The latter situation usually arises where the psychiatrist fails to restrain the patient, either by failing to postpone the patient's discharge or by failing to commit the patient. A very few courts have rejected even a limited duty to warn. These courts have held that, absent a patient's consent, the psychiatrist is prohibited from disclosing confidential information for any reason. Nevertheless, psychiatrists in those states should not assume that a duty to warn will never be imposed. As frequently happens in the law, court decisions are codified by state legislatures.
Most states now have a statute addressing dangerous patients.
These statutes allow a psychiatrist to breach confidentiality when a patient poses a danger to others. Some statutes are permissive, allowing the psychiatrist to choose whether or not to warn. Other statutes impose a duty, leaving the psychiatrist no discretion. In almost all cases, there is an accompanying immunity statute which protects the psychiatrist from liability as long as he or she acts in good faith. Risk Management Working with violent and potentially violent individuals can be a stressful and anxious experience.