The insanity defense: asking and answering the ultimate question

The authors address the main questions in the insanity defense debate: Should it be abolished? Should psychiatrists participate as expert witnesses? Is the profession damaged by such testimony? Is there a logical leap between providing psychiatric findings and providing an opinion to the ultimate question? Because the free will/determinism model underlying the current insanity defense positions can be used to argue either side of the debate, it does not supply any rational answers. The authors reframe the discussion, using a systems approach, and suggest answers to these questions that are in line with the clinical realities and on a firmer philosophic ground.     

The psychiatrist's guide to right and wrong: judicial standards of wrongfulness since M'Naghten

In insanity defense litigation, the precise legal definition of wrongfulness is often critically important. References in the M'Naghten Rules to the appropriate standard of wrongfulness were ambiguous, resulting in a divergence of judicial opinion as to whether wrongfulness means legal wrong, subjective moral wrong, or objective moral wrong. This article reviews and analyzes these three judicial standards of wrongfulness in the context of case law from jurisdictions that follow each of the respective standards. The evolution of knowledge of right and wrong tests of criminal responsibility is traced back to its philosophical roots. Most psychiatrists claim no expertise in matters of morality or law. The American Psychiatric Association would bar psychiatric expert testimony on the ultimate issue of insanity, on the grounds that there are "impermissible leaps in logic" when psychiatrists opine on the probable relationship between medical concepts and moral-legal constructs. Whether or not they testify on the ultimate issue, psychiatrists should ascertain the applicable standard of wrongfulness in order to properly relate their findings to the relevant legal criteria for insanity and thereby enhance the probative value of their testimony.     

Predicting verdicts,adherence to judge's instructions,and assumptions about the disposition of the defendant in a case involving the insanity defense

Abstract

296 college students and jury eligible adults completed attitudinal measures and read a case summary of a murder trial involving the insanity defense. The case summary included opening and closing arguments, testimony from expert witnesses, and judge's instructions. Although broader legal attitudes (the PJAQ) predicted verdicts, the Insanity Defense Attitudes-Revised scale provided incremental predictive validity. Attitudes related to the insanity defense also predicted adherence to judge's instructions, whereas more general legal biases predicted a juror's willingness to change their verdict after being provided with accurate information about the defendant's disposition following the verdict. Importantly, misconceptions concerning the insanity defense impacted verdicts and many jurors made decisions that failed to adhere to the judge's instructions, though the nullification tendency does appear to vary as a function of pretrial juror attitudes. Implications for instructing jurors in insanity defense cases will be discussed.     

The psychiatrist's guide to right and wrong: Part III: Postpartum depression and the "appreciation" of wrongfulness

Whether or not the psychiatrist testifies on the ultimate issue in insanity defense cases, it is critically important that he familiarize himself with the applicable legal standards and interpretations in order properly to relate his clinical findings to the relevant criteria for insanity and thereby enhance the probative value of his testimony. This is the third in a series of articles which attempts to explicate judicial and statutory standards of insanity and correlate them with the psychiatrist's findings of psychopathology. This article analyzes the Model Penal Code formulation of insanity, with special emphasis on the all important distinction between "know" and "appreciate." This formulation permits the defendant possessed of mere surface knowledge or cognition to be exculpated, requiring that he have a deeper affective appreciation of the legal and moral import of the conduct involved if he is to be held criminally responsible. The Model Penal Code approach more readily lends itself to application as a standard of responsibility in cases involving affective disorders. An important disorder within this group, postpartum depression, is discussed in the context of raising the insanity defense in a case of infanticide.     

司法实务中用法律精神病替换临床精神病的思考

对《刑法》第18条"精神痛"的理解,法学界和医学界的一些人观念中有整体偏差,致使法律对健康人群的保护不够,纠偏的有效措施是用法律精神病替换临床精神病。     

United States v. Lyons: toward a new conception of legal insanity

In United States v. Lyons (1984), the U.S. Fifth Circuit Court altered its definition of legal insanity to conform with recent recommendations of the American Bar Association and the American Psychiatric Association. This paper briefly reviews the social and legal context of the Court's ruling. The author then discusses the insanity defense's rationale and suggests an interpretation of the Court's new definition that should guide psychiatric testimony.     

