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Klitzman: After Germanwings, a Reconsideration of Patient Confidentiality

Should mental health professionals be required to divulge to authorities whether a patient poses a violent threat?

That’s the question that Dr. Robert Klitzman, director of the M.S. in Bioethics program, addressed this week on CBS News. Due to the recent deliberate and fatal Germanwings plane crash by one ill co-pilot, ethicists and medical practitioners are weighing the significance of patient confidentiality versus the responsibility to protect the safety of patients and those around them.

“There's legal [responsibilities] and there's ethics,” Klitzman said. “So legally, right now, I'm under no obligation as a physician to tell anyone.” CBS News reported that currently 45 U.S. states require or permit mental health workers to eschew patient confidentiality when it comes to pertinent information that a patient may endanger himself and others.

Klitzman said that, even without a mandate, “Ethically, I would argue that, if I'm a physician and I know someone might have a plane full of people and crash it, I feel that there may be times when I have an obligation to notify someone.”

He referenced a legal precedent, the Tarasoff case, in which a therapist neglected to warn a woman that one of his patients confessed his desire to kill her. “The court found that [the killer's therapist] was liable. In that case, he should have violated patient confidentiality. So there's an ethical standard on the one hand and a legal standard on the other.”

The Germanwings case is a tragedy – but also a potential flashpoint for ethicists and medical practitioners to confront the responsibilities of mental health professionals in safeguarding their patients and those around them.

Watch the rest of the story at CBS News.