Are clinicians responsible for
clients’ self-inflicted injuries?
BY MARC W. PEARCE, JD, PHD, UNIVERSITY OF NEBRASKA–LINCOLN
M.Reeves had a history of mental illness dating to 2001, and in August 2005 she attempted suicide. This led to
Reeves’s involuntary commitment to a regional hospital. Within
approximately one week, her commitment status was changed
from involuntary to voluntary, and she was moved to a group
home. She was then discharged at her own request on Aug. 17.
On Aug. 23, Reeves was voluntarily re-admitted to the group
home “because of clinical instability and danger of suicide.” Three
days later, she was visited by psychiatrist Mark Peterson, MD, who
had been treating Reeves since December 2001. Peterson diagnosed severe major depressive disorder with psychosis and bipolar disorder with psychosis, and he prescribed medication.
On Aug. 29, Reeves was discharged from the group home for
unspecified reasons. Then on Aug. 31, she doused herself with
gasoline and set herself on fire.
Reeves sued Peterson, alleging that he was legally responsible
for the injuries she suffered during her suicide attempt. Peterson
argued that the case should not proceed to trial because he had
no duty to involuntarily commit Reeves; he had no control over
Reeves when she injured herself; and his acts or omissions were
not the legal cause (i.e., “proximate cause”) of Reeves’ injuries.
The trial court rejected Peterson’s arguments, but the Georgia
Court of Appeals agreed to consider them before allowing the
case to go forward. In a splintered decision (the seven judges
issued four different opinions), the court of appeals concluded
that Reeves’s lawsuit should be resolved by a jury (Peterson v.
Reeves, March 30, 2012).
Two of the appellate judges concluded that under some
circumstances, a failure to involuntarily commit a suicidal patient
could constitute a breach of a physician’s duty of care to the
patient. Two other judges wrote a separate opinion to clarify
that in their view, mental health professionals did not have “an
affirmative duty” to involuntarily commit a potentially suicidal
patient. All four of these judges agreed, however, that a trial was
warranted because there was evidence showing that Reeves was at
a high risk for suicide when she was discharged on Aug. 29; that
Peterson breached his duty of care by failing to perform a proper
suicide-risk assessment, failing to stabilize Reeves in a proper
medication regimen, and failing to be available for consultation
(or to arrange for another psychiatrist to be available for
consultation) on the day of Reeves’s discharge; and that Reeves’s
suicide attempt was a reasonably foreseeable consequence of
Peterson’s negligence. These four judges also rejected Peterson’s
argument that he was not responsible for Reeves’s injuries because
he lacked physical control over her when she attempted suicide.
Two other judges wrote two separate dissenting opinions
noting that in Georgia, physicians had never before been held
liable for failing to involuntarily commit someone, nor had
they ever been held liable for failing to prevent a suicide when
the patient was not under the physician’s control. They also
emphasized that Peterson was not consulted about Reeves’
discharge; that Peterson’s last visit with Reeves was too far
It would be wise for clinicians in
all states to investigate whether
their treatment of potentially
suicidal clients could expose them
to legal liability.
removed from her suicide attempt to constitute a proximate
cause; and that none of Reeves’s expert witnesses was willing
to state that Peterson’s failure to involuntarily commit Reeves
on Aug. 26 fell “below the standard of care.” The dissenters
also noted that a legal duty to involuntarily commit potentially
suicidal patients could expose physicians to liability for false
Last January, the Georgia Supreme Court declined to
consider Reeves’s case — which means that the court of
appeals’s decision stands, and presumably the case will proceed
to a trial or settlement. It is important to note that the decision
is based on general principles of negligence law that could
apply not only to psychiatrists, but also to psychologists. Thus,
although the law of negligence varies somewhat from state to
state, it would be wise for clinicians in all states to investigate
whether their treatment of potentially suicidal clients could
expose them to legal liability. n
“Judicial Notebook” is a project of APA Div. 9 (Society for the
Psychological Study of Social Issues).