Public Health Law Map - Beta 5 - Medical and Public Health Law Site

campus police. The campus police detained the patient, but let him go without a
formal psychiatric evaluation. The psychologist was notified and did nothing further
to stop the patient, who then killed Tarasoff. Tarasoff’s family sued, and the court
found that there was a duty to try and stop such a patient, including, under some
circumstances, a duty to warn the intended victim.
Tarasoff is a peculiar case because it is unclear whether warning the victim is really
the correct result. The information is of limited value to the victim because in most
big cities such a threat will not trigger police protection. The better result in Tarasoff
would have been for the psychologist to have initiated the proper proceeding for an
involuntary civil commitment, as specified in the state’s mental health code, rather
than just calling the campus police. This would have been especially important after
he learned that the campus police had released the patient. The advantage of properly
invoking the mental health commitment procedures is that it does not violate the
patient’s confidence by involving the potential victim. Had the patient been properly
evaluated by a forensic psychologist or psychiatrist before being released, it is very
unlikely that the courts would have found a further duty to warn the intended victim.
The courts have found that Tarasoff is limited to situations where the health care
practitioner is convinced that the patient is dangerous to a specific individual.
General threats to kill everyone at the high school probably do not trigger a Tarasoff
duty; however, if the medical care practitioner suspects that the patient might attack
the school, it would be better to act. Some states, such as Washington, have extended
Tarasoff by passing laws requiring health care practitioners to report persons who are
dangerous by reason of mental illness.
As with other reporting duties, a good faith report to the proper authorities should not
subject the medical care practitioner to legal liability for invasion of the patient’s
privacy and will generally fulfill the duty to warn. However, this does not mean just
calling the police. The medical care practitioner should find out the procedures that
their state law provides for reporting and confining a person who is a danger to self
or others. This usually involves some kind of affidavit attesting to the diagnosis and
its factual basis, as well as identifying information about the patient. When the
process is completed appropriately, the patient will be picked up and evaluated by a
mental health expert, usually over a two- or three-day period. Only if this process
fails, or is unavailable, should the medical care practitioner start warning third
parties.
5. Elder and Spousal Abuse
Most states now have laws requiring reporting of elder and/or spousal abuse. Just
like with child abuse, medical care professionals should make the reports and leave
the investigation to the proper agency. Remember that the victim does not have to
“press charges” for these crimes to be reportable. It is the state that brings criminal
charges, even if the victim is an adult.
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