Medical Confidentiality: Patient's Threats Toward Ex-Wife Properly Reported To Police, Court Rules

Medical Confidentiality: Patient's Threats Toward Ex-Wife Properly Reported To Police, Court Rules

Legal Eagle Eye Newsletter for the Nursing Profession

It is not a breach of medical confidentiality for a healthcare professional to warn a potential victim of a patient's dangerous propensities, the Superior Court of Delaware has ruled.

Courts around the U.S. are not just overlooking the traditional definition of medical confidentiality to protect potential victims, but are now imposing an affirmative duty on psychiatrists, psychologists, therapists and other mental health workers, in inpatient and outpatient settings, to warn identifiable victims when patients make threats toward them, according to the case precedents the Delaware court reviewed in its formal opinion.

In this case, an armed forces veteran was receiving outpatient therapy for chronic alcohol abuse. Over the past twenty years he had been considered bipolar. It was known to his therapist that he had killed his brother some years before, but found not guilty by reason of insanity.

During the course of therapy the patient repeatedly voiced an intention to kill his ex-wife. It was known that his ex-wife had left the state and was living in hiding because of his harassment, intimidation and threatening conduct.

Finally, the patient stated he was leaving town that evening to find his wife and kill her. The therapist called the local police and the police in the county where the wife was known to be living. Working together, the two police agencies apprehended the man, one and one half miles from the intended victim's residence, with a newly-purchased hunting knife and roll of duct tape in his car. He was charged with making terrorist threats and attempted murder. The court had nothing but praise for the therapist's actions. State vs. Bright, 683 A. 2d 1055 (Del. Super., 1996).