The psychiatrist's guide to right and wrong: Part IV: The insanity defense and the Ultimate Issue Rule

In the wake of Hinckley, widespread public dissatisfaction with the role of psychiatrists in insanity defense litigation prompted Congress in 1984 to amend the Federal Rules of Evidence to prohibit psychiatric testimony on the ultimate legal issue of whether or not a defendant is insane. APA's Statement on the Insanity Defense served as the ably articulated premise for this evidentiary amendment. APA argued that in going beyond their psychiatric expertise by answering ultimate issue questions as to whether defendants are legally insane, experts are likely to confuse the jury and undermine public confidence in psychiatry. APA also asserted that there was an impermissible logical leap between scientific psychiatric inquiry and moral-legal conclusions on the ultimate issue of insanity. This article reviews the origins, history, and vicissitudes of the Ultimate Issue Rule and analyzes the Statement on the Insanity Defense from both a legal and psychiatric perspective on the issue of whether psychiatrists should answer the ultimate question in insanity cases. The analysis suggests that APA's conclusions are not supported on scientific or evidentiary grounds, but may be warranted as a policy consideration to safeguard the public image of psychiatry.     

Deconstructing the Criminal Defence of Insanity

The significance of this article is in its deconstruction of the criminal insanity defence in a meta-legal critical context. The article’s objective is to critically review beliefs that the insanity defence was designed solely for public protection from insane violent people, or, for criminal deterrence. Arising from the long and continued use of the Roman Law concept of non compos mentis, the question arises as to what has become of the practical meaning of the term “insanity”, when used as a defence. The article tries to show that the defence of insanity is a public act of judicial denunciation against the accused, while the accused may have no effective responsibility for the crime. Argument begins with a critical discussion on the character of common-place denunciation as an appeal to public agreement. Then, it follows how the idea of “manifest criminality”, of the 1800s, might be cognate to modern ideas of “manifest madness”, linking into the origins of the English special verdict of insanity. This will allow a short critical analysis of the M’Naghten Case. Argument is completed with analysis of a psychologists’ expert construct of insanity and its relationship to jury perception. The article will suggest strongly that arguments based on the common law rules of insanity tend to expose juries more to denunciation of the accused, than to a reasoned account of the nature of his insanity and to the defects in his responsibility. Duly persuaded jurors would tend to acquiesce and participate in the denunciation of an accused person, whose unusual and unhealthy behaviours emanated from his sufferings by dint of his unbearable circumstances.     

The Impact of Insanity Acquittees on Missouri's Public Mental Health System

Even though state departments of mental health have primary responsibility for the care, custody, and treatment of insanity acquittees, the impact of insanity acquittees on the public mental health system is generally lacking in policy discussions and as a topic for policy research. This issue has received increased attention in Missouri, where insanity acquittees now occupy half of the long-term public psychiatric hospital beds. This article examines the presence of Missouri's insanity acquittees on the state's public mental health system and includes the impact on goals, fiscal costs, inpatient and community psychiatric services, and inpatient treatment staff. As states consider managed care and other cost containment measures, it remains to be seen if the high costs associated with extensive use of hospitalization of insanity acquittees to promote public safety will influence policy changes to more community-based insanity acquittee systems.     

‘Madness is a Woman’: Constance Kent and Victorian Constructions of Female Insanity

Puerperal insanity has attracted significant academic attention in cases of Victorian child killing when mothers killed their young children. This article expands the focus of the puerperal insanity narratives in order to address how, or whether these discourses influenced the wider realm of female insanity. By using the Constance Kent case as an exemplar the article explores how medical and legal ‘tests’ translated into a social conception of female insanity. The preponderance of press reports and the decisions reached suggest insanity came to be a ready social answer when women killed children.     

论我国拒证推定规则的完善——还其推定之本来面目

我国《证据规定》第乃条所规定的拒证推定规则没能够充分体现推定之基本特征，给予法官自由心证的空间过大，阻碍了拒证推定规则本身所具有的有利于实现诉讼经济等优势的发挥。《证据规定》第75条所规定的拒证推定规则应被还以推定之本来面目，并且其本身的运用不应使当事人之间的证明责任发生转移。     

Barring ultimate issue testimony

This research focuses on one of the major changes wrought by the Insanity Defense Reform Act of 1984: the exclusion of expert mental health testimony on the “ultimate issue,” that is, testimony specifically addressing the expert's opinion that the defendant is sane or insane. Subjects in this research were presented with 1 of 10 variants of an insanity case in which experts testified for the defense, prosecution, both, or neither. The testimony was at one of three levels: diagnostic only, penultimate issue, or ultimate issue. Results showed that level of testimony had no effect on the verdict pattern. There was evidence to suggest that this effect may occur because jurors infer, and/or mistakenly recall, higher levels of expert testimony than was actually presented to them. In addition, general and specific constructs (Finkel & Handel, 1989) that predict verdict yieldedR ² values from .500 to .668 and were not significantly affected by the level of expert testimony. Implications of these findings are discussed.     

