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ARTICLE |

Confidentiality Versus the Duty to Protect: Foreseeable Harm in the Practice of Psychiatry

David I. Joseph, MD
JAMA. 1991;266(3):425. doi:10.1001/jama.1991.03470030127041.
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ABSTRACT

In 1974 American psychiatry was rocked by the now-famous Tarasoff decision, which held that psychotherapists had a duty to warn potential victims of violence. The immediate ramifications for maintaining the boundaries of confidentiality were many. In 1976 the case was reheard, and the new ruling emphasized the therapist's use of professional judgment and broadened the therapist's responsibility to include a duty to protect and not merely a duty to warn the victim. Since then, Tarasoff has been the basis for rulings on a therapist's duty to protect, not only in cases involving a threatened victim, but also in situations in which an individual who had never been threatened was killed and one in which a man burned a barn after threatening to do so.

The conflict between a patient's right to confidentiality and a therapist's duty to protect the community from foreseeable harm is the focus of this compact, well-edited,

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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