Case Studies

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Case Study #30

The Duty to Warn and to Protect

Right to live or die. Jane is a counselor who primarily sees people with HIV or those with other chronic conditions. She is often referred individuals with mental health issues from local organizations and clinics. She recently received a call from an agency saying they were referring a man named Spencer because they were concerned about possible suicidality. Spencer made an appointment and Jane gave him her standard intake paperwork. At the start of the session she says, "I noticed you didn't sign the informed consent form. Do you have some questions or concerns you would like to discuss before we begin?" Spencer replies that he wants to know what she means by the statements regarding her possibly breaking confidentiality or taking some course of action if she is concerned he may hurt himself or others. As Jane begins her standard response to the limits of confidentiality, Spencer interrupts and says that he believes it is his right to decide whether to live or to die and if she cannot accept that then she should just refer him to someone who will be more respectful of his values.

Question 1: What would you do if you were Jane?

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Question 2: What are your own beliefs about the “right to suicide?”

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Question 3: Could you agree to Spencer’s conditions for having therapy with you?

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