Spontaneous hypnosis in the forensic context

"Hypnosis" denotes either specific phenomena (altered volition, perception, cognition, and recall) or interpersonal transactions that often elicit them. Basic research leads to paradox: hypnosis is validated, and shown to be dissociative in essence, at the same time that neither its phenomena nor transactions can be separated from those of everyday living without logical absurdity. This paradox can be resolved by assuming that consciousness and volition are complex, occurring simultaneously at many levels in the same waking individual. Hypnotic-like phenomena and transactions occur spontaneously, in either covert or overt forms. The former are pervasive, whereas the latter are often associated with psychological trauma. Forensic implications are twofold: for criminal responsibility, and the reliability of eyewitness testimony. Hypnotic-like states and transactions are rarely affirmed as an insanity defense because at some level these subjects are aware of what they are doing and why. Diminished capacity and mitigation of sentence are more appropriate defense strategies. Several conflicted traditions of case law have evolved to protect eyewitness testimony from hypnotic-like distortions in cognition, perception, and memory that can occur either during or outside of formal hypnotic procedures. These include the admissibility of posthypnotic testimony, due process safeguards at eyewitness identification procedures, and the admissibility of expert testimony on the findings of eyewitness research. These areas are inseparable from one another and demand a systematic coordinated approach.     

The military insanity defense

This article describes the military insanity defense. The success of the litigated insanity defense is explored through the number of insanity acquittals over a 28-month period. A questionnaire distributed to all United States Army psychiatrists provided information on the number of forensic evaluations performed, the number of not criminally responsible (NCR) opinions made, and the disposition of noncontested NCR opinions. The questionnaire also tested the Army psychiatrists' knowledge about recent changes in the military insanity defense. This pilot study raises interesting questions about the military insanity defense that further research can address.     

论“两个证据规定”的三大突破与五个局限——以非法言词证据的证据能力为重心

两高三部新近颁布的"两个证据规定"(《关于死刑案件审查判断证据若干问题的规定》与《关于办理刑事案件排除非法证据若干问题的规定》)重申了非法言词证据一般应予排除的原则,修订了非法言词证据的涵义及取证规范,确立了瑕疵证据一般不予排除的操作程式,是我国刑事证据制度改革的突破进展。同时,也存在对严格予以排除的"强制情形"例举不细致,对"诈术情形"的证据效力有待明确,被追诉人口供的排除原理亟需完善,取证禁止规定亟需更高位阶的人权法规范引导,特殊情形下非法言词证据的证据能力仍需补充等五大改革局限。面对这些制度局限,进一步的对策、变革与完善仍值得期待。     

Myths of the insanity defense: Inherent and procedural obstacles

Often societies perceptions can be shaped by the media not only by what it reports but by how it is reported. This article discusses the impact that the American media has had on the social perception that the insanity defense is too often successfully used to avoid legal and criminal culpability. Many of the procedural obstacles associated with the assertion of an insanity defense are poorly understood or ignored. The article further address some of the less attractive characteristics associated with the assertion of the insanity defense that are not procedurally founded but nonetheless serve as an impediment the wide spread use of the defense. In conclusion the insanity defense is submitted as an unavoidable necessary evil in a civilized society that incarcerates its criminals.     

'Manifest Madness': Towards a New Understanding of the Insanity Defence

This article introduces a new concept which can serve as a theoretical frame for understanding the way in which insanity is proved for the purposes of the criminal law. With reference to George Fletcher's concept of 'manifest criminality', it introduces the concept of 'manifest madness'. This concept constructs madness (a shorthand for the types of mental abnormality known to the criminal law as insanity) in criminal law as evident to lay observers, and its meanings, which are derived from collective knowledge of it, as encoded in the defendant's acts. Through an historical analysis of the way in which insanity has been proved in criminal law, the article argues that 'manifest madness' is useful for understanding how knowledge about insanity is structured in the criminal courtroom. The concept of 'manifest madness' provides a frame that incorporates evidentiary and procedural features of the insanity defence that have resisted systematic theoretical analysis.     

Depressed but not legally mentally impaired

This article examines the mental impairment (insanity) defense in the Australian state of Victoria and argues that the defense is successful only when offenders suffer from psychotic mental illnesses. This raises the question about how non-psychotic offenders are dealt with by the courts when they claim ‘mental impairment’ for serious acts of violence such as homicide, particularly when a relatively large number of perpetrators involved in homicide suffer from non-psychotic illnesses like depression. The analysis shows that depressive illnesses do not reach the threshold for mental impairment (legal insanity) such that they mitigate violent criminal behavior, although they can, arguably, diminish culpability. This article draws upon existing literature, qualitative analysis of two court cases and semi-structured interviews with four legal representatives to make its conclusions.