AAMFT Code of Ethics
Laws and case law decisions:
All info below is quoted from Systemic Ethics Textbook, 2024, by Kristina S. Brown, published by the American Association for Marriage and Family Therapy (AAMFT)
Tarasoff v. Regents of the University of California, 1976
The decision by the California Supreme Court created a “duty to warn” that superseded, in certain situations, client-therapist confidentiality. Technically, the ruling only applied to the State of California, because that is where the ruling was adjudicated, but soon duty to warn was adopted by most professional behavioral health organizations and more than half of the states codified it by including it in their regulations or statutes (Adi & Mathbout, 2018).
Bradley Center v. Wessner, 1982
Wessner was voluntarily admitted at a facility for psychiatric care. He repeatedly threatened to murder his wife and her extramarital partner. He disclosed to a staff person that he kept a gun in his car for the purpose of murdering them. Despite these threats, Wessner was given an unrestricted visit home to see his children, during which he murdered his wife and her partner ( Bradley Center v. Wessner, 1982). His children filed a wrongful death suit against the psychiatric center. In 1982, the Georgia Supreme Court ruled that it is a physician’s duty to prevent potentially dangerous patients from inflicting harm (Laughran & Bakken, 1984). This is also applicable to the mental health field in that professionals have a duty not to negligently release dangerous clients. Jablonski by Pahls v. United States, 1983. On two occasions, Phillip Jablonski agreed to a psychiatric evaluation at a hospital because his ex partner, Melinda Kimball, was concerned for her own safety. Upon assessing Jablonski, doctors concluded that there was no reason
for involuntary hospitalization. Shortly after his second evaluation, Jablonski murdered Kimball (Jablonski by Pahls v. United States, 1983). Meghan Jablonski, their daughter, filed suit for the wrongful death of her mother. The Ninth U.S. Circuit Court of Appeals ruled that failing to obtain Jablonski’s prior medical history constituted malpractice and that professionals have a duty to commit dangerous individuals (Corey et al., 2019).
Hedlund v. Superior Court, 1983
Stephen and LaNita Wilson were receiving psychotherapy from psychologists Bonnie Hedlund and Peter Ebersole. During treatment, Stephen disclosed that he intended to harm LaNita. Both therapists warned LaNita of the threat. Later, Stephen went on to assault LaNita in the presence of her son ( Hedlund v. Superior Court, 1983). LaNita sued the therapists and claimed that they had not warned her of the danger to herself or her son and alleged that her son had experienced severe emotional injuries and trauma because of what he had witnessed (Corey et al., 2011). The California Supreme Court ruled that the therapists could be held liable for the injuries LaNita’s son sustained because they had failed to warn her of the potential harm that could come to her child if a threat against her was carried out. This case extends the duty to warn to persons closely related to an intended victim (Corey et al., 2011).
Eisel v. Board of Education, 1991
Eisel v. Board of Education (1991) is one of the first cases that addressed school counselor liability for student suicide. A 13-year-old student, Nicole, died by suicide after making a suicide pact with another student. Nicole’s peers had reported Nicole’s intentions to their school counselor. The counselor confronted Nicole about her intentions, which she denied. The counselor made no effort to contact Nicole’s parents about the situation (Corey et al., 2011). The Court of Appeals of Maryland ruled that it is a school counselor’s duty to “use reasonable means to prevent a suicide when they are on notice of a child or adolescent student’s suicidal intent” (Eisel v. Board of Education, 1991). This case set the precedent for a school’s responsibility to exercise reasonable care to prevent a student’s foreseeable injury.
Bell v. Chance, 2018
Brandon Mackey was admitted to the hospital after two suicide attempts nearly a month apart and long history of mental illness. Mackey was treated under the care of a psychiatrist, Leroy Bell, MD, who after each of Mackey’s inpatient visits determined that Mackey was safe to be discharged. Mackey did not attempt to reinjure himself during the inpatient visit, he denied current suicidal thoughts, complied with medication, agreed to follow Bell’s discharge plan, and repeatedly asked to be released. The day after Mackey’s release, however, he died of suicide. The representative of the Mackey estate, Patricia Chance, sued both Bell and the hospital at which Mackey had been held for negligently releasing Mackey. Ultimately, the Court of Appeals, the highest course in Maryland, concluded that a hospital must release the patient if a physician, acting in good faith, determined that an individual no longer meets the criteria for involuntary admission. Further, that this decision (of releasing a patient in good faith) is “immune
from civil liability and cannot be the basis of a jury verdict for medical malpractice” ( Bell v. Chance, 2018). This finding highlights the importance of both the patient’s health and personal freedom when considering involuntary commitment and treatment (cf. AMA brief 2019). Due to the relative newness of this decision, if and how this case may set precedent has not yet been seen.