BILL ANALYSIS                                                                                                                                                                                                    






                           SENATE JUDICIARY COMMITTEE
                         Senator Joseph L. Dunn, Chair
                           2005-2006 Regular Session


          AB 733                                                 A
          Assembly Member Nation                                 B
          As Amended June 5, 2006 
          Hearing Date:  June 13, 2006                           7
          Civil Code                                             3
          BCP:cjt                                                3
                                                                 

                                     SUBJECT

                         Psychotherapists:  Duty to Warn

                                   DESCRIPTION  

          This bill would clarify the existing statute by specifying  
          the two steps, notifying both the potential victim and a  
          law enforcement agency, which a psychotherapist may take to  
          discharge their duty to a potential victim of a patient's  
          communicated serious threat of violence.  By implication,  
          this bill would clarify that a psychotherapist may  
          discharge their duty under case law by taking other  
          reasonable steps.
            
                                    BACKGROUND  

          Under common law, persons generally owe no duty to control  
          the conduct of another, or to warn anyone endangered by the  
          conduct of another.  An exception to that general rule  
          applies to individuals who have a special relationship to  
          the person whose conduct needs to be controlled or to the  
          foreseeable victim of that conduct.  [Tarasoff v. Regents  
          of University of Cal. (1976) 17 Cal. 3d 425, 435.]

          In Tarasoff, the California Supreme Court held that when a  
          psychotherapist "determines, or pursuant to the standards  
          of [the] profession should determine, that [their] patient  
          presents a serious danger of violence to another, [the  
          psychotherapist] incurs an obligation to use reasonable  
          care to protect the intended victim against such danger."   
          [17 Cal. 3d 425, 431.]  To discharge their duty,  
                                                                 
          (more)



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          psychotherapists may be required to "warn the intended  
          victim or others likely to apprise the victim of the  
          danger, to notify the police, or to take whatever other  
          steps are reasonably necessary under the circumstances."   
          [Id.]  

          In 1985, AB 1133 (Chapter 737, McAlister) codified both the  
          psychotherapists' duty and one method to discharge that  
          duty.  Specifically, AB 1133 stated that a  
          psychotherapist's duty to warn and protect shall be  
          discharged upon "making reasonable efforts to communicate  
          the [patient's] threat to the victim or victims and to a  
          law enforcement agency."  [Civ. Code  43.92.]  

          As amended June 5, 2006, this bill would, by implication  
          clarify that a psychotherapist may fulfill that duty by  
          taking reasonable actions "other" than notifying a  
          potential victim and law enforcement of a patient's  
          threatened violent behavior.  This clarification is based  
          upon the sponsor's belief that California should return to  
          Tarasoff's allowance for alternate actions by a  
          psychotherapist.


                             CHANGES TO EXISTING LAW
           
           Existing case law  provides that generally "one person  
          owe[s] no duty to control the conduct of another . . . nor  
          to warn those endangered by such conduct . . . [C]ourts  
          have carved out an exception to [that] rule in cases in  
          which the defendant stands in some special relationship to  
          either the person whose conduct needs to be controlled or  
          in a relationship to the foreseeable victim of that conduct  
          . . ." [Tarasoff v. Regents of University of Cal. (1976) 17  
          Cal. 3d 425, 435.]

           Existing law  states that psychotherapists have a duty to  
          warn and protect when the "patient himself or herself  
          communicated to the psychotherapist a serious threat of  
          physical violence against a reasonably identifiable victim  
          or victims." [Civ. Code  43.92.]
          
           Existing case law  includes communications directly from the  
          patient and the "patient's immediate family [when the  
          communication] is shared for the purpose of facilitating  
                                                                       




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          and furthering the patient's treatment."  [Ewing v.  
          Goldstein (2004) 120 Cal. App. 4th 807, 817.]

           Existing law  states that the psychotherapist's duty to warn  
          and protect shall be discharged by making reasonable  
          efforts to communicate the threat to the victim and to a  
          law enforcement agency. [Civ. Code  43.92(b).]

           This bill  would restate that reasonable efforts to  
          communicate the threat to the victim and a law enforcement  
          agency discharges a psychotherapist's duty to warn and  
          protect.  By implication, the corollary effect would be to  
          reiterate that under Tarasoff there are alternate methods  
          for discharging a psychotherapist's duty once it arises.

                                     COMMENT
           
          1.    Stated need for the bill  

            The California Association of Marriage and Family  
            Therapists, sponsor, brings this narrowed version of the  
            bill to address what they perceive as a lack of clarity  
            in current law.  Current law outlines one situation where  
            psychotherapists have a duty to a third party and the way  
            to discharge that duty.   The sponsor maintains that the  
            purpose of AB 1133, which enacted the section in  
            question, was not to allow only one method for  
            discharging a psychotherapist's duty to warn and protect  
            a potential victim, but instead to provide an option that  
            would provide therapists with a clear immunity from  
            actions.  However, both the Judicial Council jury  
            instruction (1-500 CACI 503), and Matthew Bender's  
            California Forms of Pleading and Practice state that a  
            psychotherapist is negligent if the duty is not  
            discharged as specifically provided in the statute. 

