Tarasoff rule

DEFINITION: Duty of mental health professionals to warn third parties known to be the subjects of threats of injury or death by patients.

SIGNIFICANCE: When California’s highest court imposed liability on mental health professionals for serious injuries to third parties known to be the subject of threats by patients, the court held that the public interest in protecting individual safety overrides the maintenance of confidentiality between therapist and patient.

Prior to the 1976 decision of the California Supreme Court in Tarasoff v. Regents of the University of California, US courts generally did not recognize a therapist’s duty toward individuals with whom the therapist had no formal relationship. A therapist had discretion concerning any warning to a third party about a dangerous individual, as no clearly defined legal duty to do so had yet been established. Maintaining confidentiality within the confines of the therapist–patient relationship was paramount. Following the court’s ruling in Tarasoff, mental health professionals were charged with the responsibility to take reasonable steps to prevent violence threatened by their patients by warning third parties, as well as the appropriate authorities.

Because the court failed to provide guidelines concerning when warnings would be required and left it up to therapists to determine whether patients would, in fact, act on their threats, the duty imposed on therapists was subject to much conjecture and speculation. When the decision was first handed down, opponents predicted that it would lead to unwarranted hospitalizations and ineffective calls to police and potential victims. They also suggested that therapists might become wary and avoid potentially violent patients, who in turn would be reluctant to talk with therapists about their violent thoughts. Several decades of experience suggest that these concerns were largely overstated and did not materialize on a widespread or systemic level. Subsequent case law has also clarified a workable solution concerning when a therapist is required to issue a warning to a third party. When a patient expresses a threat of serious harm to an identifiable victim, many jurisdictions impose a legal obligation on the therapist to take reasonable steps to protect the intended victim. The landmark case established a “duty to protect,” a broader and more flexible principle than the “duty to warn.” That duty may require the therapist to take one or more steps, such as warning the intended victim or others of the danger, notifying law enforcement authorities, and taking whatever additional actions are necessary, depending on the nature of the case.

Facts of the Case

Prosenjit Poddar was a graduate student from India, studying at the University of California, Berkeley. In the fall of 1968, he met Tatiana (Tanya) Tarasoff at a folk-dancing class. They interacted regularly throughout that fall, and on New Year’s Eve, Tarasoff kissed Poddar. He interpreted this kiss to indicate the existence of a serious relationship between them. When Tarasoff learned of Poddar’s feelings, she told him of her involvement with other men and indicated that she was not interested in entering into an intimate relationship with him. Poddar did not understand Tarasoff’s explanation and underwent a severe emotional crisis. He spoke to a friend about his love for Tarasoff.

During the summer of 1969, Tarasoff went to Brazil. After she left, Poddar began to improve and, at a friend’s suggestion, sought help from the university’s health service. He began psychotherapy under the care of a staff psychologist, Dr. Lawrence Moore. During his therapy, Poddar disclosed to Dr. Moore that he was going to kill Tarasoff when she returned from Brazil. Two days later, Moore personally notified campus police officers that Poddar was capable of harming himself or others; he also wrote a letter to the chief of the campus police in which he stated that Poddar was an acute and severe paranoid schizophrenic and a danger to himself and others, and requested action to have him committed. The campus police took Poddar into custody, but released him after he promised to change his attitude and stay away from Tarasoff. Poddar discontinued his therapy.

When Tarasoff returned in October 1969, Poddar continued to stalk her. On October 27, 1969, Poddar went to Tarasoff’s home armed with a pellet gun and a kitchen knife. He shot her with the pellet gun, then chased her and fatally stabbed her outside the house. Afterward, he called the police, confessed, and asked to be handcuffed. Subsequent legal and psychiatric proceedings noted Poddar’s violent act and mental instability, which confirmed Moore’s diagnosis.

The Decision

Poddar was charged with Tarasoff’s murder, and he pleaded not guilty by reason of insanity. A jury convicted Poddar of second-degree murder, and he appealed on multiple grounds. The appellate court focused on jury instruction errors made in the trial court and reduced Poddar’s conviction to manslaughter. Two years later, the California Supreme Court vacated the judgment, held that the jury instruction error was prejudicial, and remanded the case for retrial. Poddar was not retried. Rather than conduct another lengthy trial, the state released Poddar after five years, on the condition that he leave for India and not return to the United States. He did so; he later married in India.

