Legal Advisor: Patient Suicidal Ideation: A Physician’s Legal Duties and Options

As many as 47,000 people in the U.S. die each year by their own hand. Among those, approximately 75% had seen a physician within a year before their death—45% to 66% within the prior month. 

These statistics point to an unfortunate but unequivocal fact: many patients’ risk for suicide could be detected and care steps taken to save lives. While short-term suicide risk prediction is not possible, preventive care steps have been outlined as recommended practice by the National Action Alliance for Suicide Prevention  as well as by The Joint Commissions (SEA 56).

More often than not, legal claims in the medical malpractice world deal with alleged failures to diagnose or properly treat a type of physical condition. However, physicians are often posed with dealing with a patient's mental health just as frequently as a patient's hypertension or cardiac issues. Patients presenting with suicide risk may have psychiatric conditions that have been identified or documented by the health system or they may not. How should physicians handle statements made by patients regarding suicide? What are the liability concerns if a physician does not take the proper steps to prevent a suicide risk from becoming a reality? What if a physician takes a statement too seriously and breaches confidentiality? Is there harm from overutilizing psychiatric hospitalization?  

Learning Objectives

  • Describe the recommended steps and limitations of assessing a patient’s risk for suicide.
  • Explain why short-term prediction of the risk for suicide attempt or death is not possible with current state of science and why prevention steps are still effective and important to take.
  • Restate why it is imperative to thoroughly document key relevant information pertaining to suicide risk assessment and steps taken.
  • Consider options for clinical treatment planning, including when to hospitalize, when to refer to specialty care, and the preventive value of simply enhancing follow-up contact or communication.
  • Discern whether disclosure of a patient’s suicide risk to a third party is a violation of confidentiality.
  • Determine how to respond to a patient’s disclosure of suicidal thoughts or other indications of suicide risk in ways that help the patient and may increase the odds of the provider prevailing in any future malpractice litigation.

Additional Information

Partner: 
Massachusetts Medical Society (MMS)
State Relevance: 
Connecticut
Massachusetts
Pennsylvania
Course summary
Available credit: 
  • 1.00 MOC II
  • 1.00 AMA PRA Category 1 Credit
Course opens: 
03/07/2019
Course expires: 
03/07/2022
Nonmember cost:
$30.00
Member cost:
$15.00
Student or Resident cost:
$7.50
Other Health Care Professionals cost:
$12.00
Cost:
$30.00
Rating: 
0

Christine Moutier, MD 
Dr. Christine Moutier knows the impact of suicide firsthand. After losing colleagues to suicide she dedicated herself to fighting this leading cause of death. As a leader in the field of suicide prevention, Dr. Moutier joined AFSP in 2013, and it’s through her passion and commitment to the work that we see a lasting impact via research, education and support to communities across the U.S

She has testified before the U.S. Congress and provided multiple Congressional Briefings on suicide prevention, presented to the White House, spoken at the National Academy of Sciences, she co-anchored CNN’s Finding Hope suicide prevention town hall, and has appeared as an expert in The New York Times, The Washington Post, Time magazine, The Economist, The Atlantic, Anderson Cooper 360, the BBC, CNN, NBC and other print and television outlets. Throughout her career she has focused on training healthcare leaders, physicians, and patient groups in order to change the healthcare system’s approach to mental health, fighting stigma and optimizing care for those suffering from mental health conditions. In addition to co-founding AFSP’s San Diego Chapter, Moutier co-led a successful suicide prevention and depression awareness program for health science faculty, residents, and students, which featured AFSP’s groundbreaking Interactive Screening Program. 

Since earning her medical degree and training in psychiatry at the University of California, San Diego, Moutier has been a practicing psychiatrist, professor and dean in the UCSD School of Medicine, medical director of the Inpatient Psychiatric Unit at the VA Medical Center in La Jolla, and has been clinically active with diverse patient populations, such as veterans, Asian refugee populations, as well as physicians and leaders with mental health conditions. She also served as co-investigator for the Sequenced Treatment Alternatives to Relieve Depression study (STAR*D), a large National Institute of Mental Health trial on the treatment of refractory depression. Moutier has authored articles and book chapters for publications such as the Journal of the American Medical Association, Academic Medicine, the American Journal of Psychiatry, the Journal of Clinical Psychiatry, Psychiatric Times, Depression and Anxiety, and Academic Psychiatry. Reviewer, Editorial Systems Manager, NEJM Group Education 

Accreditation Statement  
The Massachusetts Medical Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA Credit Designation Statement 
The Massachusetts Medical Society designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity meets the criteria for the Massachusetts Board of Registration in Medicine for risk management study.

MOC Approval Statement 
Through the American Board of Medical Specialties ("ABMS") ongoing commitment to increase access to practice relevant Maintenance of Certification ("MOC") Activities through the ABMS Continuing Certification Directory , this activity has met the requirements as an MOC Part II CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:  

Allergy and Immunology
Anesthesiology
Family Medicine
Medical Genetics and Genomics
Nuclear Medicine
Physical Medicine and Rehabilitation
Plastic Surgery
Preventive Medicine
Psychiatry & Neurology
Radiology
Thoracic Surgery
Urology

National Commission on Certification of Physicians Assistant (NCCPA)
Physician Assistants may claim a maximum of 1.00 Category 1 credit for completing this activity. NCCPA accepts AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society.

A score of 70% or higher is required to receive AMA PRA Category 1 Credit™.

Available Credit

  • 1.00 MOC II
  • 1.00 AMA PRA Category 1 Credit

Price

Nonmember cost:
$30.00
Member cost:
$15.00
Student or Resident cost:
$7.50
Other Health Care Professionals cost:
$12.00
Cost:
$30.00
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This course is offered through Massachusetts Medical Society. 

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Topics

 

Risk Management