Pivotal issues in forensic psychiatry

Objective and Method: This review examines the scope of forensic psychiatry with particular emphasis on its ethical and social implications. Some comparisons are made between the development of the subspecialty in Australasia and similar developments in the United Kingdom and North America, and the reasons for differences. Results: There has been inadequate debate in Australasia about some of the ethical issues relating to the practice of forensic psychiatry. Furthermore, Australian forensic psychiatry in particular has been slow to develop comprehensive and integrated services compared to other jurisdictions, and remains predominantly an assessment-based activity with primacy of the expert witness. Conclusions: Australasian psychiatry faces significant problems with respect to maldistribution of services. Governments are becoming more radical in their attempts to address this maldistribution and this has ethical implications for the profession itself and the practice of forensic psychiatry. Greater emphasis on the development of integrated and community-based forensic services, with leadership being provided by the profession itself, may deflect some of the present criticism, thereby allowing the subspecialty to more fully mature and develop with the approach of the new millennium.