Tarasoff’s parents filed a wrongful-death civil action simultaneously against the university’s police department, the Regents of the University of California, and the university’s health service for failing to warn their daughter about Poddar’s desire to kill her. At trial, the case was dismissed because of the absence of a cause of action (legal reason for suing) owing to the physician–patient privilege of confidentiality. Specifically, the court ruled that a physician has a duty only to the patient, not to third parties; therefore, no duty was owed to Tarasoff.

The intermediate appellate court upheld the trial court’s decision, but the California Supreme Court reversed, holding that the case stated a cause of action and must be heard. The Supreme Court reasoned that the therapist has a duty to use reasonable care to give threatened persons whatever warnings are necessary to avert foreseeable danger. The duty extends beyond the patient to foreseeable and specifically identifiable victims. Addressing the defendants’ assertion that a warning constitutes a breach of the trust inherent in confidential communications, the court recognized the public interest in supporting effective treatment of mental illness and protecting patients’ right to privacy and confidentiality but concluded that the public interest in safety from violent assault outweighs these considerations, stating, “The protective privilege ends where the public peril begins.”

The initial California Supreme Court decision in 1974 held that the campus police could be found liable for their failure to warn Tarasoff, but at the rehearing in 1976, the police were released from all liability. The holdings with respect to the psychotherapists were essentially the same in both cases and were predicated on the same arguments. The second decision provided therapists greater latitude to “protect” intended victims rather than to “warn” them. In evaluating the imposition of liability, the California Supreme Court noted the discretion given to psychiatrists to use their best judgment in determining whether patients are dangerous. Courts assess therapists’ decisions using professional standards of reasonable care, not automatically deferring to the therapist’s judgment. When a patient communicates a serious threat of physical violence against a victim who can be identified with reasonable confidence, a therapist may have a duty to protect, and liability can arise if reasonable care is not taken; however, California law provides immunity when the therapist makes reasonable efforts to warn the victim(s) and law enforcement.

Tarasoff’s Impact

The court’s ruling in Tarasoff expanded the legal concepts of duty and foreseeability. Despite initial concerns regarding therapists’ inability to predict violent behavior accurately and the effect of breach of confidentiality, these matters have not had the adverse impacts initially feared and predicted. Ultimately, the Tarasoff case stimulated greater awareness of violent patients’ potential for carrying out such behavior. That, in turn, stimulated closer scrutiny and better documentation concerning this issue.

Since the Tarasoff decision, other interesting related questions have arisen, such as whether clergy who engage in pastoral counseling activities have a duty to protect third parties. Because in pastoral counseling there is little or no “control” over the penitent as there is over the patient in psychotherapy, the legal arguments used in Tarasoff do not directly apply, though this may vary by jurisdiction. Scholars feel, however, that most members of the clergy, in their discretion, will take necessary steps to notify either potential victims or the appropriate authorities.

The Tarasoff rule imposes civil liability. The question of criminal liability has not been studied extensively, and although isolated scholarly commentary has speculated that a breach of the duty to warn might lead to criminal liability for the felony committed by the patient, this view has not gained broad acceptance in legal scholarship. Furthermore, the duty was reformulated not as a duty to treat dangerousness, but as a duty to protect third parties from foreseeable harm. It should be noted, however, that no jurisdiction has prosecuted a therapist criminally for a violation of the Tarasoff duty to warn.

Although the Tarasoff rule itself applied only in California, other states passed their own versions of the statute. By 2025, approximately twenty-three states had similar rules inscribed into state law; another ten states recognized such rules as part of their common law, legal precedents based on court decisions rather than legislatively passed law. In many states, the decision to warn or protect was left to the psychiatrist’s discretion, and a small group of states continued to lack clear Tarasoff-style rules. These figures have evolved over time as state laws and court interpretations have changed. In some cases, the legal statutes lessened the “duty to warn” aspect of the rule and put the focus on a “duty to protect.” In such cases, the therapist is not required to warn the target of violence but can protect the individual by reporting the threats to police or having the potentially violent patient hospitalized.

In Ewing v. Goldstein (2004), the California Court of Appeals clarified that a mental health professional’s duty to protect under Tarasoff may be triggered not only by threats communicated directly by the patient, but also by credible information received from third parties, such as family members. This decision expanded the scope of Tarasoff by emphasizing foreseeability and risk assessment rather than the source of the threat, and it remains relevant today as courts and statutes continue to apply a broad ‘duty to protect’ framework.

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