BMA guidance

Forensic and secure environments ethics toolkit

This toolkit is designed to help you navigate the main areas of ethical concern you are likely to encounter in your practice as a forensic physician, including consent, treating vulnerable patients and working with dual loyalties.

Location: UK
Updated: Friday 30 June 2023
Topics: Ethics
Justice scales article illustration

A sound grasp of ethical principles can help bring clarity to forensic doctors’ decision-making. In this toolkit, we outline these basic principles and give advice on how they can be interpreted in practice.


What you'll get from this guide

  • How to manage conflicting obligations between patient confidentiality and sharing information for forensic purposes.
  • Balancing your obligations to patients with concern for your own personal safety and wellbeing.
  • Ethical considerations for working with particularly vulnerable patients.


How to use this guide

This resource is not intended to be a comprehensive guide to ethical questions arising for forensic physicians. It signposts the ethical factors you need to take into consideration when making decisions.

We hope it will also provide useful guidance to other health professionals, as well as to those in management roles in the criminal justice system who work alongside forensic physicians.


  • Introduction to forensic and legal medicine
  • Guiding principles
  • Working with dual loyalties
  • Consent to examination
  • Privacy and confidentiality
  • The medical role in restraint and control
  • The use of segregation or solitary confinement
  • Managing risk and looking after yourself
  • Standards of care
  • Identifying abuse and raising concerns
  • Intimate body searches
  • Taking samples
  • Taking blood samples from incapacitated drivers
  • Assessing fitness for detention and other purposes
  • Vulnerable patients
  • Detainees under anti-terrorism legislation
  • Acting as professional and expert witnesses