Gavaghan Colin
School of Law, University of Glasgow, Glasgow, G12 8QQ, Scotland, UK.
Int J Law Psychiatry. 2007 May-Jun;30(3):255-67. doi: 10.1016/j.ijlp.2007.01.001. Epub 2007 Apr 24.
It has long been recognised by British courts that a psychiatrist can be permitted to depart from his/her duty of confidentiality, in order to issue a warning where a patient is deemed to present a real and serious threat to other parties. Until recently, however, it seemed that s/he would not be bound to give such a warning, or to take other steps to protect third parties. The approach adopted throughout much of the USA, and famously expounded in the Tarasoff judgment, appeared to have no relevance to British law. This article considers the possibility that the European Court of Human Rights' ruling in Osman v UK may be set to bring about a radical change in this respect, introducing something akin to the Tarasoff approach into the UK, and indeed throughout Europe. As well as the possible legal basis for such a duty, and the circumstances in which it would arise, it will consider how a psychiatrist might reconcile any such duty with other, more established, legal and ethical duties.
英国法院早就承认,为了在患者被认为对他人构成真实且严重威胁时发出警告,精神科医生可以被允许背离其保密义务。然而,直到最近,似乎精神科医生没有义务发出这样的警告,或采取其他措施保护第三方。美国大部分地区所采用的方法,并在塔拉索夫案判决中得到著名阐述,似乎与英国法律无关。本文探讨了欧洲人权法院在奥斯曼诉英国案中的裁决可能在这方面带来根本性变化的可能性,将类似于塔拉索夫案的方法引入英国乃至整个欧洲。除了这种义务的可能法律依据以及其产生的情形外,还将考虑精神科医生如何使任何此类义务与其他更既定的法律和道德义务相协调。