Medicolegal Considerations in the Psychiatric Management of Pregnancy and Postpartum Disorders
Allison R Horan1, Dale E McNiel2, Renée L Binder2
1Dr. Horan is a forensic psychiatrist, Dr. McNiel is a professor emeritus of clinical psychology, and Dr. Binder is a professor of psychiatry and Director, Psychiatry and the Law Program, University of California, San Francisco, San Francisco, CA. allison@doctorhoran.com.
Abstract:
Psychiatrists who treat mental disorders in pregnancy must navigate the risks associated with prescribing medication to pregnant and breastfeeding people alongside the risks associated with untreated mental illness. This article examines how U.S. courts have engaged with this complex landscape when tasked with evaluating allegations of clinician and pharmaceutical negligence in cases involving pharmacological management of perinatal mental health disorders (PMHDs). We begin first with a review of the legal theories that form the basis of negligence lawsuits related to PMHDs. We then explore cases of both pharmaceutical negligence (which are usually pursued under product liability claims) and professional negligence (i.e., malpractice), distinguishing how the courts' interpretation of liability has varied for errors of omission and errors of commission. We then provide an analysis of relevant themes in this area of case law with the goal of informing expert witnesses of considerations when called to opine upon questions related to negligence in the treatment of PMHDs.
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