Paul S. Appelbaum, MD

Can Drug Users Be Forced Into Rehab? Trump Says Yes. So Do 34 States.

An excellent overview of laws on involuntary commitment of drug users. As I said, “Passing a law doesn’t create a system. Treatment of addiction is difficult and takes time. It is not something that’s going to be solved in 30 days.” www.nytimes.com/2025/09/17/h...

🧬 What happens when a genetic therapy is made for just one patient? How do we support and regulate development?
@sandrasoojinlee.bsky.social and @appelbap.bsky.social from our Division discuss the ethical implication of “research-treatment hybrids”.
🔗https://jme.bmj.com/content/51/5/jme-2023-109729

New pre-print online: Imputing parental genotypes through Mendelian Imputation: Ethical and Legal Considerations
osf.io/preprints/ps...

Gold Dust : The Hastings Center for Bioethics The United States has never had a situation in which political and ideological nonscientists got the last word about what is credible science. The direct political oversight of science represented in ...

An important alert on the implications of an Executive Order on "gold standard science" that many of us may have missed: www.thehastingscenter.org/gold-dust/

What do we know about how mental illness affects pretrial defendants' chances of reoffending or failing to appear for trial? Answer: Not very much. See our new article: A Scoping Literature Review of Mental Illness in Decisions Regarding Pretrial Release jaapl.org/content/earl...

Our analysis of the impact of abortion restrictions on mental health in pregnancy, just out today: :https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2836537?utm_source=bluesky&utm_campaign=content-shareicons&utm_content=article_engagement&utm_medium=social&utm_term=071625

Our systematic review or the literature on the psychosocial impacts of autism-related genetic testing is now online (in preprint format) at JAACAP: doi.org/10.1016/j.ja...

The Ethical Minefield of Testing Infants for Incurable Diseases

The capacity of newborn genomic screening to identify risks for conditions without effective treatments, along with diseases that may develop much later in life, can create challenges for parents and offspring alike: www.nytimes.com/2025/06/05/h...

The new American Law Institute Restatement on Medical Malpractice portends changes in how the courts assess clinician liability, with more emphasis on evidence-based care. Neil Kaye and I discuss here: psychiatryonline.org/doi/epdf/10....

An analysis of firearm legality and lethality in 625 U.S.‐based mass murders involving firearms Understanding the relationship between firearm regulations and the lethality of mass murder involving firearms has implications for prevention efforts. We examined 625 incidents of mass murder involv...

Most firearms used in mass shootings in the US are legally acquired--and legal guns are associated with higher number of fatalities. Another reason why focusing exclusively on illegal possession won't stop the violence epidemic. onlinelibrary.wiley.com/doi/10.1111/...

Mental health care may be harder to obtain after HHS rule reversal Access to care could be affected, following HHS indication that it will not enforce updates adopted in 2024 to the mental health parity law.

Flying under the radar, HHS announces it no longer intends to enforce mental health insurance parity rules. The inevitable result: markedly reduced access to treatment. www.statnews.com/2025/05/13/h... via @statnews

What am I supposed to say to this generation of young scientists? Undermining the future of American science is not a path to accountability — it’s a path to decline.

"let’s be clear: It isn’t institutions that are being punished. It’s the researchers who are the future of science in this country"

What am I supposed to say to this generation of young scientists? www.statnews.com/2025/05/07/u... via @statnews.com

Two men in ICE custody died of ‘natural’ causes. Were their deaths preventable? Top medical experts reviewed records and questioned the treatment two immigrants received before their deaths. “That’s certainly substandard care,” said one neurologist.“That’s certainly substandard c...

No one dies of "complications of schizoaffective disorder." Disturbing questions about the quality of care rendered people in ICE custody, including people with mental illness: www.miamiherald.com/news/local/i...

In this new article, Stephanie Rolin and I review the expansion of liability for colleges and universities in addressing students with mental health issues: rdcu.be/ekaDC

Were the Menendez Murders Justified? Increasingly, judges are giving lighter sentences to criminals who suffered abuse during childhood. That could be good news for the Menendez brothers.

To what extent should childhood abuse be taken into account in sentencing for murder of the abuser? The Menendez brothers' case is dealing with exactly that question: www.thefp.com/p/the-menend...

