Free Essay

Tarasoff Case: Confidentiality

In: Philosophy and Psychology

Submitted By Escobaal
Words 1235
Pages 5
Dissenting Tarasoff In the tragic case of Tarasoff versus the Regents of the University of California the majority ruled towards making the psychiatrist liable for not detaining the patient Poddar who had expressed intentions to harm Tatiana Tarasoff during counseling. The majority ruling makes the therapist liable for the death of Tarasoff for he knew that her life was in danger, thus creating a new “duty to warn” for all therapists. The dissenting argument expresses that due to the duty to warn clause violence will increase, because patients will no longer feel comfortable seeking treatment and revealing their issues to the therapist. In order to analyze the dissenting opinion the following questions must be answered: are therapists able and equipped to determine whether a patient is dangerous? Are therapists potentially sacrificing effective treatment by violating confidentiality under duty to warn? Are therapists better off without the duty to warn clause? During the next paragraphs the duty to warn clause will be shown to be a burden not only on both patients and therapists, but on society as a whole. In examining the case of Tarasoff, Judge Mosk presses that psychiatric predictions of violence are inherently unreliable. Psychiatrists already experience a lot of difficulty accurately diagnosing mental illness, and with this uncertainty the difficulty of determining whether a patient is a danger to society becomes even harder. The majority opinion assigned a responsibility for the therapist to have a duty to warn and also a duty to protect. This duty intends to make therapists breach confidentiality with a client in order to protect an identifiable third party. The therapist in essence must have reasonable care when faced with a patient that expresses violent intents towards others, especially an identifiable target. For therapists to show reasonable care means that they are not only caring for the patient’s well-being but now for a third party’s well-being too. Mosk goes on to defend the therapist’s position by recognizing just as sane people may be dangerous, patients diagnosed may or may not be dangerous even if they express feelings that might lead to violence. Mosk also states that therapists are not uniquely qualified to predict dangerous behavior, so holding them responsible to determine unpredictable factors might interfere with their therapeutic process. This leads to the idea that the increase in violence might not only come from failing to accurately treat a possibly violent patient, but also misdiagnosing non-violent patients who are in essence expressing their anger in an unhealthy way. I as well concur with the majority opinion that patients who have threatened a third party should be held for evaluation, but I disagree when the judges burden therapists with the duty to warn after identifying threatening patients when it is already difficult to diagnose accurately. Judge Clark, another dissenting judge, argues that both legal and medical authorities have agreed that confidentiality is essential to effectively treat the mentally ill, and that exposing patients’ will greatly impair treatment. The net increase in violence will arise when overwhelming policy will place patients under inappropriate commitment for public safety. This will go contrary to the interests of society because it will ultimately impair proper treatment. The original provision had no provision to press the therapist to warn anyone of the patient’s threat; this did not mean that the patient did not go untreated. The patient intending to hurt others would be put under forced detention for 72 hours to be evaluated. The evaluation then would effectively determine whether the patient needed further treatment or the patient just needed these 72 hours to in essence cool off. This provision sounds reasonable enough, the problem that in Tarasoff’s case Poddar was not put under review since he allegedly seemed sane and promised to stay away from her. Often times when people are in situations that cause them frustration, they resort to a darker side to be able to cope with the situation. This situation might just require some guidance and time to allow the patient to come to terms with his feelings. To hold the therapist accountable to report patient’s records to law enforcement agencies and other third parties seems a bit extreme. Poddar, who was not familiar with American customs, might have been benefitted from these 72 hours of review. This failure to enforce an already placed law might have been the reason why Tarasoff died. Dr. Moore sent a letter to the campus police briefly describing the state of the patient in purpose to obtaining the 72 hour confinement period, but under police discretion the patient was prematurely released. The therapist should disclose limited information in order to get the necessary order for the patient to be confined, but not fully disclose all the information to other parties for this might tarnish the faith of people on therapy. In essence if those who seek treatment don’t feel substantial assurance of confidentiality, those who need treatment might be discouraged to the idea of seeking professional help. Clark even goes on to state that “it remains an unfortunate fact that in our society that people seeking psychiatric guidance tend to become stigmatized. “ In principle if a patient feels vulnerable to scrutiny, what makes the court think that with the duty to warn clause treatment will become more widely used. People will be reluctant to aid and thus a possible net increase in violence will occur. The judge concludes by wisely stating that “the duty to warn imposed by the majority will cripple the use and effectiveness of psychiatry. Many people, potentially violent – yet susceptible to treatment – will be deterred from seeking it; those seeking it will be inhibited from making revelations necessary to effective treatment; and, forcing the psychiatrist to violate the patient’s trust will destroy the interpersonal relationship by which treatment is effected”. Another factor that will inhibit the effectiveness of treatment will be the vulnerability that therapists feel under the duty to warn clause. Not only will they feel the pressure to predict whether patients expressing feelings towards violence will actually commit any acts, but also fear the consequences that will arise if they act or fail to act upon this prediction. If they fail to correctly assess the patient they will either lose a patient by betrayal of trust when breaking confidentiality and unjustly institutionalizing them, or be under legal penalty for failing to adhere to the duty to warn clause. In hindsight one might clearly draw a line saying that the therapist should have had Poddar put under supervision and also warned Tarasoff, but obviously therapists don’t have the luxury of a crystal ball showing them the future. According to Clark the duty to warn clause unfortunately forces the therapist under pressure to make decisions between “a rock and a hard place”. The judge shares that obviously the therapist will chose to protect himself by choosing to protect the public interest. This consequently allows room for an increase in violence.
Clark concludes that,” Until a patient can trust his psychiatrist not to violate their confidential relationship, the unconscious psychological control mechanism of repression will prevent the recall of past experiences.” As in any other type of relationship trust is essential, in principle patients’ trust is essential for effective treatment and prevention of acts of violence as explored in this tragic case, and the duty to warn clause adds negative pressure that tarnishes effective patient-therapist relations.

