n African Journal of Psychiatry - The prostitution of psychiatry : some are shameless, others are just easy : forensic forum

Volume 15, Issue 5
  • ISSN : 1994-8220



Most psychiatrists are consistently ethical and professional. But there are some who are known to be 'hired guns', that is, they will produce assessments and reports according to the desires of those who engage their services. They usually operate in those areas of practice that are relatively free from regulation and accountability, such as the psycholegal and drug research arenas. This must be distinguished from our usual (and ethical) advocacy role (to get the best care for our patients) that the fiduciary relationship demands. 'Hired guns' cynically manipulate psychiatric diagnoses and assessments, and in effect prostitute the values of our profession. They appear to be acting as advocates for the best interests of their clients, but actually cleverly exploit the ambiguities and weaknesses that do bedevil our discipline, in order to achieve outcomes that most of their colleagues would consider an abuse of psychiatry. An obvious example that springs to mind is the psychiatrist who supported his client's claim against McDonalds on the grounds that she had suffered PTSD when a waiter spilt hot coffee in her lap (she lost the case).

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