*1 No. 23042. July [S.F. 1976.] al.,
VITALY TARASOFF еt Plaintiffsand Appellants, THE REGENTS OF THE al., UNIVERSITY OF CALIFORNIA et Defendants Respondents.
Counsel Alexander
George Plaintiffs and McKray Appellants. Robert E. Demanes, A. William H. I. Edward Cartwright, Floyd Tally, Pollock, Sacks, Leonard I. Sanford M. Robert Stephen Zetterberg, Gage, O. and Melanie Bellah Amici as Curiae on Angle behalf Plaintiffs Appellants.
Ericksen, Ericksen, Arbuthnot, Ericksen, Mackenroth & Erick- Lynch, sen, Mackenroth, Ericksen, & Ericksen, & Mack- Lynch Lynch, Young Hanna, Morton,
enroth, G. R. Richard Brophy, William Logan, MacLean, V. Jensen, and James Burchell McAleer & Hanna & Brophy for Defendants and Respondents. Sabine, General, James Assistant
Evelle J. E. Younger, Attorney McGuire, General, M. Thomas John Morrison and K. Deputy Attorney Larson, General, Counsel (Los John H. County Angeles), Attorneys Moore, Mikesell, Jr., Counsel, Richard J. Daniel D. Deputy County Charles L. Counsel (Alameda), County Harrington, Deputy County Garrett, Ludlam, Severson, Werson, Counsel, Musick, & James E. Peeler Melchior, Melchior, and Jan. T. & Kurt W. Nicholas S. Freud Berke as Amici Curiae behalf Defendants Chilton Respondents. Opinion killed Tatiana 27, 1969, Poddar
TOBRINER, J. On October Prosenjit earlier Plaintiffs, that two months Tatiana’s Tarasoff.1 allege parents, Moore, a Lawrence kill to Dr. Tatiana confided his intention Poddar at the Universi- Memorial the Cowell Hospital employed psychologist on Moore’s at California request, They allege Berkeley. ty he Poddar, him when but released detained briefly police campus Powelson, that Dr. claim further Harvey rational. They appeared detain taken to that no action be then directed further Moore’s superior, of Tatiana’s No one warned Poddar. peril. plaintiffs neither causes of action these facts set forth against Concluding involved, nor Regents against therapists policemen court sustained as their California superior employer, University *6 without amended demurrers to second defendants’ plaintiffs’ complaints ensued. to amend.2 This leave appeal v. Poddar from this crime reported People 1The stemming criminal prosecution 342],
(1974) 518 P.2d Cal.3d 750 [111 Moorе, who examined Poddar 2The defendants include Dr. the therapist psychologist committed; Yandell, that should Dr. Gold and Dr. psychiatrists and decided Poddar Powelson, decision; and Dr. at who concurred in Moore’s Cowell Memorial Hospital and who Moore’s decision chief of the countermanded department psychiatry, include no Poddar. The defendants that the staff take action to confine police directed Hallerán, Atkinson, but released briefly who detained Poddar and Brownrigg Officers him; confined; Beall, that Poddar be received Moore’s letter recommending Chief who Teel, Atkinson, who, oral communica Officer received Moore’s Officer along and of Poddar. tion detention requesting predicate liability grounds: two defendants’ complaints Plaintiffs’ on danger plaintiffs impending failure to warn their failure to to bring pursuant about Poddar’s confinement the Lanterman- (Welf. § Code, Defendants, turn, & Act Inst. Petris-Short ff.) they owed no to they assert that reasonable care Tatiana and that immune from suit under the California Tort Act of are Claims (Gov. Code, § 810 ff.). explain
We shall that defendant therapists escape cannot liability npt merely because Tatiana herself patient. was their When a determines, therapist pursuant profession standards of his determine, should that his presents a serious danger of violence another, to he obligation incurs to use an reasonable protect care to intended victim against danger. The discharge of duty may this require to take one or more of various steps, depending upon the nature of may the case. Thus it call for him to warn the intended victim or likely apprise others to the victim danger, of the to notify police, or to take whatever steps other reasonably are necessary under the circumstances. bar,
In thе case at plaintiffs admit that defendant therapists notified but police, argue appeal therapists failed to exercise care to protect reasonable Tatiana in they did not confine Poddar and did not warn Tatiana or likely others apprise her danger. of the however, Defendant therapists, public employees. Consequently, to plaintiffs extent that seek predicate liability upon the therapists’ bring failure confinement, about Poddar’s the therapists can claim immunity under Government Code 856. No specific section statutory provision, however, shields them from liability based upon failure to warn Tatiana or likely others apprise her of danger, Government Code section 820.2 does not protect such failure as an exerciseof discretion. that,
Plaintiffs therefore can amend complaints allege regard- their therapists’ attempt Poddar, less unsuccessful they confine since large dangerous, knew Poddar was at their failure to warn likely danger Tatiana or others her of apprise constituted breach therapists’ duty protect to exercise reasonable care to Tatiana. *7 Plaintiffs, however, plead relationship no between and Poddar would police impose upon any Tatiana, defendants which them no a plaintiffs suggest duty. have, and other basis for such Plaintiffs sustaining the therefore, show the trial court erred failed to that amend. defendants without leave to police demurrer of Plaintiffs’complaints 1. father, virtually but separate
Plaintiffs, filed mother and Tatiana’s on this appeal The issue before us complaints. amended identical second state, state, or can be amended complaints now is whether those begin setting by We therefore forth action defendants. against causes of complaints.3 of the pertinent allegations Dangerous action, “Failure to Detain entitled Plaintiffs’first cause 1969, voluntary 20, Poddar was alleges August Patient,” that Hospital. Poddar at Cowell Memorial outpatient receiving therapy Moore, girl, kill going that he was an unnamed therapist, his informed readily Tatiana, spending home from as when she returned identifiable Moore, Gold, of Dr. who in Brazil. the concurrence the summer Poddar, Yandell, initially examined and Dr. assistant to director had should be psychiatry, decided that Poddar department hospital. orally for observation in mental Moore notified committed police campus request Teel of the that he would OfficersAtkinson and then letter to Police Chief William Beall He sent a commitment. department securing Poddar’s requesting police the assistance of the confinement. Atkinson, custody, into Brownrigg,
Officers Halleran took Poddar but, promise rational, Poddar was released him on his satisfied that Powelson, stay department director of the away from Tatiana. then to return psychiatry Hospital, police at Cowell Memorial asked letter, that Moore copies *8 action, of second cause entitled “Failure to Warn On a Plaintiffs’ Patient,” of first of cause incorporates allegations Dangerous action, but adds the assertion that defendants negligently permitted to be Poddar released from without police custody “notifying parents of Tatiana Tarasoff that their was in from daughter grave Posenjit danger Poddar.” Poddar Tatiana’s brother to share an persuaded apartment residence; Brazil, near him Tatiana’s after her return from shortly Poddar went to her residence and killed her. action, of a
Plaintiffs’ third cause of entitled “Abandonment Danger- Patient,” $10,000 ous seeks defendant Powel- against punitive damages action, of son. the crucial the first cause of Incorporating allegations “did Powelson herein with intent plaintiffs charge things alleged to abandon a and said acts were done and dangerous patient, maliciously oppressively.” action,
Plaintiffs’ fourth of for cause “Breach of Primary Duty Public,” Patient states the same as the first essentially allegations action, of but cause seeks to characterize defendants’ conduct as a breach of their and the Since such duty safeguard public. conclusory labels add to the factual the first nothing allegations complaint, and fourth causes action legally indistinguishable. we
As of this first and fourth explain part opinion, plaintiffs’ action, causes of which seek the defendants’ liability predicate upon confinement, failure about Poddar’s are barred bring by governmental Plaintiffs’ third cause of action succumbs to the decisions immunity. in a (See death action. precluding exemplary damages wrongful part attention, therefore, this We direct our issue whether opinion.) second cause of action can be amended to state a basis for plaintiffs’ recovery.