Similar Documents

Premium Essay

Tarasoff

...Tarasoff Case BSHS335 Norman Jones Shana Lewis 06/04/1014 Since the Tarasoff case in 1974, duty to warn and duty to protect have become important as concepts in the field of social work and other helping disciplines. Being able to protect potential victims from harm and protecting clients from self-harm have become ethical obligations in social work practice. This area needs to be explored and understood by social work practitioners, educators, and social work students. Duty to warn and duty to protect have ethical implications for all social workers.     Walcott, Cerundolo, and Beck (2001) describe the facts of the Tarasoff case. Prosenjit Poddar and Tatiana Tarasoff were students at UCLA. Poddar stated to the university health science psychologist that he intended to kill an unnamed woman, who was identified as Tatiana Tarasoff. Although the psychotherapist did not directly warn Tarasoff or the family, the psychologist notified the police, who interviewed Poddar for commitment. The police only warned Tarasoff to stay away. After Poddar returned for the summer from Brazil, he murdered Tatiana with a knife. Tarasoff’s family sued the campus police and the university health service for negligence. Walcott, Cerundolo, and Beck (2001) cite the second Tarasoff case, establishing a duty to protect.      The Tarasoff case imposed a liability on all mental health professionals to protect a victim from violent acts. The first Tarasoff case imposed a duty to warn the victim,......

Words: 1420 - Pages: 6

Premium Essay

Confidentiality and Informed Consent

...Confidentiality and Informed Consent Claudia Lewis PSY/305 6/29/15 Dr. Daniel Williams Jr, PsyD, MSW Confidentiality and Informed Consent Introduction Dear client this paper is to inform you, of your right to confidentiality, and further more explain the process of informed consent. In the world of Psychology and counseling, confidentiality and informed consent has been the cornerstone to our practices (University of Phoenix, 1994). This paper will help you to understand how the things you say during the counseling sessions may have legal implications against you; by first explaining the decision of Tarasoff v. the board of Regents of the University of California, followed by how it relates to the therapist-client relationship in regards to confidentiality; then finally explaining the process of informed consent and refusal. Tarasoff v. Board of Regents of the University of California Decision According to University of Phoenix Confidentiality after Tarasoff (1994), the Tarasoff v. board of regents of the University of California case was heard before the California Supreme court, when Tatiana Tarasoff, a student at The University of California was killed by a fellow student. Her parents sued the University of California, the Police and the Therapist (University of Phoenix, 1994). The parents claim was that neither the School, Police or the Therapist warned them of the intentions of this fellow school mate to kill their daughter, Tatiana Tarasoff, as the......

