Court Opinion

ID: 9549027
Source: CourtListenerOpinion
Date Created: 2023-08-07 18:12:21.028827+00
Date Added: 2024-06-11T15:19:45.606211
License: Public Domain

MOSK, J.
I dissent.
The majority opinion unfortunately perpetuates the myth that psychiatrists and psychologists inherently possess powers of clairvoyance to predict violence. There is no evidence to support this remarkable belief, and, indeed, all the credible literature in the field discounts the existence of any such mystical attribute in those who practice the mind-care professions.
The serious flaw in the majority opinion is its acceptance of the claim that a failure to diagnose “dangerousness” may be a basis for liability. In its text, the opinion employs such terms as failure to “predict” behavior, and *708flatly declares that a negligent act occurs “when the therapist has, or should have diagnosed dangerousness” (italics added), as if that subjective characteristic would be revealed through a stethoscope or by an X-ray.
In People v. Burnick (1975) 14 Cal.3d 306 [121 Cal.Rptr. 488, 535 P.2d 352], we discussed at considerable length the virtually unanimous authorities in the field of psychiatry who concede their inability to predict violence. “In the light of recent studies it is no longer heresy to question the reliability of psychiatric predictions. Psychiatrists themselves would be the first to admit that however desirable an infallible crystal ball might be, it is not among the tools of their profession. It must be conceded that psychiatrists still experience considerable difficulty in confidently and accurately diagnosing mental illness. Yet those difficulties are multiplied manyfold when psychiatrists venture from diagnosis to prognosis and undertake to predict the consequences of such illness: ‘ “A diagnosis of mental illness tells us nothing about whether the person so diagnosed is or is not dangerous. Some mental patients are dangerous, some are not. Perhaps the psychiatrist is an expert at deciding whether a person is mentally ill, but is he an expert at predicting which of the persons so diagnosed are dangerous? Sane people, too, are dangerous, and it may legitimately be inquired whether there is anything in the education, training or experience of psychiatrists which renders them particularly adept at predicting dangerous behavior. Predictions of dangerous behavior, no matter who makes them, are incredibly inaccurate, and there is a growing consensus that psychiatrists are not uniquely qualified to predict dangerous behavior and are, in fact, less accurate in their predictions than other professionals.” ’ (Murel v. Baltimore City Criminal Court (1972) ... 407 U.S. 364-365, fn. 2 [32 L.Ed.2d 791, 797, 92 S.Ct. 2091] (Douglas, J., dis. from dismissal of cert.).)
“During the past several years further empirical studies have transformed the earlier trend of opinion into an impressive unanimity: ‘The evidence, as well as the consensus of opinion by responsible scientific authorities, is now unequivocal.’ (Diamond, The Psychiatric Prediction of Dangerousness (1975) 123 U.Pa.L.Rev. 439, 451.) In the words of spokesmen for the psychiatric profession itself, ‘Unfortunately, this is the state of the art. Neither psychiatrists nor anyone else have reliably demonstrated an ability to predict future violence or “dangerousness.” Neither has any special psychiatric “expertise” in this area been established.’ (Task Force Report, Clinical Aspects of the Violent Individual (American Psychiatric Assn., 1974) p. 28.) And the same studies which proved the inaccuracy of psychiatric predictions have demonstrated beyond dispute the no less disturbing manner in which such prophecies consistently err: they predict acts of violence which will not in fact take place (‘false positives’), thus branding as *709‘dangerous’ many persons who are in reality totally harmless.” (Id., pp. 325-327, fns. omitted.)
Because of the inherent undependability of such predictions, we adopted in Burnick the beyond-a-reasonable-doubt standard for commitment to mental facilities.
Unfortunately a year later in Tarasoff v. Regents of University of California (1976) 17 Cal.3d 425 [131 Cal.Rptr. 14, 551 P.2d 334, 83 A.L.R.3d 1166], a thin majority of this court employed a loose and ill-conceived dictum that encourages a dilution of Burnick. Although the case involved actual knowledge of planned violence, the four-to-three majority spoke expansively in terms of what the doctor “knew or should have known.” My separate opinion pointed out that there are no professional standards for forecasting violence (id. at p. 451), and concluded that any rule should “eliminate all reference to conformity to standards of the profession in predicting violence. If a psychiatrist does in fact predict violence, then a duty to warn arises. The majority’s expansion of that rule will take us from the world of reality into the wonderland of clairvoyance.” (Id. at p. 452.)
The dictum in Tarasoff has been largely ignored by the profession and by potential plaintiffs, for few cases have arisen that followed its elastic provisions. (Cf. Mavroudis v. Superior Court (1980) 102 Cal.App.3d 594, 599 [162 Cal.Rptr. 724].) It has been almost universally recognized that the state of the art has not reached a pinnacle at which forecasts of future violence can be made with unerring accuracy.1 Thus no standard of predictability has developed against which professional conduct can be mea*710sured. (See the representative sample of literature on the subject cited in Burnick, supra, 14 Cal.3d at p. 328, fn. 18; see also People v. Murtishaw (1981) 29 Cal.3d 733, 768 [175 Cal.Rptr. 738, 631 P.2d 446].)
The regrettable aspect of the majority opinion is that its expansive view of the duty of defendants is probably unnecessary to the result. For in each of her successive complaints, the original and three amended complaints, plaintiff LaNita Wilson alleged that the defendant psychologists had been told that Stephen Wilson intended to commit serious bodily injury on her. Thus it can be argued that defendants had actual knowledge and therefore should have communicated a warning to the potential victim. There is no reason to muse, as the majority do, about the result that would follow if defendants merely should have known of the threatened violence.
The question then arises as to whether the failure to warn after actual knowledge is malpractice or simple negligence. Since it is not the medical care or treatment of a patient that is involved, but a species of civilian duty that has arisen to a third party, the acts or omissions of the doctors are not malpractice, but simple negligence. I agree with Tresemer v. Barke (1978) 86 Cal.App.3d 656, 672 [150 Cal.Rptr. 384, 12 A.L.R.4th 27], that the applicable statute of limitations is one year. Of course, inability to discover the facts or concealment of the facts—which might occur due to physician-patient confidentiality—may under appropriate circumstances toll the statute. That is not this case.
Therefore the petitioning defendants are entitled to have their demurrer sustained. As the Court of Appeal below held in a unanimous opinion, a peremptory writ of mandate to that end should issue.
Richardson, J., and Reynoso, J., concurred.
Petitioners’ application for a rehearing was denied December 15, 1983. Mosk, J., was of the opinion that the application should be granted.-

