In clinical psychological practice in the United States, duty to warn requires a clinician who has reasonable grounds to believe that a client may be in imminent danger of harming himself or others to warn the possible victims.[4] Duty to warn is among the few exceptions to a client's right to confidentiality and the therapist's ethical obligation to maintain confidential information related in the context of the therapeutic relationship. In the American Psychological Association's Ethical Principles of Psychologists and Code of Conduct, the therapist's duty to warn is implicitly contained within the guidelines for disclosure of confidential information without the consent of the client: "Psychologists disclose confidential information without the consent of the individual only as mandated by law, or where permitted by law for a valid purpose such as to … protect the client/patient, psychologist, or others from harm."[5] In situations when there is cause for serious concern about a client harming someone, the clinician must breach confidentiality to warn the identified victim/third party about imminent danger.[6][page needed] Although laws vary somewhat in different states, in general, the danger must be imminent and the breach of confidentiality should be made to someone who is in a position to reduce the risk of the danger.[4] People who would be appropriate recipients of such information would include the intended victim and law enforcement.
Duty to warn is embedded in the historical context of two rulings (1974 and 1976) of the California Supreme Court in the case of Tarasoff v. Regents of the University of California.[7][page needed][8] The legal case was brought by the Tarasoff family after their daughter, Tatiana Tarasoff, was murdered by Prosenjit Poddar, who had received psychological services in the university counseling center. Poddar had made it known to his psychologist, during a session, that he wanted to kill Tarasoff, and his psychologist informed the campus police, following the session, of the danger that Poddar posed to himself and others and suggested that hospitalization might be necessary. The psychologist also wrote a letter requesting assistance to the chief of campus police. Upon investigation by the police, during which Poddar was briefly detained for questioning, he was released because his mental state seemed to be stable and rational. Shortly thereafter, the director of the department of psychiatry at Cowell Hospital asked for the police to return the letter and ordered that Poddar's therapy notes should be destroyed. No one ever warned Tatiana Tarasoff. Poddar killed Tatiana Tarasoff on October 27, 1969, and her parents filed suit against several of the organizations and individuals who had been involved. The case was initially dismissed by a lower court, but her parents appealed to the California Supreme Court, which upheld the appeal in 1974 and reaffirmed the ruling in 1976. The case was settled out of court when Tarasoff's parents received a substantial sum of money.[citation needed]
Explicit in the court's decision was the principle that the confidentiality of the therapeutic relationship is subordinate to the safety of society and its members.
