Patients understand that communication with a physician is confidential. There i

Patients understand that communication with a physician is confidential. There is an exception which was codified in Tarasoff v. Regents of the University of California (17 Cal.3d 425 [1976])
In Tarasoff, a patient told his psychotherapist that he intended to kill an unnamed but readily identifiable woman. Subsequently, the patient killed the woman. Her parents then sued the psychotherapist for failing to warn them or their daughter about the danger. The California Supreme Court rejected the psychotherapist’s claim that he owed no duty to the woman because she was not his patient, holding that if a therapist determines or reasonably should have determined “that a patient poses a serious danger of violence to others, he bears a duty to exercise reasonable care to protect the foreseeable victim of that danger.”
In 1985, the California legislature codified the Tarasoff rule: California law now provides that a psychotherapist has a duty to protect or warn a third party only if the therapist actually believed or predicted that the patient posed a serious risk of inflicting serious bodily injury upon a reasonably identifiable victim.
This case is about a psychotherapist. Caselaw and other writings have applied it to other healthcare workers as well.
You have an inpatient that is in the final days of her chemotherapy treatment for leukemia. On several occasions you have observed her visibly agitated. You inquire during your visits to her room and she consistently refuses to talk. One time you come to her room and she is in the bathroom. On her bedside table she has left open a notebook with clear, large, bold writing giving details about how she will kill her step-father, who sexually abused her as a child, when she gets out. She includes his name and address in her notebook. She ends with ” I know that I am dying… and if it is the last thing I do on this earth I will protect the world from this monster.”
What do you do? What is your duty? Why?