Paul S. Appelbaum, MD's Avatar

Paul S. Appelbaum, MD

@appelbap.bsky.social

Dollard Professor of Psychiatry, Medicine & Law, Columbia University. Interested in medical ethics, ELSI of genetics and neuroscience, law and psychiatry, mental health policy.

158 Followers  |  16 Following  |  23 Posts  |  Joined: 20.11.2024  |  1.8697

Latest posts by appelbap.bsky.social on Bluesky

OSF

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

01.08.2025 12:53 โ€” ๐Ÿ‘ 10    ๐Ÿ” 5    ๐Ÿ’ฌ 2    ๐Ÿ“Œ 1
Preview
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/

29.07.2025 14:52 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
A Scoping Literature Review of Mental Illness in Decisions Regarding Pretrial Release Judges generally make pretrial release decisions based on the risk that a defendant will miss court appearances or pose a danger to the community; for criminal cases initiated in state courts, this de...

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...

23.07.2025 19:28 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

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

16.07.2025 20:39 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

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...

10.07.2025 14:15 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Preview
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...

05.06.2025 14:30 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Psychiatry Online 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.

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....

05.06.2025 00:17 โ€” ๐Ÿ‘ 1    ๐Ÿ” 1    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0
Preview
An analysis of firearm legality and lethality in 625 U.S.โ€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/...

19.05.2025 18:53 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Preview
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

14.05.2025 18:46 โ€” ๐Ÿ‘ 2    ๐Ÿ” 1    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Preview
What am I supposed to say to this generation of young scientists? Undermining the future of American science is not a path to accountability โ€” itโ€™s a path to decline.

"letโ€™s be clear: It isnโ€™t institutions that are being punished. Itโ€™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

07.05.2025 12:52 โ€” ๐Ÿ‘ 4    ๐Ÿ” 1    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Preview
Two men in ICE custody died of โ€˜naturalโ€™ causes. Were their deaths preventable? Top medical experts reviewed records and questioned the treatment two immigrants received before their deaths. โ€œThatโ€™s certainly substandard care,โ€ said one neurologist.โ€œThatโ€™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...

04.05.2025 01:45 โ€” ๐Ÿ‘ 1    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 1
Expansion of Collegesโ€™ Legal Responsibilities Regarding Student Mental Health

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

01.05.2025 17:23 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Preview
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...

17.04.2025 15:13 โ€” ๐Ÿ‘ 1    ๐Ÿ” 2    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Preview
Mental Health AI Chatbot Rivals Human-Based Tx in Less Time A generative AIโ€“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/...

03.04.2025 10:41 โ€” ๐Ÿ‘ 1    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Preview
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/...

26.03.2025 10:57 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Preview
How the NIH dominates the worldโ€™s health research โ€” 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 worldโ€™s health research โ€” in charts www.nature.com/articles/d41...

13.03.2025 21:54 โ€” ๐Ÿ‘ 4    ๐Ÿ” 1    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Preview
Inside the Collapse at the NIH Administration officials pressured the NIH to avoid clear advice from the agencyโ€™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...

28.02.2025 00:44 โ€” ๐Ÿ‘ 2    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0
Preview
How Progressives Froze the American Dream The U.S. was once the worldโ€™s most geographically mobile society. Now weโ€™re stuck in placeโ€”and thatโ€™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...

10.02.2025 19:13 โ€” ๐Ÿ‘ 2    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

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

28.01.2025 20:36 โ€” ๐Ÿ‘ 0    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

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

28.01.2025 20:28 โ€” ๐Ÿ‘ 1    ๐Ÿ” 0    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0
Preview
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/...

08.01.2025 11:34 โ€” ๐Ÿ‘ 3    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 1
Preview
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...

10.12.2024 00:40 โ€” ๐Ÿ‘ 17    ๐Ÿ” 3    ๐Ÿ’ฌ 3    ๐Ÿ“Œ 1
Preview
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/...

27.11.2024 02:03 โ€” ๐Ÿ‘ 2    ๐Ÿ” 0    ๐Ÿ’ฌ 0    ๐Ÿ“Œ 0

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.

20.11.2024 18:20 โ€” ๐Ÿ‘ 2    ๐Ÿ” 0    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0

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.

20.11.2024 14:28 โ€” ๐Ÿ‘ 2    ๐Ÿ” 0    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0
Preview
Electroconvulsive Therapy, Manufacturersโ€™ Liability, and Learned Intermediaries | Psychiatric Services Manufacturers of drugs or devices that are prescribed by physicians are protected by the โ€œlearned intermediary ruleโ€ 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 โ€œlearned intermediary rule.โ€ But the Calif. Supreme Court recently expanded the ways patients can get compensated for undisclosed risks. My latest: psychiatryonline.org/doi/10.1176/...

20.11.2024 02:50 โ€” ๐Ÿ‘ 9    ๐Ÿ” 1    ๐Ÿ’ฌ 1    ๐Ÿ“Œ 0

@appelbap is following 16 prominent accounts