2. can state a cause action against therapists Plaintiffs defendant Tatiana. negligent protect failure
The second cause of action can be amended to that Tatiana’s allege death from resulted defendants’ failure to proximately warn negligent Tatiana others her of her Plaintiffs contend likely apprise danger. amended, that as such causa- allegations negligence proximate tion, with Defendants, establish a cause action. resulting damages, however, contend that in the circumstances of the case owed present they that, no of care to her Tatiana or in the absence parents *9 434 free to in of were act careless Tatiana’s life
duty, they disregаrd safety. issue, duties are in mind that this we bear
In legal analyzing that, nature, of but discoverable facts merely conclusoiy expressions for done. should be of a cases imposed damage liability type, particular 72, 441 728, 734 v. 68 Cal.2d (1968) As stated in Dillon Cal.Rptr. Legg [69 must ... be 912, “The assertion that P.2d 29 A.L.R.3d liability 1316]: no the essential defendant bears because ‘begs denied ‘duty’ plaintiff interests are entitled legal protection plaintiff’s question—whether itself, but . not sacrosanct in conduct... is the defendant’s [Duty] against of considerations of of the sum total those an policy only expression is entitled law to which lead the particular plaintiff say Law ed. at 332-333.)” of Torts (Prosser, pp. [3d 1964] protection.’ 69 108 v. Cal.2d (1968) In the landmark case of Rowland Christian [70 97, 561, P.2d 32 A.L.R.3d Justice Peters 496], 443 recognized Cal.Rptr. his “for occasioned another should by liability imposed injury Civil of care or in section 1714 of the want skill” as expressed ordinary Peters, Thus, v. Code. Justice from Heaven Pender (1883) quoting “ 503, is Q.B.D, 11 509 stated: ‘whenever one circumstances person if with to another . .. that he did not use regard placed position would of care and skill his own conduct... he cause danger ordinary other, arises to the to use duty ordinary injury property ” avoid care skill to such danger.’ “this “balanc- We from fundamental only upon depart principle” considerations”; of “are the of a ones number foreseeability major ing suffered harm plaintiff degree certainty plaintiff, conduct the defendant’s of the connection between the closeness injury, suffered, to the defendant’s the moral blame attached injury harm, conduct, extent the burden future preventing policy to the defendant and community duty imposing consequences breach, with and the to exercise care availability, liability resulting cost and for the risk involved.”4 insurance prevalence these considerations
The most
establishing duty
important
a “defendant owes a
As
foreseeability.
general principle,
552,
456,
(1962)
304];
Cal.2d
562
375 P.2d
4See Merrill v. Buck
58
Cal.Rptr.
[25
647,
16,
1358];
(1958) 49
P.2d
65 A.L.R.2d
Walnut
v.
Cal.2d
650
Biakanja
Irving
[320
(1967)
Inc.
Co. v.
695
Cal.App.2d
Creek
Engineers
Aggregates
Testing
[56
700],
Cal.Rptr.
conduct,
to all
care
who
his
foreseeably endangered
risks which
all
make
conduct unreasonably
respect
dangerous.”
Steel
Bethlehem
Cal.3d
(Rodriguez
Corp.
739;
525 P.2d
Dillon v.
669];
Cal.2d
Legg, supra,
*10
General,
468,
v. RKO
Inc.
Weirum Cal.Rptr. [123 Code, however, Civ. As shall 36]; 1714.) P.2d see we when the § explain, a of foreseeable harm defendant to control avoidance requires conduct, or to warn of such law conduct of another common person, if the defendant some has bears only traditionally liability imposed to to the or victim. dangerous person potential special relationship between a and his this Since satisfies patient relationship we need not here decide whether alone is requirement, foreseeability to create a to to sufficient exercise reasonable care a duty protect of victim another’s conduct. potential above, we as have stated law, under the common as
Although, a rule, one no owed to control the conduct of general another5 person duty 60, v. (Richards 43 (1954) Cal.2d P.2d 23]; Stanley Wright [271 Arcade School 272, Dist. (1964) 812]; Cal.App.2d Rest.2d Torts (1965) 315), nor to warn § those endangered by Torts, conduct (Rest.2d 314, c.; Prosser, § com. Law of (4th Torts supra, ed. 1971) 341), the § courts have carved out an p. to this exception rule in cases in which the defendant stands in some special relationship to either the whose conduct to be needs controlled person or a to the foreseeable victim Torts, of that conduct (see Rest.2d relationship 315-320). §§ this case, supra, we note Applying exception present a of defendant to either Tatiana or Poddar relationship therapists will suffice to a care; establish as in section duty explained Torts, Restatement Second of a of care arise from “(a) either may relation . . . between the actor the third which special person conduct, actor control the third or imposes duty upon person’s . . (b) relation . between the actor and the other which special gives the other a right protection.” 5This rule derives from common law’s distinction between misfeasance and nonfeasance, Kime, and its (See reluctance to for the latter. & impose liability Harper Duty 887.) Control the Conduct Another 43 Yale L.J. Morally the rule owes its questionable, survival to “the difficulties standards of any setting men, unselfish service to fellow workable rule cover making any possible
situations where (Prosser, fifty (4th.ed. 1971) fail people might § rescue ....’’ Torts 341.) difficulties, Because p. these the courts increased practical the number have in which affirmative instances duties are direct the common imposed rejection rule, law but the list of by expanding which special will relationships justify departure Prosser, (See from that rule. 348-350.) at supra, § pp. between special assert no relation plaintiffs’pleadings
Although Poddar and they establish as between therapists, Tatiana and defendant patient between a special relation that arises therapists the defendant may support relationship Such a psychotherapist.6 his doctor example, Thus, persons. of third for the benefit affirmative duties the behavior of a care to control exercise must reasonable. hospital A warn a doctor must also may endanger persons.7 other which patient conduct, renders certain or medication patient’s condition if the car, others.8 dangerous to driving a such as duty have recognize this decisions that the California
Although
relationship
special
both
in a
stood
the defendant
in which
cases
involved
we do
danger,9
created
whose conduct
the victim and
*11
to such situations.
be constricted
logically
duty should
that the
not think
Decisions,
relationship of a
single
hold that the
jurisdictions
of other
duty to exercise
support
is sufficient
patient
to his
doctor
from the
emanating
against dangers
protect others
care to
reasonable
is liable
that a doctor
The courts hold
illness.
patient’s
both
between Poddar and
Dr.
6The
establish the
relationship
pleadings
requisite
Poddar,
Powelson,
Moore,
and Dr.
who
who treated
supervised
the therapist
Ppddar, and that Dr.
that Dr. Gold
examined
treatment. Plaintiffs also allege
personally
assistant,
Yandell,
the decision to
Poddar’s commitment.
as
arrange
Powelson’s
approved
or
to raise the issue whether a doctor-patient
therapist-
These
are sufficient
allegations
the doctor or
to exercise
rise to a
giving
possible duty
patient relationship,
from
patient’s
care to
a threatened
danger arising
reasonable
protect
illness,
(See
Medical
existed between Gold or Yandell and Poddar.
Harney,
mental
(1973) 7.)
p.
Malpractice
it
of facts from which might reasonably
7When a
has notice
knowledge
“hospital
harm himself or others unless
concluded that a
measures were
would be
likely
preclusive
patient
taken,
use reasonable care in the circumstances
then
must
hospital
465,
(1967)
(Vistica
67 Cal.2d
469
such harm.”
v. Presbyterian Hospital
[62
prevent
577,
(Italics added.)
if it
193].)
432 P.2d
A mental
be liable
hospital may
Cal.Rptr.
(Semler
or release of a
v.
negligently
Institute
dangerous patient
Psychiatric
permits
escape
2439;
(4th
1976)
v. United
Cir.
44 U.S.L. Week
Underwood
D.C.
Washington,
92;
288).
(5th
1956)
(5th
1966)
234 F.2d
Cir.
356 F.2d
Fair v. United States
Cir.
States
(E.D.Pa. 1971)
v.
322
a cause of action
against
Barbour
Greenberg
F.Supp.
upheld
mental
resulted in that
staff doctor whose
failure to admit a
negligent
patient
hospital
patient assaulting
plaintiff.
(1965)
14];
461
P.2d
see
8Kaiser v. Suburban
65 Wn.2d
Transportation System
[398
J.).
1973)
(Iowa
210
576
Freese v. Lemmon
N.W.2d
(concurring opn. Uhlenhopp,
(1953)
675],
a cause of action
116
310
P.2d
upheld
9Ellis D’Angelo
Cal.App.2d
[253
child;
of their
to warn
of the violent proclivities
who failed
against
babysitter
parents
352],
P.2d
(1968)
447
437
infected
his
if he
fails to
patient
negligently
diagnose
contagious
or,
disease
v. Blackmon
241 So.2d
1970)
752),
(Hofmann
(Fla.App.
illness, fails to
warn members of the
having diagnosed
patient’s
v. Aluminum Co. America
18
(1959) Misc.2d 740
family (Wojcik
[183
N.Y.S.2d
357-358]; Davis v. Rodman
385
(1921)
Ark.
S.W.
[227
612, 13 A.L.R.
v. Allen
1459];
Minn.
N.W.
