It is frustrating that Psychiatric News seems so utterly confused about the nature and obligations of Tarasoff-like rulings and subsequent duties to protect.

In the March 3 article "Jury Faults Ga. Psychologist in Duty-to-Warn Case," the headline and subsequent copy made the same mistake that many clinicians still make in believing that our primary responsibility is Tarasoff I language of "warning" rather than Tarasoff II language of "protecting."

Clinicians would be hamstrung if they were truly mandated only to "warn," but we have many more options and can be much more therapeutic when the primary focus is on "protecting." The article implies that clinicians are at the mercy of juries’ whims if they carry out the so-called duty to warn.

Indeed, warning usually requires little in the way of clinical skill and imagination. Protecting, on the other hand, may require a more careful, extended, and thorough assessment; may necessitate hospitalization; and, if a warning is determined to be necessary part of protecting, may require skillful "informed consent" when breaching confidentiality.

It would be helpful if our psychiatric newspaper did not contribute to the confusion in this critical area of clinical/forensic psychiatry.

James S. Reinhard, M.D.

Salem, Va.

Editor’s Note: The Tarasoff decision, including the issue of "duty to warn" versus "duty to protect," has previously been the subject of articles and letters to the editor in Psychiatric News. A thorough discussion of the topic appeared in the letters to the editor section of the January 1, 1999, issue. These letters can be accessed on the Psychiatric News Web site at <www.psych.org/pnews/99-01-01/tarasoff.html>. Readers who do not have access to the Web may obtain the letters by calling the newspaper offices at (202) 682-6137 or sending an e-mail request to cbrown@psych.org.