Words: 1060 - Pages: 5

Free Essay

Impacts of Tarasoff

...Running head: EXPLORING CONFIDENTIALITY 1 Impacts of Tarasoff Jennifer Munoz COUN 6306-28 Walden University Impacts of Tarasoff The 1976 case Tarasoff v. The Regents of the University of California, initiated a nationwide legislature reform. The famous California Supreme Court case propelled most states to enact a form of “duty to warn” or “duty to protect” statutes (Simone & Fulero, 2005). Tarasoff has forever impacted the liability and responsibilities of medical professionals. This paper will review a Colorado state statute influenced by Tarasoff. It will further address the “duty to warn” and “duty to protect” dilemmas and the suitable ways to address them. Lastly, this paper will examine confidentiality challenges presented in Laureate Education Inc. (2012) video, Mental Health Counseling: Confidentiality. Colorado State Law Colo. Rev. Stat. § 13-21-117 defines the responsibilities of mental health professionals. It holds mental health professionals liable for their “duty to protect” third parties in cases in which clients communicate threat or harm (Colorado Legal Resources, 2012). The statute states that a mental health professional is not liable in civil court for the failure to warn or protect a third party from a client (Colorado Legal Resources, 2012). Furthermore, it adds that the professional is not held liable to predict their client’s behavior (Colorado Legal Resources, 2012). Though, it mandates that......

Words: 1511 - Pages: 7

Premium Essay

Inter Office Memo

...services organization | from: | subject: | case ruling of tarasoff v. Regents of the univesity of california | date: | March 27, 1976 | | | As everyone knows there is a new ruling for the Tarasoff v. Regents of the University of California. The ruling two years ago caused a debate on the ruling of professionals getting charged and those that weren’t, so changes have now taken affect. As professionals in the human service field it is important for us to know that now if a client expresses they have a plan to kill someone, it is our obligation to break confidentiality and inform the potential victim and or the police of the thoughts of your client. This may be a tough thing for some of us to do because of the ethical responsibilities we have with our clients but now this is a part of our legal responsibilities to protect the welfare of the society by having the duty to protect individuals who are bing threatened with bodily harm by a client naming it “duty to warn and duty to protect” (in the previous ruling it was only known as “duty to warn”. This is also known as a “Tarasoff warning” in place, meaning where a mental health professional is required to warn of a credible danger to a reasonably identifiable victim. Duty to protect includes clients that may be suicidal. Human services code of ethics entitles us as professionals to let the client know before our sessions began that we have a limits to our confidentiality. It also provides ethical standards to which......

Words: 456 - Pages: 2

Free Essay

Confidentiality After Tarasoft

...Confidentiality after Tarasoft PSY / 305 June 30, 2014 Garen Weitman In life a person learns to keep secrets at a very young age. As a person grows up and becomes an adult we choose paths that require us to keep secrets from other individuals, when we do this it no longer is known as a secret it is called keeping things confidential. Merriam-Webster defines confidential as a secret or private, showing that you are saying something that is secret or private, and trusted with a secret or private information. (Merriam-webster, n.d.)A psychologist has a tremendous responsibility in keeping this confidential, it is what allows a client to be truthful and not worry about others knowing their secrets. However some secrets are not always meant to remain a secret, for example when it involves the endangerment of a person’s life. The story of Prosenjit Poddar and Tatiana Tarasoff is a perfect example. Prosenjit Poddar was being seen by a therapist by the name of Dr. Moore. One day Mr. Poddar informed his therapist he wanted to kill a woman upon her arrival from her vacation. Taking Poddar’s threat seriously Dr. Moore contacted his supervisor as well as the campus police. The police detained, questioned and then released him, determining that Prosenjit Poddar was rational and promised not to harm the woman. The woman later to be known as Tatiana Tarasoff returned from her vacation two month later, Poddar murdered her. Tarasoff family later sued Dr. Moore, Dr. Moore’s supervisor,...

