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Duties in Retrospect: Ethical Limitations to the Psychiatrist’s Duty to Warn

Grimes, Tinsley Holloway (2024) Duties in Retrospect: Ethical Limitations to the Psychiatrist’s Duty to Warn. Master's Thesis, University of Pittsburgh. (Unpublished)

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Abstract

Tarasoff v. Regents of the University of California established that mental health professionals in California have a legal duty to seek to protect individuals who are foreseeably endangered by violent patients, including warning them of threats of harm. In the wake of this landmark case, many other states mandated legal duties to protect in general, or warn specifically, either through statute or case law. At the same time, an ethical discourse emerged, challenging the duty to warn on the grounds that it forces physicians to breach confidentiality, an ethical obligation fundamental to medical practice. This thesis examines the origins of the legal duties to protect and warn, the consequences of these duties to the practice of psychiatry, and the conflict between legal and ethical obligations to patients and the public. Although psychiatrists have a professional obligation to maintain patient confidentiality, this obligation may be set aside in the interest of public safety. However, limitations in predicting violence thwart the psychiatrist’s ability to recognize when confidentiality should be set aside. Ultimately, imposing a mandatory legal duty to protect, and specifically a duty to warn ignores the complexity surrounding patient violence. Permissive laws are more sensible, but even these may not prevent violence, making them less justifiable ethically.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Grimes, Tinsley HollowayTHW17@pitt.eduTHW170000-0002-0291-5381
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee MemberMoschenross, Darcydmm207@pitt.edu
Committee MemberParker, Lisa S.lisap@pitt.edu
Committee ChairRozel, Johnjsr39@pitt.edu
Date: 27 August 2024
Date Type: Publication
Defense Date: 2 August 2024
Approval Date: 27 August 2024
Submission Date: 7 August 2024
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 47
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Bioethics
Degree: MA - Master of Arts
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: ethics, confidentiality, role morality
Date Deposited: 27 Aug 2024 11:32
Last Modified: 27 Aug 2024 11:32
URI: http://d-scholarship.pitt.edu/id/eprint/46872

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