Editorial: Forensic Mental Health Experts in the Court—An Ethical Dilemma

Abstract

During the past decades, mental health and legal scholars have debated the ethical role of psychiatrists and psychologists in the forensic setting, especially in those cases in which a not guilty by reason of insanity plea (NGRI) has been entered or competency to stand trial is an issue. The proper role of mental health professionals in the legal process certainly calls for clarification, and the following factors should be taken into consideration: the moral values held by society and the difference, if any, between the ethics involved in the diagnostic or treatment-oriented patient/doctor relationship and those related to a forensic mental health expert examination of a defendant who is allegedly mentally ill. Also, consideration should be given to the relationship between the court of law and the forensic mental health expert. Society upholds moral values that are accepted by the majority of its members. Those in the mental health professions abide by codes of ethics laid down by their associations (e.g., American Psychiatric Association, American Psychological Association, American Medical Association, and their respective forensic sections). Their conduct, whatever the professional setting, should comply with specific guidelines, which basically are respect for the patients/clients and their autonomous decisions, informed consent, beneficence, and nonmaleficence. The aforementioned are basic to the ethical relationships of mental health professionals with their clients/patients. Deviation from the aforementioned guidelines rarely occurs, and any person who does not uphold them may receive some type of censure and in serious cases have their licenses revoked and legal charges instituted for whatever omission or commission in which they have been involved. Although it is widely believed that a trial is aimed primarily at resolving a dispute, the ethical foundation of any court trial should primarily be the search for truth. After all, witnesses swear to “tell the truth, the whole truth, and nothing but the truth.” It is assumed that mental health professionals who testify in a trial uphold the truth and that they abide by the ethical guidelines of their professions. However, looking at the role of mental health experts in a trial, one is often left with the impression that at times the aforementioned is not fully taken into consideration by the triers of facts. Indeed, a certain degree of ethical tension exists in the forensic setting regarding the court testimony of mental health experts in NGRI or related cases. It is well known that the law gives primary importance to the facts of