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In the 2019 film Joker, it is strongly implied—but not explicitly shown—that Arthur Fleck kills the psychiatrist (who is unnamed, not 'Dr. Sally') in the final scene. He is seen leaving the therapy room with blood on his shoes and leaving bloody footprints in the hallway before being chased by orderlies. However, the scene is deliberately ambiguous, and the 2024 sequel Joker: Folie à Deux suggests he did not kill her. The character 'Dr. Sally' is actually a sex therapist who appeared earlier in the film as a guest on the Murray Franklin show.
Yes, Arthur Fleck (played by Joaquin Phoenix) kills his psychiatrist, Dr. Sally, in the final scene of the 2019 film Joker.
The scene takes place in Arkham State Hospital, where Arthur is being held after the events of the movie. He is sitting across from his psychiatrist, and they are discussing his confinement.
The specific detail confirming the killing is presented subtly, but clearly:
While the act of killing is not shown explicitly, the presence of blood on Arthur's shoes and the bloody footprints confirming violence occurred in the therapy room, combined with the context of the preceding conversation (and Arthur's established violent nature), strongly implies he murdered Dr. Sally. The final sequence of him running and dancing away while leaving a trail of blood solidifies that he committed one last, sudden act of violence before his final moments in the film.
The summary treats the ending as a definitive event, missing the film's central theme that the entire movie (or parts of it) might be a delusion, a point heavily discussed by critics and the director.
The summary does not account for information from 'Joker: Folie à Deux' which clarifies the fate of the psychiatrist.