Abstract
Ethical and medicolegal issues are an inherent part of difficult psychiatric consultations and, as we have illustrated, create special challenges for the consulting psychiatrist working with both pediatric [Ascherman and Rubin (Child Adolesc Psychiatr Clin N Am 17:21–35, 2008)] and adult populations [Arras and Steinbock (Ethical issues in modern medicine, Mayfield, 1998); Gutheil et al. (J Am Acad Psychiatry Law 33(4):432–436, 2005)]. Among the key issues which must frequently be addressed include: autonomy , nonmaleficence , beneficence , and justice . Additionally, the consulting psychiatrist should be savvy regarding the state laws related to involuntary hospitalization as well as the process by which this occurs. Finally, it is critical for the consulting psychiatrist working with the difficult psychiatric consultation to have a strong working understanding of confidentiality , privilege , and the limits limitations of these concepts.
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