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Forensic Evaluation and Treatment in the Same Institution: A Moral Dilemma (From Correctional Psychiatry, P 187-195, 1989, Richard Rosner and Ronnie B Harmon, eds. -- See NCJ-135571)

NCJ Number
135582
Author(s)
W S Packard
Date Published
1989
Length
9 pages
Annotation
This chapter examines the dilemmas and conflicts occasioned by having the same psychiatrist both treat and conduct court-ordered examinations of an inmate.
Abstract
Confidentiality becomes an issue when a psychiatrist has been treating an inmate prior to a court order that requires the psychiatrist to provide information to the court on the inmate's mental state. In such a case, the psychiatrist is fulfilling a legal function that may or may not be in the best interests of the inmate-patient. A second issue that can cause a dilemma is when the psychiatrist may feel that the duty to the inmate patient and the preservation of the therapeutic relationship are more important than meeting the need of the court. Inmates are often concerned about whether the information they divulge to a mental health professional will be obtained by others. In order to gain the inmate's trust and confidence, there may need to be a guarantee of confidentiality. An intrusion into this confidentiality by a court-ordered revelation of information and feelings shared in the treatment relationship may irrevocably damage the inmate's treatment. One resolution of the dilemma is for the psychiatrist to refuse to reveal any information obtained from the patient without the patient's express consent, except for situations where confidentiality does not exist, such as dangerousness to self or others and child abuse. 13 references