While the Agacki decision involved an evidentiary issue in a criminal proceeding, the finding and conclusion of the court has direct applications for mental health care providers. The court of appeals agreed. Often, it is not always clear to mental health professionals when the duty of confidentiality gives way to the duty to warn. The Agacki court set forth standards in an effort to assist therapists in resolving the seemingly conflicting duties.
Likewise, police have a duty to take appropriate action once warned. It would result in an absurd result if police could not then present conversations with the therapist to show probable cause. In making the assessment as to whether the dangerous patient exception exists, treating professionals should remember that:.
Although the duties described in this article apply directly to individual therapists, hospitals and nursing homes that employ therapists need to be aware of the scope of these duties. In an employment setting, tort liability based on negligent acts of employees can extend to the employer. Thus, it is important that employers ensure employed therapists remain educated on this issue.
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In Wisconsin, the dangerous patient exception has not been extended to other health care providers, such as nurses or emergency room physicians. In other words, the therapist may be the only person in a position to prevent the imminent harm. As such, he or she has a responsibility to act.
Whether the duty will be extended to others in the future is an unanswered question. There is certainly a good argument that absent that unique relationship, patient confidences should remain confidential, and no other health care providers should owe such a duty to the general population. It is intended for general information purposes for the community and highlights recent changes and developments in the legal area.
This publication does not constitute legal advice, and the reader should consult legal counsel to determine how this information applies to any specific situation. The issue you raise is huge…knocking down patient-therapist relationship on what grounds? The patient said he hated women? He said people would pay someday?
Confidentiality and its Exceptions
What criteria does the judge use for a civil commitment hearing? You are no more entitled to make people stupider than anyone else. That is not the case, and that must not be spread as if it might be the case. I guess the common refrain is that if he was a sociopath then a therapist could try modifying his behavior through conditioning him to see how others view him. Detain those who made no direct threats?
Better to work to point out the error of the path than to add to the confusion.
Raising the issue draws attention away from the fact that his parents called the police over alarming videos he had posted online, and the deputies apparently did not even look at the videos before they contacted him. If they had seen the videos, they would have searched his name on the relevant firearms databases, where it would have shown his many recent purchases of firearms. That would have been enough to hold him for 24 hours and search his house and computer, and his posts on PUAhate would have been enough to get him detained and made it an uphill battle for his attorney to get him out of a secure mental institution.
They did not need his therapist. I am not trying to make light of this terrible tragedy at all, but the fact of the matter is that sometimes terrible things happen and there is nothing concrete that could have been done to stop them. Or the implication of the potentially helpful actions are so negative, that we are prepared to accept the risk. It is entirely unclear how a watering down of Tarasoff would have made a difference here.
The police in this case had actually been notified and did nothing.
Complexities and Misunderstandings
I suspect they could have searched to see if Elliot had a gun or guns, my understanding is that they were all legally obtained and registered. The sad thing is there is likely nothing that can be done to prevent such tragedies from ever occuring. The goal is to minimize them to the extent possible. I would think in the circumstances the discussion would be more about effective access to mental health treatment rather than creating reasons people would be afraid to get treatment.
Sometimes, there is no answer that solves a problem, but every attempted answer brings more problems. I cannot help thinking that it is difficult, if not impossible, to establish a fool proof method of identifying someone who might decide to take out their anger or failings on someone else in this manner.
Both John Douglas Mindhunters and Anatomy of Motive and Paul Britton Jigsaw Man and Picking up the pieces have written excellent books regarding their experiences in dealing with minds who are out of balance. What is apparent from these works by people who are highly qualified in judging such matters is how subtle the cues are and how easy it must be to get it wrong. Disturbed people can be highly intelligent and fully capable of convincing others that they are not dangerous, that said however, it does seem as if in this instance Elliot Rodger exhibited enough signs for him to be dealt with before he started murdering.
As RROSE mentioned above, we are not in need of more rules, just more folk who are willing to do what they are expected to do. My sympathies are with all those affected by this pointless brutality. There are signs, but they are the same signs as shown by many psychotics who never harm anyone. But his mom called the cops. He stabbed three and the others he shot.
The Court Revisits The "Dangerous Patient E | von Briesen & Roper
A new day is dawning! Fubar, I hope you know that you have so much promise here within the back pages of the SJ comment section. However, to unlock your full potential, I personally, would recommend more sprits and or a few dozen or so garden variety synthetic and naturally refined opiates and potentially some other brain chemistry altering and enhancing pharmaceutical concoctions if that fails.
Related The Duty to Warn Revisited
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