It will be clear from the above discussion that the role of psychiatric experts in court can give rise to a range of ethical dilemmas and difficulties. This is an area of wide-ranging discussion, and a much cited paper by Stone(26) became the starting point for continuing debate. The range of ethical problems includes the question of whether clinicians can adhere to the basic ethical principles of beneficence and non-maleficence when engaged in work for the courts. (2Z28 and 29) Kenny(3) has drawn attention to the risk that psychiatrists can usurp the roles of judge, jury, and legislature if they adopt their own interpretations of the law, testify about legal conclusions, or base opinions on general views about what the law should stipulate.
Academic work in the field of ethics and forensic psychiatry is more extensively developed in the United States than in the United Kingdom. The American Academy of Psychiatry and the Law publishes ethical guidelines for the practice of forensic psychiatry, and these guidelines cover issues of confidentiality, consent, and objectivity.3) Applebaum and Gutheil(3l) provide a comprehensive overview for clinicians of the main areas of psychiatry and law in the United States, together with case examples and discussion of relevant ethical issues.
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