiatry and Law

The writing partnership of Robert I. Simon, M.D., and Daniel W. Shuman, J.D., has been a felicitous one for the field of psychiatry. Dr. Simon, Clinical Professor of Psychiatry and Director of the Program in Psychiatry and Law at Georgetown University School of Medicine, and Professor Shuman, Professor of Law at Dedman School of Law, Southern Methodist University, teamed together to create the innovative book Retrospective Assessment of Mental States in Litigation: Predicting the Past (1) . Their recent publication, Clinical Manual of Psychiatry and Law, continues this working partnership, which is characterized by clarity and precision and provides yet another example of their academic and practical expertise.

Clinical Manual of Psychiatry and Law untangles some of the knottiest legal issues that psychiatrists encounter in an organized and readable clinical manual and should be considered required reading for every psychiatric resident. As Dr. Simon and Professor Shuman state in the preface, clinicians cannot be expected to be as knowledgeable about the law as lawyers, but the understanding of how the law and psychiatry interact in common clinical situations should be a core competency for every clinician. This book provides easily referenced, well-formulated, and understandable discussions of the common legal issues psychiatrists face in their day-to-day clinical practice.

Dr. Simon has devoted his teaching career to educating general psychiatrists in the legal issues that affect their practice. His first book on this subject, Clinical Psychiatry and the Law (2) was the first written by a psychiatrist to offer this subject matter to psychiatrists. Dr. Simon also edited and contributed multiple chapters to the comprehensive three-volume text American Psychiatric Press Review of Clinical Psychiatry and the Law (3) . In addition, Dr. Simon is the author of Psychiatry and Law for Clinicians (4), a reference so useful that it has undergone three editions. Professor Shuman has also contributed significantly to the legal education of practicing clinicians. His books have covered specific forensic topics, such as Conducting Insanity Evaluations (5) as well as general clinical topics, such as Law, Mental Health and Mental Disorder (6) .

Dr. Simon and Professor Shuman have built on this impressive body of work in Clinical Manual of Psychiatry and Law . The subject and chapter organization are comprehensive without being overwhelming. Topics covered are those with which all practicing psychiatrists should be familiar, such as the doctor-patient relationship, confidentiality, informed consent, seclusion and restraint, and maintaining treatment boundaries. Their up-to-date review of topics concerning legal issues involved in the treatment of suicidal and violent patients and involuntary hospitalization are especially welcome, as these are areas of mental health law that are constantly evolving.

The chapter organization lends itself to the development of a working familiarity that can be easily incorporated into clinical practice. Each chapter addresses one specific clinical issue and includes an overview of the relevant law and a discussion of clinical management of legal issues pertinent to the chapter topic. Practical suggestions regarding such issues as termination of patients and suicide risk assessment will assist clinicians in effectively utilizing the insights and discussion of the subject matter. Each chapter also provides clinical and legal references for those interested in delving further into any given topic.

Dr. Simon’s and Professor Shuman’s concise but thorough legal perspective on each of these clinical issues is particularly welcome. They bring their considerable expertise to subjects that fall outside clinical psychiatric training but which can profoundly affect practice, such as the standard of care, tort law and psychiatry, and the ever puzzling concept of proximate cause. These concepts at times prove difficult for experienced forensic clinicians and even some attorneys. The authors’ explanations are among the clearest provided for a clinical audience with a need to develop a basic understanding of these nonclinical but highly relevant legal topics. The legal glossary provided is also a great assist.

Clinical Manual of Psychiatry and Law is an invaluable contribution for psychiatrists developing good clinical practices as well as those who may have such practices in place but are unaware of the legal bases upon which these practices rest. This book will strengthen the understanding of the legal and clinical reasons for these practices and clarify psychiatrists’ responsibilities while helping them assist their patients. Ultimately, and most importantly, our patients are the ones who benefit when we incorporate these insights into daily clinical practice, because in most cases, as the authors correctly point out, “good psychiatry and the law are complementary.”