Search Results

Confidentiality and the Prediction of Dangerousness in Psychiatry

William J. Curran

in Applied Ethics in Mental Health Care: An Interdisciplinary Reader

The author provides a contemporaneous and critical perspective of Tarasoff vs. Regents of the University of California and articulates concerns about the so-called ‘duty to warn’.

Confidentiality

Anita L. Allen

in Unpopular Privacy: What Must We Hide?

This chapter argues that employee and professional confidentiality rules coerce silence, generally for good purposes. Confidentiality is an arena of justified information privacy coercion. Keeping ... More

This chapter argues that employee and professional confidentiality rules coerce silence, generally for good purposes. Confidentiality is an arena of justified information privacy coercion. Keeping appropriate silences has been recognized as a challenging goal of personal virtue since Aristotle. When employees and professionals obtain knowledge of others in the course of their work, they incur ethical responsibility to comply with a complex set of civility rules, including those of confidentiality. Rules of silence are spelled out in ethical codes and are enacted into law. The people who manage corporations are duty bound to maintain trade secrets and to not disclose information that may lead to trading on insider information. The laws of confidentiality for health care professionals are open to criticism but are generally popular. The laws that require confidentiality of lawyers are also open to criticism, and are somewhat less popular. Many people are ambivalent about the adversary system that enables lawyers to profit handsomely from keeping the secrets of despicable criminals. Financial incentives exist for voluntarily assuming difficult legal burdens of silence. Payment for secrecy is not the whole story of why confidentiality is justly coerced. The larger story involves dignity and respect for moral agency, moral autonomy and the welfare of citizens of liberal democracies. Laws that demand confidence-keeping of professionals (lawyers, doctors, corporate insiders) are generally popular -- that is, they are generally applauded by the public and embraced by practitioners in the field along with experts who study the field.Less

Violent Threats

Anne C. Dailey

in Law and the Unconscious: A Psychoanalytic Perspective

The law generally takes people at their word. For example, contracts are interpreted based on the objective meaning of the written terms rather than by reference to the parties’ subjective intent. In ... More

The law generally takes people at their word. For example, contracts are interpreted based on the objective meaning of the written terms rather than by reference to the parties’ subjective intent. In contrast, psychoanalysis rarely trades in literalisms, instead examining words for their hidden associations, connotations, implications, and ambiguities. This chapter explains how a psychoanalytic perspective on the meaning of words reworks the law’s presumption of transparency. The discussion focuses on the law governing violent threats communicated to therapists but directed at third parties, the so-called Tarasoff rule. Under this rule, when a patient says to her therapist, “I am going to kill him,” the law requires that the therapist take the patient at her word. But while the Tarasoff rule may protect some potential victims, a psychoanalytic perspective suggests that the rule may do more harm than good, in particular by discouraging those individuals who struggle with violent thoughts to seek treatment, thus raising the risk of their resorting to violence. Psychoanalytic insights into interpretive opacity, transference, regression, and acting out illuminate how the law’s pragmatic reliance on the literal meaning of words can undermine the law’s own goals to protect individuals from harm to themselves and others.Less

Risk Assessment in the United States

David DeMatteo, Stephanie Brooks Holliday, Meghann Galloway, and Unnati Patel

in International Perspectives on Violence Risk Assessment

Violence risk assessment in the United States has advanced significantly during the past few decades, with notable developments in the areas of empirical research, instrument development, and legal ... More

Violence risk assessment in the United States has advanced significantly during the past few decades, with notable developments in the areas of empirical research, instrument development, and legal requirements that violence risk assessments be conducted in certain criminal and civil contexts. This chapter provides an overview of the current state of violence risk assessment in the United States. The chapter begins by giving a context for violence risk assessment in the United States by briefly tracing the development of violence risk assessment, and by describing the intersection of the mental health and criminal justice systems. The chapter then focuses on contemporary issues in violence risk assessment and commonly used violence risk assessment tools. The chapter concludes by discussing implications for research, policy, and practice.Less