Forensic Encounter Research Articles

Healer, Witness, or Double Agent? Reexamining the Ethics of Forensic Psychiatry

In recent years, psychiatrists have become ever more prevalent in American courtrooms. Consequently, the issue of when the usual rules of medical ethics should apply to forensic psychiatric encounters has taken on increased importance and is a continuing topic of discussion among both legal and medical scholars. A number of approaches to the problem of forensic psychiatric ethics have been proposed, but none adequately addresses the issues that arise when a forensic encounter develops therapeutic characteristics. This article looks to the rules governing the lawyer-client relationship as a model for a new approach to forensic psychiatric ethics. This new model focuses on the expectations of the evaluee and the ways in which the evaluating psychiatrist shapes those expectations to determine how and when the rules of medical ethics should apply to forensic psychiatric encounters. This article describes and analyzes three previously proposed approaches to that question and the closely related question of when and how a doctor-patient relationship can form in the context of a forensic psychiatric evaluation. It also explains why each of these prior approaches does not sufficiently address the issues that arise when a forensic encounter takes on therapeutic characteristics. Finally, it proposes a new approach that draws inspiration from the rules governing the lawyer-client relationship.

Not just welfare over justice: Ethics in forensic consultation

The ethics of forensic professionalism is often couched in terms of competing individual and societal values. Indeed, the welfare of individuals is often secondary to the requirements of society, especially given the public nature of courts of law, forensic hospitals, jails, and prisons. We explore the weaknesses of this dichotomous approach to forensic ethics, offering an analysis of Psychology’s historical narrative especially relevant to the national security and correctional settings. We contend that a richer, more robust ethical analysis is available if practitioners consider the multiple perspectives in the forensic encounter, and acknowledge the multiple influences of personal, professional, and social values. The setting, context, or role is not sufficient to deter mine the ethics of forensic practice. The public forum—the root of the term “forensic”—provides a setting where individual welfare and social justice strain against each other. Professionals who work in public fora (i.e., forensic practitioners), labor in settings like courtrooms, correctional facilities, and national security agencies that raise one of the most painful dilemmas in professional ethics: whether their primary duty is to the legal aspects of their work or to the clinical and scientific standards they employ. The law determines many of the elements critical to forensic work, while the scientific and clinical professions socialize, train, and introduce practitioners to their craft. The public forum consequently provides the setting where these ethical and professional tensions play out. Nowhere is this tension borne out more poignantly than in questions of community security, namely in assessing individuals who may present a danger to those around them. Individuals committed or incarcerated, for example, as a danger to commit suicide, to terrorize, assault, assassinate, rape, or set fires raise harrowing concerns for their safety and the safety of families, neighbors, and children. Such individuals bear enormous scrutiny as society determines whether they can re-enter the community and face high thresholds for that re-entry. In such cases it is almost a matter of faith that legal, and indeed community, standards will trump other considerations. After all, the decisions are often made in courtrooms—presided over by professionals with legal, not clinical, training.

In Mother’s Lap: Forging Care and Kinship in Documentary Protocols of Sexual Assault Intervention

In this article, I examine the documentary practices of forensic intervention into sexual assault as they reveal a larger set of imaginaries about kinship, gender, violence and healing. In the course of the forensic encounter, sexual assault victims frequently disclose victimization by intimates or relatives. The reading practices and audit mechanisms to which forensic documents are subjected reveal tensions between the real-life experiences of sexual assault victims and their families on the one hand, and institutional imaginaries of care and victimization on the other.