GUILTY France - Dr. Daniele Canarelli charged after patient commits murder, Marseille, 2004

[Abby Normal Again]

There is no point in less secure facilities anymore- because what psychiatrist in their right mind would EVER choose the less secure option now? None. Because if that person does something bad not only is your professional life over- but you can be held criminally accountable.

If a completely mentally stable person can choose to murder, then there is NO guarantee that a mentally ill person will never choose to murder. Therefore, the only logical conclusion is to treat them all the the maximum capacity- even if that is not what is professionally logical.

Are we going to hold doctors responsible for surgeries that aren't successful, too? Shouldn't they have 100% perfect results all the time? Doctors are people working in saving, not gods. They do not have godly capabilities.

 

[jjenny]

There is no point in less secure facilities anymore- because what psychiatrist in their right mind would EVER choose the less secure option now? None. Because if that person does something bad not only is your professional life over- but you can be held criminally accountable.

If a completely mentally stable person can choose to murder, then there is NO guarantee that a mentally ill person will never choose to murder. Therefore, the only logical conclusion is to treat them all the the maximum capacity- even if that is not what is professionally logical.

Are we going to hold doctors responsible for surgeries that aren't successful, too? Shouldn't they have 100% perfect results all the time? Doctors are people working in saving, not gods. They do not have godly capabilities.

Keep in mind that this was in France. It's not going to affect US law. But I don't mind that psychiatrists be held responsible for their patients if they know these patients are dangerous but don't secure them.

 

[Abby Normal Again]

Keep in mind that this was in France. It's not going to affect US law. But I don't mind that psychiatrists be held responsible for their patients if they know these patients are dangerous but don't secure them.

Of course. I personally don't see injustice as being divided by nation. We're all humans in this together and all that jazz.

If there is evidence of gross negligence, then I agree with you. But I'm not seeing any indication of that, even after reading some of the more in depth articles in french. There is no standard protocol of symptoms that she ignored or hid. It was a judgment call. Doctors routinely make judgment calls. Nothing is 100% without omniscient powers.

 

[MyBelle]

Of course. I personally don't see injustice as being divided by nation. We're all humans in this together and all that jazz.

If there is evidence of gross negligence, then I agree with you. But I'm not seeing any indication of that, even after reading some of the more in depth articles in french. There is no standard protocol of symptoms that she ignored or hid. It was a judgment call. Doctors routinely make judgment calls. Nothing is 100% without omniscient powers.

Omniscient powers weren't required. A little common sense was requireed. There is still a need for accountability in all professions. Judgment is supposed to based on many factors. There was a four-year doctor/patient relationship with examples of deteriorating behaviors and violent episodes. The patient escaped and the doctor did zip. The doctor failed in providing an acceptable standard of care.

JMO

 

[mikkismom]

http://www.reuters.com/article/2012/12/18/us-france-murder-psychiatrist-idUSBRE8BH13X20121218

"The court said Canarelli should have requested Gaillard be placed in a specialized medical unit or referred him to another medical team, as one of her colleagues suggested. Her stubborn refusal had equated to a form of "blindness", the court president Fabrice Castoldi said.

Gaillard had already been forcibly committed to a secure hospital on several occasions for a series of increasingly dangerous incidents."

bbm

She received a one-year suspended sentence and was ordered to pay the victim's family 8,500 Euros.

MOO is that in a situation like this, no one person should be able to make a decision like this. One colleague suggested he be placed in a special unit, she said 'No'. I wonder if a third colleague would have been available, what the outcome would be?

jmo

 

[CocoChanel]

I can see we have some polarized opinions of this issue.
It is an interesting discussion for sure.

I wonder if our division is marked by those who are in a 'helping profession', and those who are not, with a few exceptions.

 

[Abby Normal Again]

Omniscient powers weren't required. A little common sense was requireed. There is still a need for accountability in all professions. Judgment is supposed to based on many factors. There was a four-year doctor/patient relationship with examples of deteriorating behaviors and violent episodes. The patient escaped and the doctor did zip. The doctor failed in providing an acceptable standard of care.

JMO

Read the article again. She had him forcibly admitted to a SECURE mental hospital. When he escaped, she notified police.

Her "negligence" was in not referring him to another medical unit or a different medical care provider. France does not have a higher designation of psychiatric care provider, either, so she was not failing to refer him to a more qualified designation. There was no protocol that said "if symptoms reach xyz point, please refer patient to xyz medical group or unit." There was no standard to which she failed.

She provided forcible psychiatric care, to someone she is licensed to treat, and he escaped. Why aren't they holding the hospital criminally liable for letting him escape? It WAS a secure facility after all. hint: 77% of health care in France is government run.

