Obligation to disclose previous criminal behavior to law enforcement?

SuckySurgeon7

10+ Year Member
Mar 31, 2009
157
79
Status
Medical Student (Accepted)
Hypothetically speaking, if a patient disclosed to me that they have done something in the past for which there is no statute of limitations, would it be my obligation to report this to someone? For example if a patient was not specific about a time, place or specific people, only a situation that occurred many years ago involving a crime he committed, what should happen?

Thanks
 

SomeDoc

10+ Year Member
Apr 9, 2007
991
94
Status
Attending Physician
Hypothetically speaking, if a patient disclosed to me that they have done something in the past for which there is no statute of limitations, would it be my obligation to report this to someone? For example if a patient was not specific about a time, place or specific people, only a situation that occurred many years ago involving a crime he committed, what should happen?

Thanks

There is a duty to report only there is an imminent or foreseeable danger to self or to others. Past crimes do not get reported to law enforcement and is protected information, unless the aforementioned applies. It is a judgment call, but it would be wise to seek legal counsel before reporting such information if you are on the fence regarding dangerousness.
 

wolfvgang22

15+ Year Member
Jun 15, 2004
1,340
1,655
Status
Attending Physician
Not in Texas. Texas is also not a Tarasoff state.
 

SomeDoc

10+ Year Member
Apr 9, 2007
991
94
Status
Attending Physician
this thread isn't about duty to warn/protect I was obviously not talking about that
I'm certainly not aware of any state statute where there is an obligation for a treating clinician to release criminal history under the context of dangerousness. If you know of any, do share.
 
  • Like
Reactions: wolfvgang22

splik

Professional Cat at Large
7+ Year Member
Nov 30, 2009
3,757
5,142
Status
Attending Physician
I'm certainly not aware of any state statute where there is an obligation to release criminal history under the context of dangerousness. If you know of any, do share.
neither am I but I can't say for certain which is why I said it might vary and I think one should definitely check state laws

someone asked about this at the AAPL forensic board review course last year and the answer was "states typically protect therapist confidentiality but you should check your state laws"
 

wolfvgang22

15+ Year Member
Jun 15, 2004
1,340
1,655
Status
Attending Physician
this could vary between states but in most states not only is there no obligation but you would be liable for breaching confidentiality. I would recommend not even documenting it.
If you don't document it, did the disclosure even happen? ;)
 

SomeDoc

10+ Year Member
Apr 9, 2007
991
94
Status
Attending Physician
neither am I but I can't say for certain which is why I said it might vary and I think one should definitely check state laws

someone asked about this at the AAPL forensic board review course last year and the answer was "states typically protect therapist confidentiality but you should check your state laws"
Quoted by Resnick? We must have been in the same conference room. I hope fellowship is going well.
 
  • Like
Reactions: splik
OP
S

SuckySurgeon7

10+ Year Member
Mar 31, 2009
157
79
Status
Medical Student (Accepted)
Thanks for the replies! I was running a little behind on my documentation yesterday, and I'm pretty sure the patient was just mumbling, now that I think about it. ;-)
 

Crayola227

The Oncoming Storm
5+ Year Member
Oct 22, 2013
15,943
17,770
All of Time & Space
say it's child abuse for which we are mandatory reporters, I'm assuming there's no statute of limitations in reporting that? or it has to be risk of imminent harm to child/ongoing?

what about elder abuse?
 

splik

Professional Cat at Large
7+ Year Member
Nov 30, 2009
3,757
5,142
Status
Attending Physician
say it's child abuse for which we are mandatory reporters, I'm assuming there's no statute of limitations in reporting that? or it has to be risk of imminent harm to child/ongoing?

what about elder abuse?
check your state laws! this varies widely between states including who is a mandated reported, who is protected by privilege and what is reportable. most states make it clear we are talking about current child abusers, other refer to substantial future risk, some (such as Connecticut and Georgia) mandate abuse that has occurred in the past. Institutions may have their own requirements. a few years ago the VA had us report any abuse, even if it happened 50+ years ago, even if the alleged abuser was dead. CPS laughed and took the report but never investigated these cases. I don't think they do this anymore (I hope not anyway)
 
  • Like
Reactions: GUH and Crayola227

splik

Professional Cat at Large
7+ Year Member
Nov 30, 2009
3,757
5,142
Status
Attending Physician
What if this wasn't a Tarasoff issue, rather the guy just admitted to Murder?
well that is what this thread is about. the answer is usually that you do not document it and do not disclose. if unsure of local laws check your state laws or consult risk management
 

SomeDoc

10+ Year Member
Apr 9, 2007
991
94
Status
Attending Physician
What if this wasn't a Tarasoff issue, rather the guy just admitted to Murder?
Two important additional considerations for a clinician are the motivations for such disclosures to providers, namely:
1) Is the disclosure an attempt at intimidation, and
2) Is the disclosure part of a delusional system of beliefs
 
  • Like
Reactions: Jules A and splik