Court Opinion

ID: 9851034
Source: CourtListenerOpinion
Date Created: 2023-09-24 05:06:15.300576+00
Date Added: 2024-06-11T09:20:47.589003
License: Public Domain

KAUFMAN, J.
I concur in the judgment that nonsuit was properly granted, but disagree with the majority’s holding that defendants owed no duty of care to the plaintiffs.
*305The majority appears to reject the proposition that defendants in this matter, or “nontherapist counselors in general,” have a duty to advise potentially suicidal counselees to seek competent medical care. (Maj. opn. at p. 292.) Yet the majority does not purport to “foreclose imposing liability on nontherapist counselors, who hold themselves out as professionals, for injuries related to their counseling activities.” (Maj. opn. at p. 300, fn. 8.)
In view of the majority’s suggestion that a nontherapist counselor who holds himself out as competent to treat a suicidal person owes a duty of care to that person, I am baffled as to the basis or the necessity of the majority’s broad conclusion that “nontherapist counselors in general” do not owe such a duty. The evidence in the record, viewed—as the law requires—in plaintiffs' favor, demonstrates that defendants (1) expressly held themselves out as fully competent to deal with the most severe psychological disorders, including major depression with suicidal symptoms, (2) developed a close counseling relationship with Kenneth Nally for that very purpose, and (3) realized that Nally’s suicide was at least a possibility. Thus, the evidence was more than sufficient, in my view, to trigger a minimal duty of care to Nally. What was fatally absent from plaintiffs’ case was not evidence of duty, but proof that defendants breached that duty, and that such breach constituted a proximate cause of Nally’s suicide. Therefore, while I concur in the decision to reverse the judgment of the Court of Appeal and to reinstate the judgment of nonsuit and dismissal of the action, I strongly disagree with the conclusion that defendants owed no duty of care in this matter.
Facts
While the majority faithfully chronicles the tragic sequence of events which led to Nally’s suicide, it quite inexplicably overlooks the substantial evidence adduced by plaintiffs relating to the nature and extent of the pastoral counseling offered by defendants. The picture which emerges from the record is decidedly not that of a small band of simple pastors who offered occasional counseling on minor matters to the faithful few. The Grace Community Church (Church), at the time of the events in question, employed about 50 pastoral counselors to serve a congregation of over 10,000 persons. Pastoral counseling, as described in the Church’s 1979 annual report, constituted “a very important part of the ministry at Grace Church.” Church counselors offered their services not only to congregants, but to large numbers of nonmembers as well. In 1979, the annual report noted, about 50 percent of those seeking counseling came from outside the Church. Furthermore, while much of the counseling to members was apparently of an ad hoc or “drop-in” nature, more formal counseling was offered as well, with regularly scheduled counseling “sessions” much like *306those between a therapist and a patient; indeed, the Church employed a secretary whose responsibilities included the making and scheduling of such counseling appointments. Moreover, in addition to individual counseling, a number of Church pastors taught classes, published books and sold tape recordings on the subject of biblical counseling.1
In addition to the foregoing, plaintiffs adduced substantial evidence relating to the stated ability of the Church’s pastoral counselors to deal with serious emotional and psychological disorders. Several of the counselors testified that they considered themselves fully competent to treat a whole range of mental illnesses, including depression and schizophrenia—indeed, as Pastor Thomson testified, “any type of emotional problem.” Several of the counselors who testified, including Pastors Rea, Barshaw and Thomson, claimed to possess not only competence, but broad experience in the counseling of persons with recurrent suicidal or even homicidal tendencies.
This asserted capacity to handle severe psychological disorders was also reflected in a Church publication entitled “Guide For Biblical Counselors” (Guide). Pastor Thomson was the author of the Guide, which served as a basic text for aspiring biblical counselors and was required reading in Thomson’s class on biblical counseling. According to Pastor Thomson, absent a gross physiological cause such as a brain tumor, “every emotional problem” was within the competence of the pastoral counselor to handle. Among the symptoms or disorders the Guide listed as falling within the pastoral counselor’s domain were “drug abuse, alcoholism, phobias, deep depression, suicide, mania, nervous breakdown, manic-depressive [disorder] and schizophrenia.” The Guide devoted separate sections to a number of these disorders, including suicide, with hypothetical questions and answers interspersed throughout the text. One such exchange read as follows:
*307“[Question]: You mean I could counsel with an extreme problem like a suicidal tendency or nervous breakdown or something like that? [if] [Answer]: With the proper understanding of God’s Word to diagnose and treat the problems, this could not only be done occasionally but could become the rule.”2
Nally was well aware of defendants’ self-proclaimed proficiency at treating severe depression and suicidal symptoms. Nally was a student in Pastor Thomson’s course on biblical counseling, which used the Guide as a text, and affirmatively sought out formal or informal pastoral counseling from defendants during each of his several suicidal crises.
Moreover, the record leaves no doubt that defendants were aware of, and affirmatively undertook to deal with, Nally’s recurrent depression and suicidal thoughts. In January 1978, Nally initiated a counseling relationship with Pastor Rea. Rea testified that he had formal counseling sessions with Nally during the first four months of 1978, as well as many informal sessions both before and after that time. During these sessions, according to Pastor Rea, Nally often appeared distraught and cried, indicating that he “couldn’t cope.” Rea specifically recalled Nally’s statement to him in his office, “I just can’t live this life.” Rea, who considered himself both qualified and experienced in the handling of depressed and sucidal individuals, evaluated Nally as being “depressed.”3