This perceptive analysis was made by a distinguished journalist (Peter Schrag, Predicting Dangerousness, Sacramento Bee, Apr. 13, 1983):
“The hazards of the California [Tarasoff] standard are obvious. Among other things, it encourages breach of a necessarily confidential relationship and places subtle pressure on every practitioner to resolve doubts in favor of a prediction of dangerousness and the appropriate measures that follow; efforts to lock up the patient, to warn others of the danger that the patient may—but in reality probably doesn’t—represent, and to generally play it safe, even at the risk of effective therapy.
“Should the psychiatrist warn the patient—give a kind of Miranda warning—that anything he says may be used against him? If, indeed, he does give such warning (or if the patient is informed enough to make the warning unnecessary), what kind of effective therapy, what sort of trust, remains possible? Confounding the problem even further are the contrary injunctions, both in law and ethics, against divulging professional confidences. At what point does a physician become liable for issuing warnings about his patients too casually?
“There is probably no alternative to something like the standard Mosk proposed in his [separate Tarasoff] opinion. Where a psychiatrist, or anyone else for that matter, is genuinely convinced that a person is dangerous and particularly that he intends harm to a specific individual—failure to warn simply can’t be justified. Yet even with this narrow standard, it wouldn’t take an excessively paranoid individual to be extremely cautious about consulting a psychiatrist in the first place or, if he does, about the way he discusses his thoughts and feelings.”