Duty to Warn Jessica Hall PSYCH/545 09/4/2011 Dr. P. Duty to Warn The ethical dilemma I wish to explore is The Duty to Warn. This refers to the duty of a counselor, therapist to breach one of the most important bonds between a client and a therapist; the law of confidentiality. The therapist has the right to break confidentiality without the fear of being brought up for legal action.
If the therapist believes that the client poses a danger, or is a threat to himself, someone else, or society as a whole, the therapist must decide how serious of a threat the client may be, then if he decides it’s a serious issue, he must notify the person in danger, which would e the third party, or the police, or other people who may be in the position to protect that person, or the other people involved from harm. Duty to Warn received its legal precedence in a case in 1976, Tarasoff v. Regents of the University of California.
In this case, a student named Prosenjit Poddar was seeing a psychologist at the student health center at the university. He was in love with a woman named Tatiana Tarasoff, to the point of pure pathological obsession, or attachment. The psychologist, noticing his actions, seeing how attached he was to Tatiana, and on top of that, he had purchased a gun, the psychologist did the smart thing and alerted officials about Poddar. The police talked to Poddar and didn’t feel that he was a threat, so they just told him to stay away from Tatiana. Unfortunately, two months later, he killed Tatiana.
Her parents tried to sue the university, and the police, but the courts dismissed the case. This case made it very clear of the therapist’s duty to inform and use great care to protect third parties against the danger that one of their clients might pose. The above describes the ethical dilemma being explored. Now, I will apply the first 14 steps in the ethical decision making process to my selected issue of Duty to warn, and finally I will explain the importance of ethical decision making in professional psychology. 1. Identify the situation that requires ethical consideration and decision making. The ituation is the decision to breach the confidentiality between a client and his patient. The therapist has to decide if the client will pose a threat to himself or any other 3rd party, or society as a whole. If the therapist feels in any way that the client could be a threat, he has the right to notify the person or the correct officials to insure that no harm comes to anyone involved. 2. Anticipate who will be affected by your decision. The client would be affected, and his family, if he still has ties with his parents or siblings. If it was a specific person that the anger was focused on, they would be affected, as well as their families.
If the anger was just targeted at society, society as a whole would be affected. By making a decision to report such anger, the therapist is taking everyone out of harms ways, or the chance of potential danger. 3. Figure out if who is the client. In this certain dilemma, the client has already been identified. 4. Assess the relevant areas competence-and of missing knowledge, skills, experience, or expertise-in regard to the relevant aspects of the situation. The therapist has to be ready for whatever the outcome of his decision may be. The biggest thing will be the breach of confidentiality, but he is protected by law.
It is better for him to report the client to the 3rd party or official and nothing occurs, then to not report the client, and someone gets hurt. So much better to be “safe than sorry”. 5. Review relevant formal ethical standards. The Duty to Warn gives the therapist the right to breach confidentiality, which would in many cases be unethical, but since it involves the safety and well being of the client and the people involved, this breach is allowed. The only unethical standard would be to know that the client will pose a threat to someone, and do nothing, or do not report it, and someone ends up hurt, or worse, dead. . Review relevant legal standards. As I stated in the beginning, Tarasoff v. Regents of the University of California, 1976. The therapist has a right to inform a 3rd part if their client proves to be a threat to them. Another case, in which the court included going over clients past records or files to see if any patterns or history of violence is present, is the case of Jablonski by Pahls v. United States in 1983. Mr. Jablonski was dating Ms. Kimball, and he threatened to kill her and her mother. After he continued to threaten her mother, Ms.
Kimball took him to the Loma Linda VA Hospital, the doctor did a risk assessment, but he failed to look at his past records, which would have let him know that Mr. Jablonski had a violent past. The doctor determined he was not a threat, but told Ms. Kimball to be careful, when he was released, he killed her. 7. Review the relevant research and theory. Research does not have to be done to know that a person’s safety comes first. Any client, that a therapist feels may be in harm’s way, or may present harm to someone else, must be reported to a third party or police. 8.
Consider how, if at all, your personal feelings, biases, or self-interest might affect your ethical judgment and reasoning. The first feeling that comes to mind should be obligation, or duty. The therapist has an obligation, not only to keep the client safe, but the public. The last feeling the therapist should have is resentment…he should not be wondering what if…That is the reason it is so important to go with your first feeling, if you believe the client is a threat. Not doing the right thing and reporting the client could end up in tragedy and cost the therapist his license, or worse, legal action. . Consider what effects, if any, that social, cultural, religious, or similar factors may have on the situation and on identifying ethical responses. The client may believe that since it is his therapist, that what he says can never be repeated, but due to the nature, it can. Even in the armed forces, they have a code of “don’t ask don’t tell” when dealing with homosexuality, but in this particular case if a therapist doesn’t tell, the end result could be tragic. Safety is very important. 10. Consider consultation
The therapist may consult a fellow employee and get his opinion, but again, the therapist is the one that has been seeing the client and has viewed his records, but if the therapist needs a co signer or a second opinion to back his decision, that is fine. Bottom line is to not over think a situation. If the therapist believes the client is a threat, he should take the proper actions. 11. Develop alternate courses of action. When it comes to the safety of the client and 3rd party, there should be no alternate course because the end result could be death. If client is a danger, intervention, not alternatives should take place. 2. Evaluate the alternate courses of action. No need when a person’s safety is on the line. 13. Try to adopt the perspective of each person who will be affected. The client that was reported maybe feels betrayed. They may believe that the therapist broke the rule of confidentiality. If it was a person who the anger was channeled, I believe the feel gratitude that the therapist decided to not hold information, and contact them and the authorities. If the anger was in general, not focused on just one person, society would also be thankful the therapist reported the client. 4. Decide what to do and then review or reconsider it. You should not reconsider a situation when it is dealing with the well being of others. A psychologist has to determine the appropriate course of action to take when dealing with difficult dilemmas. If the psychologist possesses good ethical decision making skills, and his personal standards of right or wrong determine him to make ethically sensitive choices or decisions, his ethical decisions making skills, solving ethical dilemmas will be much easier, and the course of action he chooses will be correct.
A very important skill to have in the field of psychology. References Simon, R. I. (2001). Psychiatry and the Law. American Psychiatric Publishing. 1987 Stone, AA: The Tarasoff Decisions: suing psychotherapists to safeguard society. Harvard Law Rev 90:358-78, 1976 “Warning a Potential Victim of a Person’s Dangerousness: Clinician’s Duty or Victim’s Rights? ” Journal of the American Academy of Psychiatry and the Law Online. 2006. Retrieved 2011-09-04.