Weinstock R, Leong G B, Silva J A
UCLA School of Medicine, Greater Los Angeles Veterans Healthcare System, 1626 Westwood Boulevard No. 105, Los Angeles, CA 90024, USA.
Behav Sci Law. 2001;19(3):437-49. doi: 10.1002/bsl.443.
The "dangerous patient exception" to psychotherapist-patient privilege, adopted almost a decade before the celebrated case of Tarasoff v. Regents of the University of California (1976), was mentioned in a footnote to that decision in the context of an analogy. Although intended to permit testimony in civil commitment proceedings, this exception has been used to "criminalize" the Tarasoff duty in California. California courts eroded the privilege initially primarily to permit victims to sue psychotherapists and later to require psychotherapists to testify against their patients in criminal proceedings and appear to have confused evidentiary privilege and confidentiality. If consistent, similar reasoning in California in the future should allow therapists to testify against their patients if they were civilly committed in the past for dangerousness and attorneys to testify against their clients in criminal cases if at some earlier time they believed their clients represented a risk of future harm. Although most other jurisdictions may not word their privilege exceptions for civil commitment in the same way as California, most states have some type of privilege exception for civil commitment that could allow for such an interpretation. The United States Supreme Court in Jaffee v. Redmond (1996) found a psychotherapist-patient privilege, but stated in a footnote that an exception to the privilege would exist if a serious threat of harm to the patient could be averted only by means of disclosure by the therapist. Other jurisdictions have begun to consider these issues. Rather than being unique to California, similar reasoning could lead to the "criminalization" of Tarasoff in other jurisdictions and thereby compel therapists outside California to testify against their patients in criminal proceedings.
心理治疗师与患者之间特权的“危险患者例外”,在著名的塔拉索夫诉加利福尼亚大学董事会案(1976年)之前近十年就已采用,在该判决的一个脚注中作为类比被提及。尽管该例外旨在允许在民事强制治疗程序中作证,但在加利福尼亚州,这一例外已被用于将塔拉索夫义务“刑事化”。加利福尼亚州的法院最初削弱该特权主要是为了允许受害者起诉心理治疗师,后来则要求心理治疗师在刑事诉讼中指证其患者,而且似乎混淆了证据特权和保密义务。如果保持一致,加利福尼亚州未来类似的推理应该允许治疗师在其患者过去因危险性而被民事强制治疗的情况下指证他们,并且允许律师在刑事案件中指证其客户,如果他们在早些时候认为其客户存在未来造成伤害的风险。尽管大多数其他司法管辖区可能不会像加利福尼亚州那样措辞其关于民事强制治疗的特权例外,但大多数州都有某种类型的民事强制治疗特权例外,可能会导致这样的解释。美国最高法院在贾菲诉雷德蒙德案(1996年)中认定了心理治疗师与患者之间的特权,但在一个脚注中指出,如果只有通过治疗师披露才能避免对患者造成严重伤害的威胁,那么该特权将存在例外。其他司法管辖区也已开始考虑这些问题。塔拉索夫案并非加利福尼亚州所独有,类似的推理可能会导致在其他司法管辖区将塔拉索夫义务“刑事化”,从而迫使加利福尼亚州以外的治疗师在刑事诉讼中指证他们的患者。