Psychiatric presentence reports can originate in several ways, depending on the laws of a particular jurisdiction. The diagnostic and therapeutic aims of these reports are consistent with the psychiatrist's therapeutic role, but in criminal sentencing the main legal concern is appropriate punishment. Thus, psychiatrists face the dilemma of whether to address dispositional issues such as the severity of sentencing or whether to address such issues only when favoring leniency. Even if psychiatrists follow the recommendation of the American Psychiatric Association Task Force and does not address disposition, they must remember that any effort to protect the public has security implications and that even clinical conclusions alone can affect the severity of punishment. Therefore, psychiatrists should aim for the ideas of both clinical and legal integrity. 46 references (Author summary modified)