Forensic psychiatry, also known as psychiatry and the law, is a subspecialty of psychiatry with a separate 1-year, Accreditation Council for Graduate Medical Education-approved fellowship training program and subspecialty board certification by the American Board of Psychiatry and Neurology. Forensic psychiatrists practice at the interface of psychiatry and the law and apply scientific and clinical expertise in legal context, involving civil, criminal, correctional, regulatory, or legislative matters. Psychiatrists in the forensic role must honestly and respectfully balance competing duties to people and to society.
Forensic psychiatry is distinctive and, except for correctional psychiatry, does not constitute psychiatric medical practice even though it is governed by the ethical principles of psychiatry and medicine. Forensic examiners do not have a physician-patient relationship with the person who is being evaluated (referred to as the evaluee, who is not considered a patient). Under the auspices of the physician-patient relationship, treating physicians serve patients’ interests. However, forensic examiners do not treat or serve evaluees’ interests, but must be honest and strive for objectivity while assisting with expert opinions and legal processes. An expert opinion may or may not further an evaluee’s interests. For example, in a civil legal dispute, an evaluee (referred to as plaintiff in civil cases) seeking monetary compensation for psychic damages may not collect the desired compensation if the forensic examiner determines that the evaluee does not suffer from the alleged damages. In a criminal process, the evaluee (referred to as defendant in criminal cases) typically seeks to avoid responsibility/culpability by having criminal charges dismissed. However, the forensic examination may reveal that the evaluee was indeed culpable at the time of the alleged crime and the evaluee may face conviction and criminal punishment.
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Britta Ostermeyer, MD, MBA, FAPA
Psychiatric Annals. 2018;48(2):75-77