Alan R. Felthous

The Ever Confusing Jurisprudence of the Psychotherapist's Duty to Protect

When the duty to protect of Tarasoff was imposed upon psychotherapists by the Supreme Court of California, therapists in other states wondered whether or not other courts would adopt the legal reasoning and apply the Tarasoff Principle to them. Resulting court decisions have been much more complex and contradictory than this early question would suggest. Even the legal underpinnings of the Tarasoff Principle, where it has been adopted, are diverse: it is as amorphous and plastic as any principle can be, molded so differently by various courts. This updated review argues that the trend toward diversity and inconsistency has become greater with the increase in Tarasoff-like cases in recent years, beclouding any real moral value that may be present. Given the conflicting social values involved in this kind of public policy, it is best crafted in statutory law, not by the courts.

Competency to Waive Counsel: A Step beyond Competency to Stand Trial

Jurists and expert witnesses regard competency to waive counsel much like competency to stand trial. Although the legal purposes are the same, competency to waive counsel and argue ones own case implies additional mental requirements, which in turn suggest the need for clarification of criteria.

Book Section: Essay and Review: Do Arrests and Restraining Orders Work?Do Arrests and Restraining Orders Work? edited by BuzawaEve S. and BuzawaCarl G., (Thousand Oaks, CA: Sage Publications, 1996). 284 pp.

Do arrests and restraining orders work? The prevention of or at least a substantial reduction in the likelihood of future serious acts of domestic violence by those who have already committed or threatened violence is certainly important to policy makers and persons in the criminal justice system; it should also be a compelling interest of mental health professionals. Psychotherapists, for example, can expect to see patients who have been threatened with homicide or subjected to physical abuse by their partners. Or they might encounter a patient who, in the course of therapy, threatens to kill his or her partner. Emblazoned in my memory is the man whom I evaluated in a hospital emergency room soon after he attacked his wife with an axe. After I arranged for police transfer to a hospital with a secure unit, hospital security and city police officers decided to release the man without further intervention. A mental health professionals duty to warn or protect foreseeable identifiable victims, more firmly established in some jurisdictions than others, is fairly well known today. But what should the professional tell the potential victim? Your husband poses an imminent threat to your life and is now free to kill you seems so vapid and unhelpful, an alarm without protocol or advice. Should the victim ever be advised to have the potential abuser or killer arrested? Are there circumstances where a potential victim should be counseled to seek a restraining order? Though not discussed in the context of Do Arrests and Restraining Orders Work?, these

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What harm can a psychiatrist do? Dangers associated with brain surgery or piloting a commercial airplane are surely much more obvious and serious than any risks attending talk therapy or nerve medicines. Yet mentally disordered patients kill themselves, sometimes by overdosing on the very medicines prescribed to improve their mental symptoms; some psychiatric patients injure or kill other people. When the patient is the actor, it may be difficult to know to what extent the fatal event was due to factors beyond the psychiatrists control. Nonetheless catastrophic outcomes are occasionally the result of inappropriate treatment or inadequate management. In some cases a mental patients mental condition is made worse by a psychotherapist who exploits the patients trust for self-serving purposes. Psychiatric Malpractice: Stories of Patients, Psychiatrists, and the Law brings to life such therapeutic misadventures and presumably preventable tragedies.

Book Review: Psychiatric Malpractice: Stories of Patients, Psychiatrists, and the LawPsychiatric Malpractice: Stories of Patients, Psychiatrists, and the Law, by KelleyJames L. (New Brunswick, NJ: Rutgers University Press, 1996), 229 pp.,

Western European Penal Systems: A Critical Anatomy describes the organization, procedures, demographics, and dynamics of change in the penal systems of eight Western European countries: The Netherlands, Italy, France, England and Wales, Germany, Spain, Sweden and Ireland. The threefold purpose of this book is outlined by the co-editors in the preface: (1) to create an introductory text on Western European penal systems; (2) to focus on European rather than North American penal systems; and (3) to seek commonalties in these systems. The first chapter serves as an editorial overview, an introduction, and a summary of the common themes in multinational penal systems. Each subsequent chapter examines the penal system of a single country.

