Mental health professionals rightfully experience significant anxiety regarding their duty to protect when working with potentially dangerous individuals. This work dispels myths and provides readers with a resource addressing the situations where a duty to protect may apply.

Confidentiality is one of the foundations on which psychotherapy is built. Limitations on confidentiality in the therapeutic process have been explained and explored by many authors and organizations. However, controversy and confusion continue to exist with regard to the limitations on confidentiality in situations where clients are considering their options at the end of life and after a client has died. This article reviews these 2 areas and provides some suggestions for future research.

The development of ethical and practice guidelines related to mental health service on the Internet has lagged behind the movement of practitioners into this area. Even for clinicians who are not offering services on the Web, the Internet has led to confusion and concern about proper roles and responsibilities. This article discusses an actual experience we had with a self-described rationally suicidal man with multiple sclerosis. After presenting some background on MS, we report initial interactions with the man verbatim and (...) summarize subsequent correspondence in an analysis of the man's claim that his decision to die was well reasoned and that he should be allowed a physician's assistance. (shrink)

Case studies and first-person stories about decision-making, written by professionals in the field, bring a uniquely personal touch to this valuable text.

The leaders of many prominent health and mental health organizations have issued policy statements about the appropriateness of members of their professions being involved in assisted suicide, whether assisted suicide is ever an acceptable option for people, and what roles a professional can or should play when a client is considering assisted suicide. This article argues that only the latter focus-providing suggestions about how a professional can assist a person considering hastening death-is appropriate for an organization whose members are clinical (...) practitioners rather than theorists. The former 2 positions, it is contended, are merely political posturing and are counterproductive to providing proper care to clients in need. (shrink)