There is an interesting case out of Denver where Heidi Hemmat at KDVR Fox 31 has resigned after death threats tied to her investigation of a local business. The threat however was not made to her directly but reported by the psychiatrist treating the owner. It appears to be a direct application of the ruling in Tarasoff v. Regents of the University of California, 17 Cal. 3d 425, 551 P.2d 334, 131 Cal. Rptr. 14 (Cal. 1976), requiring doctors to disclose threats made by patients to their potential victims.
Hemmat is an award-winning journalist who went into a dumpster to find receipts that the owner had thrown away. The owner confronted her in the dumpster, as captured on the news program.
The man reportedly went to a therapist and expressed his desire to hurt or kill Hemmat. Despite the confidentiality rules under HIPPA, the psychiatrist contacted Hemmat. Hemmat said that the doctor informed her that the owner was on a “72 hour mental hold” but, since it was 4th of July weekend, he would likely be released before then. Hemet then concluded that the station was not doing enough to protect her and resigned. This happened in 2015 but she just came forward with the story. The disclosure was made in a Thanksgiving public letter.
The case obviously draws instant comparison with the Tarasoff opinion. In that seminal 1974 case, Prosinjit Podder, an Indian Graduate student at Berkeley, fell in love with Tatiana Tarasoff. When she stated that she wanted to date other men, Podder went to counseling at the University Health Service and is treated by psychologist, Dr. Lawrence Moore. When he told Moore that he wanted to get a gun and kill Tarasoff, Moore sent a letter to campus police who interview Podder and decided that he was not a risk. Podder then went ahead and murdered Tarasoff.
In a groundbreaking decision, Justice Mathew O. Tobriner held that “… the confidential character of patient-psychotherapist communications must yield to the extent that disclosure is essential to avert danger to others. The protective privilege ends where the public peril begins.” As a result, the hospital was held liable for the criminal actions of a third party — something that usually (but not always) cuts off proximate causation. It also rejects strong arguments made by doctors that such liability would create a chilling effect on counseling. A large number of patients often express their anger by focusing it on individuals and stating an intent to “kill that guy.” In the vast majority of such cases, the open disclosure is addressed and defused. However, if the patient knows that the doctor will have to tell authorities, such feelings are less likely to be expressed and addressed. In speaking with doctors around the country at hospital and conference events, this remains one of the most controversial and resented cases for some medical and psychiatric professionals. I share their concern over the lack of a clear standard of when such disclosures must be made. The standard is maddeningly vague and offer little guidance for professionals in making these tough decisions.
We have previously discussed such controversies. These are tough cases to be sure. The court was trying to establish some responsibility for doctors in cases of a clear risk to third parties. However, the fear is that doctors will simply contact police to avoid any risk of liability — seriously undermining treatment for patients expressing anger or resentment toward others.
In the Oregon case, it is not clear if the owner sued the doctor for the violation of HIPPA and insisted that he was expressing feelings and not a plan of action. However, it does not appear that the owner suffered legal fallout from the disclosure in terms of an arrest.
TIN:
The statute and rules of ethics required a direct warning to the likely victim by the psychiatrists . Oh, the joys of cultural diversity.
This isn’t exactly what happened. I was at Berkeley in the years following the murder, and the case was still being discussed. Both students lived at the International House, a lodging for foreign students. She was a Russian; he was from India. They dated briefly, and on New Year’s Eve they shared a kiss. To her it was no big deal; he thought it meant they were going to get married. When she clarified that she wasn’t that serious about him, he stopped going to class, stopped bathing, and started talking to himself. For more than a year his condition deteriorated, and the U.C. psychiatrists diagnosed him with acute schizophrenia. He stated his intent to obtain a gun and kill her, and the doctor notified the campus police. The U.C. cops detained him, but decided he was rational enough and let him go. Thus it was the POLICE, not the docs, who decided he wasn’t dangerous enough to be put on a psych hold. He promptly went to her apt, shot her and repeatedly stabbed her until she died. The reason the CA Supreme Court held against the docs was because they failed to warn the intended victim or her parents that she was in immediate danger. Personally, I think the reasoning is flawed. The doc requested that the police put a psych hold on a schizo guy who expressed his specific intent to murder a female student. The docs had no way of knowing that the campus cops would substitute their own assessment of this guy’s mental condition, which they were clearly unqualified to do, and let him go. I believe the unreasonable intervening acts by the police made them the liable party, not the campus psychiatrists.
Someone “should be shot” is often used as a figure of speech, a very poor figure of speech, but a figure of speech never the less. Kendal Ehrlich, wife of then Maryland Governor Robert said during a speech that a certain female rock star, Brittany Spears, should be shot. Despite the fact she had been a lawyer, both a Public Defender and a Prosecutor and speaking at a Domestic Violence function Kendal let slip, ultimately apologizing profusely. For the mental health practitioner to have contacted law enforcement there must have been more than a simple slip of the tongue or an ill advised figure of speech. I would hate to see a law enacted that would require doctors to report any such usage as a potential crime.
I wonder what happened to Hemmat? Murdered? Working at another station? Unemployed?
She opened her own business and appears to be happier than ever. http://heidihemmatproductions.com/why-i-left-kdvr-and-tv-news/
“If you don’t want it known, don’t say it over the phone …”
– Nelson Rockefeller, privacy hearings.
“… or in a doctor’s / psychiatrist’s / therapists’ office”.
– SD.
The source of this info was an American citizen woman, a certified and registered professional therapist, who personally confirmed exactly what I had read recently before our meeting. She confirmed that a recent annual meeting of her fellow professional therapists agreed their profession has no scientific method to confirm the failure or success of any recommended therapy. In the end, therapeutic failure or success comprises solely patient self-reporting.
She did not confirm the following, but even a cursory investigation into therapeutic methods reveals the industry comprises mutually exclusive practices.
Person A pays person B money in exchange for person B listening to person A talk about their problems. Best of luck w/that.
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KCF, Good, informative comment. I agree, HIPPAA is a cluster coitus.
Brings to mind ‘Eddie the foot’ and ‘Benny the cheese’ confessing to priest. Also brings to mind all the pedophile priests confessing to each other. This is the gray area where freedoms of this or that collides with those bizarro responsibilities.
You seem have some serious issues which “come to mind” after following your posts.
1. Her female boss at the TV station repeatedly downplayed the risk.
And here I thought women were better bosses.
2. HIPAA is regulatory idiocy.
For example, it prevents elderly wives from managing their demented husband’s medical care, and forbids parents from finding out which hospital their college kid got taken to after a car accident (on the parent’s insurance).
3. He was “expressing feelings and not a plan of action”?
I doubt it.
Further, I doubt there is any medical evidence that “expressing your homicidal rage” has any therapeutic value whatsoever, and likely only exposes that one is indeed a risk to the community..
I think Hemmat is getting set to sue the station for not protecting her. When she left the station, all the station manager said was Hemmat was no longer working for us. She, at some point, sent everyone an email explaining the situation, something the station had failed to do.
Makes sense. Patient Doctor relationship or not they would be accessories and chargeable and the penalty for accessory is the same as the crime itself. I’m sure the liability insurance companies providing policies to
Doctors would not be thrilled and probably helped pass that ruling.