Ethical Issues in Forensic and Prison Psychiatry

Abstract

Forensic psychiatry is a subspecialty of clinical psychiatry which requires special legal and criminological knowledge and experience in the treatment of mentally disordered offenders. Forensic psychiatrists should have solid psychiatric training as well as practical experience in dealing with mentally disordered offenders. The double knowledge in psychiatry and law defines the subspeciality of forensic psychiatry and provides the ethical foundations for its practitioners (Arboleda-Florez 2006). 'In psychiatric ethics, the dual-role dilemma refers to the tension between psychiatrists' obligations of beneficence towards their patients, and conflicting obligations to the community, third parties, other health-care workers, or the pursuit of knowledge in the field. These conflicting obligations present a conflict of interest in that the expectations of the psychiatrist, other than those related to patients' best interests, are so compelling. This tension illustrates how the discourse in psychiatric ethics is embedded in the social and cultural context of the situations encountered. It appears that as society changes in its approach to the value of liberal autonomy and the "collective good", psychiatrists may also need to change' (Robertson and Walter 2008). This quote reminds us that social and political factors are important drivers of decision making, particularly as in-depth analysis of specific ethical problems in forensic psychiatry are only beginning to emerge. This chapter discusses the role of a forensic psychiatrist, and ethical issues involved in risk assessment, treatment, consent, and compulsory treatment of mentally disordered prisoners. (PsycINFO Database Record (c) 2016 APA, all rights reserved)