Ethics in the Treatment of Sexual Offenders Mansfield Mela, MBBS, MSc a , Adekunle Garba Ahmed, MBBS, LLM, MSc b, * INTRODUCTION Current clinical practices implicated as a source of ethical dilemmas in sex offender treatment are those that concern the superiority of public safety over the interests of patient, clients, or offenders (hereon referred as to patients). When pitched against the best interests of patients, the interest of patient stands no chance if it is consid- ered an either or matter. 1 Restricting the goals of treatment to the sole purpose of reducing the risk of recidivism not only limits the value of but also potentially replaces the traditional ethically informed therapeutic relationship and the joint collaborative goals that flow from it. Usually in a relationship, such as exists between therapist and patient, the voice of the patient is encouraged and is necessary in setting treat- ment goals and monitoring progress. When coercion is perceived or experienced, treatment is estimated as superficial, short lived, and lacking commitment. In a Department of Psychiatry, Faculty of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; b Divisions of Forensic Psychiatry and Addiction and Mental Health, Department of Psychiatry, University of Ottawa and the Royal Ottawa Health Care Group, Ottawa, Ontario, Canada * Corresponding author. E-mail address: ag.ahmed@theroyal.ca KEYWORDS  Sex offenders  Ethics  Treatment  Consent  Confidentiality circle  Dual agency KEY POINTS  Standardization of assessment procedures is essential.  Second opinions may be necessary in treating resistance cases and consenting procedures.  Current evidence of effectiveness is imperative in pharmacologic and psychosocial treatment.  Limits of acceptable behavior in the patient–therapist relationship depend on the balance of best interests of the patient and public safety.  Professionals should be aware of the implications of court-ordered mandated treatment.  Sex offender reporting and notification laws have produced mixed outcomes on treatment access and public safety. Psychiatr Clin N Am - (2014) -–- http://dx.doi.org/10.1016/j.psc.2014.03.008 psych.theclinics.com 0193-953X/14/$ – see front matter Ó 2014 Elsevier Inc. All rights reserved.