*308In 1974, when Nally first joined the Church, he developed a close friendship with Pastor Cory, who was responsible for overseeing the ministry to the collegians attending the Church. In December 1978, after Nally’s breakup with his girlfriend, Cory became concerned about Nally’s apparent depression and referred him to Pastors Rea or Thomson for counseling. In late February or early March of 1979, Nally did approach Pastor Thomson and told him that he was depressed about his relationship with his girlfriend and his family. Nally told Thomson that he had once before considered suicide. Thomson, who considered himself both qualified and experienced in the counseling of severe depression, felt that there was an “intimation” of suicide in Nally’s statements and concluded that suicide was a “vague possibility.”4 Although Thomson testified that he took such intimations *309“seriously,” he concluded that he could continue to help Nally with his problems through counseling and prayer.
Several weeks later, after Nally had in fact attempted suicide, Nally approached Thomson on two more separate occasions. During their second informal meeting, which lasted about an hour, Nally again, according to Thomson, “intimated” suicide and again Thomson concluded that suicide was a “possibility” which he continued to take “seriously.”5 During the third meeting between Nally and Thomson, the latter remained convinced that suicide was a “possibility.”6 Although Thomson was persuaded that Nally was depressed and “intimating]” suicide, he continued to believe that he could help him through biblical counseling.
After Nally was released from the hospital following his suicide attempt in March 1979, he went to stay with another Church counselor, Pastor MacArthur. During long discussions over the next week, Nally discussed his depression and thoughts of suicide, and MacArthur became convinced that suicide was a real possibility. Indeed, MacArthur became so concerned from these sessions that he advised Nally to see a psychiatrist. One week after Nally left the MacArthur residence, his fears were realized. On April 1, 1979, Nally committed suicide.
Discussion
In light of the foregoing factual background, I believe the conclusion is inescapable that defendants owed a duty of care to Nally. That duty, in my *310view, was simply to recognize the limits of their own competence to treat an individual, such as Nally, who exhibited suicidal tendencies, and once having recognized such symptoms, to advise that individual to seek competent professional medical care. The record further demonstrates, however, and the majority correctly concludes, that defendants neither breached their duty to Nally nor contributed in any legally significant respect to his suicide.7
It is black-letter law that one may have an affirmative duty to protect another from harm where a “special relationship” exists. (Williams v. State of California (1983) 34 Cal.3d 18, 23 [192 Cal.Rptr. 233, 664 P.2d 137]; Weirum v. RKO General, Inc. (1975) 15 Cal.3d 40, 48 [123 Cal.Rptr. 468, 539 P.2d 36]; Clarke v. Hoek (1985) 174 Cal.App.3d 208, 215-216 [219 Cal.Rptr. 845]; Rest.2d Torts, § 314; Prosser & Keeton, Torts (5th ed. 1984) § 56, p. 374.) The critical question, therefore, is whether there existed some special relationship between Nally and defendants which would give rise to an affirmative duty to act.
In the special case of determining the existence of an affirmative duty to protect another, courts have traditionally looked to relationships where “the plaintiff is typically in some respect particularly vulnerable and dependent upon the defendant who, correspondingly, holds considerable power over the plaintiff’s welfare.” (Prosser & Keeton, supra, at p. 374.)
The special relationship that arises between a patient and his doctor or psychotherapist creates an affirmative duty to see that the patient does no harm either to himself (Bellah v. Greenson (1978) 81 Cal.App.3d 614, 619 [146 Cal.Rptr. 535, 17 A.L.R.4th 111 8])8 or to others (Tarasoff v. Regents of *311University of California, supra, 17 Cal.3d 425, 436-437). The relation of the nontherapist or pastoral counselor to his counselee contains elements of trust and dependence which closely resemble those that exist in the therapist-patient context. Defendants here patently held themselves out as competent to counsel the mentally ill, and Nally responded to these inducements, placing his psychological and ultimately his physical well-being in defendants’ care. Whether defendants adequately fulfilled their responsibilities to Nally is a separate question to which I will turn in a moment. That defendants had some responsibilities to fulfill, however, is not, in my view, open to question.
Nor is the nature of defendants’ duty to Nally especially difficult to perceive. As in every negligence case, the precise nature of the defendant’s duty will necessarily vary with the facts. (Tarasoff v. Regents of University of California, supra, 17 Cal.3d at p. 439.) In each instance, the adequacy of the nontherapist counselor’s conduct must be judged according to what is reasonable under the circumstances. {Ibid.) Where, as here, defendants have invited and engaged in an extensive and ongoing pastoral counseling relationship with an individual whom they perceive to be suicidal, both reason and sound public policy dictate that defendants be required to advise that individual to seek professional medical care.
The point, which the majority persistently misperceives, is not that Pastors Rea or Thomson or anyone else should have known that Nally would, in fact, commit suicide. The point rather, is that the evidence, read in the light most favorable to plaintiffs, presents a triable issue as to whether defendants knew or should have known that suicide was a sufficient possibility to require that defendants advise Nally to seek competent medical care. Notwithstanding the majority opinion’s conclusion to the contrary, the evidence in the record leaves no room for doubt on this question.
