Final answer:
The difficulty with the Ewing v. Goldstein case lies in determining the legal responsibility of therapists to warn potential victims when threats are disclosed by third parties, complicating the original Tarasoff ruling's guidelines.
Step-by-step explanation:
A difficulty posed by the 2004 California extension of the Tarasoff ruling in Ewing v. Goldstein is determining the ethical boundaries and legal responsibilities of mental health professionals when threats against third parties are disclosed by someone other than the patient, such as through family members. This extends the original Tarasoff duty to warn, which was more clearly defined and initially obligated therapists to take action if their client directly expressed a serious threat of violence towards another person. The challenge lies in balancing client confidentiality with the duty to protect potential victims, while also navigating the less clear circumstances in which third-party communications trigger this ethical and legal responsibility.