The psychiatrist’s dilemma: a conflict of roles in legal executions*
Alfred M. Freedman, Abraham L. Halpern
In the United States, a critical controversy is taking place in regard
to psychiatrists’ and other physicians’ participation in legal
executions. Under pressure from the criminal justice system and
legislatures to expedite executions, some forensic psychiatrists
have succeeded in loosening traditional prohibitions against such
participation. Further, there has been a weakening of the
prohibition against treatment designed to facilitate immediate
execution of those condemned to death. The rationale offered for
these departures from current psychiatric ethical codes is the novel
notion that when a psychiatrist acts in the court or criminal justice
situation, that individual is no longer a psychiatrist and is not bound
by psychiatric ethics. Rather, the forensic psychiatrist, termed a
‘forensicist’, serves as an assistant in the ‘administration of justice’
or ‘an agent of the State’ and thus works in a different ethical
framework from the ordinary psychiatrist. This justification has
similarities to the rationale offered by physicians involved in human
experiments and other criminal acts in Nazi Germany, as well as
psychiatrists in the former Soviet Union who explained their
involvement in psychiatric abuse as a result of being agents of the
State and thus not responsible for carrying out orders. Clearly, this
controversy could be eliminated by a campaign for the abolition of
capital punishment, characterised by the American Psychiatric
Association as ‘anachronistic, brutalizing and] ineffective’. Such a
campaign should serve as a call for psychiatrists and other
physicians to join in the struggle to uphold ethical and moral
principles.