Doctors on tribunals - A confusion of roles

Background Mental health review tribunals are required to apply regal crite ria within a clinical context. This can create tensions within both law and psychiatry. Aims To examine the role of the medical member of the tribunal as a possibl e mediator between the two disciplines. Method Observation of tribunal hearings and panel deliberations and intervi ews with tribunal members were used to describe the role of the medical mem ber. Results The dual roles imposed on the medical member as witness and decisio n maker and as doctor and legal actor create formal demands and ethical con flicts that are hard, in practice, either to meet or to resolve. Conclusions The structure for providing tribunals with access to expert psy chiatric input and advice requires reconsideration. Declaration of interest Funding received from the Economic and Social Resea rch Council, award no. R000 237 006.