Patient Client Confidentiality


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On the case of Tarasoff v. Regents of University of California presented before the Supreme Court of California, Tobriner, the author, argues that the privilege of confidentiality guaranteed through physician-patient relationship should be breached in cases where the need to protect an individual or the society from threats of harm arises. His argument is concurrent with that of the Court which held on July 1, 1976, that if on the basis of patient’s confidentiality statements and professional judgment, the psychotherapist believes that an individual is at risk of being harmed by a patient, the psychotherapist has a duty to protect such an individual.
The author is of the opinion that the murder of Tatiana Tarasoff by Prosenjit Poddar could have been avoided. He, therefore, argues that through certain laws, such a case could be avoided in the future. Tobriner’s argument is driven by the need for the safety of the public from acts of violence which he contends to be much significant than the doctor-patient confidentiality. He is, however, not quick to undermine the importance of such confidentiality. However, given that such a case involved a mentally ill individual, the author is of the opinion that the therapist, being aware of his patient’s condition and intentions should be held liable for omission of information that could deter crime.


Thesis: the public interest in safety from violent assault must be weighed against the patients’ right to privacy.

            Tobriner’s argument is concrete with solid references that support his points. For instance, he does not merely accuse the defendant therapists of liability for Tatiana’s death but goes ahead to reference previous cases such as Dillon v. Legg (1968) and Rowland v. Christian (1968). Other cases that are cited in the argument include Heaven v. Pender (1883), Rodriguez v. Bethlehem Steel Corp. (1974), Wright v. Arcade School Dist. (1964), Wojcik v. Aluminum Co. of America (1959), among many others. The author does not hesitate to apply critical thinking to analyze such cases and apply them to his argument. He is also not ignorant to existent laws and is careful not to contradict them. A good example is where he notes that indeed under the common law, a person neither owes a duty to control the conduct of another person nor to warn those who are endangered by such conduct. He, however, points to the exception to this rule where there is a special relationship between the given parties. The author also proves to be unbiased in his argument by being keen to consider carefully both sides. A great example is where, despite his stance, he recognizes the difficulty faced by a psychotherapist in determining whether the patient poses danger to the society.

This paper agrees with the author’s conclusion that the therapists should have in fact taken steps to notify the deceased of the imminent danger even if that meant breaking the physician-patient confidentiality. This is informed by the fact that indeed public safety should always be a priority and supersedes the confidentiality issue. Despite this paper concurring, it is quite aware of certain issues that are raised by Tobriner’s argument. He is, however, not blind to these various problems that arise from his conclusion. One of the major issues is that a breach of confidentiality might hinder the treatment of mentally ill patients. This means that such patients might not be comfortable to share their thoughts. Another issue is that the therapists might make erroneous judgments in predicting acts of violence by the patients since very few of such threats are ever executed. However, it would be fair to say that the author handles these problems exhaustively.

However, those of a dissenting opinion may not be very eager to agree on the issue of prediction of violence. Tobriner does admit that the frequency of erroneously predicting that a mentally ill patient will commit a crime is very high. Those of a contrary opinion also add that the idea of a psychotherapist using predictions is unprofessional and far-fetched. After all, the profession mainly aims at diagnosis and treatment. Despite these presented facts, this paper leans towards the author’s views since he proposes that the therapists should not be held accountable in a court of law based on erroneous judgments and predictions.

Also, when it comes to breaching confidentiality, those against such a legislature might argue that it is an infringement of the right of treatment for the mentally ill. It is well known that such patients face stigma and thus one of the factors that encourages them to seek treatment is the guaranteed confidentiality. Lack of this factor might discourage treatment hence doing great harm to society. The result is a large number of untreated mentally ill patients who pose a great risk to society. Even in cases where they seek treatment, they would not be open to disclosing everything for fear of prosecution which is a great hindrance to effective treatment. The author’s solution to this is that any disclosure of confidential information should be done discreetly so as not to infringe on the patient’s right to treatment. However, the process of such disclosure does require being well-established through legislature to ensure that the issue of interference with treatment is addressed (Briefs, 2013).


By adopting the author’s argument that Public safety from violent assault supersedes the patient’s right to privacy, we have greater chances of avoiding such assaults as the one where Poddar killed Tarasoff. This paper scrutinizes Tobriner’s argument critically and agrees with his opinion. Bias is also avoided by studying concerns of those who may dissent. This paper is satisfied that the author addresses such concerns. The fact that public safety is of much importance than an individual is the view that informs this paper. However, this paper is quick to note that, according to the author, certain steps can be undertaken to ensure the patient’s welfare even in cases of such disclosure of confidential information.



Briefs, C. (2013). Tarasoff v. Regents of University of California. Retrieved from


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