Warning a potential victim of a person's dangerousness: clinician's duty or victim's right?

The legal duty of a psychiatrist or psychotherapist to warn an identifiable victim of a patient's serious threat of harm has been well recognized in U.S. jurisprudence and clinical practice since the Tarasoff decision of the Supreme Court of California in 1976. Warning practices vary over a spectrum ranging from those that are essentially legally required duties of clinicians to those based on rights of actual or potential victims to be warned of a specific event. These practices can be categorized as follows: (1) warning of the risk of violence; (2) warning of the threat of violence; (3) requested warning; and (4) criminal victims' warning mandated by statute. As legal requirements and clinical standards for Tarasoff-type warnings continue to evolve, it behooves mental health professionals to recognize these four different types of warnings. Although not all are equally supported in law, all four practices can appear to carry some measure of legal obligation.