In psychiatric and psychotherapeutic practice, 'boundaries' delineate the personal and the professional roles and the differences that should characterise the interpersonal encounters between the patient/ client and the professional. Boundaries are essential to keep both parties safe. The author outlines the various types of boundary violation that can arise in clinical practice, their consequences (both clinical and legal), how professionals can avoid them and how health care institutions might respond, should they occur. He concentrates on sexual boundary violations, because these have been the subject of most empirical study.Sameer P. Sarkar is a consultant in forensic psychiatry at Broadmoor Hospital (Crowthorne, Berkshire RG45 7EG, UK. E-mail: Sameer.Sarkar@wlmht.nhs.uk) and an associate in the hospital's psychotherapy department. He has studied law at the University of Northumbria at Newcastle and at Harvard Law School and has written on the law and ethics in forensic psychiatry. He teaches ethics of forensic psychiatry to psychiatrists and mental health professionals at two London medical schools. The opinions expressed are those of the author and do not reflect the opinions of West London Mental Health Trust, of Broadmoor Hospital or of the Ethics and the Law sub-committees of the Royal College of Psychiatrists, of both of which the author is a member.

Forensic psychiatry, as a medical specialty, perhaps understandably leans toward beneficence or welfare as its main ethical underpinning. However, the special nature of the art or science of forensic psychiatry makes it imperative that beneficence is not the only ethical principle that guides the 'good' forensic psychiatrist. Indeed, the commonest ethical dilemmas in forensic psychiatry arise from a conflict between two ethical principles: beneficence, or promotion of welfare, and respect for justice. These two paradigms dominate discussions about the moral role and ethical duties of forensic psychiatrists and, in effect, give rise to two different practices in forensic psychiatry, each of which can also be said to have acquired a national identity. We discuss these competing principles and offer some thoughts about what this means for the ethics and values of forensic psychiatry.

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Forensic psychiatry, as a medical specialty, perhaps understandably leans toward beneficence or welfare as its main ethical underpinning. However, the special nature of the art or science of forensic psychiatry makes it imperative that beneficence is not the only ethical principle that guides the 'good' forensic psychiatrist. Indeed, the commonest ethical dilemmas in forensic psychiatry arise from a conflict between two ethical principles: beneficence, or promotion of welfare, and respect for justice. These two paradigms dominate discussions about the moral role and ethical duties of forensic psychiatrists and, in effect, give rise to two different practices in forensic psychiatry, each of which can also be said to have acquired a national identity. We discuss these competing principles and offer some thoughts about what this means for the ethics and values of forensic psychiatry.

Protecting children and reducing social exclusion are the priorities