It has been suggested that both public policy and the constitutional right to the “free exercise” of religion militate against the recognition of a duty of care in these circumstances. I cannot agree.
The “policy” considerations most often mentioned are the possibilities that a duty of care “could deter those most in need of help from seeking treatment out of fear that their private disclosures could subject them to *312involuntary commitment to psychiatric facilities” (maj. opn. at p.297) or that such a duty could discourage “private assistance efforts.” (Maj. opn. at p. 298.) Such concerns are unfounded. The scope of the duty contemplated is commensurate with the nontherapist counselor’s background and stated mission. Unless he also happens to be a licensed therapist, his duty in most cases would not require disclosure of confidential communications, but would simply require that he advise the counselee to seek competent medical care.
Concerns about the possible exposure of counseling “hot lines” or even well-meaning friends to liability, are equally misplaced. There is simply no meaningful resemblance between such activities and the sort of counseling relationship at issue here.
Finally, it is urged that the imposition of a duty of care on defendants would unconstitutionally burden their First Amendment right to the free exercise of religion. There is no merit to this contention.
While the First Amendment bars the government from “prohibiting the free exercise of religion,” religiously motivated conduct “remains subject to regulation for the protection of society.” (Cantwell v. Connecticut (1940) 310 U.S. 296, 303-304 [84 L.Ed. 1213, 1218, 60 S.Ct. 900, 128 A.L.R. 1352]; accord Molko v. Holy Spirit Assn. (1988) 46 Cal.3d 1092, 1112-1113 [252 Cal.Rptr. 122, 762 P.2d 431].) However, it should be noted that defendants here do not claim that their religious principles prohibit resort to psychiatric counseling or the use of antidepressant drugs, nor do they claim that their religious beliefs prohibit a pastoral counselor from advising a counselee to seek psychiatric care. On the contrary, the record shows that defendants not only acquiesced in, but on occasion recommended such treatment.
Thus, defendants do not contend that a psychiatric referral itself violates their religious beliefs. They contend, rather, that the imposition of tort law duties in general creates an impermissible “burden” on religious liberty. Where the interest is sufficient, however, it is well settled that government may as readily compel religiously prohibited conduct as prohibit religiously motivated acts. (See United States v. Lee (1982) 455 U.S. 252, 261 [71 L.Ed.2d 127, 134-135, 102 S.Ct. 1051] [court upheld federal law requiring that Amish violate the tenets of their faith by participating in the Social Security system]; Jacobson v. Massachusetts (1905) 197 U.S. 11, 39 [49 L.Ed. 643, 655, 25 S.Ct. 358] [court upheld law requiring the vaccination of children despite parental religious objections].) Accordingly, courts, including our own, have determined that religious groups may be held liable in tort for their actions (Molko v. Holy Spirit Assn., supra, 46 Cal.3d 1092), *313even where they occur in the context of religiously motivated counseling. (See, e.g., O’Neil v. Schuckardt (1986) 112 Idaho 472 [733 P.2d 693, 699-700] [church may be held liable for invasion of privacy resulting from marital counseling]; Bear v. Reformed Mennonite Church (1975) 462 Pa. 330 [341 A.2d 105, 107] [action for interference with marriage and business relations permitted where church ordered “shunning” of former member]; Carrieri v. Bush (1966) 62 Wn.2d 536 [419 P.2d 132, 137] [court allowed action for alienation of affections where church pastor counseled woman to leave her husband who was “full of the devil”].) As the court explained in Carrieri: “Good faith and reasonable conduct are the necessary touchstones to any qualified [First Amendment] privilege that may arise from any invited and religiously directed family counseling, assistance, or advice.” (419 P.2d at p. 137.)
We need not go as far as these courts in sanctioning tort recovery for conduct which was religiously motivated. The intrusion in this case (i.e., the duty to advise a suicidal counselee to seek medical care) is religiously neutral. Defendants are not exposed to liability for refusing to counsel contrary to their religious beliefs or for affirmatively counseling in conformity with their beliefs. Thus, the burden on religion is relatively minimal.
The governmental interest, on the other hand, is compelling; society’s interest in preserving the life of a would-be suicide is as profound as its interest in preserving life generally. To this end, society surely may require a pastoral counselor who invites and undertakes a counseling relationship with an individual in whom he recognizes suicidal tendencies, to advise that individual to seek competent medical care.
Thus, I am persuaded, on the facts presented, that defendants owed a minimal duty of care to Nally. I am equally persuaded, however, that defendants fulfilled their duty.
The facts in this regard are adequately stated in the majority opinion and need not be retold here. Although defendants were aware of Nally’s suicidal tendencies and continued to offer counseling, they were also aware that he had been hospitalized as a result of an earlier suicide attempt, had seen a psychiatrist while in the hospital and been given a strong antidepressant drug. The record shows that defendants were not only aware that Nally was under the intermittent care of medical doctors, including a psychiatrist, but affirmatively advised him on several occasions to seek medical care. Moreover, Nally’s psychiatrist, Dr. Hall, testified that he had examined Nally in the hospital and had advised his parents to have him committed. Dr. Hall, however, refrained from initiating involuntary commitment proceedings.
*314Therefore, as the trial court expressly found, the evidence shows that defendants neither breached their duty to Nally, nor contributed in any causally significant respect to his suicide.9 For these reasons, I conclude that the Court of Appeal erred in reversing the judgment of nonsuit and dismissal of the action.
Accordingly, I concur in this court’s judgment.
Broussard, J., concurred.

