case study:
In Montana, a 32 year old man who has been diagnosed with schizophrenia has been in a maximum security hospital for just over 20 years. Due to him assaulting other patients numerous times, he has been placed under solitary confinement where he comes in no contact with any patients not even at mealtime. The majority of the attacks were sudden and completely unexpected. During these the patient experienced delusional beliefs about his power while he injured fellow patients. However, solitary confinement has not improved the patients mental state and there is controversy about allowing him to come into contact with the others. The controversy revolves around the idea of using a mechanical restraint while he was around others. There is no legal framework to support the use of mechanical restraint for mental illnesses which causes anxiety about the use of it in a maximum security hospital.
Another outcome?
I think I would have kept the patient in solitary confinement because even if you used the mechanical restraint and slowly returned the patient to a social environment, another incident could still occur. The patient had a history of random violent outbreaks and there is no telling if another one would occur. I do not think it's worth risking the health and safety of the other patients and staff to try and help one who has a mental issue and can;t make decisions for himself.
cons:
The forensic psychologist faces many challenges such as considering both the patients and employees needs and safety, decision to use mechanical restraint, use of physical treatment without consent, conflicts with the four principals plus scope, and the publication of case histories such as the one described above. The balancing of both the patient's and employees needs is a difficult task because if the patient poses a threat, there is a high risk of putting the employee in harms way. This leads to the conflict of using mechanical restraint to prevent such incidents from occurring without having to separate the patient entirely. Another difficulty includes the use of physical treatment without consent because some patients may not have the mental capacity to make these choices so it is up to the psychiatrist to make the decision. The four principals plus scope is an ethic code that helps psychiatrists make these hard choices. The four principals are as follows, respect for autonomy, beneficence, non-maleficence, and justice; although these principals face limitations the psychiatrist must deal with. Lastly, there are many ethical complications about publishing case histories on patients because they can not always give written consent.
Pros:
There are also many benefits of becoming a forensic psychiatrist such as high earnings, flexible hours, helping others, exciting field of work, and some enjoy giving testimonies. Psychologists make an average of $87,960 per year which is significantly higher than the average for all occupations which was $46,440. They also have flexible hours, especially since one third of psychiatrists are self-employed, and can schedule their appointments based on what works for them. Many psychiatrists agree that the most rewarding part of their profession is knowing that they help improve other people's lives in some way. Forensic psychiatry is also provides a thrill without the major risks that exist in professions like police work. Finally, some enjoy giving testimony at trials because it has a bit of a competitive nature and allows for collaboration with attorneys.
Do the pros outweigh the cons?
In my opinion I believe the cons outweigh the pros. A forensic psychiatrist faces difficult ethical choices that can be almost impossible to make and requires a certain type of personality to handle that kind of pressure. They have to hear painful and awful stories and watch people completely lose their minds. I think it is a career for those who have a strong desire to help others and those who can easily separate work from their personal life so the stories don't depress them. I have the utmost respect for people who choose this career path and are able to help the people who need them.
Works cited:
- Sen, P., Gordon, H., Adshead,, G., & Irons, A. (2007, June 1). Ethical dilemmas in forensic psychiatry: two illustrative cases. . Retrieved June 15, 2014, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2598271/
- The Pros and Cons of a Career in Forensic Psychology. (n.d.). Online Psychology Degree Guide. Retrieved June 15, 2014, from http://www.onlinepsychologydegree.info/faq/the-pros-and-cons-of-a-career-in-forensic-psychology/
- What Are the Benefits of Being a Psychologist?. (n.d.). . Retrieved June 15, 2014, from http://degreedirectory.org/articles/What_are_the_Benefits_of_Being_a_Psychologist.html