title: Misapplication of the Tarasoff duty to driving cases: a call for a reframing of theory.
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.
authors.affiliation: Program in Psychiatry and the Law, Massachusetts Mental Health Center, Harvard Medical School, Boston, MA.
authors.forename: R W
authors.initials: RW
authors.lastname: Pettis
authors.forename: T G
authors.initials: TG
authors.lastname: Gutheil
mesh_terms: D000063:Accidents, Traffic / Q000331:legislation & jurisprudence* / Q000523:psychology; D003617:Dangerous Behavior; D017007:Duty to Warn / Q000331:legislation & jurisprudence*; D005104:Expert Testimony / Q000331:legislation & jurisprudence; D006801:Humans; D007298:Insanity Defense; D016365:Liability, Legal; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation; D028642:Persons with Psychiatric Disorders; D010819:Physician's Role; D011613:Psychotherapy / Q000331:legislation & jurisprudence*; D012307:Risk Factors; D014754:Violence