Institutional Response to Inpatients' Threats Against the President

Federal law makes it a crime to threaten the life of the President of the United States. However, psychiatric clinicians have no legal obligation to report all such threats encountered in their practice. In deciding whether to report a threat, they must balance their obligation to protect the President with their duty to up-hold a patient's rights to confidentiality and to freedom from self-incrimination. The authors present a case highlighting the issues faced by clinicians in deciding whether to report threats made by psychiatric inpatients and offer guidelines for dealing with such situations. In general, responses to patients' threats against the President should follow the Tarasoff principle, which asserts that clinicians who conclude that a patient presents a danger to another person should take steps to protect that person.