(1919)
Skillings
663,
Since it involved a mental the decision in Mer- dangerous patient, chants Nat. Bank & Trust Co. v. United States (D.N.D. 1967) Fargo 409 comes closer to the issue. The Veterans Administration F.Supp. farm, for the to work on a local but did not inform the arranged patient farmer of the man’s The farmer background. consequently permitted hours; come and patient go freely during nonworking car, borrowed a drove to his wife’s residence and killed her. Notwith- the lack of between the standing Veterans any “special relationship” wife, Administration and the the court found the Veterans Administra- tion liable for the death of the wife. wrongful
In their of the relevant *12 and summary Maximov rulings Fleming conclude that the “case law should notion that to dispel any impose the a to take for therapists the of duty precautions safety persons threatened a where due care so by is in patient, requires, any way rules on opposed the On the cоntemporary ground duty relationship. there now seems to be sufficient contrary, the authority support conclusion that into a the by entering doctor-patient relationship becomes involved to assume some therapist sufficiently responsibility the not himself, of the of but also third safety, only patient any whom the doctor knows to be threatened the & patient.” (Fleming Maximov, The Patient or His Victim: The Dilemma 62 (1974) Therapist’s 1025, Cal. L.Rev. 1030.) contend, however,
Defendants that of a to exercise imposition reasonable care to third is unworkable because protect therapists cannot whether or not a will resort to violence. accurately predict patient In of this amicus the support American argument representing Psychi- atric Association and other societies cites numerous articles professional which indicate that in art, state of the are unable therapists, present acts; forecasts, violent claims, their reliably predict amicus tend violence, and indeed are consistently more often overpredict wrong 438 erroneous, of are often violence amicus
than Since right.10 predictions concludes, courts should render liability predicate rulings validity predictions. therapists upon medicine, indeed role of who is practitioner psychiatrist, function, an allied like who of the and that performs psychologist of the standards who must conform that of the physician based and and who must often make predictions diagnoses profession Thus the such evaluations. judgment therapist diagnosing upon whether disorders and emotional presents predicting which doctors violence is serious judgment comparable danger under rules must render accepted respon- professionals regularly sibility.
We that a encounters attempting recоgnize difficulty therapist violence. forecast whether a serious danger patient presents we do not Obviously, therapist, making require determination, need render a only performance; perfect therapist skill, “that exercise and care reasonable knowledge, ordinarily degree and exercised members specialty] possessed professional [that 3 under similar v. Cal.3d (Bardessono (1970) circumstances.” Michels 480, 45 717]; Quintal P.2d A.L.R.3d Cal.Rptr. [91 Laurel Grove 159-160 Cal.2d Hospital Torts, Witkin, (8th 1974) P.2d of Cal. Law ed. 161]; see Summary 514 and cases Within the broad of reasonable cited.) § range practice differ, in which treatment judgment may professional opinion his best without is free to exercise or her own judgment or she that he aided wrongly liability; by hindsight, judged proof, insufficient *13 establish negligence. however, case, the do not as
In the instant raise any question pleadings of Poddar to failure defendant presented therapists predict On the serious of violence. the complaints danger contrary, present would that defendant did in fact that Poddar allege therapists predict kill, were but in to warn. negligent failing 10See, (1975) 325-328 v. Burnick 14 Cal.3d e.g., People Cal.Rptr. Violence, Monahan, in Health the 352]; in Mental P.2d The Community Prevention of Diamond, 1975); Prediction (Monahan ed. The
Criminal Justice Psychiatric System of e Litwack, 439; and th (1975) Ennis & Psychiatry 123 U.Pa.L.Rev. Dangerousness (1974) 693. 62 Cal.L.Rev. Coins the Courtroom in Expertise: Flipping Presumption of however, contends, even when a in Amicus does fact therapist others, that a a serious of violence to the patient poses danger predict should be absolved of to act to any therapist responsibility failing view, however, the In victim. our once a does protect potential therapist determine, in fact or under standards applicable professional reasonably determined, should have that a a serious of violence patient poses danger others, he bears to exercise reasonable care to the duty protect foreseeable victim of that While the of this of due danger. discharge duty case,11 care will with the facts of each in each instance vary necessarily the conduct must be measured the adequacy therapist’s against traditional standard of the rendition of reasonable care under negligence the circumstances. Cobbs v. Grant (Accord (1972) Cal.3d 243 [104 Maximov, 502 P.2d As 1].) explained Fleming Patient His Victim: The Dilemma 62 Cal.L.Rev. Therapist’s 1025, 1067: “. . . the of ultimate the between tension question resolving the interests victim is one social conflicting patient potential sum, not ... In the owes a professional policy, expertise. therapist legal not his but also his would-be victim and only patient, patient’s is in both subject scrutiny by respects judge jury.” amicus, to the assertion of this conclusion is not inconsistent
Contrary
Burnick,
with our recent decision in
We interest effective treatment public supporting recognize mental illness and In re (see protecting rights patients privacy 2 Cal.3d at and the 432), consequent Lifschutz, supra, p. public character of confidential psychothera- importance safeguarding interest, however, this we must communication. weigh peutic Against has from assault. The interest violent Legislature public safety In concerns. undertaken the task of countervailing difficult balancing 1014, it rule of Evidеnce Code section established broad privilege communications between confidential psychothera- protect Association predict American Psychiatric and amicus defendant 12Counselfor Regents warn bear may potential court that therapist a decision of this holding that victim treatment and hamper from seeking therapy, will deter violence-prone Maximov, in Fleming was examined This contention other patients. Cal.L.Rev. Dilemma His Victim: The Therapist’s The Patient or 1038-1044; In re In are entirely that such predictions speculative. conclude they if the could that state for the argued 2 Cal.3d counsel psychiatrist supra, Lifschutz, communications, no could psychotherapy disclosure of some psychotherapeutic compel 426.) it We that (2 Cal.3d at rejected argument, successfully. p. longer practiced fact affected the psychotherapy our decision in adversely practice does not appear case, strikes us as equally forecast of harm in the present in California. Counsels’ dubious. note, moreover, established Code section enacted that Evidence We when disclosure necessary is not privileged communication psychotherapeutic counsels’ implicit cannot without threatened We danger. accept question prevent either the violent depends upon effective for potentially patients assumption therapy disclose confidential communications lack awareness that a can patient’s never to reveal advance avert danger, upon therapist’s promise impending threats of violence. nonprivileged *15 In Evidence Code section the created a pist. Legislature specific to the and limited is “There exception psychotherapist-patient privilege': the no ... if has reasonable cause to believe privilege psychotherapist the in such or that is mental emotional condition as to be patient to or himself or of another and that dangerous property disclosure of the communication is the threatened necessary prevent danger.”13 of
We realize the and character that confidential open psychothera- violence, of threats few dialogue encourages patients express peutic not be are ever executed. should which Certainly therapist encouraged threats; to reveal such such disclosures could routinely seriously disrupt with the with his the patient’s relationship therapist To to his threatened. contrary, therapist’s patient obligations that he not disclose a confidence such disclosure is unless require others, avert even then that he do so necessary danger and in fashion that would his discreetly, preserve privacy patient fullest extent the threatened compatible prevention Maximov, & (See The His Patient or Victim: The danger. Fleming Dilemma (1974) 1065-1066.)14 Cal.L.Rev. Therapist’s The aof communication under the revelation above- circumstances is not a ethics; or a breach trust violation of as stated in the professional of Medical Ethics of the American Medical Association Principles (1957), section 9: “A not reveal the confidence entrusted physician may to him in the he course medical attendance .. . is do unless required so law or unless it becomes order to necessary protect welfare and Maximov note that 13Fleming “While less supports therapist’s [section 1024] disclosure, controversial to make a it does not right him a admittedly impose duty But the do so. does not have it argument to be that far. For if is once conceded ... pressed favor of the foreseeable victims accord patient’s would with general of tort we need no look principles to the statute for a source of is liability, It longer duty. if sufficient the needs of the statute be relied can for the ... the claim that upon purpose countering confidentiality and must therefore defeat paramount any In this more modest the Evidence Code’s hypothetical duty. patient’ exception may perspective, ‘dangerous be invoked with some confidence a clear as expression the balance between the values of legislative policy concerning confidentiality patient (Italics of his values foreseeable victims.” & safety original.) Fleming Maximov, The Patient His The Victim: Dilemma Cal.L.Rev. Therapist's 1025, 1063. 14Amicus who suggests concludes his should dangerous victim, warn the but institute detention of the potential involuntary proceedings however, of a would in a far lesser patient. giving warning, cases many represent inroad than upon patient’s privacy would commitment. involuntary *16 the conclude that (Italics added.) the We individual community.”15 of the of the confidential character public policy favoring protection must to the extent to communications yield patient-psychotherapist to to others. The which disclosure avert essential danger protective ends where the privilege public peril begins. interde- crowded and the
Our current computerized society compels of its members. In risk-infested we can society hardly pendence this tolerate the further to that would result from a exposure danger If concealed that his was lethal. the knowledge therapist of reasonable to the threatened victim the care exercise protect requires to warn the or thоse who can endangered party reasonably him, to we see no sufficient societal interest would expected notify and concealment. The containment of such risks lies in the protect justify reasons, the we find that interest. For public foregoing plaintiffs’ state a defendants can be cause action amended against complaints Moore, Powelson, Gold, and Yandell and the as their Regents against for breach exercise reasonable duty protect employer, care Tatiana.16 we the dissent that the contention reject provisions
Finally, of confidential Act which release Lanterman-Petris-Short govern Code, defendant information & Inst. (Welf. 5328-5328.9) §§ prevented contention rests on the from Tatiana. The dissent’s therapists warning letter to constituted an assertion that Dr. Moore’s the campus police within the of Welfare and Institutions writing” meaning “application section and thus initiates under Lanterman- Code proceedings however, A at the will Petris-Short Act. closer look terms section case. demonstrate that it is inapplicable present Section 5150 to a written refers application only by professional is “a member of the staff who ... an evaluation person attending of the Task Force also of the Council on Summary 15See Report Confidentiality (1975). and Associations of the American Professions Association Psychiatric 16Moore that after Powelson countermanded the argues decision to seek commitment Poddar, Moore was decision of his and that therefore he obliged obey superior not be should held liable for from his obedience to any dereliction arising superior orders. Plaintiffs in contend that Moore’s to members of the response duty public Poddar should take over his Powelson. Since endangered prеcedence obey order, do not set out the date of Powelson’s terms of plaintiffs’ that specific complaints order, or Powelson’s overrule Moore’s decisions authority respecting patients conflict; care, need not we under Moore’s we this adjudicate pass only upon decide if the be amended to state a at this can cause stage pleadings complaints action. or who is himself facility designated by county,” “designated by as one authorized to take a into him in county” custody place the State facility designated by county approved Depart- ment of Mental fails Hygiene. complaint specifically allege *17 Dr. Moore was so Dr. Moore and the cannot empowered. Regents rely inference to be drawn from upon any contrary might plaintiff’s Dr. Poddar; that Moore intended to a “detention” on allegation “assign” both Dr. Moore and the have conceded that neither Regents expressly Cowell Memorial nor of its staff has member ever been Hospital any of Alameda to institute commit- designated by County involuntary ment to section 5150. pursuant proceedings
Furthermore, of the Lanterman-Petris-Short Act defin- provisions withhold confidential information therapist’s ing duty expressly limited to “information and records obtained in the course providing 5 services under Division with section 5000), Division 6 (commencing with section or 6000), Division 7 with section (commencing (commencing 7000)” of the Welfare arid Code, Institutions & (Welf. Code Inst. 5328). § 5, added.) (Italics Divisions 6 7 describe for variety programs treatment of ill retarded.17 The or at issue on this mentally pleadings however, state no facts that the appeal, showing psychotherapy provided to Poddar the Cowell Memorial falls under of these by Hospital any We therefore conclude that the Lanterman-Petris-Short Act рrograms. not does release of information Moore govern by acquired during course of rendition of those services.
