Therapists
and counselors typically purchase malpractice insurance in order to protect
themselves from claims and lawsuits alleging, among other things, that the
practitioner was negligent (by acting in a certain manner or by the failure to
act in a certain manner) with respect to the treatment of a client or patient.
If negligence is proven, or is apparent or arguable, the practitioner may have
liability (e.g., responsibility to pay money damages). Plaintiffs’ lawyers can
easily and inventively allege theories of negligence (or intentional
misconduct) in their efforts to establish liability. In most states, therapists
and counselors are given “immunity from liability” in limited circumstances. It
is useful to know when immunity from liability may be available, how one
achieves it, and what it actually means.
Immunity
from liability essentially means that one is not subject to a lawsuit or to
monetary liability if the circumstances extant meet the requirements of a
particular statute granting immunity. When it is said that one is not subject
to a lawsuit, it must be remembered that generally, anyone can sue anyone else
for anything. A statutory grant of immunity would mean that once a lawsuit is
filed and served, the lawsuit can be dismissed forthwith upon the proper
request (e.g., a motion for summary judgment) by counsel for the person
entitled to the immunity. If one is not covered by a grant of immunity, this
generally means that the case will not be dismissed at an early stage of the proceedings
and that the issue of negligence, and the resulting liability if one is found
to be negligent, will be determined at trial by either judge or jury.
Immunity
from liability is created by statute. It is the exception rather than the rule.
It is not easy for immunity statutes to be passed by state legislatures because
associations representing trial lawyers will usually lobby intensively to
prevent or limit the grant of immunity. Trial lawyers generally favor a public
policy that allows for the filing of lawsuits without limitation or
interference, and the trial of those lawsuits without the threat of a premature
dismissal as the result of a statutory immunity. In order for an immunity
statute to be passed, there will generally need to be a strong public policy
interest demonstrated in order for a legislature to grant immunity to a
particular kind of “actor.” There are immunities granted in law to a variety of
“actors,” such as judges, law enforcement officers, governmental entities or
individual office-holders, good Samaritans, and health care practitioners.
With
respect to therapists and counselors, one of the most common immunities granted
by state law is the immunity from civil or criminal liability for reporting (as
required or authorized) known or reasonably suspected child abuse or neglect.
Each state’s law may be worded differently, and nuances exist between the
various state laws. For instance, in one state the immunity applies whether or
not the therapist was negligent in determining that a report must be made. The
immunity in this particular state is absolute, and would apply even if the
therapist was grossly negligent, or arguably, if the therapist did not act in
good faith in making the report. Additionally, the immunity applies if the mandated
reporter acquired the knowledge or reasonable suspicion of child abuse or
neglect outside of his or her professional capacity or outside the scope of his
or her employment, but nevertheless filed a child abuse report – although not
required. How broad is the immunity for reporting child abuse or neglect in the
state in which you practice?
Another
common immunity granted to therapists or counselors can usually be found in the
“elder” or “dependent adult” (or similar title) abuse reporting laws. This immunity
will usually be patterned after the immunity granted in the case of child abuse
reporting, but it need not, nor may not, be identical. Another area of the law
where one may find an immunity granted (by statute) to psychotherapists
involves dangerous patients. In California, for instance, where the famed
Tarasoff case was decided by the California Supreme Court in 1976, there is a
statute that provides immunity from monetary liability to therapists who, under
specified circumstances, take certain actions in order to prevent the
threatened violence of the patient. The same statute, described below, also
provides immunity from monetary liability to therapists who fail to predict and
warn of and protect from a patient’s violent behavior.
With
respect to the specific actions that must be taken, this immunity statute
provides that the therapist must make reasonable efforts to communicate the
threat to the victim or victims and to a law enforcement agency. If
the therapist complies with the statute, assuming that his or her actions have
been triggered by the communications of the patient to the therapist of a
serious threat of physical violence against a reasonably identifiable victim,
he or she will have no monetary liability and a cause of action shall not
arise. I have often thought of a case where the therapist does make reasonable
efforts to communicate the threat as specified above, but is aware that the
police are not going to do anything – despite the notification to them by the
therapist. Assuming that the therapist should have hospitalized the patient
when the police indicated that they would not act, the therapist would
nevertheless be entitled to immunity from liability under the statute – even if
the failure to hospitalize constituted negligence.
Under
this statute, the failure to make reasonable efforts to communicate the threat
to the victim and to a law enforcement agency does not necessarily mean that
the therapist was negligent, or that the therapist will be held liable. It
simply means that the therapist will not be entitled to the immunity granted by
the statute, and therefore, the case may proceed to trial. As to the issue of
whether or not the therapist acted reasonably or negligently, a judge or jury
will ultimately decide the matter. In many of these cases, therapists will
decide to hospitalize patients. While hospitalization may constitute reasonable
action, and while the therapist may ultimately be found to have acted without
negligence, there is no immunity from liability because the statute has not
been followed. In other states, however, hospitalization of the patient may
entitle the practitioner to immunity from liability. Additionally, some states
may offer immunity if solely the intended victim is notified of the threat
(e.g., no notification of law enforcement). Obviously, one must carefully
examine the immunity statute in the state in which he or she practices in order
to determine what actions may result in this broad protection for the
practitioner.
There
may be a variety of other immunities in state law that, in one way or another,
affect therapists or counselors, although they are not often discussed. For
instance, in some states, there may be immunity granted to persons who serve on
professional association ethics committees or other peer review committees -
under specified circumstances and with specified limitations. Likewise, there
may exist some immunity for persons who communicate with specified educational
institutions about the character or fitness of persons pursuing a license to
practice in a health care profession, or for communications with health care
licensing boards investigating a complaint. In some states, professional
associations may have immunity from liability for operating a referral or
information service for the public.
It is important to remember that with each grant of
immunity there will likely be limitations or exceptions. Careful attention must
therefore be given to the terms and conditions of the immunity statute
involved. While it is advantageous to have immunity from liability, it also
should be remembered that if immunity from liability does not apply, this does
not generally mean that the therapist or counselor will later be held liable.
It simply means that the case will likely not be subject to early dismissal and
that it may proceed to a trial. Of course, the vast majority of lawsuits are
eventually settled (where immunity from liability does not apply).