title: Legal vulnerabilities in the treatment of chemically dependent dual diagnosis patients.
abstract: Substance abusing patients with significant psychiatric disorders can present unique legal vulnerabilities for treatment professionals. The tendency within the chemical dependency community to treat patients uniformly can militate against the individualized treatment planning that satisfies legal obligations to act in the best interest of the patient. The failure to adequately consider both the psychiatric disorder and substance abuse problem may create legal vulnerabilities that issue from the failure to refer a patient in need of medication or the failure to prevent the suicide of a patient in a situation where suicide is preventable. Patients suffering harm from acts of commission or omission of a chemical dependency treatment specialist have recourse through laws regarding negligence. Variations in the backgrounds and training of care providers create problems for the harmed patient in establishing a standard of care for the treatment of chemical dependence. However, the psychological symptoms of the dual diagnosis patient make it easier to establish a standard of care that may be legally cognizable. The chemical dependency specialist--of whatever discipline--has a duty to patients that requires sound assessment and disposition.
authors.affiliation: University of California, San Francisco.
authors.forename: H W
authors.initials: HW
authors.lastname: Clark
authors.forename: J E
authors.initials: JE
authors.lastname: Zweben
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000523:psychology; D014151:Anti-Anxiety Agents; D001569:Benzodiazepines; D005260:Female; D006801:Humans; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence*; D001523:Mental Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D010200:Panic; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D014481:United States
chemical_list: D014151:Anti-Anxiety Agents; D001569:Benzodiazepines