The responsibility of professionals in the medical management of violent and threatening patients is discussed using the Tarasoff case (American) and the Lawson case (Canadian) as landmark cases influencing subsequent jurisprudence.
It is becoming increasingly important to be aware of the court's interpretations in such areas as confidentiality, predictions regarding dangerousness, the duty to warn, and the legal duty to strangers to the therapist/patient relationship. A number of other issues relating to the risks involved in management of patients potentially dangerous as a result of the use of drugs are also discussed.
References
1.
(1974), 529 P.2d 553 (Cal.Sup.Ct.) and (1976), 551 P. 2d 334 (Cal.Sup.Ct.). All further references to the Tarasoff case will be to the 1976 judgment of the Supreme Court of California.
2.
(1977), 76 D.L.R. (3d) 688.
3.
People v. Poddar (1974), 518 P. 2d 342 (Cal.Sup.Ct.).
4.
See Reibl v. Hughes (1980), 114 D.L.R. (3d) 1.
5.
Note 1 above, at 346.
6.
Ibid. at 347; see also DickensB.M.“Legal Protection of Psychiatric Confidentiality”,Int'l J Law and Psychiatry1978; 1: 255–281.
7.
Ibid. at 344.
8.
See for instance WebsterC., DickensB.M. and AddarioS.Constructing Dangerousness: Scientific, Legal and Policy Implications (1985), Centre of Criminology, University of Toronto; J.W. Hinton, Dangerousness: Problems of Assessment and Prediction (1983); J. Monahan, Predicting Violent Behavior: An Assessment of Clinical Techniques (1981).
9.
Citing Bardessono. v. Michels (1970), 478 P. 2d 480 (Cal.Sup.Ct.) at 484.
10.
Note 1 above, at 345.
11.
See Mcintosh vs. Milano (1979), 403 A. 2d 500 (N.J.Super.Ct.) at 511–512.
12.
Note 1 above, at 344, citing FlemingJ.G. and MaximovB.“The Patient or his Victim: The Therapists's Dilemma” (1974), 62 California Law Rev. 1025–68, at 1030.
13.
Ibid. at 340.
14.
See note 2 above, at 692.
15.
See more generally DickensB.M.“Prediction, Professionalism and Public Policy” In: C.D. Webster, M.H. Ben-Aron and S.J. Hucker, Dangerousness: Probability and Prediction, Psychiatry and Public Policy (1985) 177–207.
16.
The series of cases changed name as different Commissioners held office; the best known decision in the case is Rogers v. Okin (1979), 478 F. Supp. 1342 (U.S.Dist.Ct., Dist.Mass.).
17.
StoneA.A.Law, Psychiatry, and Morality (1984) at 185–186.
18.
Note 1 above.
19.
R.S.O.1980, c. 262.
20.
Lawson v. Wellesley Hospital (1974), 44 D.L.R. (3d) 24 (Ont.Co.Ct.). At the time, the present s. 63 was numbered s. 59.
See generally W.J. Curran and T.W. Harding, The Law and Mental Health: Harmonizing Objectives (1978).
23.
See The Mental Hospitals Act, R.S.O. 1960, c. 236, s. 1(m), and the discussion in B.A. Martin, “Criteria for Civil Commitment: Medicolegal. Impasse”, in C.D. Webster, M.H. Ben-Aron and S.J. Hucker, note 15 above, at 161–175.
24.
The Mental Health Act, 1967, S.O. 1967, c. 185, s.8(1)(a).
25.
Note 19 above.
26.
See Rogers v. Okin, note 16 above.
27.
(1983), 671 P. 2d 230 (Wash.Sup.Ct.).
28.
It has been reported that upon release he returned to his native India and is now happily married; see A.A. Stone, note 17 above, at 161.
29.
“Hospitalization of the Dangerous Patient: Legal Pressures and Clinical Responses” (1984), 12 Bulletin Am. Acad. Psychiatry and Law323–329, at 327.
30.
In classical form, it is expressed as volenti non fit injuria.
31.
United States’ courts are increasingly using the doctrine of contributory negligence in preference to the doctrine of assumption of (the entire) risk; see ToddyM.J., “Assumption of Risk Merged with Contributory Negligence: Anderson v. Ceddardi” (1984), 45Ohio State Law J.1059–1076.
32.
WexlerD.B.Mental Health Law and Major Issues (1981) at 168.
33.
WexlerD.B.“Patient, Therapists, and Third Parties; The Victimological Virtues of Tarasoff” (1979), 2Int'l. J. of Law and Psychiatry1–28.
34.
Re Attorney-General of British Columbia and Astaforoff (1983), 6 C.C.C. (3d) 498 (B.C.C.A.).
35.
(1980), 110 D.L.R. (3d) 513 (Ont. C.A.).
36.
See Yepremian v. Scarborough General Hospital (No. 2) (1981), 120 D.L.R. (3d) 341.
