Ethical Issues in the Practice of Forensic Psychiatry

The recent, rapid development of the practice of forensic psychiatry has led to an increasing awareness of and a growing concern about the ethical issues that inhere in this subspecialty. While some such issues are similar to those found in the general practice of psychiatry (confidentiality, informed consent, etc.), there are aspects of these and other ethical issues which are unique to the practice of forensic psychiatry. On October 16 and 17, 1980, at the annual meeting of the American Academy of Psychiatry and Law held in Chicago, Illinois, a panel discussion concerning ethical issues in forensic psychiatry took place. The chairman was Henry C. Weinstein, M.D., Director, Forensic Psychiatry Services, Bellevue Hospital Center, New York.

This panel, made up of two forensic psychiatrists and two philosophers (with special interests in medical ethics), discussed the ethical issues in the practice of forensic psychiatry from a variety of perspectives. A general statement in regard to ethics and forensic psychiatry opened the panel, followed by a series of presentations relating to specific ethical issues, including those which face the forensic psychiatrist practicing in a secure forensic unit, those which arise in the practice of forensic psychiatry with children and adolescents, as well as ethical issues relating to research in forensic psychiatry. A special program for the exploration and teaching of ethical issues, in a clinical forensic psychiatric setting, utilizing a philosopher-in-residence, was described and discussed. The panel presentation was concluded by a commentary from the philosophical perspective.