Clinical Handbook of Psychiatry and the Law, by T. G. Gutheil and P. S. Appelbaum. New York:  McGraw-Hill, 1982,  385 pp.

This volume is eminently readable and clearly designed for leading the mental health clinician (not only the psychiatrist) through the labyrinth of confidentiality, privilege, liability, competency, guardianship, forensic evaluation, and courtroom presentation. Each chapter begins with an outline of its contents. The text is thoroughly sectioned and headed to enhance accessibility. “Action guides” enable the clinician to follow enumerated steps necessary for applying legal principles to his own specific clinical-legal questions.

Rich in illustration, this volume effectively demonstrates how legal issues impinge on clinical practices. It is perhaps this, in keeping the clinician in the consulting room, though aware of legal practicalities, where Gutheil and Appelbaum most succeed. Never is the clinician presented as needing to compromise clinical concerns for legal reasons (“defensive” practice) or to think as he supposes a lawyer might. Rather, the authors encourage psychiatric nondefensiveness in the face of legal involvement, urging the psychiatrist to take sensible precautions yet to educate lawyers and judges about the legitimacy of the psychiatric point of view.

A second contribution of this book is in its clearly indicating those segments of the boundary separating law and psychiatry where fuzziness and inconsistency challenge even the most expert forensic psychiatric experience. For example, mental competency is a legal, nonpsychiatric, term indicating capacity to enter into contracts, handle one's affairs, and so forth. The legal definition of competency is so vague as to depend virtually on individual judicial determination. Now, consider the dilemma of the psychiatrist who wishes to hospitalize a grossly psychotic, unquestionably incompetent patient, but one who agrees to voluntary admission. Despite the psychiatrist's awareness that the patient is not truly “competent” to agree to hospitalization, medical ethics dictates that the psychiatrist forego the ent