Freedman A M, Halpern A L
New York Medical College, New York, USA.
Aust N Z J Psychiatry. 1999 Oct;33(5):629-35. doi: 10.1080/j.1440-1614.1999.00625.x.
In the United States, a critical controversy is taking place in regard to psychiatrists' and other physicians' participation in legal executions. Under pressure from the criminal justice system and legislatures to expedite executions, some forensic psychiatrists have succeeded in loosening traditional prohibitions against such participation. Further, there has been a weakening of the prohibition against treatment designed to facilitate immediate execution of those condemned to death. The rationale offered for these departures from current psychiatric ethical codes is the novel notion that when a psychiatrist acts in the court or criminal justice situation, that individual is no longer a psychiatrist and is not bound by psychiatric ethics. Rather, the forensic psychiatrist, termed a 'forensicist', serves as an assistant in the 'administration of justice' or 'an agent of the State' and thus works in a different ethical framework from the ordinary psychiatrist. This justification has similarities to the rationale offered by physicians involved in human experiments and other criminal acts in Nazi Germany, as well as psychiatrists in the former Soviet Union who explained their involvement in psychiatric abuse as a result of being agents of the State and thus not responsible for carrying out orders. Clearly, this controversy could be eliminated by a campaign for the abolition of capital punishment, characterised by the American Psychiatric Association as 'anachronistic, brutalizing [and] ineffective'. Such a campaign should serve as a call for psychiatrists and other physicians to join in the struggle to uphold ethical and moral principles.
在美国，关于精神科医生及其他医生参与合法处决一事正引发一场激烈的争议。在刑事司法系统和立法机构要求加快处决速度的压力下，一些法医精神科医生成功地放宽了对这种参与行为的传统禁令。此外，对于旨在便利立即处决死刑犯的治疗的禁令也有所松动。对这些背离现行精神科伦理准则的行为所给出的理由是一种新奇的观念，即当精神科医生在法庭或刑事司法环境中行事时，该个体就不再是精神科医生，不受精神科伦理的约束。相反，法医精神科医生，被称作“法医专家”，充当“司法行政”的助手或“国家的代理人”，因而在一个与普通精神科医生不同的伦理框架内工作。这种辩解与纳粹德国参与人体实验及其他犯罪行为的医生所给出的理由相似，也与前苏联的精神科医生的理由相似，他们将自己参与精神科虐待行为解释为是国家的代理人，因此无需对执行命令负责。显然，这场争议可以通过一场废除死刑的运动来消除，美国精神病学协会将死刑描述为“过时的、残忍的且无效的”。这样一场运动应该呼吁精神科医生和其他医生加入到维护伦理和道德原则的斗争中来。
