As clinicians, psychiatrists are unequivocally dedicated to relieving the suffering of those who are afflicted with mental disorders. However, the public and those individuals, who are assessed, find it difficult to draw a distinction between forensic psychiatrists acting in a clinical role and the very same professionals acting in an evaluative role, on behalf of the state. This paper examines the ethical issues raised by psychiatric involvement in the sentencing process. It rejects the view that a forensic psychiatrist, who undertakes an evaluation for the state, is to be considered as an advocate of justice who is not bound by conventional ethical duties to the individual whom he or she assesses. It contends that the forensic psychiatrist has an important role to play in presenting evidence that may result in the mitigation of the sentence that may be imposed on a person who is mentally disordered. The paper will focus on these issues in the particular context of the situation in England and Wales, Canada and the United States.