Academic journal article
By Young, Bradford E.
American Journal of Law & Medicine , Vol. 28, No. 4
Evidence: "Dangerous Patient" Exception to Psychotherapist-Patient Privilege Permits Psychiatrists to Testify Against Their Patients-United States v. Chase1-The U.S. Court of Appeals for the Ninth Circuit held that there is a "dangerous patient" exception to the psychotherapist's obligation of confidentiality, which permits a psychiatrist to testify against a patient.2 The appellant, Steven Gene Chase, argued that the trial court erred when it permitted his psychiatrist to testify against him concerning threats he made in the course of diagnosis and treatment.3 The district court held that the psychotherapist-patient privilege was inapplicable because the psychiatrist, Dr. Kay Dieter, had properly concluded "(1) that Chase's threats were serious when uttered, (2) that harm was imminent, and (3) that disclosure to the authorities was the only means of averting the threatened harm."4 The Ninth Circuit found that the trial court was correct in admitting Dr. Dieter's testimony, thus affirming Chase's conviction for threatening to murder federal law enforcement officers.5
Chase, who was diagnosed with a "bipolar type II disorder with episodes of intense anger and obsessive rumination against certain individuals,"6 began receiving treatment from Dr. Dieter in 1997 for irritability, anger symptoms and depression. On August 18, 1999, Chase showed Dr. Dieter his appointment book, which contained a list of names, addresses and social security numbers of people, including two FBI agents, whom Chase admitted to having thoughts of killing or injuring. During that session, Chase also admitted that he had threatened several of them in the past and had recently begun drinking. When Dr. Dieter warned Chase that she would have to alert those people if he told her specifics about his intentions to harm them, he denied any intent to take immediate action. Dr. Dieter next spoke with Chase two months later, at which time he admitted that he was extremely upset about a recent fight with his wife and mentioned that his life insurance policy would pay out if anything happened to him. After this conversation, Dr. Dieter contacted her supervisors and the FBI, both of whom encouraged her to attempt to elicit more information from Chase at their next appointment.
At the next appointment, Chase talked about another fight with his wife, the fact that his mother had just been diagnosed with cancer, his frustration with the legal system and the lien against his house. Chase said that if the lien was not dropped within the week, "he would get his guns, get in his vehicle and have himself some justice."7 He also told Dr. Dieter that he had located nearly all of the people on his list and was targeting their children as well. Upon receiving this information, the FBI made plans to interview Chase in his home and execute a search warrant for his appointment book and any weapons. That same day, Chase made several calls to Dr. Dieter's office, stating that U.S. Marshals had questioned his neighbor about him and that he believed he was about to be arrested. Chase also spoke to one of the clinic's receptionists, saying that "there are FBI Marshals on their way out to get me and if that happens, people are going to die."8 After the FBI arrived at Chase's residence and a number of phone negotiations were made, Chase was arrested without incident.
In its analysis, the Ninth Circuit acknowledged that Jaffee v. Redmond9 established a psychotherapist-patient privilege under federal common law.10 In Jaffee, the U.S. Supreme Court held that "confidential communications between a licensed psychotherapist and her patients in the course of diagnosis or treatment are protected from compelled disclosure under Rule 501 of the Federal Rules of Evidence."11 However, the Ninth Circuit also found that "Jaffee left the delineation of the scope of that privilege to future cases."12 In order to demonstrate that Jaffee did not necessarily establish a universal privilege, the Ninth Circuit cited the "Jaffee footnote,"13 which states that "[a]lthough it would be premature to speculate about most future developments in the federal psychotherapist privilege, we do not doubt that there are situations in which the privilege must give way, for example, if a serious threat of harm to the patient or to others can be averted only by means of a disclosure by the therapist. …