 Contrast this picture of the Church’s extensive involvement in pastoral counseling (based on evidence in the record), with that portrayed in the majority opinion. The majority writes: “According to the trial testimony of defendant Senior Pastor MacArthur, ‘Grace Community Church does not have a professional or clinical counseling ministry. We don’t run a counseling center as such. We aren’t paid for that, and we don’t solicit that....’” (Maj. opn. at p. 284.) While not a major point in itself, such selective citation of the record undoubtedly colors one’s overall assessment of the case, and to that extent is objectionable. As the majority itself notes, on review of a nonsuit “the evidence most favorable to plaintiffs] must be accepted as true and conflicting evidence must be disregarded. The court must give ‘to the plaintiffs’] evidence all the value to which it is legally entitled,. . . indulging every legitimate inference which may be drawn from the evidence in plaintiffs’] favor.’ ” (Campbell v. General Motors Corp. (1982) 32 Cal.3d 112, 117-118 [184 Cal.Rptr. 891, 649 P.2d 224, 35 A.L.R.4th 1036], italics added.) The majority has reversed this fundamental principle of appellate review, stating the evidence, resolving all factual conflicts, and drawing all reasonable inferences in favor of defendants. Moreover, in addition to the above example, violations of this principle occur throughout the majority opinion. (See fns. 2, 3, 4, and 5, post, at pp. 284-285, 289.)