Neither can we the dissent’s that we adopt suggestion import wholesale the detailed Act of the Lanterman-Petris-Short provisions the disclosure of confidential information and them to regulating apply disclosure information not the act. Since the governed by Legislature did not extend the act to all control disclosures of confidential matter by we must infer that the not relieve did the courts therapist, Legislature of their to define reference to the of the common obligation principles law the of the in those situations not obligation governed act. 17Division 5 includes the Lanterman-Petris-Short Act Act Short-Doyle services). mental health (community Division 6 relates treatment of programs committed as disordered sex offenders or judicially mentally retarded. mentally Division 7 treatment at state and mental encompasses county hospitals, Langley Porter Medical Center. Institute and the Neuropsychiatric Institute U.C.L.A. Neuropsychiatric
444 defendants, now do we conclude that they
Turning police to either Tatiana to Poddar have any relationship special such defendants to warn sufficient to impose respecting upon 46 Jose violent intentions. Hartzler v. San (See (1975) Poddar’s City of 6, 9-10 Arts v. 5]; City Cal.App.3d Cal.Rptr. Antique Corp. [120 Plaintiffs 332].) 39 593 Torrance (1974) Cal.App.3d Cal.Rptr. [114 no to warn facts that rise no give any duty theory,18 plead suggest absent such a on the defendants relationship. special police part erred that the trial court thus failed to demonstrate have denying They Co. v. Leslie Salt as defendants. (See leave amend the police Cooper 406]; P.2d Filice Cal.2d Cal.Rptr. [75 789].) Boccardo (1962) Cal.App.2d *18 are not immune 3. liability therapists for from failure Defendant warn. We address the issue of whether defendant are protected by therapists or who for failed to warn Tatiana those having governmental immunity of her We could been her have notify reasonably expected peril. That our on section 820.2 of the Government Code.19 analysis postulate declares, here, that not “a with applicable public provision exceptions his act or omission is not liable for an from employee injury resulting of the of the discretion where the act or omission was result exercise him, not such abused.”20 vested in whether or discretion [was] 18We could be amended have considered whether sua sponte plaintiffs’ complaints under Restatement assert cause of action defendants against police principles act, (1965) does Second which that “If the actor an of Torts section provides or realize created an of causing realizes should that it has unreasonable risk subsequently physical risk from another, care to he is under a to exercise harm reasonable prevent Jose, 6, 10.) (See effect.” San 46 Hartzler taking supra, Cal.App.3d City of record, however, which, The form no facts if inserted into the complaints, might suggests for such of action. assertion of a cause of action foundation cause The against of causation and of defendants under this would raise difficult problems police theory which should not be resolved the basis of facts not averred public policy, conjectural in the those or amendment to pleadings. pleadings any proposed Code to address 19No of the Government appears more immunity provision specific the issue. that is liable entity of the Government Code declares 20Section 815.2 public “[a] of an entity caused an act or omission public injury proximately employee section, would, if the omission from this within the have The of his act or apart scope employment his representative.” a cause of action that against personal rise to given employee here, that “a entity public section further provides, exceptions applicable from an or omission of an of the public not liable for an act injury resulting employee therefore, are where the is immune from liability.” Regents, entity employee immune all individual defendants are immune. similarly from if liability only 445 act admits of some element Noting virtually every public discretion, we drew line in Johnson v. State (1968) of California Cal.2d 782 447 P.2d between 352], Cal.Rptr. discretionary [73 policy decisions which and ministerial administrative enjoy statutory immunity acts which do not. We concluded that section 820.2 affords immunity for “basic decisions.” (Italics added.) also Elton v. only (See policy 1057-1058 (1970) 27]; County Orange Cal.App.3d Law 810; Cal. Revision Com. Van (1963) Alstyne, Rep. p. Supplement 5.54, 16-17; to Cal. Government Tort Bar (Cont. Ed. 1969) § liability pp. Comment, Tort Claims Act: (1966) Discretionary Immunity California 470, 471; James, So.Cal.L.Rev. cf. Tort Governmental Units Liability of 610, 637-638, 640, and Their U.Chi.L.Rev. 651.) Officers We also observed if courts did this not respect immunity, statutory would find themselves “in the they unseemly position determining of decisions entrusted coordinate branch propriety expressly v. State (Johnson at It 793.) government.” California, supra, p. concluded, therefore is we “isolate those areas necessary, quasi- which are sensitive legislative policy-making sufficiently justify blanket rule that will courts not entertain a tort action alleging *19 careless conduct contributed to decision.” v. (Johnson governmental State at 794.) After careful we in California, supra, p. analysis rejected, Johnson, other rationales advanced to commonly support governmental and concluded that be no immunity21 should immunity’s scope than is to and exeсutive greater required give legislative policymakers sufficient in which to their vital breathing space perform policymaking functions. Johnson, we conclude that defendant in the
Relying therapists case are not immune from for their failure to warn of present liability Tatiana’s Johnson held that a officer’s determination peril. parole to whether warn an adult that their foster child had couple prospective of violence no . . . reasons for background “presented] immunity” lowest, v. (Johnson State at 795), was “at the California, supra, p. dismissed, Johnson, 21We the view that continues to be immunity in order necessary insure will be public employees zealous of their sufficiently performance official duties. The California Tort Claims of 1963 Act for indemnification of provides faith, public employees insist absent bad against liability, and also permits employees 825-825.6, Code, (See that their defenses be conducted at public Gov. expense. §§ 995-995.2.) Public thus no employees longer have reason to fear as significant liability also, Johnson, about they their official We go tasks. that a rejected argument public concern over the employee’s of his or her serves as basis for potential liability employer (Johnson 790-793.) v. State at immunity. California, supra, pp. 446 constituted official action” at indeed (id., 796),
ministerial p. rung 797; cf. of tort (Id., “a case for the classic liability.” p. imposition Morgan 938, Yuba, 230 942-943.) v. Cal.App.2d Although County supra, that the decision whether to inform the defendants Johnson argued the exercise of foster of the child’s background required parents skills, was we concluded that state considerable judgmental for the officer’s failure warn because immune from liability parole rise of a decision.” did not to the level “basic such a decision policy have We in Johnson federal courts also noted consistently latent as outside failures to warn of scope dangers falling categorized Claims Act.22 the Federal Tort immunized omissions discretionary 379, Lines, F.2d 1964) Cir. 335 v. Wiener (9th Air Inc. United (See States, Lines, 379 Inc. United 397-398, nom. United Air cert. den. sub 549, to conduct (decision S.Ct. U.S. 951 L.Ed.2d 85 military 452] airline but failure warn commercial was discretionary flights training Cir. 351 F.2d 1965) (9th was v. State United States not); Washington was lines where transmission 916 (decision canyon spanning place not); to warn was United to be but failure assumed pilot discretionary 82 not to “dedud” (decision States v. White Cir. F.2d 1954) (9th but failure to warn assumed to army range discretionaiy firing v. United not); about condition was Bulloch onto unsafe range go how and when (decision States 1955) (D.Utah F.Supp. failure to afford conduct nuclear test deemed but discretionary proper notice (D.Hawaii 1953) was Hernandez v. United States not); F.Supp. as but to erect road block characterized (decision discretionary not). failure to warn of resultant hazard was conclude, therefore, failure to warn defendants’
We *20 have been her those who could Tatiana or expected notify reasonably afforded of not fall within the absolute her does by protection peril Government conclu- of We that our section 820.2 Code. emphasize of Government Code furnishes additional for support section 830.8 22Byanalogy, the zone of created failure to warn does not fall within immunity our conclusion a nor 830.8 “Neither a a entity 820.2. Section provides: public public employee section by or an caused the failure to traffic warning signals, signs, is ... for by provide liable injury a in this section exonerates described in the Vehicle Code. Nothing or devices markings caused from for or liability injury proximately entity public employee public of a . was warn dangerous or device . . necessary failure if a marking signal, sign, of and which would not safe movement traffic which condition endangered to, due have anticipated by, person exercising not been would reasonably apparent failure to warn another context at least in thus concluded care.” The Legislature (See Hilts County omission. discretionary not an immunized of a latent danger of 161, 275].) (1968) Cal.App.2d Solano of does not raise sion government specter therapists employed liable for held their exercise indiscriminately being damage despite We thera- sound professional judgment. require publicly employed of care which the common law only pists quantum requires The in those rare cases in which therapists. imposition liability private falls short this standard does not contravene the employee public or of Government Code section 820.2. language purpose 4. are immune therapists liability failing Defendant from for Poddar. confine
We sustain defendant contention that Government Code therapists’ section 856 insulates them from under first and fourth liability plaintiffs’ causes action for to confine Poddar. Section affords failing public entities their absolute from employees protection liability “any from accordance injury resulting determining any applicable enactment.. . whether to confine a for mental illness.” Since this section refers to a determination to confine “in accordance with any enactment,” that the is limited to applicable plaintiffs suggest immunity under Welfare and Institutions Code section 5150 as designated authorized confinement. Defendant finally adjudicate patient’s out, therapists, plaintiffs point persons designated among under section 5150.
