Misapplication of the Tarasoff duty to driving cases: a call for a reframing of theory

Bull Am Acad Psychiatry Law. 1993;21(3):263-75.


In the years since the original Tarasoff cases created a new duty for psychotherapists toward third parties harmed by patients' violence, a series of cases nationwide--so called "driving cases"--have applied Tarasoff-like reasoning to situations where a patient injured others while driving a car. Our thesis in this paper is that such application is inappropriate since it represents an unjustified and largely unexamined assumption that driving injury is an expression of the mental-illness-derived intended violence that justifies the Tarasoff duty and its inevitable associated breach of confidentiality. We suggest to the contrary that driving cases almost invariably result from a patient's negligent driving rather than intentional violence stemming from mental illness; that clinicians in most instances have almost no capacity, training, or clinical bases on which to predict a patient's future negligence, violence aside; and that the theory of driving cases should be revised.

Publication types

  • Review

MeSH terms

  • Accidents, Traffic / legislation & jurisprudence*
  • Accidents, Traffic / psychology
  • Dangerous Behavior
  • Duty to Warn / legislation & jurisprudence*
  • Expert Testimony / legislation & jurisprudence
  • Humans
  • Insanity Defense
  • Liability, Legal
  • Mental Disorders / diagnosis
  • Mental Disorders / psychology*
  • Mental Disorders / rehabilitation
  • Mentally Ill Persons*
  • Physician's Role
  • Psychotherapy / legislation & jurisprudence*
  • Risk Factors
  • Violence*