Appelbaum Paul S
New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
J Am Acad Psychiatry Law. 2008;36(2):195-200.
Twenty-five years ago, Alan Stone expressed his skepticism that forensic psychiatry could be practiced ethically. His remarks have proven a useful goad to the field, focusing attention on the importance of an ethics framework for forensic practice. But Stone remains dubious that any system of ethics--including the "Standard Position" on which he focuses his critique--could be of much value in practice. In contrast, I suggest that Stone's pessimism is not well founded. Immanent in forensic practice itself is a reasonable set of ethics principles, based on truth-telling and respect for persons. Psychiatrists can offer reliable and valid testimony, while resisting seduction into an advocacy role. Indeed, with new structured approaches to assessment, the potential utility of forensic testimony is probably greater than ever. Though problematic behavior still exists, forensic psychiatry offers the factual background and interpretive context to allow legal decision-makers to make better choices than they otherwise would.
25年前,艾伦·斯通对法医精神病学能否合乎伦理地开展表示怀疑。他的言论已被证明是该领域的一个有益刺激因素,促使人们关注法医实践伦理框架的重要性。但斯通仍然怀疑任何伦理体系——包括他所批判的“标准立场”——在实践中是否有多大价值。相比之下,我认为斯通的悲观态度没有充分依据。法医实践本身内在就有一套合理的伦理原则,其基础是讲真话和尊重他人。精神科医生可以提供可靠且有效的证词,同时抵制沦为辩护角色的诱惑。事实上,有了新的结构化评估方法,法医证词的潜在效用可能比以往任何时候都更大。尽管问题行为仍然存在,但法医精神病学提供了事实背景和解释背景,使法律决策者能够做出比没有这些背景时更好的选择。