Does a psychotherapist who determines, or under professional standards should determine, that a patient presents a serious danger of violence to another person owe that person a duty to use reasonable care to protect them, including by warning the victim or those likely to apprise the victim of the danger?

Prosenjit Poddar, a voluntary outpatient at Cowell Memorial Hospital at the University of California at Berkeley, told his psychologist, Dr. Lawrence Moore, in August 1969 that he intended to kill an unnamed girl, readily identifiable as Tatiana Tarasoff, when she returned from spending the summer in Brazil. Moore, with the concurrence of Drs. Gold and Yandell, decided Poddar should be committed for observation and notified campus police orally and by letter requesting assistance in securing his confinement. Campus police detained Poddar briefly but released him after concluding he was rational and obtaining his promise to stay away from Tatiana. Dr. Powelson, Moore's superior and director of the department of psychiatry, then asked the police to return Moore's letter, directed that all copies of the letter and Moore's notes be destroyed, and ordered that no action be taken to place Poddar in a 72-hour treatment and evaluation facility. No one warned Tatiana or her parents of the danger. Poddar later befriended Tatiana's brother and moved into an apartment near her residence. On October 27, 1969, shortly after her return from Brazil, Poddar killed Tatiana. Her parents sued the therapists, the campus police officers, and the Regents of the University of California.

Tatiana's parents filed separate but virtually identical complaints against the therapists, campus police, and the Regents of the University of California, asserting causes of action for failure to detain a dangerous patient, failure to warn, abandonment of a dangerous patient, and breach of primary duty to patient and public. The Superior Court sustained defendants' demurrers to plaintiffs' second amended complaints without leave to amend, concluding that the complaints stated no causes of action against the therapists, the police, or the Regents. Plaintiffs appealed to the Supreme Court of California.

(Tobriner, J.)

Yes. When a therapist determines, or pursuant to the standards of the profession should determine, that a patient presents a serious danger of violence to another, the therapist incurs an obligation to use reasonable care to protect the intended victim. Depending on the circumstances, discharging that duty may require warning the victim or others likely to apprise the victim, notifying the police, or taking other reasonably necessary steps.

Duty is a conclusion reflecting policy considerations, including foreseeability of harm, closeness of the connection between conduct and injury, moral blame, the policy of preventing future harm, and the burden on the defendant and community. Rowland v. Christian, 69 Cal. 2d 108 (1968); Dillon v. Legg, 68 Cal. 2d 728 (1968). Although there is generally no duty to control the conduct of another or warn those endangered by it, an exception applies where the defendant stands in a special relationship to the dangerous person or the potential victim. Restatement Second of Torts § 315. The therapist-patient relationship supplies that special relationship. Decisions imposing liability on hospitals and doctors for failing to control dangerous patients or to warn those endangered by contagious disease support the duty.

The difficulty of predicting violence does not negate the duty. A therapist need only exercise the reasonable degree of skill, knowledge, and care ordinarily exercised by members of the profession under similar circumstances; honest errors within the range of reasonable professional judgment are not negligent. Here the complaints allege the therapists actually predicted Poddar would kill.

Confidentiality does not bar the duty. Evidence Code section 1024 reflects a legislative policy that the psychotherapist-patient privilege yields when disclosure is necessary to prevent danger. The protective privilege ends where the public peril begins. The Lanterman-Petris-Short Act's confidentiality provisions do not apply on the pleaded facts.

The therapists are not immune from liability for failure to warn, because Government Code section 820.2 protects only basic policy decisions, not operational decisions such as warning of a latent danger. Johnson v. State of California, 69 Cal. 2d 782 (1968). They are immune under Government Code section 856 for failure to confine Poddar. The police defendants owed no duty to warn because they had no special relationship with Tatiana or Poddar, and they are immune under Welfare and Institutions Code section 5154 for releasing him. Punitive damages are unavailable in a wrongful death action. The judgment for the police defendants is affirmed; the judgment for the therapists and Regents is reversed and remanded.

Concurrence and Dissent (Mosk, J.) Concurs in the result only because the complaints allege the therapists actually predicted that Poddar would kill, making the issue narrow. Dissents from the rule that a therapist may be liable for failing to predict violence that other practitioners, under professional standards, would have predicted. Psychiatric predictions of violence are inherently unreliable, as recognized in People v. Burnick, 14 Cal. 3d 306 (1975). The majority answered that Burnick concerned incarcerating the patient, while here the question is whether the therapist should take any steps to protect the victim, and that inaccuracy in predicting violence cannot negate the duty. The rule should be limited so that a duty to warn arises only when a psychiatrist in fact predicts violence; otherwise the law moves from reality into clairvoyance.

Dissent (Clark, J.) The Legislature has already balanced the competing interests in the Lanterman-Petris-Short Act, which makes treatment information confidential under section 5328 and allows only narrow exceptions, none applicable here. The majority answered that section 5150 does not apply, that the Act's confidentiality rules cover only services under Divisions 5, 6 and 7 that the pleadings do not show, and that the Legislature left the common-law duty to the courts where the Act does not govern. It also answered that the privilege yields where public peril begins. The majority disregards this clear legislative policy and the Evidence Code provisions it relies on concern judicial disclosure, not therapist warnings. Even without the statute, policy forbids the duty. Confidentiality is essential to deter patients from avoiding treatment, to elicit full disclosure, and to sustain the trust on which therapy depends. Because violence prediction is unreliable, therapists will warn or commit in cases of doubt to protect themselves, impairing treatment, increasing violence, and causing overcommitment of the mentally ill. The judgment should be affirmed.

Dissent (McComb, J.) Concurs in Justice Clark's dissent.