 How the majority could omit from its opinion this extensive evidence of defendants’ “holding out” is quite beyond my understanding. (See fn. 1, ante, at p. 283.)

 The majority asserts that I have mischaracterized Rea’s testimony, that in fact “Rea did not become aware Nally could not cope in the physical sense until after his suicide attempt.” (Maj. opn. at p. 284, fn. 2, original italics.) On the contrary, the majority either ignores the full record of Rea’s testimony or, contrary to fundamental principles of appellate review, draws only those inferences favorable to defendants. It must be recalled that Rea was testifying as a hostile witness under Evidence Code section 776; his responses on direct examination were both dissembling and contradictory. Time and again, Rea was impeached with his own counseling notes or prior deposition testimony. So it was with his testimony regarding Nally’s expressed inability to “cope.” Initially, Rea admitted that Nally had stated that from time to time he could not “cope.” Rea immediately denied, however, that the “cope concept” had “come out” until after Nally’s first suicide attempt. Counsel then confronted Rea with his own counseling notes, and Rea was forced to admit that just the opposite was true.
“Q: Isn’t it your recollection that from January forward, Ken frequently used that term, T don’t know how to cope.’?
“A: Frequently? I can’t say that, but I wrote down to express what Ken expressed to me.
“Q: And from time to time he used that phrase?
“A: I would have to say so from that record.
“Q: From time to time he used it before you terminated the formal counseling relationship?
“A: That’s true.
“Q: Thank you.”
Later, Rea attempted to characterize Nally’s comments as referring exclusively to the “spiritual,” not the “physical” life. When confronted with his prior deposition testimony, *308however, Rea was compelled to concede that the idea of suicide was fairly inferable from Nally’s statements and conduct during the counseling sessions:
“Q: Was there an inference of suicide?
“A: Not to my knowledge.
“Q: Look to page 70 of your depo. Read from line 7 on down.
“Mr. Cooksey: How far, counsel?
“Mr. Barker: Down through line 22.
“Q: By Mr. Barker: Does that refresh your recollection?
“A: Yes.
“Q: Was there an inference of suicide in some of the things Ken said?
“A: Inference in the extent (sic) of coping and how far you stretch the word, not being able to live this life, but the life is not physical life; it’s the spiritual life.
“Q: There was an inference of suicide in some of the things Ken said during the normal counseling sessions?
“A: It could be construed that way.
“Q: And the term inference was your term; is that correct?
“A: Yes.” (Italics added.)
Viewing this evidence in the light most favorable to plaintiffs, it is reasonable to conclude that Nally’s statements and actions during his counseling sessions with Rea reasonably indicated the possibility of suicide. The point, it should be stressed, is not that defendants knew or should have known that Nally would commit suicide; the point, rather, is that the evidence was sufficient to raise the reasonable possibility, and the reasonable possibility was sufficient to trigger a minimal duty to advise Nally to seek competent medical care.

