NCJ Number
168204
Date Published
1997
Length
6 pages
Annotation
This overview of medico-legal ethics in forensic psychotherapy focuses on the nature and extent of therapists' duty of care, reconciling conflicting duties, and doing no harm.
Abstract
Any therapeutic relationship involves ethical responsibilities. Benefiting the patient is the guiding Hippocratic principle. Although all therapists would accept that treating a patient may have consequences for third parties, ordinarily their duty as therapists lies in helping the individual. In a forensic setting, however, this position is fundamentally different. The purpose of forensic psychotherapy is to help offenders understand their actions in the hope that this will prevent them from reoffending. Forensic psychotherapists also have direct responsibilities to the state as their employers. This ambiguity has profound ethical implications; it raises a number of issues: (1) Does the psychotherapist serve the patient, the institution, or society as a whole? and further, (2) how far do forensic psychotherapists' duties extend toward third parties who may be in danger from the patient. Because of psychotherapists' responsibility to parties in addition to the patient, they should explain to patients that they may not be able to maintain strict confidentiality to their clients at the outset of treatment, but should nonetheless attempt to secure the patient's consent before disclosing confidential information to others. In discussing the reconciliation of conflicting duties, this paper addresses the need for consent, respect for confidentiality in a forensic setting, and the role of the therapist in case conferences and tribunals. In discussing issues pertinent to the ethical mandate to "do no harm," the author addresses training, the recognition of the limits of competence, the effectiveness of psychotherapy in a forensic setting, and resources.