When tragedy strikes, it is a normal human reaction to look to blame somebody. If we can ascribe fault, we can theoretically prevent that type of tragedy in the future, so we make ourselves feel safer and more secure. In the case of James Holmes and the attack at the Aurora Colorado movie theatre, we looked for someone to blame other than the shooter. James Holmes was clearly mentally unstable,

so to blame only him was not satisfying. With 70 people dead or injured, surely there was someone else at fault, who could have prevented this tragic loss of life. Maybe we should have instituted a ban on assault weapons? Maybe the movie theatre should have used some type of metal detectors.  Maybe the movie theatre should have had uniformed security guards? We know that James Holmes was under the care of a psychiatrist, Dr. Lynne Fenton. We knew that James Holmes sent a detailed description of the assault he planned but that it remained in the university’s mail room.  While Mr. Holmes was shooting victims in the theater, his description of the attack remained in the university mail room…unopened. Maybe it was the fault of a drug company for not adequately disclosing the potential side effects of a medication taken by Mr. Holmes.  The reality is that there was an opportunity to prevent this attack, but nobody paid attention.

 

The dr/patient confidentiality mandate is well known. In Colorado there is an express law that allows a psychiatrist to legally breach that pledge of confidentiality. In the event a psychiatrist becomes aware of a “serious and imminent threat” that their patient might cause harm to others, the psychiatrist is allowed to breach that confidential relationship. Of course if the psychiatrist does breach that relationship, he/she does so at their peril. If the patient sues them they could potentially prove malpractice if the psychiatrist is shown to have breached that confidential relationship when there was no “serious and imminent threat.” In the case of James Holmes, his psychiatrist Dr. Lynne Fenton was fearful enough that she DID breach her patient’s confidentiality. Dr. Fenton made contact with a University of Colorado police officer prior to the shooting to express her concerns about the behavior of Holmes. This took place “several weeks” before Mr. Holmes shot 70 people. It is unclear what if anything was done as a result of this report. What is clear is that Dr. Fenton was right. James Holmes did pose a “serious and imminent” threat, but the threat was not averted and 70 people were shot.

It seems a pattern is emerging. People identify a potential threat, report that threat, nothing is done to extinguish the threat, and people die. In the 2011 Tuscon shooting by Jared Lee Loughner, he had been reported to campus police on at least 18 occasions before his shooting spree that took the lives of 6 people and injured many others.

Similarly, in the case of the Virginia Tech shooter Cho, there was abundant evidence that he was a tragedy waiting to happen.

He did not attend class, socialized with no one, lived on campus planning his crime in uninterrupted solitude.  The volume of written complaints about Cho filled a dozen evidence boxes. All three shooters were allowed to plan their attacks, acquire the weapons and ammunition necessary, and carry out their assaults, unimpeded by anyone!

We live in the information age. Between Facebook, Twitter, texting and the internet, there is an abundance of information accessible to anyone interested. However it seems that either there is too much information to process, or there is no interest in processing any information other than celebrity gossip. People are being killed. Nobody is willing to step forward to be responsible for investigating these reports of potentially dangerous people. Just as Homeland Security is responsible for investigating potential foreign terrorists, they must increasingly be concerned with domestic terrorists.