Boundary Violations in Psychiatric Standard-of-Care Cases: Separating Ethics, Departure, and Causation in New York

Stephan M. Carlson, MD, MBA, FAPA · Psychiatric Malpractice

A boundary violation can be an ethics breach, a licensing matter, and a tort all at once—but they are not the same finding, and they do not prove each other. The forensic task is to keep the ethics question, the standard-of-care question, and the causation question on separate tracks, because conflating them is exactly what makes a boundary opinion easy to attack. Why a boundary violation is not automatically malpractice A psychiatrist who crosses a professional boundary—a sexual relationship with a patient, a business entanglement, excessive self-disclosure, a dual role—may face a professional misconduct charge, a licensure action, and a civil suit. But a New York malpractice plaintiff must

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