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Ethical Aspects of Long-Stay Forensic Psychiatric Care

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Long-Term Forensic Psychiatric Care

Abstract

Forensic psychiatry, as a medical profession within a multidisciplinary field of criminal justice and psychiatry, produces a wealth of moral dilemmas. This chapter will discuss some of these dilemmas, making reference to two of the four principles of biomedical ethics by Beauchamp and Childress: respect for justice and respect for autonomy. These principles will be addressed with the use of case studies. As forensic psychiatry is part of medicine, the principle for the respect of justice poses challenges as medicine is usually concerned with the needs to individual patients, unlike criminal justice where punishment comes into play. Respect for autonomy is a core principle in healthcare. However, in forensic psychiatry autonomy is a complex concept, e.g. due to the involuntary detainment of patients. Discussing ethical dilemmas in the context of forensic psychiatry issues arises at the level of patients, victims and society as a whole; others pose challenges for the system in itself. As the field is a complex field, new moral dilemmas occur on a daily basis and deserve further academic research.

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Notes

  1. 1.

    The topic of this book is long-term forensic psychiatric care. In this context, whenever the terms “forensic psychiatry”, “forensic long stay” or “long stay” are used, this refers to long-term forensic psychiatric care.

  2. 2.

    With this argument, Fried is addressing Robert Nozick’s libertarian property rights. The problem she stipulates is similar to formal theories of justice. Due to the nature of formal theories, they do not contain content. A famous example of a formal rule is “always tell the truth”. Prima facie, this seems to be a rule most people would agree to follow. However, if, for instance, during WWII one was hiding a Jewish family and the Nazis knocked at the door, would it be wrong to lie? Or should one be honest at the expense of the Jewish family?

  3. 3.

    Anne Faber was a 25-year-old woman who was killed and raped by an offender with a history of two counts of rape. He refused to be examined for admission to forensic–psychiatric care in 2010 and therefore received a prison sentence and was released in 2017.

  4. 4.

    For a full discussion of this subject see O’Neill 2002 Autonomy and Trust in Bioethics, Cambridge, UK, Cambridge University Press.

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Authors and Affiliations

  1. Centre for Forensic-Psychiatric Treatment, Pompestichting, Nijmegen, The Netherlands

    Peter Hettema MA

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  1. Peter Hettema MA
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Editors and Affiliations

  1. Forensic Psychiatric Hospital, University Rostock, Rostock, Germany

    Birgit Völlm

  2. Pompe Foundation Department LFPC, Forensic Psychiatric Hospital, Zeeland, The Netherlands

    Peter Braun

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Hettema, P. (2019). Ethical Aspects of Long-Stay Forensic Psychiatric Care. In: Völlm, B., Braun, P. (eds) Long-Term Forensic Psychiatric Care. Springer, Cham. https://doi.org/10.1007/978-3-030-12594-3_5

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  • DOI: https://doi.org/10.1007/978-3-030-12594-3_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-12593-6

  • Online ISBN: 978-3-030-12594-3

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