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Family Violence Across the Lifespan is as broad and all-encompassing as its title suggests. The authors have essentially summarized much of the English literature, especially psychologically or sociologically oriented scientific articles, on a variety of violent and neglectful behaviors that occur within families and courting couples. Beginning with the history of family violence and concluding with a futuristic outlook on research and preventive strategies, Family Violence covers victimization patterns that include children, dating people, married people and elders. Different types of child abuse-i.e., physical abuse, sexual abuse, and exposure to marital violence-are each discussed separately.

Book Review: Western European Penal Systems: A Critical AnatomyWestern European Penal Systems: A Critical Anatomy, edited by RuggieroVincenzo, RyanMick, and SimJoe (Thousand Oaks, CA: Sage Publications, 1995), 241 pp., hardcover

The Kinsey reports in 1948 and 19532 tantalized and shocked Americans by disclosing sexual behaviors of their compatriots that until then had gone largely undiscussed in polite society. Other surveys followed, including a Redbook survey and The Hite Report: During the years since these reports (and particularly beginning in the 1960s), popular writings on American sexual behaviors, and the increasing preoccupation with explicit sexual themes in the celluloid, discoid, and tabloid entertainment media, suggest that we live in an exceptionally erotically oriented society. If only because of age-old and recently recognized venereal diseases, the importance of accurate, current, and comprehensive data on sexual views and behaviors is most compelling. If these eternal viral and bacterial menaces and the potential for untimely human conception and death were not enough, the importance of such an inquiry is underlined today by the threats and mysteries of the human immunodeficiency virus. As billed, Sex in America: A Definitive Survey appears to be the most definitive epidemiological study of sexual views and behaviors in the United States today, providing current and more accurate representative data than prior surveys.

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More specifically, this study consists of interviews with officers of the Oakland Police Department who had been assaulted, men who had themselves assaulted police officers, prison inmates, and parolees who had been violent. The prison inmates were housed in the San Quentin Prison and the California Medical Facility at Vacaville. The study design includes an interview schedule and utilizes peers to

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Each of the three editors is capable of speaking authoritatively on the relationship between the criminal justice system and mental retardation. Ronald W. Conley, Ph.D., has dealt professionally with economic and programmatic issues involving the disabled; Ruth Luckasson, J.D., chaired the American Bar Association Commission on Mental and Physical Disability Law and coauthored the disability Amicus Curiae brief in the Penry case (the major death penalty case concerning mental retardation to come before the United States Supreme Court.) George N. Bouthilet, Ph.D., coordinated the work of the Subcomminee on Full Citizenship with Justice with that of the Presidents Committee on Mental Retardation. An additional 19 contributors are listed as chapter authors.

Book Review: Family Violence across the Lifespan: An IntroductionFamily Violence Across the Lifespan: An Introduction, by BarnettOla W., Miller-PerrinCindy L. and PerrinRobin D. (Thousand Oaks, CA: Sage Publications, 1997), 392 pp.,

The Comprehensive Textbook of Psychiatry, now in its fourth edition, is a recognized institution in American psychiatry. The first edition, in 1967, edited by Alfred M. Freedman and Harold I. Kaplan, served as a handy reference and source of facts and theories for this psychiatrist, and presumably for thousands of others, in the early 1970s. I found reading the second edition (1975), all 2,609 pages of the two volumes, an enriching exercise; but the third edition seemed too large and was published too soon after the second to engage my interest for after-dinner reading. With the fourth edition, the editors resumed the challenge of organizing a comprehensive, fair, accurate, and current text. The Comprehensive Textbook represents both a monumental achievement and an ongoing organizational process (as future editions are prepared).