Recent debates in the ethics of forensic psychiatry have centered on the applicability of traditional medical ethics to forensic practice. Two prominent theories, one taking a principled approach and another taking a narrative approach, have attempted to resolve the tension between medical and legal settings. In this article we contend that the two theories are related closely and work at two different levels: principles at the level of theory and narrative at the level of application. We offer an approach to forensic ethics that reconciles competing theoretical views by relating professional role and personal integrity.