Police surgeons play an important role in the British criminal justice system. Professionally located between the two worlds of medicine and the law, they face ethical dilemmas which derive from the dual nature of their role. The development of the police surgeon service has seen the emergence of three further dualisms within the police surgeon role. These are the forensic-therapeutic divide, the specialist-generalist division, and the issue of dependence or independence with regard to the police. These internal dualisms are discussed and their implications explored. Attention then turns to a consideration of three issues which demonstrate the nature of the ethical dilemmas facing the British police surgeon: the particular articulation of the (police) doctor-patient relationship, the matter of consent, and the subject of confidentiality. Both these ethical issues and the nature of the police surgeon role are explored through the primary analysis of survey and interview data collected from a national sample of police surgeons and police services, and the secondary analysis of key documents on the police surgeon, the paper concludes that specific ethical guidance is needed to address the forensic aspects of the police surgeon role.