Confidentiality in Crisis: Part I—The Duty to Inform

OBJECTIVE: To discuss the ethical and legal imperatives to protect third parties from harm in circumstances often believed to be protected by doctor-patient confidentiality. METHOD: A review of recent legislative changes and legal decisions pertaining to a psychiatrist's duty to warn. CONCLUSION: The current legislative and legal climate presents many risks to the concept of doctor-patient confidentiality. Psychiatrists must carefully consider any guarantees of confidentiality made to patients and must discuss the limits of confidentiality when obtaining consent for treatment.