Nishiyama A
Department of Social Psychiatry, Tokyo Institute of Psychiatry, Japan.
Jpn J Psychiatry Neurol. 1994;48 Suppl:63-70. doi: 10.1111/j.1440-1819.1994.tb03040.x.
Psychiatric practices have been widely intervened by third parties, so that absolute confidentiality cannot be demanded. Forensic psychiatry holds a distinctive position in such practices. Ethics in forensic evaluations rely on the role of the psychiatrist. That role must be provided not only within the relationship with the truster, but also with the evaluee. The latter relationship has seldom been discussed. It is not therapist-patient-relationship, leaving some therapist attitude. A warning (lack of confidentiality, etc.) is necessary before the evaluation. Despite all, psychiatric evaluations cannot be conducted without some reliance. It is important to inform the evaluee of the evaluator's opinion prior to the trial, and involve the evaluee in the process of the evaluator's recognition.
精神科诊疗活动受到第三方的广泛干预，因此无法要求绝对保密。法医精神病学在这类诊疗活动中占据独特地位。法医评估中的伦理依赖于精神科医生的角色。该角色不仅必须在与委托方的关系中得以体现，还需在与被评估者的关系中体现。后一种关系很少被讨论。它并非治疗师与患者的关系，还保留着一些治疗师的态度。在评估前有必要进行警告（如缺乏保密性等）。尽管如此，精神科评估在某种程度上还是需要一定的信赖才能进行。在审判前告知被评估者评估者的意见，并让被评估者参与评估者的认知过程，这一点很重要。
