Psychiatry in Law/Law in Psychiatry, 2nd ed

Article Abstract

From our regular book review column.

Psychiatry in Law/Law in Psychiatry, 2nd ed

by Ralph Slovenko, LLB, PhD. Routledge Taylor & Francis Group, New York, NY, 2009, 780 pages, $195.00.

Prof Ralph Slovenko is ideally suited to write such an extensive compendium (780 pages) in the areas of both psychiatry and law, since he has studied and written knowledgeably about the psychiatry-law interface for decades and has been a faithful attendee at the meetings of the American Academy of Psychiatry and the Law, the national forensic psychiatric organization. The first edition of this dual volume was published in 2002; Prof Slovenko notes that the present edition contains 11 new chapters, and the remainder of the book has been updated.

The concept is that of "two books in one," each of which looks at the other field from its native viewpoint. The section labeled Psychiatry in Law is divided into 5 parts: expert testimony, evidentiary issues, criminal cases, sexual deviation, and civil cases, each containing between 4 and 6 chapters. The section labeled Law in Psychiatry has 2 parts: hospitalization of the mentally ill and psychiatric malpractice. There are, remarkably, 3 indices: a case index, a name index, and a subject index, making it easy to find a reference in the text with only partial information. This is particularly useful, since, in this reviewer’s opinion, this tome serves best as a resource in which to look up particular issues, rather than as a text to be read cover to cover.

As the text walks the reader through the complexities of the law-psychiatry interface, Prof Slovenko’s energetic prose, meticulous discussion, and extremely detailed citations and notes clarify some of the obscurities in this area. Prof Slovenko’s familiarity with even peripheral legal and psychiatric literature is astonishingly broad. It would be little exaggeration to state that any important citation relevant to the psychiatry-law interface can be found in this volume.

There are particular areas in which Prof Slovenko serves the reader as a skeptical observer. For example, regarding blaming practitioners for economically determined faults, he notes that "economic accountability very much controls the nature or type of treatment. More and more, the fiscal third-party controls ‘ who gets what’ " (p 497).

He is also somewhat skeptical about the claimed damages from sexual misconduct. To cite just a few examples, admittedly out of context: "The symptoms usually suffered by patients as a result of the sexual intimacy [in sexual misconduct by a psychiatrist] are said, but not proven at trial" (p 604). And: "Women who have been raped suffer a ‘ rape trauma syndrome.’ Do women who are sexually involved with a therapist as a result of the transference phenomenon suffer a similar syndrome? The answer is no" (p 608).

Actually, in this reviewer’s experience of over 250 cases, the answer is, sometimes, yes. Similar skepticism is expressed about the validity of recovered memory and other points.

These quibbles aside, this text belongs on the shelf of every serious scholar concerned about the mutual impact the disciplines of psychiatry and law have had on each other in the early 21st century. It is a remarkable accomplishment by a remarkable teacher.

Thomas G. Gutheil, MD

Author affiliation: Department of Psychiatry, Beth Israel-Deaconess Medical Center, Harvard Medical School, Brookline, Massachusetts. Potential conflicts of interest: None reported.

J Clin Psychiatry 2010;71(12):1704

Volume: 71

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