The 856, however, of section language legislative history suggest far broader In when enacted, section 856 was immunity. had not established the Legislature structure thе Lanterman- statutoiy Petris-Short Act. Former Welfare and Institutions Code section 5050.3 (renumbered as Code, 5880; Welf. & Inst. § 1969) which repealed July resembled section authorized present detention at the emergency officers, behest officers, health only peace county physicians, assistant former (renumbered section 5047 county as Welf. & physicians; Code, 5551; Inst. however, § 1969), authorized a repealed July petition commitment seeking by any person, including “physician attending did not refer in section patient.” those Legislature only *21 authorized to institute under section persons emergency proceedings 5050.3; it extended to all who in acted broadly immunity employees enactment,” accord with thus not “any applicable granting immunity confine, to who are but to also to those only empowered authorized to or recommend confinement. request Act,
The its extensive revision Lanterman-Petris-Short ill, eliminated for commitment the mentally any specific procedures it reference to but did not limit by treating statutory petitions physicians, of a to recom- the authority therapist government employ request, initiate actions which lead to commitment of his mend or may which under the act. We believe section refers language to action the course accordance with any employment any enactment, who must undertake this applicable protects Maximov, & delicate and difficult task. The Patient His (See Fleming Dilemma (1974) 1064.) Victim: Cal.L.Rev. Thus Therapist’s not extends to final determination to scope immunity only illness, confine or not confine for mental but to all determinations involved in the of commitment. (Cf. Hernandez process State 899-900 Cal.App.3d California 205].) to section we first Dr. Powelson’s status respect
Turning fall to him the actions attributed observe that by plaintiffs’ complaints Plaintiffs furnished within the prоvision. protections squarely detention be no actions Poddar’s ordered that Powelson leading allege not seek reflected Powelson’s determination This conduct taken. within the and thus falls Poddar’s confinement immunity. statutory Moore for his conduct Section 856 also insulates Dr. respecting bit subtle. confinement, in his case is a more the analysis although be was not a Moore’s decision that Poddar confined proximate Clearly, death, about if Moore’s efforts cause of Tatiana’s for indeed bring successful, Tatiana still alive Poddar’s confinement had been might Rather, rest claim Moore must confinement against upon today. any Powelson’s decision and actions Moore’s failure to overcome opposing confinement. claim, be,
Such it would subordinate’s based as necessarily upon failure over his would derive from rather superior, obviously prevail decide, onerous Whether such a we need duty. impose however, can whether since we confine our question analysis falls within Moore’s overcome failure to Powelson’s decision realistically before afforded 856. Based section allegations protection upon us, we conclude that Moore’s conduct protected. in Powelson’s Moore
Plaintiffs’ acquiesced complaints imply Such confinement recommendation. countermand Moore’s acquies *22 cence is seek not to Poddar’s functionally equivalent determining confinement and thus merits under section 856. At this protection stage course, unaware, we are how Moore to Powel precisely responded actions; Powelson, son’s he have debated the confinement issue with may whatsoever, for or taken no initiative because he example, perhaps Powelson’s for feared his future at the or respected judgment, hospital, that the was on the None simply wall. recognized proverbial handwriting constitutes, of these however, of careless or possibilities type behavior to a decision wrongful confinement subsequent respecting which is in Rather, section 856.23 stripped protection by exception each is in the nature of decision not to continue to for Poddar’s press confinement. No or amended language plaintiffs’ original complaints that Moore Powelson, determined to but suggests failed fight successfully so, to do due to or otherwise acts or omissions. Under negligent wrongful circumstances, we conclude that second amended com plaintiffs’ facts which for Dr. plaints allege Moore under section trigger immunity 856.24
5. are immune police liability failing Defendant officers from for Poddar their custody. confine whether the defendant
Confronting, officers finally, question police are immune from for Poddar after his brief confine- liability releasing ment, we conclude that are. The of their source is section they immunity 5154 of the Code, Welfare and Institutions which declares that: “[t]he professional 72-hour treatment person charge facility providing evaluation, his and the designee, peace responsible officer detainment shall not be held or liable for person civilly criminally action any released at or before the end of 72 . . . hours .” person (Italics added.) defendant officers were not
Although police technically “peace officers” as Code,25 the Welfare and Institutions contempláted by 23Section 856 includes the “for rule exception general immunity injury caused . . proximately by . acts or omission out or wrongful negligent carrying failing illness____” carry out... or not confine a for mental determination confine subordinates, 24Because Dr. Gold and werе Dr. Yandell Dr. Powelson’s analysis whether are immune for failed to obtain Poddar’s confinement respecting they having similar to the to Dr. Moore. analysis applicable (i), 25Welfare and Institutions Code section defines officer” subdivision “peace for and 830.2 of the Lanterman-Petris-Short as a in sections 830.1 purposes Act person specified Penal within section Code. do fall Campus police coverage 830.1 and were not included in section 830.2 1971. until *23 incurred assertion that the officers liability failing plaintiffs’ that the officers continue Poddar’s confinement contemplates clearly We could for the detainment of were impose [Poddar].” “responsible them the Poddar confined the officers deny yet duty keep upon for . . . those furnished a statute “responsible immunizing protection officers us treat defendant would have Because plaintiffs [confinement].” the functions were as who “peace performing capable Code, we must Welfare and Institutions officers” contemplated by for code which that officers accord prescribed defendant protections officers.” such “peace
6. state no cause action damages. complaints exemplary Plaintiffs’ for
Plaintiff’s third cause of action seeks damages against punitive decisions, however, defendant Powelson. The California statutes and have been to bar the interpreted recoveiy punitive damages death action. Pease v. Beech (See wrongful Corp. Aircraft cited.) there 460-462 and authorities Cal.App.3d 416]
7. Conclusion stated, can amend their
For that the reasons we conclude plaintiffs cause of action defendant state a against therapists by complaints that in fact determined that Poddar presented asserting therapists Tatiana, to the standards of serious of violence to pursuаnt danger determined, failed to but nevertheless their should have so profession extent, from that To her exercise reasonable care danger. protect that however, their claim defendant that base therapists plaintiffs confinement, Poddar’s failed to breached that because they procure Further, 856. Code section find in Government immunity therapists have failed to we conclude as to the defendants plaintiffs police without leave their demurrer trial court erred show sustaining to amend. Atkinson, in favor defendants court of the
The superior judgment Hallernan, of the is affirmed. Beall, Teel judgment Brownrigg, Yandell, Powelson, Moore, Gold, court in favor defendants superior reversed, cause and the of California and the University Regents with the views consistent expressed remanded further proceedings herein. J., J., Richardson, Sullivan, concurred. J., C.
Wright, MOSK, J., in this I concur the result Dissenting. Concurring instance did because defendant only complaints allege therapists in fact that Poddar would kill and were therefore predict negligent *24 to warn of that the issue here is narrow: we are Thus failing danger. veiy not concerned with whether to the standards therapists, pursuant violence; their “should have” profession, predicted potential they did so I Under these limited circumstances allegedly actuality. agree that a cause of can be action stated.
