A 26-year-old man presents to his psychiatrist for his weekly scheduled visit. The patient has a 3-year history of severe major depressive disorder with psychotic features and is currently treated with a combination of sertraline and olanzapine. At the visit, the patient appears extremely agitated and describes that his week has been stressful due to difficulties at work. Towards the end of the visit, he tells the physician that he plans to attack his boss when he starts his shift the following day.
The physician’s legal obligation regarding this disclosure is guided by which of the following principles?
- A) Fick’s law
- B) Good Samaritan law
- C) Primary prevention
- D) Tarasoff rule
- E) Tertiary prevention
D) Tarasoff rule
This rule, based on a Supreme court decision, obligates physicians to breach confidentiality when a patient threatens to harm another person. The physician should contact the police and try to warn the potential victim.
Answer choice A: Fick’s law, is incorrect. This is a gas exchange equation that states the rate of gas diffusion is directly proportional to the gas’ partial pressure difference and diffusion surface area, and inversely proportional to barrier thickness.
Answer choice B: Good Samaritan Law, is incorrect. This law limits the liability of physicians who treat patients in an emergency when the physician is not receiving compensation.
Answer choice C: Primary prevention, is incorrect. This refers to actions taken to prevent disease processes from ever occurring. Examples include the use of sunscreen and vaccinations.
Answer choice E: Tertiary prevention, is incorrect. This refers to actions taken to prevent disease sequelae and reduce disability from illness. Examples include routine measurement of hemoglobin A1c as a metric of long-term glycemic control in patients with diabetes.
Key Learning Point
The Tarasoff rule mandates that physicians breach patient-provider confidentiality when the patient threatens harm against someone.