Confidentiality in crisis: Part I - The duty to inform

Objective: To discuss the ethical and legal imperatives to protect third pa rties from harm in circumstances often believed to be protected by doctor-p atient confidentiality. Method: A review of recent legislative changes and legal decisions pertaini ng to a psychiatrist's duty to warn. Conclusion: The current legislative and legal climate presents many risks t o the concept of doctor-patient confidentiality. Psychiatrists must careful ly consider any guarantees of confidentiality made to patients and must dis cuss the limits of confidentiality when obtaining consent for treatment.