The Patient or His Victim: The Therapist's Dilemma

Abstract

A distraught young man seeks help and counsel from a psychotherapist.During treatment he confides his plan to kill his former lover, who has jilted him and destroyed his pride.The therapist believes him.What must he do?If he warns the potential victim or alerts the police, he violates confidentiality, jeopardizing the therapeutic relationship and, with it, perhaps the best chance of preventing the threatened harm.If instead he relies on his ability to dissuade the young man in time and fails,-an innocent person's life may be lost.That this is no idle school hypothetical is borne out by Tarasoff V. Regents of the University of California,' a case presently before ithe Supreme Court of California.We do not propose to discuss that case as such, lest we get entangled in or limited by its specific facts or the posture in which it is now being considered on appeal.'Rather, We prefer to explore the therapist's dilemma 3 as a general model, in search of an acceptable accommodation between his potentially conflicting obligations to the patient and to the threatened victim.Alternatively, we can formulate the issue using the conventional terminology of torts, by asking whether a therapist in this delicate situation owes to the threatened victim a duty of reasonable care compatible with his responsibility for safeguarding relevant interests of the patient.The question of whether the law imposes on the therapist a duty