Ethical Issues in Clinical Forensic Psychiatry

This work explores and discusses the ethical dilemmas clinicians face in everyday forensic psychiatry practice. We discuss and reflect on ethical issues involving treatment decisions such as antipsychotic polypharmacy, high doses antipsychotics and prescribing anti-libidinal medications. Ethical issues surrounding the use of technology for the management of mentally disordered offenders are explored in depth. The use of the polygraph test, a controversial method of truth facilitation for sex offenders, is discussed. Similarly, we discuss the use of "tagging" for serious offenders that despite being used in the United States of America for a while it has been heavily criticized and opposed. Tagging is gradually being introduced in the UK and other European countries, making consideration of the ethical issues and dilemmas surrounding its use both timely and necessary. This work is a valuable guide for clinicians working in forensic psychiatry settings, particularly when faced with ethical dilemmas concerning decisions around interventions.  

Dr.  Artemis Igoumenou is a medical doctor, trained in Forensic Psychiatry, but also General Adult Psychiatry and Psychiatry of Addictions. She has a PhD and a MSc in Mental Health, and she is a Fellow of the Higher Education Academy. Since July 2018 she is a Senior Clinical Lecturer in the Division of Psychiatry at University College London, and between February 2013 and August 2016 she was a Clinical Lecturer in Forensic Psychiatry, at the Barts and the London School of Medicine and Dentistry, Queen Mary University, London, UK. Clinically she is currently working in a High Dependency Locked Rehabilitation Unit and worked in the past in a number of forensic psychiatry settings including Therapeutic Community Services, Secure Units and prisons. Her academic duties spread over research and teaching. Her research focuses on factors that affect recidivism of mentally disordered offenders, particularly neuropsychological deficits. Dr. Igoumenou has researched both hospital and prison populations. Future plans for research include investigation of risk factors for self harm and institutional violence (in hospitals and prisons) and how these factors are associated with risk in the community. Her overall aim is to investigate causes for violence and to develop interventions that could stop violence from occurring, where possible. She is teaching risk assessment and management in mental health, in undergraduate and postgraduate courses in a variety of institutions (NHS, Universities, prisons). Ethical issues in clinical forensic psychiatry interest her as a clinician, as teacher and as a researcher.