Here, we explore the thorny issue of the involuntary detention of those with ASPD (and those with psychopathic traits) for treatment. We use, as a frame, the recent history in the United Kingdom of attitudes using the changes in the legal designation of ‘psychopathic disorder’ whereby such individuals might be so detained. As there is undeniable evidence that those with the legal designation of psychopathic disorder are at higher risk of re-offending after discharge, psychiatrists were reluctant to admit them for treatment. This filtered down to the community so that those with a PD label were denied treatment. Faced with this dilemma, the government introduced the DSPD programme, whose rationale was underpinned by a defensible notion of both risk and treatability. We believe that, given the wide margin of error associated with both risk estimation and the efficacy of treatment (especially if the latter is imposed rather than consented to), this was unlikely to have a good outcome, and so it proved. We propose an alternative whereby sentencing and treatment of those with PD if convicted are uncoupled, thereby preserving a cordon sanitaire between the custodial and therapeutic realms.