In October 1969, Poddar stabbed Tarasoff. The two previously had an acquaintance which did not end well and Poddar was devastated. He even confided to his therapist, Dr. Moore, the intension to kill Tarasoff. Dr. Moore reacted swiftly by informing the university security of Poddars mental state. Poddar was detained for several hours but later released upon the recommendation of Dr. Harvey Powelson, Moores supervisor. After the release and a plea to stay away from Tarasoff, Poddar went ahead to kill her. Because the therapists had already known about the intension, Tarasoffs parents decided to sue the four psychiatrists of Cowell Memorial Hospital at the University of California for the failure to warn them of their daughters situation before it happened. The case resulted in the Supreme Court of California directing all mental health practitioners to honor the duty of protecting the third party from any body harm (Gostin, 2002).
Analysis of the Issue
The main issue presented by this case was the decision of the court to state that therapists have a duty to defend third parties from threats of any bodily harm from patients. The dilemma presented here is having practitioners torn between the duty to protect the public from the threats posed by mental patients against the obligation of confidentiality. Psychotherapy as profession thrives well when a better rapport between the patient and the doctor is existent. Based on this logical disposition, it is hard to ask mental health practitioners to use the confidential information from sessions in the name of saving the public. Within his analysis, Nesbitt (1977) quotes the ethics of American Medical Association (AMA), which indicate that;A physician may not reveal the confidences entrusted to him in the course of medical attendance, or the deficiencies he may observe in the character of patients, unless he is required to do so by law or unless it becomes necessary in order to protect the welfare of the individual or of the community (p. 755).
The predicament of Tarasoff could have been prevented had Dr. Moore contacted her parents when the alarm was raised by Poddar during one of the sessions. The above provision by AMA fully covers relatable scenarios to the case of Tarasoff, which makes it necessary for the mental health practitioners to try as much as possible to protect the public when imminent danger looms.
From a personal point of view, the case of Tarasoff and the duty to protect the third party creates a lot of openings that make the work of a psychotherapist complicated. It is true that Tarasoff would not have gone through the ordeal had she or her family received an early warning. Before the accident, it was not an obligation that a psychiatrist was to look after the welfare of the third party. However, aspects of this profession changed when it became necessary for psychotherapists to make sure that the public is safe from unstable individuals. My take on this issue is that psychotherapy as a profession yields optimal result when non-rigid structures are imposed. As appreciated by Nesbitt (1977), the flexibility of a psychiatrist by being open with the patient establishes an effective way to deal with pending problem. However, having been owed the duty to protect the public, there are limits that professionals have to bear with when deducing methodologies to deal with patients. The dilemma is that mental health practitioners cannot accurately predict whether or not violence will occur. The Tarasoff case is effective in demonstrating this. Dr. Powelson did not predict that Poddar would actually go ahead to kill Tarasoff. Since putting in place the duty, several law suits against psychotherapists have happened for failing to accurately predict pending dangers.
On a positive note, I have personally conceptualized important factors from the Tarasoff case that can guide my practice. As a psychotherapist, it is important that I consider both the obligation to confidentiality and protecting the public. All these factors cannot be simultaneously achieved. One has to learn to compromise depending with the situation. My duty to protect the public is only limited to events that I am sure are real threats. This is the only way that a certified psychotherapist can get to adhere to the confidentiality obligation. Revealing the inner information of your patient is an aspect that most professionals are not happy with, an aspect that makes them compromise on the duty to protect the public. Although not perfect, my practice would try to consider both factors at the same time. This is a line of reasoning that I have deduced throughout the semester by closely analyzing the case. Professionals would argue that confidentiality is more important than anything. As much as this is the defining factor of psychotherapy, knowing that you could have saved a life and did not do so is equally significant. In summary, I would posit that a positive revelation from the case is that psychotherapists have a duty to protect the public, but do not have to jeopardize the core principles of the profession in doing so.
Gostin, L.O., (2002). Chapter 10, Public health law and ethics: A reader. http://www.publichealthlaw.net/Reader/docs/Tarasoff.pdf
Nesbitt, N. A. (1976). Tarasoff v. Regents of the University of California: Psychotherapist's obligation of confidentiality versus the duty to warn. Tulsa LJ, 12, 747-757.
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