Mental Health AI Chatbot Rivals Human-Based Tx in Less Time A generative AI–powered therapy chatbot is linked to significant reductions in symptoms of depression, anxiety, and eating disorders, results of a randomized controlled trial show.

A study of AI chatbots for treatment of mental disorders has gotten attention recently, but we should restrain our enthusiasm until some key questions are answered: selection bias? appropriate control? duration of effect? human supervision required? www.medscape.com/viewarticle/...

Lonely Planet: How the World Is Fighting Social Isolation Loneliness has become a global health crisis, linked to depression, dementia, and early death. With over a billion people affected, how are countries working to reconnect us?

Social isolation and loneliness are common problems that bring people into psychiatric treatment--and are widely prevalent outside of treatment settings as well. Clinicians need to pay more attention to these factors and help patients break the cycle of isolation. www.medscape.com/viewarticle/...

How the NIH dominates the world’s health research — in charts Abrupt cuts by the Trump administration to the US National Institutes of Health threaten progress in medical research globally.

How the NIH dominates the world’s health research — in charts www.nature.com/articles/d41...

Inside the Collapse at the NIH Administration officials pressured the NIH to avoid clear advice from the agency’s own lawyers to restart grant funding now.

A fascinating and terrifying look inside the chaos at NIH--and an answer to the question of why, despite court orders, grant funding has not started flowing again: www.theatlantic.com/health/archi...

How Progressives Froze the American Dream The U.S. was once the world’s most geographically mobile society. Now we’re stuck in place—and that’s a very big problem.

[Off-topic alert] The loss of geographic mobility in America and its effect on economic prosperity, social solidarity, and political polarization. The Atlantic's March cover story, adapted from my son Yoni's new book: www.theatlantic.com/magazine/arc...

For the moment, at least, PubMed seems to be back online.

PubMed, the indispensable online index of medical literature--essential for all types of medical research--seems not to be accessible. Another effect of the freeze of federal funding? What's next? pubmed.ncbi.nlm.nih.gov

Is There a Role for Palliative Care of Severe and Chronic Mental Disorders? | Psychiatric News PsychiatryOnline.org is the platform for all American Psychiatric Association Publishing journals, DSM, and bestselling textbooks, as well as APA Practice Guidelines, and continuing medical education.

This report on the effort to characterize psychiatric treatment of some chronic disorders as "palliative care" includes my thoughts on why that's a really bad idea. psychiatryonline.org/doi/10.1176/...

Treatment Expectancies and Psilocybin vs Escitalopram for Depression This randomized controlled trial secondary analysis examines the association between treatment expectancies and the relative efficacy of psilocybin compared with escitalopram for major depressive diso...

Very interesting look at how treatment expectancies for psilocybin vs escitalopram for depression affected a trial outcome. Spoiler: the psychedelic was only superior for patients with low expectations for the antidepressant. jamanetwork.com/journals/jam...

Re: Assisted dying laws around the world: Proposed UK Assisted Dying Bill Fails the Public Safety Test

The UK is considering a bill legalizing physician-assisted death (likely being considered this week). I joined a number of colleagues in noting that the provisions would allow patients with treatable eating disorders to qualify, poor public health policy: www.bmj.com/content/387/...

I suspect not, though I can't be sure. Per the court's decision, they can insulate themselves from liability by disclosing material risks to the physicians who use their equipment.

We don't know a great deal about the psychiatrist's behavior from the published record, but as you say it appears that he did not inform his patient about the risk of memory issues (which I think was fairly routine). Also unclear why the patient elected not to sue the psychiatrist.

Electroconvulsive Therapy, Manufacturers’ Liability, and Learned Intermediaries | Psychiatric Services Manufacturers of drugs or devices that are prescribed by physicians are protected by the “learned intermediary rule” from having to disclose risks directly to patients. Instead, they must inform physi...

Manufacturers of drugs or devices don't have to disclose risks directly to patients because of the “learned intermediary rule.” But the Calif. Supreme Court recently expanded the ways patients can get compensated for undisclosed risks. My latest: psychiatryonline.org/doi/10.1176/...