Ethical and Legal Dilemmas in Risk Assessment and Confidentiality: Cannabis Use, Psychosis, and Recidivism in Young Adults

This paper explores ethical and legal complexities related to confidentiality and risk assessment in young adults with cannabis use disorder and schizophrenia. Drawing from case law, professional ethical codes, and contemporary research, the article evaluates the justification for breaching confidentiality when the individual displays signs of verbal aggression and possible psychotic relapse. It also discusses the limits of foreseeability in predicting harm and outlines standards such as the Appelbaum test for assessing decision-making capacity. The analysis integrates statutory mandates, including HIPAA, FERPA, and New York State’s Mental Hygiene Law, and addresses the central ethical dilemma of autonomy versus safety in clinical decisions.