LANDMARK CASES IN FORENSIC PSYCHIATRY:

Duty to Protect

Poddar, a university student, confided to a psychologist at the UC student health center that he intended to kill Tarasoff, a student in whom he had an unrequited romantic interest.
The psychologist notified police, who briefly detained Poddar before releasing him.
Tarasoff and her family were not notified, and 2 months later, Poddar killed Tarasoff.
Tarasoff’s parents sued the therapist and UC.
Psychologist argued no duty to third parties, need to protect patient confidentiality, and that dangerousness is difficult to predict.
Tarasoff I Ruling (1974): therapists have a duty to warn third parties when a patient represents a serious threat.
Tarasoff II Ruling (1976): case was reheard, finding a duty to protect identifiable third parties from a dangerous patient based on foreseeability.

When a therapist knows, or should know, that a patient represents a serious danger to an identifiable third party, there is a duty to use reasonable care to protect the intended victim, which may include warning them or notifying police.
Confidentiality is not absolute when there is a foreseeable risk of harm to identifiable individuals: “The protective privilege ends where the public peril begins.”
Tarasoff is a Supreme Court of California case, but other states have similar requirements.

Lipari was shot, and her husband killed, by Cribbs.
Cribbs had previously been committed to a psychiatric hospital and had recently received care through the Veterans Administration.
Lipari sued Sears, who sold the gun to Cribbs, claiming that they shouldn’t have sold a gun to someone “mentally defective” and previously committed. Sears then filed an FTCA claim against the US for negligent treatment at the VA, followed by an FTCA claim by Lipari.
Nebraska District Court ruled that there is a special relationship between therapists and their patients, and a duty to protect third parties, extending Tarasoff to Nebraska.
Psychiatrists are not responsible for all acts of violent patients, but there was a failed duty to protect.

Extended Duty to Protect to Nebraska.
Potential victims are not limited to named or specific individuals, but those who belong to a “class of persons” to whom harm by the patient is “reasonably foreseen.”