Founder of Modern Forensic Psychiatry Honored With Guttmacher Award

Robert Sadoff, M.D., was there in spirit, if not in person, when the book he edited, The Evolution of Forensic Psychiatry (Oxford University Press, 2015), received the 2017 Manfred S. Guttmacher Award. The award, cosponsored by APA and the American Academy of Psychiatry and the Law (AAPL), recognizes an outstanding contribution to the literature of forensic psychiatry.

Sadoff, a professor of psychiatry at the University of Pennsylvania, died on April 17. He was represented at the award presentation during APA’s Annual Meeting in San Diego by several contributors to the book and other colleagues.

Kenneth Weiss, M.D., a clinical professor of psychiatry at the University of Pennsylvania and one of the book’s chapter authors, read a statement written by Sadoff earlier this year when he became ill and anticipated that he wouldn’t be able to attend the Annual Meeting. He hoped the book would present “the current history of the field, the outstanding programs teaching concepts and practices, and proposals for future development,” wrote Sadoff, who was one of the eight founding members of AAPL in 1969. He also wanted to integrate forensic psychiatry into other aspects of the field, like child and adolescent psychiatry, geriatric psychiatry, addiction psychiatry, and correctional psychiatry, as well as with psychology, nursing, criminal justice, law, and law enforcement.

Another speaker, Octavio Choi, M.D., Ph.D., was a forensic fellow at Penn under Sadoff and Weiss in 2011-2012. The difference between psychiatry in general and forensic psychiatry was clear, said Choi, now an assistant professor of public psychiatry at the Oregon Health and Science University and director of the Forensic Evaluation Service at Oregon State Hospital.

“The goal of treatment is to help the patient, but the goal of forensic psychiatry is to seek justice and truth while respecting the rights of those who are examined,” he said. “Our work can harm those whom we evaluate.”

The forensic psychiatrist must follow the law and ethical guidelines, but the criminal justice system has intentional “harms” built in such as imprisonment, Sadoff taught his fellows and colleagues. The effects can be minimized by showing respect, sensitivity, and kindness toward individual evaluees, said Choi. “Bob was a highly compassionate person who worked in an adversarial system in which certain harms are unavoidable.”

In the message read at the Annual Meeting session, Sadoff pointed to the growing body of work in neuroscience and its potential for use in forensic psychiatric assessment. That potential was still unclear, although it is being used more often in courtrooms, said Choi.

“The brain is a complex structure, and it is difficult to explain behavior from brain activity and structure in individual cases,” said Choi. “Good brains can produce bad actions and vice versa. Courts care about individual cases, and it is hard to go from general research findings to individual cases.”

In reality, neuroscientific evidence can serve to generate hypotheses that can be tested with neuropsychiatric tests and close analysis of the behavior of the person being evaluated, he said. Neuroevidence that converges with other evidence of behavior can play an important supportive role.

Choi urged his audience to live up to Sadoff’s spirit. “I think we need to struggle to master the challenge he set forth—to live life fully with open eyes and sensitivity and awareness, a life in which the ethical practice of psychiatry arises simply as a manifestation of the practice of kindness and respect for others. Thank you, Bob, for letting me know it’s possible and showing me how it’s done.”

The Isaac Ray Award was also presented in this session. This award, which recognizes outstanding contributions to forensic psychiatry, was given to Joseph Bloom, M.D., who has served as chair of the department of psychiatry and dean of the school of Medicine at Oregon Health and Science University. He is a past president of AAPL, the American Board of Forensic Psychiatry, the Oregon Neuropsychiatric Association, and the Oregon Psychiatric Association.

Bloom has written or edited more than 130 papers, book chapters, and other publications on involuntary commitment, the right to refuse treatment, the insanity defense, dangerousness, duty to warn, and competency to stand trial, said former APA President Renȳe Binder, M.D., when presenting the award.

“Joe is not only an excellent researcher and scholar, he is also an exceptional mentor of younger colleagues as they begin their academic careers,” said Binder. ■