The consequences of impairment among medical practitioners and specialist psychiatrists as well as the under-reporting of impaired practitioners is a significant problem.

Prevention, early detection, intervention, and treatment programs that are more continuous more sensitive to the needs of impaired practitioners, that are more continuous, better structured, and rehabilitation and recovery focused, may be more likely to produce a positive outcome.

Although sexual relationships between medical practitioners and their patients have been forbidden by most professional and statutory bodies, the reported prevalence of sexual misconduct does not appear to have altered in the last 20 years. A recent Australian study has also suggested that psychiatrists are over-represented in comparison to others in the medical workforce. The reasons that may account for this finding are discussed, and issues which require further debate by the profession are outlined. These include the acceptability of post-termination relationships, the applicability of criminal statutes, the role of treatment in the management of offenders, and whether mandatory reporting of sexual misconduct should be considered.

Research on FASD has focused on medical/scientific findings (Gallicano, 2010; Jones, & Smith, 1973; Streissguth, Bookstein, Barr, Sampson, O’Malley, & Young, 2004). Continued medical research is thought to be helpful to our understanding of the origins of FASD and the interventions that help to address the psychosocial needs of persons with FASD. However, this paper stresses the need to also focus on the social aspects of FASD and the implications for human service workers who provide support for persons with FASD and their families. Gough and Fuchs (2006) indicate that although there is a growing prevalence of FASD-related disabilities, there is not a substantive knowledge base on child welfare practice in response to FASD. The need for human service workers to look beyond identifying a condition and addressing symptoms is emphasized. The author suggests human service workers need to prepare to work with children with FASD by reflectively appreciating the economic, legal, and cultural influences affecting persons as well as medically- and evidenced-based interventions.