Ethical medical practice and treatment in psychiatry are based on
the concept of first do no harm. However, this cannot, and does
not, apply to forensic cases where there is no doctor-patient
relationship and the forensic psychiatrist may indeed cause harm to
the examinee. In this book, Robert Sadoff analyzes the ethical
issues affecting forensic psychiatric practice, especially those
promulgated by the American Academy of Psychiatry and the Law.
Within those guidelines, he looks at individual bias, vulnerability
of the examinee, and potential harm to the mental health
professional. The book discusses each of the procedures of the
forensic expert separately with respect to minimizing harm. It has
been written with an international audience in mind and features
chapters reviewing the European and UK perspectives, by Emanuele
Valenti and John Baird, respectively.
Robert Sadoff addresses the long-term harm that can be either
avoided or minimized through careful planning and application of
ethical principles. He is not advocating that the harm can be
totally eliminated, because that is impossible in the adversarial
system in which forensic psychiatrists work. However, there are
means by which harm may be minimized if care is taken during the
assessment, the report writing, and the testimony phase of the
proceedings. The book develops the scope of forensic psychiatry
from the standpoint of administrative, civil and criminal cases. It
presents the practical issues involved in conducting forensic
psychiatric assessments under various conditions plus special
considerations, such as bias, minimizing harm, developing a
therapeutic approach, and elaborating on various vulnerable
individuals who are frequently examined in forensic cases. These
include juveniles, mentally retarded, autistic, sexual assault
victims, the elderly, the organically damaged, the psychotic, and
mentally disabled prisoners. Immigrants are covered in a chapter by
Solange Margery Bertoglia. The ethical issues in conducting
forensic psychiatric examinations and presenting psychiatric
testimony in court are examined and discussed. Cases illustrating
the difficulties involved punctuate the presentation. The book
closes with a fascinating account of the legal perspective by Donna
Vanderpool.
In summary, this book illustrates the ethical and practical
issues that affect forensic psychiatric practice. The question is
not what we do, but how we do it, and which standards, ethical
guidelines and personal values contribute to the total picture.
Despite the fact that we cannot always adhere to the doctrine of
"primum non nocere," we can minimize the harm caused inherently by
the adversarial system in which we participate.
Praise for "Ethical Issues in Forensic Psychiatry"
"One of the founding giants of the forensic psychiatric field
has written here far more than a "mere" ethics textbook. Instead,
this compendium serves multiple purposes: it is a valuable primer
on forensic techniques of examination and testimony, a model of
best forensic practices, and an instruction on the most
appropriately civilized way in which to conduct oneself as a
forensic psychiatrist.
The success of these multiple accomplishments clearly derives
from characteristics of the author. In both sage advice to
practitioners and in many revealing case examples, Dr. Sadoff
displays the tact, good manners and sensitivity of a consummate
gentleman - a term not always associated with the hurly-burly of
courtroom work. The book's primary focus on avoiding harm to all
the parties involved in the work places it on the moral high ground
of the legal system in which participating clinicians must find a
place."
Thomas G. Gutheil, MD, Professor of Psychiatry and Co-Founder,
Program in Psychiatry and the Law, Beth Israel Deaconess Medical
Center, Harvard Medical School
General
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