Whether can is As at best. plaintiffs ultimately prevail problematical admit, did that Poddar was complaints notify therapists police to kill a identifiable as I Tatiana. While doubt more planning girl be should this issue be raised in its defense and required, may determination is a of fact. question concur, however,
I cannot in the rule that majority’s therapist may be held liable for if his to violence tendency failing predict patient’s other “standards would рursuant practitioners, profession,” is, have done so. The what standards? Defendants and question curiae, amicus an of literature responsible impressive body supported discussed at in our recent v. 14 Burnick (1975) length opinion People Cal.3d 352], P.2d demonstrate that psychi [121 atric of violence are unreliable. predictions inherently Burnick, 325-326,
In at we “In observed: pages of recent light studies it is no longer heresy question reliability psychiatric themselves would be the predictions. first to Psychiatrists admit however desirable an be, infallible ball it is not crystal might among tools of their It must be conceded that profession. still psychiatrists considerable experience difficulty confidently accurately diagnos mental illness. Yet those difficulties are ing when multiplied manyfold venture from psychiatrists undertake diagnosis prognosis ' of such illness: “A of mental predict illness consequences diagnosis tells us about whether so or nothing is is not diagnosed mental, Some are some dangerous. are not. patients dangerous, Perhaps is ill, an at whether a psychiatrist expert deciding person mentally but is he an at which of the are so expert predicting diagnosed too, Sane are and it dangerous? people, dangerous, may legitimately education, whether there is in the inquired anything training which renders them at experience psychiatrists particularly adept behavior, behavior. predicting Predictions no dangerous dangerous inaccurate, them, and there is a are matter who makes incredibly consensus that predict qualified psychiatrists uniquely growing fact, are, in their less accurate behavior and predictions dangerous ’ Court Criminal (Murel Baltimore than other City professionals.” 796-797, 355, 364-365, 92 S.Ct. L.Ed.2d 407 U.S. fn. (1972)... J., of certiorari).)” (Fns. from dismissal dissenting (Douglas, 2091] 327 & fn. 18 of Cal.3d.) also authorities cited at omitted.) (See p. claim their is not offensive confidently opinion majority Burnick, that Burnick involved the stated proceedings ground this case does an disordered sex offender and commit alleged mentally *25 two cases I not so about the distinction. the not. am Obviously sanguine identical, in issues is but the are striking: factually similarity the called to Burnick we were likewise ability upon appraise all while we declined to bar dangerousness, psychiatrists predict un- it so 327-328) we found at {id., inherently testimony pp. civil even in a so-called we would confinement permit trustworthy a doubt. reasonable only upon beyond proceeding proof to eliminate all the the rule I would restructure majority designed of the to standards predicting reference profession conformity violence, then a does in fact duty If a violence. predict psychiatrist us from the rule will take of that The arises. warn majority’s expansion into the wonderland world clairvoyance. reality and medical both CLARK, J. legal majority opinion, Until today’s treat is essential effectively have authorities confidentiality agreed to disclose ill, on doctors and that patient the duty imposing mentally Further, treatment. would victims threats to greatly impair potential treatment necessarily that effective safety society’s recognizing effective and confiden- intertwined, decided has the already Legislature to warn. over is tial treatment duty imposition preferred ill should be for the effective treatment The issue whether mentally is, one for the to a sacrificed my opinion, properly warnings system Moreover, in the even its and we are bound by judgment. Legislature, direction, same conclusion must reach the we of clear absence legislative in a net certain result new the because imposing majority’s in violence. increase the achieved Legislature’s balance the The rejects majority Code, et seq., § & Inst. (Welf. Act.
Lanterman-Petris-Short addition, that, act.)1 the In hereafter fails to even majority recognize act, absent considerations mandate overwhelming policy against fundamental interests without sacrificing gaining corresponding increase in benefit. public
Statutory Provisions on the have touched nondisclosure
Although parties only briefly act, amici have out their provisions pointed importance. demurrer, instant case after must confront arising ruling parties the act’s trial In court. these circumstances the provisions parties’ failure meet the act would not this court’s fully provisions justify refusal discuss law. apply on future treatment of the ill in our
Having grave impact mentally state, transcends interests of majority opinion clearly immediate and must all It discuss law. abdicates parties applicable to refuse to the clear judicial responsibility recognize legislative policy reflected in the act.
Effective 1 created a July Legislature comprehensive of resolution and duties of both the infirm statutory rights mentally and those with their care and treatment. act’s The charged purposes care, commitment, include ending inappropriate providing prompt 5001.) and The (§ protecting public safety, safeguarding personal rights. act to both and both commitment and to applies voluntary involuntary institutions; and it details for commit- public private procedure legal ment; it committed; enumerates the and civil of legal rights persons duties, it out the liabilities and of Thus spells rights psychotherapist. the act evinces the of the clearly Legislature’s weighing countervailing concerns before us—when a has threatened a third presently treatment. person during psychiatric that confidences
Reflecting legislative recognition disclosing impairs ill, effective treatment of the and thus is to the best mentally contrary interests the act establishes the to not disclose. society, therapist’s duty Section 5328 in that information and records provides part “[a]ll in obtained the course of services ... to either or voluntary providing (Italics added.) services shall be confidential.” involuntary recipients Further, a in disclosure violation of statute patient may and. enjoin may references, stated, 1All unless statutory otherwise Welfare and Institutions Code. $500 actual three the amount or recover times damage greater (§ 5330.) for disclosure. unlawful interests must
However, that some private public recognizing limited several established override the excep- patient’s, Legislature and the limited nature of these tions to exceptions confidentiality.2 in the 2Section 5328 “All information and records obtained course of provides: 5000), services under Division 5 with Section Division (commencing providing 6000), 7000), with Section or Division Section (commencing either (commencing or of services be confidential. Information shall voluntary involuntary recipients (a) In between records be disclosed communications may qualified only: [¶] referrals, in the of services or or course professional persons of provision appropriate of the or his or The consent guardian conservatorship proceedings. patient, obtained or be a conservator must be before records disclosed may by information a to a employed professional person employed by facility professional person by (b) does not have the medical for the care. who responsibility patient’s When facility the [¶] with the of the patient, patient, approval physician charge designates released, in this nothing information records be to whom or may except nurse, worker, a social article shall be construed psychologist, compel physician, him which has been given other to reveal information or professional person attorney, in (c) for a necessary To the family; confidence extent patient’s [¶] members aid, claim, made of a for recipient or a claim to be on behalf to make recipient insurance, entitled; (d) be If the recipient medical which he may or assistance to [¶] ward, minor, conservatee, or conservator or and his is a parent, guardian, services disclosed, records or except to whom information may designates, writing, persons social this article be construed to compel psychologist, that worker, nurse, shall physician, nothing has reveal which other information attorney, professional research, (e) For been to him in confidence members patient’s family; given [¶] for the conduct of the Director of rules by regulation, Health designates provided to, include, all need not be research. Such rules shall but limited requirement oath researchers must an as follows: sign confidentiality Date received services from As a condition of research who have doing concerning persons *27 ........(fill not to information any in the or facility, agency I,.........agree divulge person), not to in the course of such research to unauthorized and publish obtained otherwise make persons, who have received services any information public regarding persons such who services is that the received identifiable. person make me I that of confidential may subject unauthorized information recognize release Welfare and Institutions Code. to a civil action under of the provisions constitutional such committee. disclosed. Assembly insurance [H] presentation patient law identity (0 enforcement agencies To the is unable to sign of said designates Rules Committee for the [H] courts, officers and (j) attorney, [H] To release as (i) in the necessary such If the writing and attorney their as release, of the information signed needed for recipient families. to the administration of the insurer for the fact that the attorney purposes the staff of [11] of services who the (h) patient to which records or of legislative investigation protection To the the by facility, upon the Senate any justice. patient, does of federal applies and all proceedings represent Rules [H] except satisfying information for (g) and state Committee or To governmental life or the interests that when the authorized by Signed itself of the disability may elective upon the treatment, disclosure concern that legislative might impair thereby both and section 5328.1. The shown harming patient society, section that a disclose “to a member of the may provides therapist family of a the is in the information patient patient presently patient or that the is .. if ill. facility patient seriously physically professional of the of such determines person charge facility release Thus, information is in the best interest of the even patient.” disclosing the fact of treatment is limited. severely
