Edit: Here’s a link to what is most likely the real manifesto: https://www.kenklippenstein.com/p/luigis-manifesto
Ken Klippenstein is a very reliable journalist and this version of the manifesto contains the snippets that have been released by law enforcement. Also, considering the thing was hand-written, that very long version involving his mom is dubious. (And there’s not any good evidence that his mom is in anything besides decent/good health)
Unfortunately, that would end up under the Tarasoff precedent and we would be required by law to report it to police and the intended target. There’s better ways to weasel around this when filing insurance paperwork, but we’ll have to have a designated person in the clinic whose job it is to fight with the insurance companies.
Headache? Report to police.
Back Pain? Report to police. (That nearly 30% of all Americans have suffered from)
You get a police report. You get a police report! Everybody gets a police report!!! - Oprah Winfrey the MD
You have to make a report if the patient expresses homicidal ideation, intent, and a plan with a specific target or targets in mind. If the target is a particular person (like a partner or friend) you are supposed to notify that person directly or ensure that the police notify them.
Establishing any kind of precedent that chronic pain = homicidal ideation and intent is an extremely bad idea, and not something I’m even willing to joke about.
Yeah I get it, as a doctor your professional rep is on the line, inserting casual threats to insurance execs is not something to do (unless you can somehow organize it across a large group to keep insurers’ feet to the fire).
For me, it’s not the professional reputation, but the second that kind of thing gets tagged onto a patient’s chart, it becomes extremely hard to expunge. There are a lot of patients with mental illnesses (some which are misdiagnoses) that face significant problems because of that diagnosis. If a chart gets flagged with “homicidal ideation” at any point, that patient will forever be flagged as dangerous and people will be suspicious of them immediately.