Dr. Marett is Volunteer Assistant Professor, and Dr. Mossman is Professor of Clinical Psychiatry and Director, Division of Forensic Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Disclosures
The authors report no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.
If you’re in a situation similar to the one Dr. R describes, you can take solace in knowing that courts generally provide immunity to a psychiatrist who makes a reasonable, well-intentioned decision to commit someone. The degree of immunity offered varies by jurisdiction. Table 1provides examples of immunity language from several states’ statutes.
Many states’ statutes also lay out the potential consequences if a psychiatrist takes action to involuntarily hospitalize someone in bad faith or with malicious intent. In some jurisdictions, such actions can lead to criminal sanctions against the doctor or against the party who made a false petition (eg, a devious family member) (Table 2). Commenting on Texas’s statute, attorney Jeffrey Anderson explains, “The touchstone for causes of action based upon a wrongful civil commitment require that the psychiatrist[’s] conduct be found to be unreasonable and negligent. [Immunity…] still requires that a psychiatrist[’s] diagnosis of a patient[’s] threat to harm himself or others be a reasonable and prudent one.”37
The immunity extended through such statutes usually is limited to claims arising directly from the detention. For example, in the California case of Jacobs v Grossmont Hospital, a patient under a 72-hour hold fell and fractured her leg, and she sought damages. The trial court dismissed the suit under the immunity statute applicable to commitment decisions, but the appellate court held that “the immunity did not extend to other negligent acts.… The trial court erred in assuming that … the hospital was exempt from all liability for any negligence that occurred during the lawful hold.”38
Bingham v Cedars-Sinai Health Systems illustrates how physicians can lose immunity.39 A nurse contacted her supervisor to report a colleague who had stolen narcotics from work and compromised patient care. In response, the supervisor, hospital, and several physicians agreed to have her involuntarily committed. Later, it was confirmed that the colleague had taken the narcotics. She later sued the hospital system, claiming—in addition to malpractice—retaliation, invasion of privacy, assault and battery, false imprisonment, defamation, intentional infliction of emotional distress, disability-based harassment, and violation of her civil rights. Citing California’s immunity statute, the trial court granted summary judgment to the clinicians and hospital system. On appeal, however, the appellate court reversed the judgment, holding that the defendants had not shown that “the decision to detain Bingham was based on probable cause, a prerequisite to the exemption from liability,” and that Bingham had some legitimate grounds for her lawsuit.
A key point for Dr. R to consider is that, although some states provide immunity if the psychiatrist’s admitting decision was based on an evaluation “performed in good faith,”40 other states’ immunity provisions apply only if the psychiatrist had probable cause to make a decision to detain.41
