Care or custody? Ethical dilemmas in forensic psychiatry.

Ethical dilemmas in forensic psychiatry have not, on the whole, been exposed to the same degree of scrutiny as other medical topics in the medical ethical literature. In this editorial, I will hope to show that forensic psychiatric practice raises many ethical dilemmas; not only practical, but also conceptual. Indeed the level of public debate following the publication of the Fallon report and new proposals for preventive detention of dangerous people suggest that these dilemmas also belong in the political sphere. Renewed attention to this area is therefore timely. In this editorial, I shall provide a brief overview of the many ethical dilemmas that arise in relation to the practice of forensic psychiatry. I shall use the four principles plus scope approach for my analysis. I will invert the usual discussion order; reflecting perhaps the relative importance of the diVerent principles in forensic psychiatry.