Invited Commentary

Commentary on “A Misguided Venture: Presidential Fitness and the Duty to Warn”

Authors: Manuel Cepeda, MD


For >40 years, the Tarasoff duty to warn of a threat to kill has become an accepted part of medical care. The use of this warning by physician political activists is new. In this response to the editorial by Kels and Kels1 in this issue of the Southern Medical Journal, I first comment on the aim of physician activism to achieve political goals using medical constructs such as the duty to warn. I then focus on the current use of the Tarasoff doctrine by physicians and outline a way to incorporate the more traditional duty to warn into clinical practice.

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1. Kels CJ, Jr Kels LH. A misguided venture: presidential fitness and the duty to warn. South Med J 2018;111:767-769.
2. Cha SS, Ross JS, Lurie P, et al. Description of a research-based health activism curriculum for medical students. J Gen Intern Med 2006;21:1325-1328.
3. Beck JC. When the patient threatens violence: an empirical study of clinical practice after Tarasoff. Bull Am Acad Psychiatry Law 1982;10:189-201.
4. Weinstock R, Bonnici D, Seroussi A, et al. No duty to warn in California: now unambiguously solely a duty to protect. J Am Acad Psychiatry Law 2014;42:101-108.
5. Scarano VR, Baily CM, Banfield JR. The Texas Supreme Court speaks: mental health professionals have no duty to warn or protect third parties. Tex Med 2002;98:61-64.
6. Alabama Code §34-17A-23.