A note on responsibility in psychiatric practice On May 24, 2000, in Imola (near Bologna, Italy) a patient of a residential facility for chronic psychiatric patients committed homicide. The psychiatrist who was in charge of him (who is also the author of this contribution) and the residential facility’s director were judged guilty of manslaughter. This sentence, that is unprecedented in the history of Italian jurisprudence, is analyzed in detail, and its implications regarding the problems of patient’s dangerousness, physician’s responsibility, prevention, roles of the psychiatrist and of medication are discussed, together with the repercussions on Italian Law no. 180/1978 on psychiatric reform. On the Internet website of the Italian Psychiatric Association (SIP) (http://www.psichiatria.it) the court’s complete proceedings and an ongoing open discussion are published. [KEY WORDS: forensic psychiatry, dangerousness, custody of the patient, physician’s guilt, psychiatrist’s legal responsibility]