An Approach to Selected Legal Issues: Confidentiality, Mandatory Reporting, Abuse and Neglect, Informed Consent, Capacity Decisions, Boundary Issues, and Malpractice Claims

Medical Clinics of North America

Volumn 94, Issue 6, 2010, Pages 1229-1240

  Brendel, Rebecca Weintraub ^a,b   Wei, Marlynn H ^a,b   Schouten, Ronald ^a,b   Edersheim, Judith G ^a,b  

^a MASSACHUSETTS GENERAL HOSPITAL   (United States)

^b HARVARD MEDICAL SCHOOL   (United States)

Author keywords

Informed consent; Malpractice; Medicolegal issues; Reporting obligations

Indexed keywords

ABUSE; CONFIDENTIALITY; HEALTH INSURANCE; HUMAN; INFORMED CONSENT; LEGAL ASPECT; MALPRACTICE; MANDATORY REPORTING; MEDICAL DECISION MAKING; NEGLECT; PATIENT CARE; PRIORITY JOURNAL; REVIEW; TREATMENT REFUSAL;

CONFIDENTIALITY; DOMESTIC VIOLENCE; HUMANS; INFORMED CONSENT; MALPRACTICE; MANDATORY REPORTING; MENTAL COMPETENCY; UNITED STATES;

EID: 77957881565     PISSN: 00257125     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.mcna.2010.08.003     Document Type: Review

References (58)

