Forensic Ethics

In the September 7 issue, Jack Schoenholtz, M.D., is quoted as saying: “We should not medicate [Russell] Weston to have him appear competent to stand trial. The job of the doctor here must not be to serve the interests of the state.”

This is, obviously, his opinion; it is not an ethical principle binding on us all. Every day in this country unwilling criminal defendants are made to give blood specimens, buccal swabs, and possibly other materials, since the Fifth Amendment protection does not apply in these situations. These specimens are then processed by forensic physicians, who are clearly serving the government interest in having criminal cases adjudicated using the best available evidence. Nobody suggests that these physicians are unethical.

Whether a criminal defendant is best presented at the bar of justice at his psychotic baseline or in a state of medicated sanity is for the courts to decide and, as the article itself pointed out, judicial opinion on this issue is evolving. However, once the courts have spoken, there is no ethical bar to restoring the defendant to the highest functional level attainable, and the kinds of justifications that Dr. Schoenholtz is reported to be offering are totally unnecessary.