In the wake of Ake: the ethics of expert testimony in an advocate's world.

The decision of the U.S. Supreme Court in Ake v. Oklahoma redefined the role of psychiatrists as experts in criminal cases. In addition to the expert's serving as evaluator and witness, the Court stressed the importance of the defense having a psychiatrist available to act as a consultant in the preparation and presentation of its case. This broader conception of the expert's role has raised ethical questions among psychiatrists, many of whom are concerned that their impartiality may be compromised. A careful analysis of Ake, however, demonstrates that substantial differences remain between the roles of consultant and advocate. Subtle pressures on impartial functioning will be increased, but they will not differ in kind from those operative before the decision. Several ethical issues related to the consultative role are considered and possible means of dealing with them addressed.