Forensic psychiatry: the need for self-regulation.

The shortcomings of forensic psychiatrists in the courtroom fall into two categories: failure to meet expected levels of performance in evaluation and testimony; and unethical behavior or deliberate misfeasance. Legal mechanisms for controlling the quality of testimony have been inadequate to the task. Courts rarely make use of their powers to screen expert witnesses with care; and post-hoc remedies, such as malpractice actions or charges of perjury, are almost unheard of. Psychiatry has been equally ineffective to date in responding to these problems, with educational programs usually reaching those least in need of help, and ethical codes either not addressing forensic issues or lacking powers of enforcement. Each class of problem calls for a distinct response. Inadequate performance in forensic work can be monitored and corrected by implementation of a program of peer review of forensic testimony. Preliminary attempts indicate the feasibility and utility of this effort. Unethical behavior, on the other hand, should be addressed by clear standards of forensic ethics, enforced by the relevant professional organizations. Forensic psychiatry bears the responsibility of cleaning its own house.