In this paper, we analyze the concept of objectivity as it is accepted in the ‘standard position’ on ethical practice in forensic psychiatry and confront it with the current trends of psychiatric nosology, specially the debate that we have now regarding the theoretical orientation of DSM-5, which is intended to be more based on neuroscientific more than on clinical data, as has been the tradition in psychiatry so far.
In view of those elements, we review the skeptical position about the ethics of forensic psychiatry and the obstacles that, in my opinion, are still standing according to Stone's proposal: the fact–value distinction, determinism vs. free will, the deconstruction of the self, the mind–brain problem, and the chasm between morality and normal science. In my opinion the objections made by Stone on the feasibility of forensic psychiatry in the courts continue in full force, to the extent that these objections are the heart of the debate about the theoretical orientation of the DSM-5.
The advocates of the standard position have an overly optimistic view of the capacity of objectification of forensic psychiatry. This problem has also been revealed in the intense debates on the direction of the DSM-5 in general psychiatry, a draft of which appears excessively based on neuroscience and little on traditional clinical practice.
Department of Psychiatry, Hospital Gregorio Marañón, Ibiza, Madrid, Spain
Correspondence to Alfredo Calcedo-Barba, Department of Psychiatry, Hospital Gregorio Marañón, Universidad Complutense de Madrid, Spain E-mail: firstname.lastname@example.org