Caring for the Dangerous Patient: Legal and Ethical Considerations

When assessing and treating patients who report that they are thinking about hurting themselves or others, nurse practitioners (NPs) must consider not just their codes of ethics but federal laws, state laws, cases in the different courts, and the guidelines set forth by credentialing boards and professional organizations, all of which impact the application of basic confidentiality. The purpose of this article is to help NPs deal with unusual situations that might require a breach of patient confidentiality and to address legal concerns and possible actions by state boards of nursing for breach of patient confidentiality. A list of 10 considerations for NPs facing such a challenge is included.