Under Tarasoff-style duty to warn, when may a clinician breach confidentiality?

• A. If a patient expresses a credible intent to harm a specific person.
• B. If a patient requests confidentiality for personal reasons.
• C. If the patient is unable to pay for services.
• D. If a clinician suspects but has no evidence of risk.

Answer: (A)

Tarasoff duty to warn allows breaching confidentiality only when there is a credible, specific threat against an identifiable victim. When a patient expresses a credible intent to harm a specific person, the clinician must take steps to protect that person, which can include warning the potential victim or notifying authorities. This scenario meets the threshold where the risk is real and targeted, justifying disclosure to prevent harm.

Confidentiality isn’t breached merely because the patient asks for it, because financial issues don’t affect safety, and because a clinician suspects risk without solid evidence; none of those establish a credible, identifiable threat that requires disclosure.