Coping with the ethical conundra of forensic psychiatry: a tribute to Howard Zonana, MD.

As part of the Festschrift in honor of Howard Zonana, MD, this article reviews two important concerns that emerged in the ethics of forensic psychiatry in the resolution of which he played critical roles. In the late 1980s and early 1990s, the question arose of what role, if any, was proper for psychiatrists to play with regard to evaluations of competence to be executed and treatment of incompetent prisoners. Dr. Zonana was a major force in developing the American Psychiatric Association's position, in which the rights of prisoners were balanced with protection of the integrity of the medical profession. He was then deeply involved in helping to persuade the American Medical Association to reject a more extreme position and to adopt this approach. Similarly, in the mid-2000s, Dr. Zonana brought to the attention of the American Psychiatric Association (APA) the participation of psychiatrists in interrogation of detainees in national security settings. The policy that he subsequently helped to craft was adopted by APA and influenced the subsequent, very similar AMA policy. These two examples, of the many that could have been chosen, illustrate the profound impact that Howard Zonana has had on the ethics of psychiatry as a whole and on the ethics of forensic psychiatry in particular.