As enacted the act no originally provision contained allowing to warn 1970, however, of a threat. In therapist anyone patient’s act was amended to disclosure in two permit limited circumstances. Section amended, 5328 was in subdivision to allow disclosure (g), govern- “[/]o mental law as needed for the of federal agencies protection enforcement state elective constitutional and officers and their (Italics families.” addition, In added.) section 5328.3 was added to that when provide for the of the “necessary оr others due to the protection patient patient’s from, to, without notice disappearance and prior his designated facility unknown, whereabouts is notice of be made disappearance may relatives and law governmental agencies designated by enforcement or the physician charge professional person charge or his (Italics added.) facility designee.” neither
Obviously exception confidentiality requirement to the instant case. applicable
Not has the dealt with only Legislature disclosure specifically but it also has warning, dealt officer therapist police liability acts of the has that the patient. Legislature provided the officer shall not be liable for prematurely releasing patient. 5151, 5154,5173, 5278, 5305, (§§ 5306,) release all information and patient, may records relating patient except in this article shall be construed to nothing social compel physician, psychologist, worker, nurse, or other to reveal information has attorney, professional which been to him in confidence given members of a The amendment of patient’s family. [1i] *28 (d) subdivision of this section enacted at the 1970 Session the does Regular Legislature in, of, not constitute but the law.” change declaratory preexisting (h), (i) Subdivisions were added (g), amendment in 1972. Subdivision was by (j) added amendment in by 1974. Section specifically to the enumerating exceptions confidentiality requirement, does not admit of an interpretation importing implied (County exceptions. Riverside Court, 478,481 Superior 886].) Cal.App.3d to focus the has chosen detailed the act’s majority provisions,
Ignoring the on exception” psychotherapist-patient patient “dangerous that “the 1024 as Evidence Code sections indicating privilege counter- task of the the difficult has undertaken balancing Legislature However, conclusion is erroneous. this 440.) (Ante, concerns.” p. vailing in an disclosure is that when fails to The permitted appreciate majority court’s comes into fourth interest play—the hearing, evidentiary are the Because necessary they concern judicial supervision. from are the to the courts disclosures excepted administration justice, However, (f). subdivision section by nondisclosure requirement and the (f) Subdivision disclosure. involve a court does not this case on the relied clearly inapposite. Code sections majority Evidence by fn. (see here. Section of the act are The applicable provisions the course obtained in and records ante) “All provides, information (Italics . . shall be under division 5 . services providing confidential.” mental condition letter Poddar’s added.) Dr. Moore’s describing a transmit- 72-hour commitment was undisputedly obtaining purposes it of division 5. As such to invoke tal of information designed application 5. services under division information obtained constituted providing Dr. Moore has been true of whether This is designated regardless section 5150 of Alameda. Although by County professional person shall be based on a that commitment for 72 hours’ evaluation provides section officer or statement by county, by peace person designated disclosure of the disclosure of all just information, prohibits statement or disclosure county. by persons designated by committing addition, for disclosure a cause of action In section gives individual” rather than of confidential information “an by 5150. enumerated in section
Moreover, that Dr. it from the complaint appears allegations under section 5150. Moore is in fact a county person designated 20, 1969, Dr. “On or about defendant August complaint alleges Teel, he would Officers Atkinson and Moore notified campus give Poddar, so the a letter police Prosenjit campus diagnosis police him to Herrick Poddar and take could Hospital Berkeley pick up a 72-hour Dr. would where Moore Psychiatric Emergency assign no that Dr. Since there is Detention on Poddar.” allegation Prosenjit document, be concluded must was not authorized to Moore it. sign and thus a he authorized that under the was complaint allegations county. professional person designated *29 Whether we the facts as stated in the that Dr. Moore rely complaint is a under section or on the strict designated person prohibitions section 5328 disclosure “all prohibiting imposition informationthe to warn the flies in the face duty by majority directly Lanterman-Petris-Short Act. act,
Under the can there be no for Poddar’s release. liability premature It is likewise clear there exists no to warn. Under section duty disclose, were under a to not no to therapists duty duty exception here. to warn on the tort basis applicable Establishing general a Draconian dilemma on violate imposes principles therapists—either the act the attendant thereby incurring statutory penalties, ignore to warn civil I am majority’s duty thereby incurring liability. potential unable assent to such. dilemma, it an
If the feels that must then it has majority impose under which the enumerate circumstances obligation specifically Act to the Lanterman-Petris-Short as circumstances applies opposed when tort will The failure to “general principles” govern. majority’s this the subtle as perform obligation—leaving therapist questions each when rule unfair. opposing manifestly applies—is Duty Controlling to Disclose in the Absence Statutory Provision
Even the act’s assuming conduct provisions applicable only commitment, after conduct, not to occurring the act remains prior to the most applicable committed. The dangerous patients—those determined Legislature balance of several interests having commitment, nondisclosure in the would it requires graver public danger be anomalous for this court interests, disclosure reweigh requiring Rather, for those less we should follow the dangerous. legislative direction disclosure of confidential information by refusing require received either before or absence commitment. is more than is this court Legislature obviously capable debate and harm disclosure investigate, weigh through potential patient the risk of harm to its nondisclosure. We should defer against public judgment. Analysis Law
Common from the result same must Entirely apart statutory provisions, reached both tort upon considering general principles public
458 treatment, violence, and reduction of effective justified favoring policies commitment. the conduct of another. a owes no control duty
Generally, 60, v. 43 65 P.2d 23]; v. Cal.2d (1954) (Richards Wright Stanley [271 272, 812]; 230 277 School Dist. (1964) Arcade Cal.App.2d Cal.Rptr. [40 in limited 315.) Torts (1965) § Rest.2d only Exceptions recognized exists between the defendant (1) where situations special relationship exists between defendant (2) special injured party, relationship on defendant to control the active and the duty wrongdoer, imposing is does not contend the first conduct. The exception majority wrongdoer’s this case. appropriate 728, 68 Cal.2d (Dillon (1968) determines Legg duty.
Policy generally 72, 912, 1316].) 441 29 A.L.R.3d P.2d 734 Principal policy Cal.Rptr. [69 harm, of the include considerations certainty plaintiff’s foreseeability to the defendant’s conduct injury, plaintiff’s proximity injury, conduct, of future to defendant’s moral blame attributable prevention defendant, harm, on the burden community. consequences 108, 97, 443 P.2d Cal.2d 113 (1968) v. Christian 69 (Rowland Cal.Rptr. [70 561,32 A.L.RJd 496].) considerations imрosing duty weigh against
Overwhelming policy While victim harm. to warn a offering against potential psychotherapists will frustrate such a no benefit psychiatric virtually society, violence. treatment, and increase fundamental invade patient rights confidentiali treatment and its need for The importance psychiatric 2 Cal.3d court. re (In (1970) been this have recognized by ty Lifschutz “It is 1].) 467 P.2d 44 A.L.R.3d 421-422 that the vitally psychiatry depends clearly recognized very practice will not tell.” that the in the community psychiatrist upon reputation (1960) Medical Look at the and a Second (Slovenko, Privilege Psychiatry 175, 188.) L.Rev. Wayne for three reasons. Assurance of important confidentiality Deterrence Treatment From those
First, without substantial assurance confidentiality, requiring Sen. (See assistance. from Judiciary will be deterred treatment seeking Slovenko, Code; of Evid. supra, Com. comment § accompanying 187-188; Katz, L.Rev. Goldstein & Psychiatrist-Patient Wayne GAP Connecticut Statute Privilege: Proposal 175, 178.) Conn.Bar J. It remains an unfortunate fact in our *31 society tend to become people seeking psychiatric guidance stigmatized. Appre- hension of increased stigma—apparently by propensity treatment see themselves in the worst people considering possible a reluctance (Fisher, to seek aid. The light—creates well-recognized and Law Communications Psychotherapeutic Privileged Professions 609, 617; Slovenko, 175, 10 L.Rev. (1964) 6 Wayne L.Rev. Wayne supra, 188; see also (1963) 23 Md.L.J. Psychiatrist-Patient Rappeport, Privilege 39, This 46-47.) reluctance is alleviated assurance of psychiatrist’s confidentiality.
Full Disclosure
Second, the is essential in the full guarantee confidentiality eliciting disclosure for (In effective treatment. re 2 Lifschutz, necessary supra, 415, 431; 398, Cal.3d 222 (D.C.Cir. 1955) United States F.2d Taylor 175, Katz, 401 373]; Goldstein & 36 J. Conn.Bar [95 App.D.C. supra, 178; Heller, Some Comments on the Practice Lawyers Psychiatry 401; Weihofen, 30 (1957) & Guttmacher Commu- Temp.L.Q. Privileged Ind.L.J.32, nications Between (1952) 34.)3 and Patient 28 Psychiatrist with and treatment conscious unconscious psychiatric patient approaches inhibitions his innermost against revealing thoughts. “Every person, well-motivated, however has overcome resistances to therapeutic These resistances seek from exploration. source support every possible and the of disclosure would be in the service possibility easily employed Katz, 179; resistance.” (Goldstein 175, & 36 J. Conn.Bar see supra, also, 734, 735.) Until can trust his Am.J.Psych. psychiatrist not to violate their confidential “the unconscious relationship, psycholog- ical control mechanism of will the recall of repression prevent past (Butler, and Griswold: experiences.” Is Psychotherapy Confidentiality (1971) 604.) Conn.L.Rev. Privilege Right?
