1976). n107 Discrepancies and vagueness between states, as well as between providers, regarding how and when to apply the duty to protect still exist. Please read the entire Privacy Policy and Terms of Use. 14, was a case in which the Supreme Court of California held that mental health professionals have a duty to protect individuals who are being threatened with bodily harm by a patient. Regents of University of California, 17 Cal.3d 425, 131 Cal.Rptr. Although some state legislation imposes a mandatory duty on mental health providers, other states have implemented a permissive … In Tarasoff v. After the plaintiffs appealed this decision, the California Supreme Court reviewed the case and in 1976, handed down what was to be a landmark decision, in favor of Tarasoff… in the tarasoff case, amicus contended that even when a therapist predicts that a patient is dangerous, the therapist has no responsibility to protect a third party false under uncommon law, an ordinary person like you or me has no duty to control the conduct of another, even if we for see that such conduct will harm a third party In Tarasoff v. Regents of the University of California (1976), the California Supreme Court held that mental health providers have an obligation to protect persons who could be harmed by a patient. One was arguably appropriate; the other, arguably not. Mental health providers, mindful of the duty they have to warn potential third-party victims, are more acutely aware of risk factors for violence (6). BMJ 2013; 347:f4572 Crossref, Google Scholar. : Validation of the HCR-20 Scale for Assessing Risk of Violent Behavior in Israeli Psychiatric Inpatients. The immediate dilemma created by the Tarasoff ruling is that of identifying the point at which "dangerousness" (typically, but not always, of an identifiable individual) outweighs protective privilege. Thus the case is analogous to the Tarasoff line of cases adopting a duty to warn of danger and the contagious disease cases adopting a comparable duty to warn. Leong GB, Eth S, Silva JA: The psychotherapist as witness for the prosecution: the criminalization of Tarasoff. The use of analogical reasoning would have illuminated the similarities and differences between the two cases and would have helped the authors to determine which morally relevant features a paradigm case should minimally share with its analogous cases. Part of the heterogeneity of the impact of the Tarasoff ruling is that different states have adopted different approaches to the implementation of the duty to warn or protect. The Tarasoff decision, as it is presently interpreted, raises a set of questions that may be problematic from both medical and legal standpoints. Prosenjit Poddar, a University of California graduate student, developed an infatuation with Tatiana Tarasoff, a woman he met at a dance class. Coid JW, Ullrich S, Kallis C: Predicting future violence among individuals with psychopathy. HIPAA ensures that communication (for the purpose of treatment) among health care providers about a patient is privileged. In the years following the Tarasoff ruling, its effects on the mental health field have been substantial. 1. However, although the duty to protect, as delineated in the Tarasoff decision, is intended to relieve providers of such liability by mandating that they alert others of a possible threat from a patient, an incorrect reading of a situation could have the opposite effect. J Am Acad Psychiatry Law 2006; 34(4):523–528 Google Scholar, 8. at 23. California courts imposed a legal duty on psychotherapists to warn third parties of patients’ threats to their safety in 1976 in Tarasoff v. The Regents of the University of California . The practice of warning an identifiable victim of the risk of violence, adequately determined through clinical assessment, is the model that is discussed and promoted in the professional literature and is in greatest agreement with the Tarasoff principle itself. However, there remain some challenges involved in implementing the duty to protect. 14 (Cal. Specifically, in a situation in which a provider strongly feels that a particular circumstance justifies a breach of provider-patient confidentiality but is ultimately mistaken, the provider could then be held liable to the patient for the breach, irrespective of any good intention on the part of the provider. The intricacies of Tarasoff involve so many variables, from state to state, scenario to scenario, case to case. Duty to warn (Tarasoff duty): A basis for justifying a limited exception to the rule of patient confidentiality when a patient of a psychiatrist makes an explicit, serious threat of grave bodily harm to an identifiable person(s) in the imminent future. A study conducted in the United Kingdom examined both the aforementioned risk-assessment models in a prison setting (14). Am J Psychiatry 1987; 144(1):68–74 Google Scholar, 2. Cooper AE: Duty to warn third parties. of Cal., 551 P.2d 334 (Cal. 3d at 435, 551 P.2d at 342-43, 131 Cal. The duty has foundations in clinical ethics and was acknowledged even prior to the time that the Tarasoff case established a legal duty. Crim Behav Ment Health CBMH 2007; 17(2):89–100 Crossref, Google Scholar, 14. Cases of Duty to Warn or Protect. One possible mechanism by which third parties could be warned is a clinical point-system scale capable of assisting in the evaluation of the probability of a patient carrying out a threat. any benefit from simply warning a third party. Such situations could, however, result in the reporting of suspected child, elder, or dependent adult abuse, depending on the facts. How does one practice good clinical judgment? Neuropsychiatr Dis Treat 2013; 9:1725–1736 Google Scholar, 16. Tarasoff v. Regents of the University of California The seminal case which lead to the body of law addressing a mental health providers’ duty to third party victims was Tarasoff v. Regents of the Universityof California, 17 Cal. Although some state legislation imposes a mandatory duty on mental health providers, other states have implemented a permissive The pre-eminent case in this area is Tarasoff, a California Supreme Court case wherein the court found a duty to warn an identifiable third party of a patient’s threats (Tarasoff v. Regents of Univ. Rptr. Furthermore, a national consensus on the guidelines pertaining to the duty to protect needs to be established. The authors thank attorney Sumayya Saleh, from the Hillsborough County Office of the Public Defender, Hillsborough, Fla., for her legal expertise. Morriss R, Kapur N, Byng R: Assessing risk of suicide or self harm in adults. The immediate dilemma created by the Tarasoff ruling is that of identifying the point at which "dangerousness" (typically, but not always, of an identifiable individual) outweighs protective privilege. To Invoke or Not to Invoke: Tarasoff Is the Question. Although some state legislation imposes a mandatory duty on mental health providers, other states have implemented a permissive duty (in that providers are not liable for breaching confidentiality and are not required to do so). Am J Psychiatry 1992; 149(8):1011–1015 Google Scholar, 12. One challenge in predicting dangerousness is that providers are often unclear about how to accurately prognosticate, because "prediction and assessment of violent behavior do not yet have reliable, clinically validated paradigms" (1). In Tarasoff v. Regents of the University of California (1976), the California Supreme Court held that mental health providers have an obligation to protect persons who could be harmed by a patient. 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