            Accordingly, the sponsor states that AB 733 is necessary  
            to clarify that other reasonable actions may be taken to  
            discharge their duty, as provided in the Tarasoff  
            decision itself.  

          2.    Current liability for psychotherapists when faced with  
            a patient communication of a serious threat of physical  
            violence against a reasonably identifiable victim  

                                                                       




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            The sponsor's asserted lack of clarity as to actions that  
            a psychotherapist may take when faced with a threat  
            against a reasonably identifiable victim rests in Civil  
            Code Section 43.92, enacted by AB 1133.  According to  
            Ewing v. Goldstein (2004) 120 Cal. App. 4th 807, 815-16,  
            the intent of AB 1133 was to limit a psychotherapists'  
            liability to instances where the patient has communicated  
            an actual threat, and to clarify that a psychotherapist  
            cannot be liable for failure to predict a patient's  
            violent behavior.

            A.   Current statutory and case law  
             
                Civil Code Section 43.92 (a) states an exception to  
               the general rule that individuals have no duty to  
               protect third parties from the actions of another.   
               That duty arises for psychotherapists when "the  
               patient has communicated to the psychotherapist a  
               serious threat of physical violence against a  
               reasonably identifiable victim or victims."  Once that  
               duty is triggered, failure to satisfy that duty  
               results in a finding of negligence.  Section 43.92 (b)  
               states one specific way that an established "duty to  
               warn and protect" shall be discharged: "making  
               reasonable efforts to communicate the threat to the  
               victim or victims and to a law enforcement agency."   
               The subdivision is silent as to whether that is the  
               only way to discharge the psychotherapist's duty when  
               raised.  

               Case law for the most part is equally silent; the  
               majority of published cases concern whether the duty  
               to warn and protect is in fact triggered.  The only  
               case of note, Ewing v. Northridge Hosp. Medical Center  
               (2004) 120 Cal. App. 4th 1289, 1292, states that "when  
               a patient has 'communicated to the psychotherapist a  
               serious threat of physical violence against a  
               reasonably identifiable victim,' the psychotherapist  
               must take reasonable steps to warn the victim and a  
               law enforcement agency of the threat." [Citations  
               omitted.] Presumably that case based its findings on  
               both Civ. Code Section 43.92 and the Judicial  
               Council's jury instructions.  

            B.    Judicial Council jury instructions
                                                                       




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               The Judicial Council's jury instructions (1-500 CACI  
               503) require the psychotherapist to both warn the  
               victim and communicate the threat to law enforcement.   
               Specifically, the CACI instruction, which is the  
               official jury instruction for the State of California,  
               states that a psychotherapist is negligent for failure  
               to warn if they do not "make reasonable efforts to  
               warn [the victim] and a law enforcement agency about  
               the threat."  [1-500 CACI 503.]  Thus, that jury  
               instruction would result in a finding of negligence  
               for any action taken by the psychotherapist that does  
               not consist of both warning the victim and  
               communicating the threat to law enforcement.

               For example, during the course of sessions with their  
               psychotherapist, a patient could state their intent to  
               kill a former spouse's new husband.  The  
               psychotherapist, believing the threat to be a serious  
               threat of physical violence, decides that she has duty  
               to protect that individual.  The psychotherapist warns  
               the potential victim of the threat and hospitalizes  
               the patient.  After several weeks of hospitalization,  
               the patient is released and immediately kills their  
               former spouse's husband. Under the existing jury  
               instruction, the psychotherapist would be negligent  
               due to her failure to warn both the potential victim  
               and a law enforcement agency of the threat.

               The sponsor believes that the above jury instruction  
               is in error and does not reflect Tarasoff.  In the  
               above situation, the sponsor believes that a jury  
               should evaluate whether the steps taken by the  
               psychotherapist to protect the intended victim were  
               reasonable.  While psychotherapists would be wise to  
               make a reasonable attempt to warn both the victim and  
               law enforcement of any serious threat by a patient, AB  
               733 would allow a jury to decide whether alternative  
               actions are reasonable and therefore immune from  
               liability.  

          3.    Implications of the proposed change  

            The California Association of Marriage and Family  
            Therapists, sponsor, is very concerned that actions other  
                                                                       




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            than warning both the victim and a law enforcement agency  
            could result in a finding of negligence.  The sponsor has  
            not produced any published cases which demonstrate such a  
            finding by a court.  Additionally, no court has commented  
            on any ambiguity present in the existing language.  AB  
            733's essential return to Tarasoff raises questions about  
            the other actions that may be taken, and the effect upon  
            current and future litigation.

