The so-called duty to warn: The psychotherapeutic duty to protect third parties from patients' violent acts


  • Mark J. Mills J.D., M.D.

    Corresponding author
    1. Chief, Psychiatry Service, West Los Angeles Veterans Administration Medical Center, Brentwood Division
    2. Associate Professor, Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California at Los Angeles; and a member of the journal's editorial board
    • VAMC West Los Angeles, 11301 Wilshire Boulevard, Los Angeles, CA 90073
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This article discusses the much-misunderstood Tarasoff decision that requires psychotherapists to protect third parties from patients' violent acts. Through a normative approach, the paper analyzes four important issues: what to do when potential victims are unknown; what to do about the fact that the patients' potential for violence may be incorrectly perceived; the value of warning potential victims; and, the problem of discharging potentially violent patients from the hospital. The author proposes that the courts adopt a more flexible substantial departure test in most cases that involve psychiatric negligence.