Forensic Psychiatry and Ethics
Core concepts
Understand the four ethical principles: autonomy, beneficence, non-maleficence, justice. Know confidentiality and its limits (risk to others, child protection, court order, public interest). Informed consent requires capacity, information, and voluntariness. Fitness to stand trial vs criminal responsibility (M'Naghten rules - knowing the nature of the act or that it was wrong). Distinguish the roles: treating psychiatrist vs expert witness. Understand involuntary detention criteria (mental disorder + risk to self/others + treatment available), least restrictive alternative, and the right to appeal. Know about testamentary capacity, advance directives, and guardianship. Cultural and legal variation across jurisdictions matters - the Arab Board context may test local mental health legislation principles.
Traps
Do not confuse fitness to stand trial (present ability to participate) with criminal responsibility (mental state at the time of the offence). Confidentiality is not absolute - risk to others overrides it. A psychiatrist treating a patient should not also act as an expert witness in the same case.
Rule of thumb
When confidentiality conflicts with serious risk to others, disclose the minimum necessary to the appropriate person - and document the reasoning.