Provided by: PRMS

Malpractice and Liability in Psychiatry Textbook

PRMS is proud to congratulate our talented risk managers on an exciting accomplishment! Our Director of Risk Management, Donna Vanderpool, MBA, JD, and Associate Director of Risk Management, Dave Cash, JD, LLM, each contributed a chapter in the new textbook, “Malpractice and Liability in Psychiatry.” Get your copy here: https://link.springer.com/book/10.1007/978-3-030-91975-7

April 2022 Fact vs. Fiction Resource

You’ve been treating a 10-year-old patient for a number of months.  He has always been brought in by his father, who has told you he is divorced from the mother, and that she is no longer involved in the patient’s life.  Out of the blue you get a call from the patient’s mother who just found out that you are treating her son, and is upset about the medication you are prescribing.  She demands a copy of the child’s record.  When you explain to her that the father had given consent for the medications, she tells you she and the father have joint decision-making authority for all medical care.  She further tells you she wants to be involved in her son’s care, but the father is preventing this.  She offers to send you a copy of the custody order.  You contact the father who assures you that he is the one with sole physical custody, and only he can consent to release of the record; he also tells you that nothing in the custody order changes that and there’s no need for you to review the order.

What do you think - fact or fiction?

ANSWER: Fiction!

You need to see the custody order as it will likely spell out which parent(s) must consent to treatment, and who can access the patient’s record.  Typically, unless parental rights have been terminated, both parents can access treatment information, even a parent without custody. If parents are in disagreement over consent to treatment and/or release of treatment information, and these issues are not addressed in the order, the parents should seek resolution from their attorneys.

Psychiatrists treating minors may want to consider the following:

• When a new appointment is made for a new patient who is a minor, ask if the parents are divorced.  If so, advise that a copy of the custody order will need to be brought to the first appointment. Without the order, the psychiatrist may not be able to see the patient because there is no proof that the parent bringing the minor has the legal authority to consent to treatment.

• Manage the expectations of all parties.  Explain your process for keeping parents informed about their child’s treatment.