Legal Support for Psychiatrists
Recently there has been an increase in the number of times lawyers are advising their patients to appeal the decisions of the Ontario Review Board regarding certification. What is the most appropriate source for legal support for the physician in these circumstances? The CMPA declare that they will deal with these situations on a case by case basis, but they have also provided feedback to some of our staff that because the Hospital is detaining these patients under the Mental Health Act, then the Hospital should be providing legal backup. The Hospital states that the physician is the one who completed the certificate and so they should deal with CMPA.
This issue is becoming more and more common physicians seems to be stuck in the middle, with no certainty of support from either the hospital or the CMPA. It seems to me that we need to have a more systematic approach to this problem and to get confirmation from legal and regulatory and hospital groups on a predictable response to the legal needs of Hospital-based physicians.
Regards,
Anthony Levitt, MD
Professor, Department of Psychiatry,
University of Toronto.
Psychiatrist-in-chief,
Sunnybrook Health Sciences Centre &
Women's College Hospital.
This issue is becoming more and more common physicians seems to be stuck in the middle, with no certainty of support from either the hospital or the CMPA. It seems to me that we need to have a more systematic approach to this problem and to get confirmation from legal and regulatory and hospital groups on a predictable response to the legal needs of Hospital-based physicians.
Regards,
Anthony Levitt, MD
Professor, Department of Psychiatry,
University of Toronto.
Psychiatrist-in-chief,
Sunnybrook Health Sciences Centre &
Women's College Hospital.
Comments (5) |
#5 Submitted by on August 21, 2010 5:07PM
Hospital is a party & should be responsible for providing legal assistance when necessary. Any adverse out come to psychiatrists could result in adverse out come to the hospital because of coperate liabilty CTO co-ordinators are a significant sourse of support & hearing go well & are rarely appealed. Expanding their role to assist psychiatrists in all CCB matters will reduce grounds for appeal As a member of CCB & ORB I see the advantage of such a model. I made apresentaion at the annual meeting of CCB last year at the Chairs request how such amodel will work & the cost effectiveness Ill be happy to discuss with any one interested Ranjith Chandrasena Chief of Psychiatry Chatham Kent Health Alliance | |
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#4 Submitted by on August 19, 2010 9:13AM
Agree that psychiatrists should have legal representation if requested likely by hospital counsel . As far as who should pay costs - given that appearance is mandated by legal requirement - I think government should pay. It would at least bring to attention the growing costs associated with process. PConlon Chief of Psychiatry AMGH Goderich | |
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#3 Submitted by on August 18, 2010 10:04AM
I agree with the above opinions. We had complex cases in the past and after much discussion, the hospital provided is with a lawyer. I believe this should be the OHAs position. Anil Joseph MD, FRCPC Chief of Psychiatry Sudbury Regional Hospital Sudbury, ON | |
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#2 Submitted by on August 17, 2010 1:01PM
I agree with the above opinions. Clearly psychiatrists need to have the ability to fully represent themselves at an appeal. If psychiatrists are asked to shoulder the burden themselves financially it will make attracting psychiatrists to Schedule 1 facilities much more difficult .One might never know when you might have to pay $100K or more personally in legal bills. Its not fair to ask CMPA to foot the bill for the appeal only,as this introduces the possibilty the CMPA would not agree with the arguments used at the CCB hearings,which may have been influenced by a Hospital lawyer.This would suggest CMPA should provide all legal support,which I doubt they are willing to do. I believe that we should argue with any hospital that refuses to pay appeal costs that it will have significant difficulties staffing its units. Could we bring this to the OHAs attention? Greg Jaychuk MD FRCPC Medical Director, Bluewaterhealth, Sarnia Ont. | |
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#1 Submitted by June Hylands on August 12, 2010 9:49AM
Hello Anthony, It is a very interesting question. Anecdotally I have dealt with a similar situation at Markham Stouffville Hospital and after the same sort of response and much discussion I was represented by hospital legal counsel. Same thing at Osler Im told but no cases in the last couple of years. My opinion is that Hospitals should be providing the lawyers. Physicians can not certify unless working in a Schedule 1 Hospital Facility and I would think that it is incumbent upon the Hospital to provide necessary supports, including the occasional appeal to a higher court. If there were legal action or College complaint initiated against the Physician for alleged impropriety or negligent care around a certification, than more clearly CMPA would be appropriate. However this is just my opinion and I am not aware if there are other precedents around the province. We can try and survey Chiefs, as June suggested, using our recently updated web site and data base andor Im happy to pose the question to the OHA Mental Health Leadership Council at their next meeting. I agree that a consistent approach amongst hospitals and CMPA would be helpful and in that regard an opinion from the OHA may be of help. Regards, David David Koczerginski MD FRCPC Chief of Psychiatry Medical Director, Mental Health and Addictions William Osler Health Centre |