Also: she was not sued for malpractice, she was found criminally responsible for manslaughter.

 

[jjenny]

No, the article doesn't say she had him forcibly admitted to a secure mental hospital. It says he had been admitted to a secure mental hospital on a number of occasions (prior to this incident, I presume).

 

[Abby Normal Again]

JJenny- If he was not under secure restrictions at that time, how could this be a logical course of events? "Canarelli had notified police and other authorities after her patient's escape."

There are other articles to look up as well. How does an outpatient "escape"?

I don't know if this has been stated in English articles yet, but the french articles state that the victim was his grandmother's partner/boyfriend/husband. Perhaps, if police were looking for him as this doctor requested, they could have started with the most likely place he would have and did go? There was a period of 20 days between between her reporting him missing and him becoming violent.

 

[Abby Normal Again]

The person who did this has been found criminally irresponsible. In another facility, now. Will not face trial.

The hospital he was being held in was found responsible in what equates to a civil (not criminal) case. Which makes sense to me. (and also shows that the person was currently locked up)

She was not tried in a civil manner, she was prosecuted in a criminal court room. There was nobody else to pay criminally, so she paid.

It's a sad era for the French medical community.

 

[Nova]

People need to be accountable. If they are hired and paid to do a job, and failure to do that job results in a foreseeable disaster, then there should be some form of consequences ... shouldn't there? Isn't that's how it's been in the US for a very long time? Lawsuits seem very common. It seems like the only difference here is that, instead of lawsuits where one private citizen gets rich due to the fault of another, instead of someone opening their wallet to settle the problem, the person at fault is prosecuted. Seems like a better system, in some ways.

Think about it ... if person A does something incorrect that results in the death of person B, then, should person A be:

a. prosecuted for negligence and rehabilitated, or
b. forced to pay person C a bunch of money and continue in the professional where they have failed?

Which is more likely to protect society in the long run?

The Italian ship captain that caused fatalities by taking the ship too close to shore is being prosecuted because he screwed up in his job. It seems to me to be the same situation.

The Italian ship captain is being prosecuted for HIS actions, not because he failed to predict the actions of others.

There are two problems with the conviction of the psychiatrist: (a) it assumes that psychiatry as a science has powers of prediction it does not possess; and (b) it makes the shrink an agent of LE, a serious impediment to the trust necessary for effective treatment.

Yes, psychotherapists should report violent threats made by their clients, as required by law, but convicting shrinks for failing to predict violence when no threat has been made is a very bad idea.

 

[otto]

Unfortunately we do not yet have the science to predict human behavior based on behavioral output. It's not an exact science that enables doctors to make perfect calls every time.

Without omniscience, you can not expect omniscient results.

What they effectively did is reduce the number of people willing to go into this field of helping others by at least half. He/she did not fail at their job, because NOBODY is able to make perfect calls every time. Because they are human doctors, not gods.

Other professionals advised that this particular patient required additional supervision, and recommended more restriction. This particular psychiatrist disagreed. That was a serious error in judgment. Other's in the profession should be careful to protect the integrity of the profession.

There is no place for an incompetent psychiatrist. If half of the psychiatrists leave the field because of a fear of being found incompetent, that would be best. No one wants an incompetent psychiatrist recommending that insane people be placed in environments where they may realize their murderous fantasies.

 

[Nova]

Other professionals advised that this particular patient required additional supervision, and recommended more restriction. This particular psychiatrist disagreed. That was a serious error in judgment. Other's in the profession should be careful to protect the integrity of the profession.

There is no place for an incompetent psychiatrist. If half of the psychiatrists leave the field because of a fear of being found incompetent, that would be best. No one wants an incompetent psychiatrist recommending that insane people be placed in environments where they may realize their murderous fantasies.

You do not know what you are talking about. There isn't a psychotherapist on the planet who has perfectly predicted the behavior of all his or her clients.

If there were, we could just give everyone a psych test and lock up future criminals in advance.

 

[otto]

Psychiatry isn't like taking your car to the shop. It isn't a clean mechanical process.

This situation is tragic - but for goodness' sake, I think sinking to this level litigiousness is not the way to address it.

Let's attempt to put this in perspective -- thousands of murderers, rapists, child killers and pedos are released from prison every year, to clutter up this forum with repeats of the same horrendous crimes that put them in prison in the first place.

Think about the agonies suffered by their thousands of victims, all those kids, partners lost, lives and bodies and minds shattered, all the pain they cause because some folks decide for whatever unfathomable reason to let them ---out--- of prison to walk among innocents.

How about making a comparison between that endemic, monumentally stupid and damaging state of affairs, and this ONE possible error made by ONE doctor who's dedicated their life to improving the human condition?

