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How do you approach disposition planning when a patient makes homicidal threats on presentation to the emergency department but later recants?

Occasionally a patient makes explicit threats toward an identifiable individual, but later denies intent once stabilized or when asked directly. In some cases, the treatment team may be unable to reach the person who was threatened. How do you approach risk assessment and disposition in this scenario? How do you approach duty-to-warn obligations if the potential target cannot be reached?
2 Answers
Mednet Member
Mednet MemberInvited Expert
Psychiatry · Costello Clinic
Answered on · Updated on

Tarasoff rules.

Tarasoff v. Regents of the University of California

The ER department remains in the purview of all medicine in the USA, in my opinion.

“How do you approach” is the same regardless of the setting. The thought of the clinician remains superordinate. Is this really a question?

Recant.....

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Mednet Member
Mednet Member
Psychiatry · Private Pratice
Answered on

We are psychiatrists, and we have our area of expertise... the legal system has theirs... the legal system, NOT the medical system, has created Tarasoff or more specifically THE DUTY TO WARN. I have taught residents, medical students, and nurse practitioners for many years, and I present a very simp...

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