Ethical issues in the use of electronic monitoring (Global Positioning System 'tracking' technology) in forensic mental health settings - A four principles approach

Electronic monitoring ('tracking') of individuals has been used in the UK criminal justice system for over three decades, and its use is increasing. Electronic monitoring has more recently been implemented in forensic psychiatric services, which has generated considerable debate about the appropriateness of its use in clinical settings, and about legal and ethical concerns. The purpose of this article is to formally address the ethical issues that arise from using electronic monitoring in forensic psychiatry. These issues are considered using the Four Principles approach to medical ethics, namely autonomy, beneficence, non-maleficence, and justice. We conclude that by adopting a patient-centred approach, where informed consent is sought, and the patient's best interests remain central to the decision-making process, electronic monitoring is both ethical and justifiable. More robust studies are required to develop standardised clinical guidelines for the use of EM in forensic psychiatry, and to apply the theory of patient-centred, consent-driven care to practice.