Successful Treatment
Third, even if the his discloses assurance that patient fully thoughts, the confidential will not be is breached necessary relationship 3One indicated five of seven survey interviewed said would every people they less make full disclosure to a likely absence of assurance of psychiatrist Comment, (See, Lawyer Functional confidentiality. Between the and Overlap Other (1962) Its Implications Communications Doctrine 71 Yale Privileged Professionals: 1226, 1255.) LJ. which means treatment his in his
maintain trust psychiatrist—the very is contribution of much effected. essence psychotherapy “[T]he self, modelled in the external world trust ultimately upon (Dawidoff, The Mal established relationship during therapy.” trusting will be L.J. Patients 704.) 1966 Duke Psychiatrists, helped practice of at (Id., can if form only they trusting relationship psychiatrist. Burham, 34; (1965) fn. Anxiety Arch.Gen.Psych. Separation p. 346, 356; Heller, All authorities 406.) supra, Temp.L.Q. if the trust cannot be developed agree relationship appear others, because of cоllusive communication between the psychiatrist will (See, treatment be frustrated. Slovenko e.g., Psychiatry *32 Cross, 61; Law, Communications Between Participants p. Privileged Order, 191, 199; Hollender, The (1970) Law & Soc. Group Psychotherapy 116 and the Release Patient (1960) Psychiatrist of Information 828, 829.) Am.J.Psych. it to of the of the Given psychiatry, importance confidentiality practice the will clear the to warn the becomes by majority cripple duty imposed violent— and effectiveness of use Many potentially psychiatry. people, it; those from treatment—will be deterred to seeking yet susceptible from revelations it will be inhibited necessary making seeking treatment; and, the to violate the effective patient’s forcing psychiatrist is which treatment trust will by interpersonal relationship destroy effected. and
Violence Civil Commitment warn, a contributes to By imposing duty majority danger ill and the risk of of violence increases society by mentally greatly who civil commitment—the total those should deprivation liberty—of and not confined.4 The of treatment risk be impairment improper will new be limited to a commitment from the warn resulting ill. few but will extend number the mentally patients large in the also improper result may 4The burden majority placed psychiatrists First, constitutional rights. patient’s constitutionally protected of two other deprivation 415) encroached (In upon is obviously re 2 Cal.3d Lifschutz, supra, right privacy Secondly, confidential communications. to disclose the psychotherapist requiring treatment, also decision to effective majority’s is essential because confidentiality v. Feagley treatment. (People receive the constitutionally recognized right threatens (1975) 509, (M.D.Ala. 373]; P.2d v. Stickney 535 Wyatt 359 14 Cal.3d Cal.Rptr. 338. [121 1974) 781, 784, (5th F.2d Cir. v. 1971) Aderholt affd. sub nom. Wyatt 325 F.Supp. 1305; (1968) Mass. 604 [233 State Bridgewater Hosp. Nason Superintendent of 908].) N.E.2d under few psychiаtric only Although existing procedures relatively violence, treatment will ever risk the number receiving present threats and it the latter is is huge, making group—not just will whose former—whose treatment and risk of commit- impaired ment will be increased.
Both the
communities
that the
legal
psychiatric
process
recognize
exact,
violence in
far from
determining potential
being
(1975)
v. Burnick
fraught
complexity
uncertainty. (E.g., People
306,
14 Cal.3d
overwhelming hindsight Now, the new violent. become confronted duty, majority’s ultimately violence from the must calculate instantaneously potential psychiatrist encountered The difficulties researchers have on each visit. each in violence be will for practicing accurately predicting heightened in with .heretofore his office brief periods psychiatrist dealing And, or commit must decision not warn nonviolent to patients. given one can most at the civil be made peril, expect always psychiatrist’s himself. will doubts resolved favor be psychiatrist protecting himself Neither alternative seeking open psychiatrist protect in the interest. The itself is an is public warning impairment treat, ability many patients adequate psychiatrist’s depriving threats, their treatment. It is be after that expected disclosing would not violent if treated number of who become significant patients, as a will violent conduct result according existing practices, engage short, In treatment. warn will not unsuccessful majority’s duty who would never violent treatment become but only many impair worse, will result in a net increase in violence.6 6The concedes that results in the patient often majority dialogue psychotherapeutic 441.) (Ante, threats executed. The rarely practical violence expressing p. course, lies which will from be carried ascertaining which threats problem, out. As to patients however, do, this silent. caution that majority problem, They therapist threats; “should not reveal such disclosures certainly could encouraged routinely his and with seriously disrupt patient’s relationship (Id) threatened.’’ Thus, effect, informs the must accurately predict majority therapists they task as face civil crushing liability. dangerousness—a recognized extremely difficult—or care reliance on the traditional standard of for professionals majority’s *34 skill, and care need exercise ‘that reasonable of only degree knowledge, “therapist under and members of specialty] exercised ordinarily possessed by professional [that ” 438) (ante, This of care similar circumstances' is standard p. seriously misplaced. that, extent, matter of the is ascertainable. One assumes to a the large subject specialty field the element the is cannot ascertainable clearly accurately predict dangerousness, psychiatric which, turn, is means that the standard inappro The to the decision. for lack of relevant criterion which by judge therapist’s priate the us use is made when of standard would have patent the inappropriateness majority studies, authorities, several consideration is eminent given indicating “[t]he of ‘are of a second with a first diagnosis chances the agreeing psychiatrist psychiatrist 50-50; is chance that a better than or stated there about as much barеly differently, there that the different would conclusion as is other would come some different expert " Litwack, (Ennis & the Coins agree.’ Presumption and Psychiatry Expertise: Flipping of 701, Ziskin, Courtroom, 693, in the With Psychiatric 62 Cal.L.Rev. supra, Coping quoting, 126.) and Psychological The scheme Testimony, p. a normative majority’s attempt apply that balk at standardization which must be concerned profession problems clearly erroneous. event, In disclosure an ascertainable standard would not serve to limit any psychiatrist threats with the of treatment. However compassionate, resulting impairment
463 second to the The is to commit his alternative open psychiatrist patient rather than to warn. Even in the absence of threat of civil liability, doubts of threats have led as seriousness psychiatrists to overcommit to mental institutions. This overcommitment psychiatrists has been documented in both authoritatively legal psychiatric Litwack, & (Ennis studies. and the Psychiatry Presumption Expertise: 693, Courtroom, 62 Cal.L.Rev. 711 et Coins supra, Flipping seq.; Maximov, & The Patient or The His Victim: Fleming Dilemma, Therapist’s 1025, 1044-1046; 62 Cal.L.Rev. Am. Assn. Task Psychiatric Individual, 1974) Force Clinical the Violent Rep. (July Aspects 23-24; Livermore, Meehl, see On the Civil pp. Malmquist & Justifications for Commitment, 84.) U.Pa.L.Rev. This is so that it practice prevalent has been estimated that “as as harmless many twenty for one who will incarcerated commit a violent act.” (Steadman & every Cocozza, We Who (Jan. Can’t Predict Is Stimulus/Response: Dangerous 1975) 35.) Psych. Today
Given the incentive to commit created this majority’s duty, worsened, serious will be situation already Chief Justice contrary is no admonition “that less because Wright’s forfeited in liberty precious a civil than when taken as a proceeding a criminal consequence re (In conviction.” W. 5 Cal.3d Gary
P.2d 1201].)
Conclusion act,
In the concerns that adopting Legislature fully recognized ill, must decision our treatment govern today—adequate mentally our our devotion individual safety society, liberty, making overcommitment of the 5001.) ill abhorrent. (§ mentally Again, balanced these 5328), concerns favor (§ nondisclosure Legislature treatment, effective for overcom- thereby promoting reducing temptation mitment, and for our ensuring greater safety society. Psychiatric on the the same legal expertise subject requires judgment. Tarasoff has led Tatiana tragedy majority disregard
clear Worse, mandate legislative Lanterman-Petris-Short Act. treatment, medical in increased majority violence impedes resulting from—and to—the ill. deprivation liberty mentally psychiatrist mistaken remains faced with hearing civil potential crushing threat for a liability evaluation his bewill forced to resolve even doubt slightest favor disclosure commitment. upon judgment, relying medical legislative accept We should warning. on indiscriminate than rather treatment effective be affirmed. should judgment McComb, J., concurred. all letter notes Moore’s directed that destroyed, place no be and “ordered action had taken as facility.” Prosenjit Poddar in 72-hour treatment evaluation to warn plaintiffs failed defendant therapists 3Plaintiffs’ allege merely complaints do not allege to Tatiana. complaints —Tatiana’s danger parents—of herself, than to warn other Tatiana failed failed to warn defendant therapists can Such omissions Tatiana the danger. who be her would likely apprise parents (1974) Los Angeles we stated in v. City As Minsky be cured amendment. properly 102, 113, that if is a is axiomatic there P.2d “It 118-119 726]: 11 Cal.3d Cal.Rptr. [113 can cured amendment or in the that defect complaint reasonable possibility action, should not be a demurrer can state a cause construed liberally pleading & Loan Assn. (Accord, v. American Sav. La Sala to amend.” without leave sustained v. 1113]; Electric County P.2d Lemoge (1971) 5 Cal.3d [97 (1971) 638]; Court Superior P.2d Beckstead 46 Cal.2d Mateo [297 San 779].) 782 Cal.Rptr. 21 Cal.App.3d
