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Commentary: Mapping a Changing Landscape in the Ethics of Forensic Psychiatry

Dr. Grubin is Professor of Forensic Psychiatry, Newcastle University, and (Hon) Consultant Forensic Psychiatrist, Northumberland, Tyne and Wear National Health Service Trust, Newcastle-upon-Tyne, UK. Address correspondence to: Don Grubin, MD, FRCPsych, Department of Forensic Psychiatry, St. Nicholas Hospital, Bamburgh Clinic, Gosforth, Newcastle-upon-Tyne NE3 3XT, UK. E-mail: don.grubin{at}ncl.ac.uk

In 1984, Alan Stone, writing in the Bulletin of the American Academy of Psychiatry and the Law, stated that "forensic psychiatrists are without any clear guidelines as to what is proper and ethical," adding that because of the nature of psychiatry and the realities of the law, no such guidelines can be drawn. Put starkly, his conclusion was that the practice of forensic psychiatry is fundamentally unethical. In the same issue, several contemporary commentators criticized his position, arguing that he misunderstood the social context of forensic psychiatry and that, in any case, he was wrong to say that ethics standards did not exist. In this article, these questions are reviewed again, starting from the principle articulated by the philosopher, A. J. Ayer, that that there is no such thing as an ethical fact.