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心理治疗师-患者特权的危险患者例外情况:塔萨夫义务与贾菲脚注

The dangerous patient exception to the psychotherapist-patient privilege: the Tarasoff duty and the Jaffee footnote.

作者信息

Harris G C

机构信息

University of Utah College of Law, USA.

出版信息

Wash Law Rev. 1999 Jan;74(1):33-68.

Abstract

With the U.S. Supreme Court's 1996 decision in Jaffee v. Redmond, all U.S. jurisdictions have now adopted some form of evidentiary privilege for confidential statements by patients to psychotherapists for the purpose of seeking treatment. The majority of states, following the decision of the Supreme Court of California in Tarasoff v. Regents of the University of California, have also adopted some form of duty by psychotherapists to breach confidentiality and warn potential victims against foreseeable violence by their patients. Largely unresolved is whether there should be a dangerous patient exception to the evidentiary privilege parallel to the Tarasoff exception to confidentiality. This Article argues that exception to the evidentiary privilege should be evaluated separately from the exception to confidentiality. Whether or not a Tarasoff duty to warn existed at an earlier time, exception to the evidentiary privilege should be made only where psychotherapists' testimony is necessary to prevent future harm to patients or identified potential victims. Applying this standard, the dangerous patient exception generally would not apply in criminal actions against patients, but would apply only in proceedings for the purpose of protecting patients or third parties, such as restraining order hearings or proceedings to hospitalize patients.

摘要

随着美国最高法院1996年对“贾菲诉雷德蒙德案”的判决,美国所有司法管辖区现在都采用了某种形式的证据特权,以保护患者为寻求治疗而向心理治疗师作出的保密陈述。大多数州遵循加利福尼亚最高法院在“塔拉索夫诉加利福尼亚大学董事会案”中的判决,也采用了某种形式的规定,要求心理治疗师违反保密义务,警告潜在受害者防范其患者可预见的暴力行为。一个在很大程度上尚未解决的问题是,是否应该存在一个与塔拉索夫保密例外并行的证据特权危险患者例外。本文认为,证据特权例外应与保密例外分开评估。无论之前是否存在塔拉索夫警告义务,只有在心理治疗师的证词对于防止对患者或已确定的潜在受害者的未来伤害必不可少时,才应作出证据特权例外。适用这一标准,危险患者例外通常不适用于针对患者的刑事诉讼,而仅适用于为保护患者或第三方的程序,如限制令听证会或患者住院程序。

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