Words: 825 - Pages: 4

Free Essay

Tarasoff

...The Tarasoff v. Regents of the University of California case involves the family of Tatiana Tarasoff and the team of professionals who was taking care of Prosenijit Poddar’s mental health. Tarasoff and Poddar were just friends but Poddar wanted more than that. Tarasoff let Poddar know she was not interested in him. Poddar did not like that and started to stalk Tarasoff. Poddar had made threats about hurting Tarasoff but the professionals taking care of him did not alert the right authorities, Tarasoff, or her family. From withholding that information Poddar did act on his threat and murdered Tarasoff. Poddar was convicted on second degree murder but that trial was overturned. Poddar was released and was expedited out the country and went back to live in India. Tarasoff family went after the four psychiatrists who were taking care of Poddar for failure to protect their daughter. The Tarasoff v. Regents of the University of California case has made huge impact in the human service field. As human service professionals we have to protect our clients as well as others. With this ruling we now have to take in the consideration of our clients as well as people who are close to client and the general public. Human service providers have always been taught to protect and help our clients. Now with the Tarasoff ruling human service professionals need to make sure that those closes with the client are not any danger and if they are they need to be alerted. As human......

Words: 382 - Pages: 2

Premium Essay

Bshs 305 Interoffice Memo

...Employees FROM: Zachary Robertson, Administrator DATE: July 2, 1976 SUBJECT: Tarasoff v. Regents of the University of California As human service professionals, the ruling of the Tarasoff v. Regents of the University of California is very important to the ethical code we currently practice. By ruling in favor of Tarasoff, the court now implements the duty to warn and the duty to protect. Directly: “The Court stated that when a therapist determines, or pursuant to the standards of his profession should determine, that his patient presents a serious danger of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger.” The discharge of this duty may require you to take one or more steps, depending on the nature of the case. Thus, it may call for you to warn the intended victim or others likely to apprise the victim of the danger, to notify the police, or to take whatever other steps are reasonably necessary under the circumstances. This legislation not only affects the human service’s code of ethics, but also our decision making process. The following will provide, in greater detail, what that means to you. Human Services Code of Ethics The primary functions of our code of ethics are to establish guidelines for professional behavior and to assist members of the profession in establishing a professional identity. The Tarasoff case seemingly presents limitations to our current code of ethics by......

Words: 387 - Pages: 2

Premium Essay

Ethics of Confidentiality

...February 2nd, 2014   Breaking confidentiality is never ethical and is also losing faith between the patient-nurse relationships or amongst healthcare providers. The minute a patient walks into a health care setting they feel a trusting bond with the providers and expect reciprocation. The U.S. department of health and human services has the office of civil rights which imposes the “Health Insurance Portability and Accountability Act” (HIPAA) which protects patient information. Breaches of confidentiality are taken seriously by the office of civil rights and any breach of unsecured health information will be analyzed, and the person responsible will be prosecuted. All healthcare providers are expected to follow basic ethical principles during their practice and they are: “Respect for autonomy, Veracity, Beneficence, Non-maleficence, Fidelity, and Justice” (Maurer & Smith, 2013). These ethical principles are implemented and mandated through standards of practice and federal law in all healthcare and professional organizations. According to the American Nurses Association’s (ANA) standard of codes, the most important ethical principle is “respect for the inherent dignity and worth… of human existence and the individuality of all persons” (Maurer & Smith, pg. 12). When a patient arrives to the hospital the first task the patient goes through is to sign an informed consent form, also known as advanced directive which is done for confidentiality purposes. On Feb 24, 2000......

