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Ethics... Exoploring Privacy and Confidentiality: Gray Areas
The correct answer is A, say "hello" to the client and continue walking. Did you come up with something different? Well, here is my thinking...This one involves a judgment call.
C, act as if you do not see the client, could be a correct answer if the therapist and client have previously discussed what to do if this situation should arise. However, this previous agreement was not indicated in the question.
A, say "hello" to the client and continue walking, is a better answer, because it could apply whether or not such previous discussion has been held.
B, say "hello" and ask how Mildred feels about this accidental meeting and
D, carefully observe the client's social functioning in this community setting, blur the boundaries of a professionally distant relationship, and both of these answers involve the possibility of revealing to others the nature of the therapist's and client's relationship. A does not do so because even total strangers might exchange a simple, friendly greeting in the mall if their paths crossed or if they make eye contact.
♦ The Tarasoff Decision
Ethics necessarily entails, then, two types of respect, a respect for the law and a respect for the other.
In 1974 the California Supreme Court established the principle that requires physicians and psychotherapists to warn intended victims of dangerous patients. This is known as the Tarasoff decision. It brought to widespread attention the legal principle known as the "duty to warn."
Key provisions of the duty to warn were elaborated in a 1976 court decision containing the following statement:
When a therapist determines, or pursuant to the standards of his profession should determine, that his patient presents a serious danger of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger. The discharge of this duty may require the therapist to take one or more of various steps, depending upon the nature of the case. Thus, it may call for him to warn the intended victim of the danger, to notify the police, or to take whatever other steps are reasonably necessary under the circumstances.
The Tarasoff decision is not a specific law. It is a legal principle based on an interpretation of laws and precedents. Therefore, the duty to warn is an evolving principle.
Note that the Tarasoff Decision ruled that the therapist should have warned the intended victim or the police. Subsequent decisions, however, have required notification of both the intended victim and the police. Also, note that the Tarasoff Decision involved a threat to commit murder. It is not clear how much violence, short of murder, requires a duty to warn.
♦ Six Principles in Carrying out Duty to Warn:
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