Ethics and forensic psychiatry

This article has attempted to outline some of the important ethical issues faced by the psychiatrist in the forensic role. Much of forensic psychiatry is practiced by general psychiatrists without specific forensic training who must thereby familiarize themselves with the problem areas likely to be encountered in this work. They should also be knowledgeable about the ethics guidelines prepared by forensic psychology and forensic psychiatry organizations that are subject to frequent modification. Ethical problems often occur when psychiatrists exceed their expertise, their role as contracted, or the actual facts in the case. Psychiatric experts usually represent just a small part of most litigation, and an attitude of humility rather than grandiosity is appropriate. Expert witnesses serve as educators rather than decision makers in the case [21]. Given the complexity and uncertainty of medical decision making generally, whether in clinical or forensic medicine, forensic psychiatric opinions should be appropriately qualified by their limitations, acknowledged affirmatively rather than only on cross-examination. Expert witnesses commonly take an oath to "tell the truth, the whole truth." Forensic psychiatrists are not experts in moral matters and should not be rendering moral judgments or misusing their authority as psychiatrists to advance their own political or social ideology [19]. Testimony should be based on data and theory generally accepted in the profession, recognizing that there will always be minority views. Psychiatrists, however, should not be testifying based upon idiosyncratic views unsupported by at least a respectable minority of the profession. As in clinical psychiatry, complex or challenging forensic cases often require consultation from a knowledgeable colleague.