Words: 1065 - Pages: 5

Free Essay

Informed Consent and Refusal

...The decision of Tarasoff v. the Board of Regents of the University of California was that, for the first time imposed a liability on a therapist for failing to protect a potential victim, when therapist Dr. Moore had a client, Prosenjit Poddar that confided in him that he intended to kill a woman, he did not name the woman, but none the less he claimed he was going to kill her when she got back from her vacation, even though Dr. Moore called his supervisor and the campus police, he was still sued by The Tarasoff family when Poddar did indeed end up killing her after campus police let him go two months prior because he appeared to be rational and promised he would not harm her (Kagle J, Kopels S. P.1 1994). The therapist – client relationship is that of a confidential manner. The therapist is to keep anything the client says under strict confidentiality however; this article argues that this is not the case because social workers have never really been able to offer their clients unlimited confidentiality because in recent years the demand for accountability has increased as well as greater access to information in records, mandated child abuse reporting and expanding court involvement in professional decision making (Kagle J, Kopels S. P.1 1994). Now more than ever therapists are faced with their obligation to protect their client’s privacy as well as the duty to protect third parties from harm. Especially when dealing with potentially violent clients who are court ordered...

Words: 403 - Pages: 2

Free Essay

Bioethics: Modern Science and Ethics

...Science defines human life as a characteristic that exhibit a process with organization, growth, adaptation, etc.; however, ancient sages told people human life is extremely valuable and sacred, as a religious doctrine in the Ten Commandments: “Thou shalt not kill.” Moreover, when people talk about ethics, they will think about rules to differentiate right and wrong. It might be wise maxims of Confucius or religious beliefs. The most general way to define “ethics” is that “moral principles that govern a person's or group's behavior” (American English in Oxford Dictionary). Bioethics is a pretty young interdisciplinary study, which is considered with ethical questions related to the relationships among human beings, animals, and environments in the late twentieth century. Based on this, bioethics derived three main subdisciplines, which are medical ethics, animal ethics, and environmental ethics. Although each sub-discipline has particular study area in bioethics, there still are overlaps of ethical considerations and approaches. This makes it difficult to easily discuss ethics questions such as stem cell research, xenotransplantation, the ethical status of animals and the ethical status of the environment. Further discussion about the vital issue of moral status solutions is necessary at the same time. In the rapid development of the natural sciences and biotechnology has greatly promoted better living conditions and improve the living standards of people around the......

Words: 2352 - Pages: 10

Premium Essay

Ethical Considerations for Counselling in Rural Conditions

...Ethics, a form of philosophy involves dealings with morality and judgements of proper conduct (Frankena, 1973), denoting the significance of psychotherapists’ moral obligation towards the client. Its purpose is to reflect a straightforward value system, and to communicate decisional and behavioural rules with clarity To illustrate this further, the Australian Psychological Society (APS) Code of Ethics specifies ethical principles and accepted guidelines governing the psychologists’ actions and methods to make the public known of their professional practices. The ethical standards define the best practices of professionals and ensure the high quality of practice. A psychologist must bring and maintain appropriate skills and learning within her area of practice. Falling under the Prudence principle, The Code of Ethics (2007) section B.1.2 states that a psychologist may only provide psychological services within boundaries of their professional competence, where a) working within their limits of training, education, and experience and b) basing their service on established knowledge of discipline and profession of psychology. However, the psychologist concerned is specialized in clinical psychology for adults, and now is dealing with adolescents, whom are clients beyond her scope of expertise. This raises the issue of limited professional competence. Nonetheless, rural regions often see a high demand due to lack of specialists normally found in urban locations. A......

Words: 2040 - Pages: 9

Premium Essay

Applying Ethical Frameworks in Practice

...Patient Confidentiality: A Nurse’s Perspective Grand Canyon University: NRS-437V Ethical Decision Making in Health Care Ann Yurco, RN June 15, 2014 Patient Confidentiality: A Nurse’s Perspective One of the first things we learn in nursing school is in regard to a patient’s privacy and the confidentiality we are to abide by when caring for them. We learn the rules and regulations of the “Privacy Rule” and HIPPA (Health Insurance Portability and Accountability Act of 1996). These were put in place to ensure confidentiality and accountability in cases where patient’s health information is compromised, (U.S. Department of Health & Human Services, 2014). During an episode of the television series “ER” a main character, “Nurse Hathaway”, struggles with an ethical dilemma in which she must decide whether or not to break confidentiality with her patient who is also a minor in the name of the law. This patient’s diagnosis turns out to be a serious condition, cervical cancer. The author will discuss this dilemma in terms of ethical implications, ethical theories, alternative solutions, if any, as well as the author’s position on this dilemma. The author will also refer to a landmark case, “Tarasoff vs. Regents” in which “a psychologist failed to warn a woman or her family when his patient threatened to murder the woman,” (Nathanson, 2000) to discuss confidentiality ethics. Ethical Implications of a Breach of Confidentiality There are several implications when referring to...

