When Doctors Must Break Confidentiality to Protect Essay

Excerpt from Essay :

Court Case

On Duty to Warn: The California Supreme Court's response is that the defendants have a duty to protect not only to the patients but also to those individuals who may come under assault from the mental health patient. Thus, the defendants are negligent of and derelict in their duty in not warning Tatiana of the danger presented her by the patient's inclination. The defendants also should have insisted that the police detain the patient. As Berger and Berger (2009) point out, the duty to warn translates into the duty "to protect."

On Duty to Forecast Harm: The defendant has a duty to exercise care in the event that danger is foreseeable. In this case, it was evident that danger was foreseen, which is why the defendant alerted the police; however, the issue was not followed-up on and the patient was allowed to go free without further precautionary measures put into effect. Thus the defendant is liable because harm was only marginally forecast and not thoroughly forecast.


On Medical Confidentiality: The defendant was responsible for communicating to law enforcement officials any threat to the security of others as a result of disclosures made in confidence. The defendant is not violating disclosure as the patient poses a risk to himself and to others and thus is actually being helped by the communication between psychologists and law enforcement agents. To not communicate would be to not give the patient the proper assistance that he needs and would show dereliction the part of the therapist.


According to Kipnis, the legal justifications for breaching confidentiality can conflict with the caregiver's moral obligation to maintain confidentiality: "The unhappy truth is that ethical obligations can conflict with legal ones ... Although law demands disclosure, professional ethics requires silence" (Kipnis, 2003). Further, Kipnis states that "to assume that legal obligations always trump or settle ethical ones is to blind oneself to the possibility of conflict." The sense of the conflict is rooted in the profession's "assurance of confidentiality," which if breached makes "such assurances fraudulent" (Kipnis, 2003). Thus, patients have a right to know that if they project harm to themselves, confidentiality will be broken. However, this raises issues as well: the patient may not divulge this information as a result of this sense of not having confidentiality. (Then again why is the patient there in the first place if not to receive help?)…

Sources Used in Document:


Berger, S., Berger, M. (2009). Tarasoff "duty to warn" clarified. Retrieved from http://nationalpsychologist.com/2009/03/tarasoff-%E2%80%9Cduty-to-warn%E2%80%9D-clarified/101056.html

Kipnis, K. (2003). In Defense of Absolute Confidentiality. AMA Journal of Ethics. #

10, Volume 5. Retrieved from http://journalofethics.ama-assn.org/2003/10/hlaw2-0310.html

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