Legal and Ethical Considerations in the Treatment of Psychosis

A variety of legal and ethical issues surround any decision about the treatment of patients with psychosis. These issues have come to the forefront with the introduction of the atypical antipsychotic agents. The law defines the minimum expected level of conduct for a health care professional, and where the law ends, ethics begin. Adverse drug reactions are a leading cause of death in the United States, and medication error is a common reason for liability claims against health care professionals. Patients alleging negligence must prove that the health care professional owed a duty to the patient, that the duty was breached, that the patient was injured, and that the breach of duty was the legal cause of the injury. Professional ethics are governed by various models for ethical decision making. The principles model, which can be readily applied to the patient with mental illness, is based on the ethical principles of beneficence, nonmaleficence, autonomy, utility, and justice.