This report alerts clinicians to circumstances associated with murder-suicide. The case of a father shooting his 24-year-old daughter, then himself, after her brief hospitalization & treatment for paranoid decompensation is cited. Overlooking family distress, a lack of focus on family dynamics & response, dependence on patient willingness for hospitalization, & a respect for patient privacy which leaves family uninformed are interpreted as contributing factors to the murder-suicide. (RP)