Abstract
This paper clarifies the conceptual space of discussion of legal insanity by considering the virtues of the ‘medical model’ model that has been used in Norway for almost a century. The medical model identifies insanity exclusively with mental disorder, and especially with psychosis, without any requirement that the disorder causally influenced the commission of the crime. We explore the medical model from a transdisciplinary perspective and show how it can be utilised to systematise and reconsider the central philosophical, legal and medical premises involved in the insanity debate. A key concern is how recent transdiagnostic and dimensional approaches to psychosis can illuminate the law's understanding of insanity and its relation to mental disorder. The authors eventually raise the question whether the medical model can be reconstructed into a unified insanity model that is valid across the related disciplinary perspectives, and that moves beyond current insanity models.
Highlights
The legal doctrine of criminal insanity concerns a criminal defendant's lack of capacity for responsible action and provides an excuse from responsibility and punishment in most countries
Scholars disagree on which insanity model reflects the most adequate approach to provide legally, morally, and socially justifiable delimitation of criminal responsibility – and on whether the insanity doctrine can be defended at all
We have shown how the medical model can be a gateway to get a better understanding of the links between philosophical, legal, and medical premises involved in insanity discussions
Summary
The legal doctrine of criminal insanity concerns a criminal defendant's lack of capacity for responsible action and provides an excuse from responsibility and punishment in most countries. The international discourse currently reflects a paradigmatic understanding of insanity that is mainly framed by Anglo-American law (Sinnott-Armstrong & Levy, 2011) Following this paradigm, most countries have modelled their rules (or practices) on a ‘mixed model’ which requires both a mental disorder criterion, and a functional causal requirement that the disorder resulted in certain functional (cognitive or control) impairments that influenced the commission of the crime (Simon & Ahn-Redding, 2008; Stuckenberg, 2016). We propose a conceptual framework that views criminal insanity as a multifaceted phenomenon, consisting of legal, and of philosophical and medical elements This framework utilizes the disciplinary fields that are central to illuminate the law's understanding of insanity and its relation to mental disorder.
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