The concept of dangerousness challenges the clinician's ability to manage conflicting demands and role expectations in the judicial process. Responsibilities of the clinician extend beyond patient examination to a careful scrutiny of the clinical task. To conduct a responsible and relevant assessment, clinicians must be aware of their role in the judicial process and the intended purpose of the evaluation. The reason for the referral, the possible application of assessment findings, and the clinician's theoretical bias may be crucial considerations in the assessment of dangerousness. Before advances can be made in the clinical prediction of dangerous behavior, more attention must be paid to the theoretical basis of clinical assessment. Clinicians and researchers should abandon the search for empirically-derived predictors of violence and focus instead on the development of theoretically-based decisionmaking procedures for arriving at defensible clinical decisions about dangerousness. Several models for clinical decisions about dangerousness are reviewed, and a decision-based approach is applied to assess dangerousness. The authors conclude that accurate measurement and prediction of violence potential are not always possible. Nonetheless, the forensic clinician can make defensible decisions about dangerousness using a theoretically-based decisionmaking approach while maintaining a balance between scientific and social responsibility. 56 references.