Patient Suicide and Litigation

Suicides account for nearly 30,000 deaths annually in the United States and are the eleventh leading cause of death (National Center for Health Statistics 2000; National Institute of Mental Health 2004). Studies indicate that during the course of his or her career, a psychiatrist has a 50% chance of losing a patient to suicide (Chemtob et al. 1988). In a review of malpractice claims against psychiatrists between 1980 and 1985, Robertson (1988) reported that lawsuits involving suicide represented the largest number of suits and yielded the largest financial settlements (Baerger 2001). In this chapter, we examine psychiatrists' roles in two areas of litigation. In the first, we provide an overview of malpractice litigation when the psychiatrist is a defendant in a lawsuit. In the second section, we review retrospective psychiatric evaluations conducted to determine whether a person's death was due to a suicide or resulted from other causes. In both situations, it is important that the psychiatrist be familiar with the legal principles that are relevant in approaching the referral issue. In the following case example, the psychiatrist received a formallegal complaint against him alleging psychiatric malpractice: