Do forensic mental health services have an ethical duty towards victims of mentally disordered offenders?

Despite important changes in the rights of victims of crime and their role in influencing public policy across most jurisdictions, victims of mentally disordered offenders are often neglected in public discourse. They are also neglected in clinical discourse by forensic practitioners who are responsible for the care and treatment of mentally disordered offenders. In England, as in other countries, this duty is outsourced to public sector agencies for the most part. This review sets out to understand what has been written about ethical obligations of forensic practitioners towards victims. An examination of literature on ethical dilemmas commonly encountered in forensic mental health services has found that most of the existing literature focuses on issues such as the dual obligation nature of the specialty and the difficulties of promoting autonomy in long-term incarceration, with relatively little written about ethical obligations towards the victims of our patients. Some of the ethical and clinical arguments for including victims in our thinking are described, considering the Principlist approach of biomedical ethics, as well as other approaches including relational and communitarian ethics. Some implications for practice are considered.