The duty to protect, or Tarasoff duty, has been conceptualized as arising solely in the context of a clinical setting. A recent California Supreme Court ruling in People v. Clark adds legal, clinical, and ethical dilemmas to the oftentimes contentious Tarasoff issue. Though the Tarasoff issue is but a minor legal point in Clark, a possible consequence of Clark is that a Tarasoff warning could be deemed nonconfidential and admissible in a criminal trial. Psychotherapists could therefore be testifying in criminal courts as prosecution witnesses. While the possibility of a chilling effect on patients' disclosure of violent ideation in the context of psychotherapy first caused apprehension after the California Supreme Court's 1976 decision in Tarasoff v. Regents of the University of California, this same Court's ruling in People v. Clark some 14 years later may ensure that this fear finally becomes realized.
In 1976, the California Supreme Court ruled in Tarasoff v. Regents of the University of California that a duty to protect arises when a psychotherapist's patient poses a serious danger of physical harm to an identifiable third party. Discharging this duty by the issuance of a warning breaches the confidentiality of the psychotherapist-patient relationship. However, the potential benefit to society offsets the possible harm caused by the breach of confidentiality. Until recently, such warnings have served little purpose outside of possibly preventing harm. However, the cumulative effect of three recent California Supreme Court cases has been to permit the use of these confidentiality breaches in criminal proceedings to fulfill prosecutorial goals. Nonetheless, the cost of achieving social justice may be at the expense of other important ethical values for both the psychotherapeutic professions and society in general.
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