Unforeseeable Liability for Patients' Violent Acts

Psychiatrists have been held liable for violent acts committed by their patients when more than an error in professional judgment could be demonstrated. The authors describe several recent court cases in which judges have ignored or distorted acceptable clinical practices, conceivably creating a new liability standard whereby a tragic outcome is considered the result of failure to apply appropriate judgment. Following discussion of the cases are recommendations for managing the risks attendant to psychiatric decision making today, such as gathering as much of the patient's history as possible, obtaining previous records, documenting clinical reasoning, and consulting colleagues. Reforms for the legal process are also suggested.