            A.    Effect of allowing alternative actions and returning  
            to Tarasoff  

               As stated above, Tarasoff requires a psychotherapist  
               to use reasonable care to protect the intended victim  
               against a patient's threat of violent behavior.  [17  
               Cal. 3d 425, 431.]  Unlike the current statute,  
               Tarasoff states that "discharge of this duty may  
               require the therapist to take one or more of various  
               steps, depending upon the nature of the case."  [Id.]   
               The Tarasoff court, as an example which was codified  
               by AB 1133, stated that discharge of the duty may  
               require the psychotherapist to notify both the victim  
               and law enforcement of the threat.  While AB 733  
               preserves the ability of a psychotherapist to take  
               those two actions, the bill seeks to return to  
               Tarasoff's allowance for alternative steps that a  
               psychotherapist may take to avoid liability.  However,  
               psychotherapists would have no assurance that  
               alternative actions, other than notifying both law  
               enforcement and the victim, would discharge their  
               duty.  That determination will be made by the trier of  
               fact.

               Accordingly, psychotherapists who take alternative  
               actions would have to affirmatively demonstrate that  
               those actions fulfilled their duty.  This departure  
               from the current bright-line rule could raise the  
               problems discussed below. 

            B.    Impact upon the courts  

               As stated previously, the current Judicial Council  
               jury instruction provides a clear test for when a  
               psychotherapist is negligent for failing to discharge  
               their duty to protect and warn a potential victim from  
                                                                       




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               a patient's violent behavior.  Once the duty is  
               established, the psychotherapist must take two  
               specific actions to discharge that duty.  Failure to  
               discharge the duty necessarily results in a finding of  
               negligence.

               AB 733 would remove that clarity and instead require  
               the finder of fact to evaluate whether the  
               psychotherapist's "other" actions discharged their  
               duty to the victim.  The result of this proposed  
               change would be the litigation of every "other" action  
               taken by a psychotherapist which allegedly discharged  
               their duty to the victim.  This would result in longer  
               and more expensive trials with the introduction of  
               even more experts, and could make it more difficult to  
               find a psychotherapist liable for breaching their duty  
               to the victim of a patient's violent behavior.

               For example, a patient could communicate to their  
               psychotherapist that they intend to kill their former  
               spouse.  The psychotherapist, believing the threat to  
               be credible, realizes that they have a duty to protect  
               that spouse.  Realizing that the patient lives in  
               California, and their former spouse lives in Nevada,  
               the psychotherapist decides to let the air out of the  
               patient's tires to prevent the patient from driving to  
               Nevada.  The patient then gets on a bus to Nevada and  
               severely injures their former spouse.  At trial, the  
               psychotherapist contends that letting the air out of  
               the patient's tires fulfilled their duty to the  
               victim.  The parties must then litigate whether the  
               psychotherapist satisfied their duty to protect the  
               victim by taking that alternate action.  Under current  
               law, the psychotherapist would be negligent, but AB  
               733 would allow the finder of fact to evaluate whether  
               their "other" action, in fact, discharged their duty.

               Accordingly, AB 733 would encourage any  
               psychotherapist facing charges of negligence for  
               failure to protect a victim to litigate whether their  
               "other" actions discharged their duty to the victim.   
               That litigation would lengthen trial times, increase  
               legal costs and potentially allow some psychologists  
               to avoid liability.  However, that circumstance is  
               consistent with the Tarasoff holding.  It is what it  
                                                                       




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               is.  

          4.    Language finding "no monetary liability on the part  
            of, and no cause of action shall rise against" mirrors  
            existing law

             The author's recent amendments to the bill state that a  
            psychotherapist "shall [have] no monetary liability on  
            the part of, and no cause of action shall rise against" a  
            psychotherapist when they make reasonable efforts to  
            communicate a threat to a reasonably identifiable victim  
            or victims and to a law enforcement agency.  This  
            immunity language tracks existing law and only applies in  
            cases where the psychotherapist has a duty to warn and  
            protect a reasonably identifiable victim from a serious  
            threat of physical violence, as evidenced by the bill's  
            language "under the limited circumstances specified  
            above."   

            Accordingly, the amended language proposed by AB 733  
            would not substantively change or expand the immunity  
            currently enjoyed by psychotherapists who warn both the  
            victim and law enforcement. As discussed above, a  
            psychotherapist would have to demonstrate that any  
            alternative actions taken to discharge their duty to the  
            victim were reasonable.

          5.    Consumer Attorneys of California (CAOC) neutral  

            CAOC is neutral on the bill as amended.  
           
          Support: National Association of Social Workers (NASW-CA)

          Opposition: None Known

                                     HISTORY
           
          Source:  The California Association of Marriage and Family  
          Therapists

          Related Pending Legislation:  None Known

          Prior Legislation:  AB 1133 (Chapter 737, Statutes of  
                        1985), codified the limited situations where  
                        a psychotherapist has a duty to a potential  
                                                                       




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                        victim and one way to discharge that duty.  

          Prior Vote (on a prior version of the bill)
                             Assembly Judiciary Committee (9 Ayes, 0  
          Noes)
                      Assembly Floor                            (77  
          Ayes, 0 Noes)

          
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