The majority suggests that I have mischaracterized the record of Thomson’s testimony. (Maj. opn. at p. 285, fn. 3.) On the contrary, the majority has simply construed the evidence most favorably to defendants, rather than, as the law requires, indulging all reasonable inferences in favor of plaintiffs.
In fact, Thomson testified as follows: “Q: You reached the conclusion, didn’t you, at the end of your first meeting with Ken in March, that Ken might try suicide?
“A: There was that vague possibility, yes. I didn’t conclude within myself that it was a serious enough likelihood where other help would be needed at this point, so I counseled him and prayed for him.
“Q: Did you think that Ken, in fact, might try suicide?
“A: It was a possibility. It was a vague possibility, yes.”
Thomson further testified: “Q: And you then concluded, after your questioning session, that although there was some possibility of suicide, it wasn’t likely?
“A: That’s true.”
Elsewhere he testified: “Q: And you concluded that he probably wasn’t going to commit suicide, but it was a possibility?
*309“A: It was a vague possibility, yes.
“Q: You took that possibility seriously?
“A: Yes.
“Q: And in taking it seriously, you talked with him about biblical concepts and about what his inter [szc] strifes were that led to his depression and led to his suicidal feelings?
“A: Yes.
“Q: But you did not talk to anyone else after that meeting with Ken about the fact that Ken might be a threat to himself before the Verdugo attempt?
“A: Not that I recall.”

 Concerning this second meeting, Thomson testified as follows: “Q: And in that second visit, the suicide was discussed again, wasn’t it?
“A: Yes. There was that possibility ....
“Q: In trying to help him as he was down, did you indirectly make an effort to find out if he was going to try again?
“A: There was that intimation there, and that’s as far as I wanted to carry it.”

Thomson testified as follows concerning the third meeting: “Q: Were you—at that time, you still took seriously Ken’s suicidality, didn’t you?
“A: Yes.
“Q: And at that time, as with the first two visits, you still felt there was a chance Ken was going to commit suicide?
“A: There was a possibility.”

 Unfortunately, the majority’s analysis fails to properly distinguish between duty and proximate cause. Based upon a misunderstanding of our seminal decision in Rowland v. Christian (1968) 69 Cal.2d 108 [70 Cal.Rptr. 97, 443 P.2d 561, 32 A.L.R.3d 496], the majority implies that lack of causation precludes the imposition of a duty. This is a misreading of Rowland. That decision merely held that the “closeness of the connection between the defendant’s conduct and the injury suffered” was one of a number of factors which might justify a departure from the general principle that “ *[a]ll persons are required to use ordinary care to prevent others being injured as a result of their conduct.’ ” (Id. at pp. 112-113.)

 The majority suggests that I have mischaracterized the court’s holding in Bellah v. Greenson, supra, 81 Cal.App.3d 614. Not so. The Bellah court stated the issues before it as follows: “[I]n the present case, we must determine whether plaintiffs have alleged facts sufficient to give rise to a duty on the part of defendant to take steps to prevent [decedent] from committing suicide or to advise [decedent’s parents] about the existence of conditions which might cause [decedent] to take her own life, so that they could take such steps.” (Id. at p. 619, italics added.) The Bellah court answered the first question as follows: “Here, the complaint alleged the existence of a psychiatrist-patient relationship between defendant and [decedent], knowledge on the part of the defendant that [decedent] was likely to attempt suicide, and a failure by defendant to take appropriate preventive measures. We are satisfied that these allegations are sufficient to state a cause of action for the breach of a psychiatrist’s duty of care towards his *311patient.” (Id. at p. 620, italics added.) My summary of the Bellah court’s holding is accurate. A psychiatrist’s duty is to take reasonable steps to prevent a patient’s suicide. This does not imply, as the majority asserts, that a psychiatrist can guarantee his patients’ safety. On the contrary, as Justice Mosk has observed, “psychiatric predictions of violence are inherently unreliable.” (Tarasoff v. Regents of University of California (1976) 17 Cal.3d 425, 451 [131 Cal.Rptr. 14, 551 P.2d 334, 83 A.L.R.3d 1166] (cone, and dis. opn. of Mosk, J.).)

The absence of breach or proximate cause does not, of course, preclude our holding that defendants nevertheless owed a minimal duty of care. (See fn. 7, ante, at p. 310.)