Ethics in forensic psychiatry: a cultural response to Stone and Appelbaum.

Dr. Alan Stone has argued that forensic psychiatrists lack clear guidelines about what is proper and ethical with respect to their professional activity and consequently, that they ought to stay out of the courtroom. Dr. Paul Appelbaum and others have responded to Stone's critique with proposals that provide a countervailing framework of ethical guidance for forensic psychiatrists. It is this author's contention that both sides in the debate have ignored the issues that are important to forensic psychiatrists who belong to culturally nondominant groups in the United States. As a result, African-American forensic psychiatrists are likely to be troubled by an ethics framework that ignores their special struggles linked to the matter of race. By gutting the debate of any reference to a cultural context, the participants have enunciated a culture-free theory of ethics that is an ineffective tool for the black professional. The author argues for a reworking of the theoretical reasoning behind the debate that would ultimately render the debate more relevant to the professional life of African-American forensic psychiatrists and those from other nondominant groups.