Illinois court of appeals reaffirms its policy to reject Tarasoff, ... or does it?

Just a few days ago the Illinois Court of Appeals issued an opinion in a case called Sherer v. Sarma in which it once again followed the state's policy that rejects the imposition of a duty to warn on a psychotherapist made famous by the Surpeme Court of California in Tarasoff v Regents of the University of California.  You can read the opinion here.

As you probably remember from your days in law school, in Tarasoff the court was asked to decide whether a therapist has a duty to warn an unsuspecting possible victim of the expressed intent of a patient to cause her harm.  The court found that even though the therapist did not have a relationship with the victim, he did owe her a duty to warn.  The court opined that the benefit of having the therapist help prevent an injury to someone who did not know was in danger is more important that the duty of confidentiality owed to the patient and than the possible negative effects on the process of therapy itself.

Meanwhile, in Illinois, the courts have considered the same questions and have decided to take the opposite approach, finding that not recognizing a duty to warn advances the goals of protecting the confidentiality of the medical treatment, which itself promotes better opportunities for treatment.

One can disagree whether it is better to adopt or to reject Tarasoff, but the fact of the matter is that courts in Illinois have rejected it, ... for the most part.

Now, I have to say "for the most part" because in an unnecessary attempt to qualify the ruling the opinions would recognize a duty to warn if:  (1) the patient made specific threats of violence, (2) the threats of violence were directed against a specific and readily identifiable victim, and (3) there is a direct physician-patient relationship between the defendant and the victim or a special relationship between the patient and the victim.

But wait!  If there is a duty to warn under these circumstances, including circumstances in which there is no relationship between the doctor and the victim as long as there is a relationship between the patient and the victim, how can we say that the state does not follow Tarasoff?   The three elements that would support a finding of a duty to warn are pretty much what supports the duty to warn in Tarasoff, are they not?

But wait; there's more!!  In Sherer v Sarma, the actor and the victim were both patients of the defendant and they were husband and wife.  Yet the court did not find those relationships to be special relationships for purposes of the doctrine.  If the circumstances in this case did not meet the three elements listed above, under what circumstances would Illinois recognize a duty to warn?