With reference to case studies, or any other relevant scenarios (articles, news, etc) as examples, critically...

Answer:-

ethical diaelectrical principle:-

Most forensic psychiatrists occasionally face complex situations in forensic work in which ethics dilemmas cause discomfort. They want to determine the most ethical action, but the best choice is unclear. Fostering justice is primary in forensic roles, but secondary duties such as traditional biomedical ethics and personal values like helping society, combating racism, and being sensitive to cultural issues can impinge on or even outweigh the presumptive primary duty in extreme cases. Similarly, in treatment the psychiatrists' primary duty is to patients, but that can be outweighed by secondary duties such as protecting children and the elderly or maintaining security. The implications of one's actions matter. In forensic work, if the psychiatrist determines that he should not assist the party who wants to hire him, despite evidence clearly supporting its side, the only ethical option becomes not to accept the case at all, because the evidence does not support the better side. Sometimes it can be ethical to accept cases only for one side. In ethics-related dilemmas, I call the method of prioritizing and balancing all types of conflicting principles, duties, and personal and societal values in a dialectic to resolve conflicts among them dialectical principlism. This approach is designed to help determine the most ethical action. It is aspirational and is not intended to get the psychiatrist into trouble.

In forensic contexts, most psychiatrists are uncomfortable from time to time with the roles that they are asked to assume. This discomfort can represent many things. It does not necessarily reflect ethics concerns and does not necessarily mean that they should not accept the case. For example, their discomfort could be based on bias and prejudice. I will focus on what the psychiatrist should do if asked to perform an evaluation in a case where he thinks it might be wrong to do what is asked without considering other factors.

First, the forensic psychiatrist might check the American Academy of Psychiatry and the Law (AAPL) Ethics Guidelines¹ and Questions and Answers,² only to find that what he has been asked to do violates no guideline; but it may still seem wrong. Some might argue that if it is possible to give a reasonably objective opinion and the position that the hiring party wants the psychiatrist to take seems valid, then he should just put blinders on, accept the case, and ask no further questions. Some might speculate that the hindrance is inappropriate therapeutic bias, and as a forensic psychiatrist, one must be resolute in avoiding that bias. In some extreme circumstances, though, concern for the person to be evaluated because of his potential to cause severe harm and other factors can have relevance in a forensic context. In my opinion, the question of whether what the psychiatrist is being asked to do is wrong is a legitimate one that requires further exploration.

When a prospective case causes discomfort, further analysis is needed, because the problem could be ethics based. Ethics-related discomfort must be distinguished from other types of discomfort, such as prejudices and concerns about displeasing a referral source, rejecting an opportunity, or hurting someone; but an ethics dilemma must be addressed.

One example is being asked to take a case for an organization such as the Ku Klux Klan (KKK). The facts may support their position, but associating with such an organization may cause extreme personal discomfort.

Another example is a request to evaluate an individual involved in a high-profile case. It first seems like a great opportunity that can generate more referrals and help one's forensic career. A review of the material provided, however, reveals little evidence for the view the attorney desires.

Ethics challenges also arise when a forensic psychiatrist is asked to assist the prosecution in the penalty phase of a capital case in which the only sentencing options are death or life without the possibility of parole. The prosecutor is interested only in identifying the aggravating circumstances that would support a death sentence.

The Method of Dialectical Principlism

Analysis of an ethics dilemma first starts with the specific context and then determines which duties are primary and which are secondary for that particular role. Then, a balance must be struck between competing duties and principles, weighing the primary duties against secondary duties of all types. Next, conflicts must be resolved among principles and duties in such a way as to have them impinge as little as possible on each other. Afterward, the weighted principles are applied to the situation in question. Those with less weight and importance in the situation may have little or no impact and in the interest of reducing complexity do not enter into the decisional equation.

I am referring to principles here in the broadest sense of the term. By that I mean, for example, the principle of fostering justice and answering the legal question honestly and as objectively as possible, the principles of biomedical ethics, the principle of meeting societal expectations of the forensic psychiatrist's role, the principles reflected in one's personal values, and the principle of providing for one's family and oneself, among such principles.

Challenging cases present ethics dilemmas causing the greatest initial discomfort, but I believe an equal or greater satisfaction occurs when the dilemmas are resolved. This article presents a framework to help in achieving the most ethical conclusion possible when faced with such difficult circumstances.

I call this method of prioritizing and balancing all significant conflicting principles for the purpose of determining the most ethical course dialectical principlism. Dialectical describes a method (originated in ancient Greece) by which apparently contradictory and competing considerations can be synthesized into a coherent whole to guide one's actions. The term emphasizes the need not to be purely situational and subjective, but instead to focus on the more generalizable principles deriving from a narrative. Competing principles must then be prioritized, weighed, and balanced, with the goal of resolving conflicts among them with minimal intrusion of one on the other. Last, the weighted principles are applied to the context in question. I will demonstrate what I mean later.

Dialectical principlism accepts as legitimate the appropriate uneasiness many, if not most, forensic psychiatrists feel in some extreme situations that raise ethics-related concerns and provides a method to help analyze and resolve ethics dilemmas. The method helps identify, prioritize, weigh, and balance conflicting considerations in a dialectical manner in which considerations compete to reach a determination of the most ethical course of action