David N. Weisstub

The theoretical relationship between law and psychiatry

As it becomes apparent that the justice system is uncomfortable with its goals and has the propensity to turn to psychiatry to launder its own public embarrassments, psychiatry is drawn by law into a forced, sometimes perverse, dialogue.’ Psychoanalysts, behavior therapists, and organically-oriented researchers join ranks to propose that the power of the legal system and its unanalyzed assumptions about the nature of human consciousness and freedom stand squarely in the way of a more harmonious and ordered society. Psychiatry cannot understand why it is that the legal system will not sustain and protect it in its attempt to realize a shared goal with a utilitarian and democratically-minded judicial order. Psychiatrists as a community are dismayed by the law’s aggressive language and its witch-hunting, the destruction of their clients, the intrusion into the privacy of the confessional, and the manipulation of their colleagues. Psychiatry is viewed as a body of professional expertise which is exploited to the advantage of the lawyer.’ It is argued that lawyers are adversarial by training if not by nature, that judges are judgmental by nature if not by training, and that psychiatrists are, in the main, humanists whose benevolence is accord-

Pour une distinction entre l'expérimentation thérapeutique et l'expérimentation non thérapeutique

La distinction claire entre la recherche et le traitement, la thérapie et non thérapie est essentielle à l’identification des responsabilités juridiques et éthiques du médecin-chercheur et les droits et attentes corrélatives du sujetpatient. Ces distinctions n’ont pas toujours été claires, particulièrement en présence de termes tels«soins innovateurs» et «recherche thérapeutique» dans la littérature scientifique. Au mieux, on décrit la recherche comme se situant sur une échelle continue dont les pôles sont l’expérimentation non thérapeutique et le traitement reconnu. Nous discutons également des questions d’éthique reliées aux essais cliniques randomisés et le rôle du médecin-chercheur.