Doctors on tribunals. A confusion of roles.

Abstract

Mental health review tribunals are required to apply legal criteria within a clinical context. This can create tensions within both law and psychiatry. To examine the role of the medical member of the tribunal as a possible mediator between the two disciplines. Observation of tribunal hearings and panel deliberations and interviews with tribunal members were used to describe the role of the medical member. The dual roles imposed on the medical member as witness and decision-maker and as doctor and legal actor create formal demands and ethical conflicts that are hard, in practice, either to meet or to resolve. The structure for providing tribunals with access to expert psychiatric input and advice requires reconsideration.