Abstract
In the years since the original Tarasoff cases created a new duty for psychotherapists toward third parties harmed by patients' violence, a series of cases nationwide—so called “driving cases”—have applied Tarasoff-like reasoning to situations where a patient injured others while driving a car. Our thesis in this paper is that such application is inappropriate since it represents an unjustified and largely unexamined assumption that driving injury is an expression of the mental-illness-derived intended violence that justifies the Tarasoff duty and its inevitable associated breach of confidentiality. We suggest to the contrary that driving cases almost invariably result from a patient's negligent driving rather than intentional violence stemming from mental illness; that clinicians in most instances have almost no capacity, training, or clinical bases on which to predict a patient's future negligence, violence aside; and that the theory of driving cases should be revised.
Footnotes
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From the Program in Psychiatry and the Law, Massachusetts Mental Health Center, Harvard Medical School and the Charles C. Gaughan Fellowship in Forensic and Correctional Psychiatry, Bridgewater State Hospital, Bridgewater, MA. Reprint request to Dr. Gutheil at 74 Fenwood Road, Boston, MA 02115. The authors acknowledge their indebtedness to members of the Program for critical review and comments and to Debra Morley, M.A., and Ellen Rubin, M.M.H.S., for assistance in the preparation of this manuscript.
- Copyright © 1993, The American Academy of Psychiatry and the Law