Words: 1302 - Pages: 6

Premium Essay

Legal and Forensic

...Legal and Forensic Psychology Michael Betters Keiser University Legal and Forensic Psychology Abstract Legal and forensic psychologists are often torn between fulfilling their duties as a legal and forensic workers in the criminal justice system, and adhering to the ethical obligations to their clients as psychologists. This paper explores the dilemma faced by legal and forensic psychologists in carrying out their day-to-day roles as officials in the criminal justice system and in upholding their professional ethics as psychologists. The paper begins with an introduction of the main controversy surrounding the role of legal and forensic psychologists to the criminal justice systems (Day, 2014). It then describes some of the typical dilemmas faced by legal and forensic psychologists in the course of their work. The paper concludes with a discussion on the implications of the dilemmas faced by legal and forensic psychologists in the criminal justice system. Introduction Legal and forensic psychologists are a special type of psychologists who are often charged with the responsibility of standing as expert witnesses in court proceedings. The duties, roles, and responsibilities of legal and forensic psychologists in legal matters are strikingly different from those of an ordinary psychologist. It is paramount for legal and forensic psychologists to recognize the obligations as well as the limitations of their obligations when appearing as witnesses in court......

Words: 2332 - Pages: 10

Premium Essay

Giving Back

...To: All Human Service Workers From: Administration Date: August 18, 2014 Subject: The ruling in the case of Tarasoff vs. Regents of the University of California states “those who face possible danger must be alerted.” Our duty as Human Service Professionals is to follow code of ethics and protect others who may be in potential danger. This may violate the client’s rights to privacy, but it is our duty as a Human Service Professional to help maintain safety to those the client is trying to hurt. We must go through proper channels to notify other agencies that may be able to help. Trust should be gained between Social worker and client, so that the information the client gives is true and can be verified. All the while making sure that what the client says is true, by using our professional judgment to assess the situation so that hasty decisions are not made. Ethical issues, urge social workers when making agreements for service, explain in detail the issue of confidentiality and its limits, breaking confidentiality and the clients right to privacy should only be done when there is a duty to warn others of danger, this also includes child abuse, or a client that wants to self-harm. Civil committed states include Alabama, California, Connecticut, Florida, Idaho, Illinois, Kansas and fourteen other states, that state no civil action towards the Social Worker will be taken if all proper protocol is followed in warning a third party of......

Words: 361 - Pages: 2

Premium Essay

Ethical Vinegette

...Ethical Vignette Paper Rashanda Joe Liberty University Abstract This paper presents a summary of the Counseling in Therapy video. In the video the actors discuss real life cases where the Supreme Court Judge had to rule on topics such as: exceptions to confidentiality, privilege, reporting, and the duty to warn. This writer will also discuss her finding s about the statures and laws as they pertain to North Carolina and give a summary of each. Finally the writer will discuss her reflection and how she could put these to action in her counseling career. Summary The video presentation was very interesting. It allowed actors to discuss real cases to give a better understanding about Confidentiality, Privilege, Reporting, and the Duty to Warn. It gave a clear picture of how these things, though they may sound similar are quite different in many ways. The first case was about a young boy was taken to the hospital by his foster parents. He was unconscious with bruises down the spine of his back and a bruise under his eye. When the nurse questioned her about it she stated that it was from being jostled in his car seat. The nurse did not make any note of that observation nor did she call CPS to report possible abuse as she believed what she was told by the foster mother. Dominic was then brought back to the hospital four days later suffering from head trauma and then died. Nurse Brown was being charged with a crime for failure to report the abuse. It is noted...

Words: 1311 - Pages: 6