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Showing posts with label Tarasoff Rule. Show all posts
Showing posts with label Tarasoff Rule. Show all posts

Sunday, January 22, 2017

State Supreme Court Ruling Expands 'Tarasoff' Duty for Washington State Clinicians

Psychiatric News Alert
Originally released January 3, 2017

A Washington state Supreme Court decision appears to significantly broaden the duty that psychiatrists and other mental health professionals in that state have to protect and warn potential victims of violence by a patient under their care.

In Volk v. De Meerleer, the Washington state Supreme Court expanded the so-called Tarasoff standard regarding a mental health professional's duty to protect and warn a third party of possible violence, asserting that the duty extends to any possible victim--even one that has not been specifically identified by the patient.

The ruling applies only to clinicians in Washington state. Although other states could conceivably adopt a similar standard, the ruling does not establish a legal precedent outside of Washington. (It was a 1976 case, Tarasoff v. Regents of the University of California, that established the principle that a mental health professional has the duty to protect a third party, specifically identified by a patient, that he or she may be potential victim of violence.)

Tarasoff has typically been interpreted to mean that the mental health provider owes a duty to the intended victim if the victim is identified or reasonably identifiable. But the new decision by the Washington state Supreme Court suggests that the duty is more expansive and that the provider may have an obligation to probe statements about violence to determine whether there is an intended victim and/or to infer intended victims from past sessions.

The decision creates a new category of "medical negligence," rendering clinicians in Washington state potentially legally liable if it is determined that they should have known someone would be a victim of violence. APA signed on to an amicus brief with the Washington State Medical Society and six other groups saying that a lower court's finding that mental health professionals owe a duty of care to the general public, not just to reasonably identifiable third parties, places an unfair burden on clinicians.

APA CEO and Medical Director Saul Levin, M.D., M.P.A., said the ruling is a troubling one. "The court's ruling in Volk v. De Meerleer places clinicians in Washington state in a difficult position and could have detrimental effects on the patient-psychiatrist relationship," he said. "To the extent that a similar standard of liability could be adopted in other states, it should be of concern to psychiatrists and mental health professionals everywhere. APA will continue to follow developments in Washington state and continue to advocate for a fair and rational approach to Tarasoff duties."

APA President Maria A. Oquendo, M.D., Ph.D., echoed those remarks. "Holding mental health professionals liable to third-party victims who were not  identifiable as targets of actual threats places an unreasonable burden on mental health professionals," she said. "This decision marks a significant departure from previous case law concerning Tarasoff duties. Leaving it to a jury to determine whether a mental health provider 'should have known' that a patient would be dangerous has a real potential to interfere with treatment of mental health patients."

Marvin Swartz, M.D., chair of the APA Committee on Judicial Action, told Psychiatric News that the decision potentially undermines the traditional understanding of physician liability. "Expanding physician liability to a new doctrine of 'medical negligence' suggests that courts and juries might begin to adopt a liability standard akin to strict product liability rather than the established standards of medical malpractice," he said. "The likely result would be a serious undermining of the physician/patient relationship."

Wednesday, September 7, 2016

APA Signs Onto Amicus Brief Supporting Confidentiality

Aaron Levin
Psychiatric News
Originally published August 11, 2016

APA has signed on to an amicus curiae brief with the California Psychiatric Association and the California Association of Marriage and Family Therapists in a case before the California Supreme Court with important implications for patient confidentiality and clinicians’ liability.

APA is concerned that a ruling in favor of the plaintiff would change the existing California standard (the so-called Tarasoff rule) requiring action when “a patient has communicated to the psychotherapist a serious threat of physical violence against a reasonably identifiable victim or victims.”

The case, Rosen v. Regents of the UCLA, arose when Damon Thompson, a student treated by UCLA’s counseling service, attacked and stabbed a fellow student, Katherine Rosen.

Under California law, a therapist has a “duty to protect” a potential victim if the patient makes a reasonably identifiable threat to harm a specific person.

The entire article is here.

Thursday, May 28, 2015

Tarasoff's catch-22.

By Stephen R. Huey
The American Psychologist
2015 Apr;70(3):284-5. doi: 10.1037/a0039064

Abstract

Comments on the article by D. N. Bersoff (see record 2014-28692-002). Bersoff poses a much-needed challenge to the rationale of laws based on Tarasoff v. Regents of the University of California (1976), which exist in most states and require therapists to warn the intended victim, police, and/or others when a patient voices serious threats of violence. If Tarasoff-related laws were ever to be modified, research support would be required. To begin with, what is the experience of other countries that happen to address this issue differently and of the seven states that, according to Bersoff, have not adopted Tarasoff-related requirements? Another question is whether patients who are unwilling to invite the consequences of therapist disclosure ever reveal reportable intentions to their therapists anyway-say, by mistake or impulse-thus making current law marginally useful? Rules that undercut sacrosanct confidentiality create a catch-22 in which the indisputable ethical necessity of informed consent has an unintended consequence- namely, therapy is preceded by informed consent but precluded by it.

The entire article is here.

Wednesday, December 31, 2014

The Tarasoff Rule: The Implications of Interstate Variation and Gaps in Professional Training

By Rebecca Johnson, Govind Persad, and Dominic Sisti
J Am Acad Psychiatry Law 42:4:469-477 (December 2014)

Abstract

Recent events have revived questions about the circumstances that ought to trigger therapists' duty to warn or protect. There is extensive interstate variation in duty to warn or protect statutes enacted and rulings made in the wake of the California Tarasoff ruling. These duties may be codified in legislative statutes, established in common law through court rulings, or remain unspecified. Furthermore, the duty to warn or protect is not only variable between states but also has been dynamic across time. In this article, we review the implications of this variability and dynamism, focusing on three sets of questions: first, what legal and ethics-related challenges do therapists in each of the three broad categories of states (states that mandate therapists to warn or protect, states that permit therapists to breach confidentiality for warnings but have no mandate, and states that give no guidance) face in handling threats of violence? Second, what training do therapists and other professionals involved in handling violent threats receive, and is this training adequate for the task that these professionals are charged with? Third, how have recent court cases changed the scope of the duty? We conclude by pointing to gaps in the empirical and conceptual scholarship surrounding the duty to warn or protect.

The entire article can be found here.