And you know, just get real.

What if this happened in the middle of Texas. Could there be a lawsuit against the facility and the psychiatrist ... settled with a bucket of money ... and the psychiatrist could go on to make the same mistake again?

 

[otto]

12/18/12: French psychiatrist sentenced after patient commits murder

... Gaillard [the patient who hacked to death 80yo] was not held responsible for his actions and was freed under medical supervision.

http://www.reuters.com/article/2012/12/18/us-france-murder-psychiatrist-idUSBRE8BH13X20121218

Thanks for the link!

"A court in Marseilles said Daniele Canarelli, 58, had committed a "grave error" by failing to recognize the public danger posed by Joel Gaillard, her patient of four years.

...

Canarelli was handed a one-year prison sentence and ordered to pay 8,500 euros to the victim's children, in the first case of its kind in France.

...

The court said Canarelli should have requested Gaillard be placed in a specialized medical unit or referred him to another medical team, as one of her colleagues suggested. Her stubborn refusal had equated to a form of "blindness", the court president Fabrice Castoldi said.

Gaillard had already been forcibly committed to a secure hospital on several occasions for a series of increasingly dangerous incidents."

He's back in psychiatric care, and I think we can be sure that this time, he will be reffered to the correct medical team.

http://www.reuters.com/article/2012/12/18/us-france-murder-psychiatrist-idUSBRE8BH13X20121218

 

[otto]

I agree. I think those that allowed him to escape should share in this punishment. If he "escaped" he obviously was not supposed to leave the premises and someone was supposed to be watching him. Begs the question - who is really at fault here?

Salem

The psychiatrist was supposed to be watching him when he escaped, and apparently the psychiatrist placed him in a situation where he could escape ... and he did ... and he butchered an 80 year old man before he was recaptured and returned to psychiatric care:

"Gaillard hacked to death 80-year-old Germain Trabuc with an axe in March 2004 in Gap, in the Alps region of southeastern France, 20 days after fleeing a consultation with [psychiatrist Daniele Canarelli], 58, at Marseilles's Edouard Toulouse hospital."

http://www.reuters.com/article/2012/12/18/us-france-murder-psychiatrist-idUSBRE8BH13X20121218

 

[otto]

Omniscient powers weren't required. A little common sense was requireed. There is still a need for accountability in all professions. Judgment is supposed to based on many factors. There was a four-year doctor/patient relationship with examples of deteriorating behaviors and violent episodes. The patient escaped and the doctor did zip. The doctor failed in providing an acceptable standard of care.

JMO

I absolutely agree. I see no risk to the reputation of professional psychiatrists. I see no reason for professional psychiatrists to be so paranoid of being found incompetent that they should avoid the professoin. Upholding the integrity of the profession should be more important than ducking the consequences of a fatal error in judgment. Psychiatrists shouldn't make that type of mistake after working with a patient for 4 years. She ignored advice from colleagues, ignored increasingly violent behavior and placed a murderer in a position where he was in charge long enough to escape.

 

[otto]

I can see we have some polarized opinions of this issue.
It is an interesting discussion for sure.

I wonder if our division is marked by those who are in a 'helping profession', and those who are not, with a few exceptions.

This is a helping profession, but it is a very specialized area of the helping profession. These are the people that understand how neurological changes impact behavior ... medicine, brain and behavior.

Surely French Psychiatrists are not paranoid ... afraid to ply their trade simply because an incompetent psychiatrist has been ordered to compensate the family (very small award) and assigned one year of prison rehabilitation.

 

[otto]

Also: she was not sued for malpractice, she was found criminally responsible for manslaughter.

<respectfully snipped>

That is exactly the point. She could be found guilty by the French people and sentenced ... but in the US she would most likely be sued for malpractice and then she would be free to continue making serious, potentially fatal, errors in judgment.

Which is better for society?

a. the family gets a bucket of money (malpractice lawsuit), or
b. the guilty party, in this case the psychiatrist, is prosecuted for incompetence and is rehabilitated (it's only a year)

 

[otto]

The Italian ship captain is being prosecuted for HIS actions, not because he failed to predict the actions of others.

There are two problems with the conviction of the psychiatrist: (a) it assumes that psychiatry as a science has powers of prediction it does not possess; and (b) it makes the shrink an agent of LE, a serious impediment to the trust necessary for effective treatment.

Yes, psychotherapists should report violent threats made by their clients, as required by law, but convicting shrinks for failing to predict violence when no threat has been made is a very bad idea.

The Italian ship captain and the French psychiatrist made exactly the same mistake. In their professional capacities, they made a serious error in judgment that resulted in fatalities.