1. Schouten R., Brendel R.W. Common pitfalls in giving medical-legal advice to trainees and supervisees. Harv Rev Psychiatry 2009, 17(4):291-294.
2. Chadwick J., Mann W.N. Hippocrates. The Oath. Hippocratic writings 1983, 67. Penguin Books, London. G.E.R. Lloyd (Ed.).
3. American Medical Association Opinion 5.05: confidentiality Available at:, Accessed March 21, 2010. http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion505.shtml.
4. American Psychiatric Association Position statement on confidentiality 1978, American Psychiatric Association, Washington, DC.
5. Centers for Disease Control and Prevention Nationally notifiable conditions Available at:, Accessed March 21, 2010. http://www.cdc.gov/ncphi/disss/nndss/phs/infdis.htm.
6. Centers for Disease Control and Prevention National notifiable diseases surveillance system Available at:, Accessed on March 21, 2010. http://www.cdc.gov/ncphi/disss/nndss/nndsshis.htm.
7. Brendel R.W., Cohen M.A. Ethical issues, advance directives, and surrogate decision-making. Comprehensive textbook of AIDS psychiatry 2008, 577-584. Oxford University Press, New York. M.A. Cohen, J. Gorman (Eds.).
8. Schuck P.H., Givelber D.J. Tarasoff v Regents of the University of California: the therapist's dilemma. Tort stories 2003, 99-128. Foundation Press, New York. R.L. Rabin, S.D. Sugarman (Eds.).
9. Tarasoff v Board of Regents of the University of California, 17 Cal. 3d425, 551 P.2d 334, 131 Cal. Rptr. 14 (Cal 1976).
10. Harris G.C. The dangerous patient exception to the psychotherapist-patient privilege: the Tarasoff Duty and the Jaffee Footnote. Wash Law Rev 1999, 74:33-46.
11. Klinka E. It's been a privilege: advising patients of the Tarasoff Duty and its legal consequences for the Federal psychotherapist-patient privilege. Fordham Law Rev 2009, 78:863.
12. Duty to warn patient's potential victims; cause of action 2005, 123 Ch. § 36B; Mass. Gen. Laws.
13. Schouten R. Legal responsibilities with child abuse and domestic violence. Psychiatric secrets 2001, Hanley & Belfus, Philadelphia. J.L. Jacobson, A.M. Jacobson (Eds.).
14. Milosavljevic N., Brendel R.W. Abuse and neglect. Comprehensive clinical psychiatry 2008, 1133-1142. Mosby/Elsevier, Philadelphia. T.A. Stern, J.F. Rosenbaum, M. Fava (Eds.).
15. Kazim A., Brendel R.W. Abuse and neglect. Massachusetts general hospital psychiatry update and board preparation 2004, 539-544. McGraw-Hill, New York. 2nd edition. T.A. Stern, J.B. Herman (Eds.).
16. Kahan F.S., Paris B.E. Why elder abuse continues to elude the health care system. Mt Sinai J Med 2003, 70:62-68.
17. Houry D., Sachs C.J., Feldhaus K.M., et al. Violence-inflicted injuries: reporting laws in the fifty states. Ann Emerg Med 2002, 39(1):56-60.
18. Frampton A. Reporting of gunshot wounds by doctors in emergency departments: a duty or a right? Some legal and ethical issues surrounding breaking patient confidentiality. Emerg Med J 2005, 22:84-86.
19. Massachusetts General Laws, Ch. 112, S. 12a.
20. Kansas Statute 2006, §21-4213.
21. Conn. General Statute Sec 2003. 19a-510a.
22. Texas Health and Safety Code Ann. S 2007. § 161.041.
23. New York CLS Penal 2010. § 265.25.
24. N.C. Gen. Stat. 2007. § 90-21.20.
25. Hawaii Rev Stat. 453-14. Available at: Accessed August 10, 2010. http://www.capitol.hawaii.gov/hrscurrent/Vol10_Ch0436-0474/HRS0453/HRS_0453-0014.htm.
26. National District Attorneys Organization, Mandatory reporting of child abuse and neglect: state statutes and professional ethics Available at:, Accessed August 10, 2010. http://www.ndaa.org/pdf/mandatory_reporting_state_statutes.pdf.
27. National Center for the Prosecution of Violence Against Women, APRI, summary of laws relevant to the mandatory reporting of domestic violence when the victim is a competent adult Available at:, Accessed August 10, 2010. http://www.ndaa.org/pdf/dv_summary.pdf.
28. Hyman A., Schillinger D., Lo B. Laws mandating reporting of domestic violence-do they promote well-being?. JAMA 1995, 273(22):1781-1784.
29. Health Insurance Portability and Accountability Act of 1996. Public Law 1996:104-91.
30. Brendel R.W., Bryan E. HIPAA for psychiatrists. Harv Rev Psychiatry 2004, 12:177-183.
31. Health Insurance Portablity and Accountability Act (HIPAA): its broad effect on practice. Am J Gastroenterol 2005, 100:1440-1443.
32. HIPAA Privacy Rule. 45, 164.512. 2001. C.F.R.
33. HIPAA Privacy Rule. 45, 164.502(b), 164.514(d). 2001. C.F.R.
34. Appelbaum P.S., Lidz C.W., Meisel A. Informed consent: legal theory and clinical practice 1987, Oxford University Press, New York.
35. Katz J. The silent world of doctor and patient 1984, Free Press, New York, 48-9.
36. Schouten R., Edersheim J.G. Informed consent, competency, treatment refusal, and civil commitment. Massachusetts General Hospital comprehensive clinical psychiatry 2008, 1143-1154. Mosby/Elsevier, Philadelphia. T.A. Stern, J.F. Rosenbaum, M. Fava (Eds.).
37. Appelbaum P.S., Roth L.H. Clinical issues in the assessment of competency. Am J Psychiatry 1981, 138:1462-1467.
38. Appelbaum P.S., Grisso T. Assessing patients' capacities to consent to treatment. N Engl J Med 1988, 319:1635-1638.
39. Meisel A., Rotrh L.H., Lidz C.W. Toward a model of legal doctrine of informed consent. Am J Psychiatry 1977, 134:285-289.
40. Roth L.H., Meisel A., LIdz C.W. Tests of competency to consent to treatment. Am J Psychiatry 1977, 134:279-284.
41. Appelbaum P.S. Assessment of patients' competence to consent to treatment. N Engl J Med 2007, 357:1834-1837.
42. Schloendorff v Society of New York Hospital, 92 105, NE (1914).
43. Salgo v Leland Stanford, Jr. University Board of Trustees, 170 P2d 317, 170-182 (Cal Court of Appeals 1957).
44. Natanson v Kline, 1093 P2nd 350, 1093-1109 (1960) Supreme Court of Kansas.
45. Canterbury v Spence, 772 F2.d 464, (DC Cir. cert. denied, 409 U.S. 1064).
46. Schuck P.H. Rethinking informed consent. Yale Law J 1994, 103:899-959.
47. King J.S., Moulton B.W. Rethinking informed consent: the case for shared medical decision-making. Am J Law Med 2006, 32:429-493.
48. Roberts L.W. Informed consent and the capacity for voluntarism. Am J Psychiatry 2002, 159:705-712.
49. Meisel A. The " exceptions" to the informed consent doctrine: striking a balance between competing value in medical decision making. Wis L Rev 1979, 413-488.
50. Health Care Surrogate Act of 2005, 755, 40. Ill. Comp. Stat.
51. Ch. 201, § 1-15 (2009); Mass. Gen. Laws.
52. Melton GB, Petrila J, Poythress NG, et al. Psychological evaluations for the courts: a handbook for mental health professionals and lawyers. 2nd edition. New York: Guilford Press; 1997. p. 339.
53. Karp N., Wood E. Guardianship monitoring: a national survey of court practices Available at:, Accessed August 10, 2010. http://www.guardianship.org/reports/07GuardianshipMonitoring.pdf.
54. Gallagher T.H., Studdert D., Levinson W. Disclosing harmful medical errors to patients. N Engl J Med 2007, 2713-2719.
55. Schouten R., Brendel R.W., Edersheim J.G. Malpractice and boundary violations. Massachusetts General Hospital comprehensive clinical psychiatry 2008, 1165-1175. Mosby/Elsevier, Philadelphia. T.A. Stern, J.F. Rosenbaum, M. Fava (Eds.).
56. Sansone R.A., Sansone L.A. Crossing the line: sexual boundary violations by physicians. Psychiatry 2009, 6(6):45-48.
57. Benedek E.P., Wahl D. Sexual misconduct, The American Psychiatric Association, and the American Medical Association. Physician sexual misconduct 1999, 91-107. American Psychiatric Press, Washington, DC. J.D. Bloom (Ed.).
58. American Medical Association, Opinion 8.14 Sexual misconduct in the practice of medicine. AMA Code of Medical Ethics. Available at: Accessed February 19, 2010. http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion814.shtml.