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February 7, 1986

Defendant: A Psychiatrist on Trial for Medical Malpractice

JAMA. 1986;255(5):660. doi:10.1001/jama.1986.03370050102032

This is a slender blue paperback book that begins innocently enough as an account of one doctor's encounter with a medical malpractice suit. It ends on a deeply disturbing note. By then it is clear that medical malpractice is not just an economic or legal problem. It is one of the most personal and far-reaching of the many ailments that beset contemporary medicine.

The physician is a psychiatrist who initiated treatment of her patient in December 1974. Therapy had continued and progressed during most of 1975. On December 16, 1975, the psychiatrist's telephone rang. She was informed that her patient had jumped from a rooftop and was receiving treatment in the intensive care unit at a nearby hospital. The physician had consulted with her patient by telephone earlier that morning, and the patient had made an appointment to be seen in two days.

Later, it was established that the patient