Insanity Defense Research Articles

CASE ANALYSIS: R v McNaughton (1843) 8 E. R. 718

Actus Non Facit Reum, Nisi Mens Sit Rea` is a Latin maxim that means that an act does not make the person guilty unless the mind is also guilty.1 This particular maxim identifies the two important elements necessary to convict of the crime committed. The two important elements are Mens Rea and Actus Reus, with the mental and physical elements involved, respectively. For a person to be legally responsible for an act, criminal intent is required, and therefore the ability of the perpetrator to establish criminal intent is a relevant consideration in determining the person's criminal responsibility. However, due to immaturity of age or lack of mental faculties, an individual may not have sufficient mental faculties to form a criminal intent. When such a defect is caused by mental illness, a person is said to be insane. A person who has a natural handicap to differentiate between right and wrong or good and bad, such as young children under a certain age, idiots, crazy, therefore is not punishable. Stephen states in his Compilation of Criminal Law that “no act is a crime if the person who does it, is at the same time when it is done prevented either by defective mental power or by any disease affecting his mind from knowing the nature and quality of the act or from knowing that the act is wrong”.2 Over the years, the defence of the insane has developed through various precedents and laws. The McNaughton case, dating back to the 19th century, marks a milestone in the defence of insanity. The principle or rule in McNaughton's case is a legendary principle related to the defence of insanity.

Limitations Using Neuroimaging to Reconstruct Mental State After a Crime.

Neuroimaging offers great potential to clinicians and researchers for a host of mental and physical conditions. The use of imaging has been trumpeted for forensic psychiatric and psychological evaluations to allow greater insight into the relationship between the brain and behavior. The results of imaging certainly can be used to inform clinical diagnoses; however, there continue to be limitations in using neuroimaging for insanity cases due to limited scientific backing for how neuroimaging can inform retrospective evaluations of mental state. In making this case, this paper reviews the history of the insanity defense and explains how the use of neuroimaging is not an effective way of improving the reliability of insanity defense evaluations.

Settled Insanity: Substance Use Meets the Insanity Defense.

Mental impairments as a result of intoxication with alcohol or drugs have never been accepted as bases for an insanity defense. However, most U.S. jurisdictions have agreed that when the downstream effects of substance use lead to longer-term impairment, this circumstance can serve as legitimate grounds for an insanity plea. A recent Massachusetts case illustrates the application of this doctrine of "settled insanity." Although subject to criticism as excusing volitional behavior, recognition of the interplay between endogenous dispositions and the effects of substances suggests the wisdom of allowing settled insanity pleas.

PRIVATE DEFENCE IN CONTEXT OF THE BATTERED WIFE WHO KILLS HER ABUSIVE HUSBAND/PARTNER Ann Elizabeth Steyn v The State (reported as S v Steyn 2010 1 SACR 411 (SCA))

In South Africa where there is a high incidence of domestic violence, it is not surprising to find our reported criminal case law abound with many examples where battered spouses have killed their abusive partners. It is to be noted that all these accused were charged with, and more often than not, convicted of murder. In all these cases extreme provocation and emotional distress ultimately led to the homicide and caused the accused to invoke either non-pathological automatism (sane automatism) and/or nonpathologicalcriminal incapacity as defences. Consequently, it was argued on behalf of the accused that they either acted involuntarily or withoutcriminal capacity, or at the most with diminished criminal capacity at the time of the homicide due to provocation or emotional distress. In some instances, where a voluntary act and criminal capacity were proved, the provocation/emotional distress even had the effect that the state could not prove intention beyond reasonable doubt for a conviction on murder, but had to concede that only a conviction on culpable homicide was justified, as the accused acted negligently under the circumstances. The notion that a battered (provoked) wife/husband/partner who kills her/his abusive husband/wife/partner may or can invoke private defence (self-defence) has rarely been considered by our courts. Provocation or emotional distress, in principle, influences the voluntary act committed by the accused and/or the criminal capacity of the accused and may affect the element of intention, but seldom has any bearing on the element of unlawfulness. After all, private defence requires an unlawful, immediate or imminent human attack perpetrated upon the accused or another person. Since the disappointing decision in S v Eadie (2002 1 SACR 633 (SCA)), in which the defence of non-pathological criminal incapacity due to provocation was effectively abolished (battered wives now have to rely on sane automatism, which is difficult to prove), battered wives who now kill their abusive husbands/partners are “left in the lurch” as it were, specifically in view of systematic assaults/attacks perpetrated upon them by their abusive partners. From a legal point of view it seems as though a “reconfiguration” of the principles of criminal law in these instances is called for. The “reconfiguration” of the defence essentially relates to the material requirements for the unlawful human attack, as well as the requirements for the lawful fending off the attack, specifically in context of domestic violence. It is for this reason that the judgment under discussion is particularly instructive and to be noted.

Psychiatric Expertise in Tragic Circumstances: The Role of the Forensic Psychiatrist in Infanticide

Psychiatric Expertise in Tragic Circumstances: The Role of the Forensic Psychiatrist in Infanticide

Self-confidence in conducting forensic psychiatric evaluations among general psychiatrists in Indonesia

ObjectiveSeveral general psychiatrists experience lack of confidence when they perform forensic psychiatric evaluations that may be due to limited or insufficient training. This study aimed to determine whether structured forensic psychiatry educational modules are associated with general psychiatrists’ self-confidence in conducting forensic psychiatric evaluations in Indonesia. MethodA cross-sectional study was conducted with 246 general psychiatrists. A questionnaire was developed exclusively for this study by a group of experts based on relevant references and it was distributed online. Sample questions included: “How often do you perform forensic psychiatric evaluations?”, “As a general psychiatrist, are you confident in conducting forensic psychiatric evaluations?”, and “Do you experience any difficulties when conducting forensic psychiatric evaluations?” Data were analyzed through SPSS 20 for Windows; a p-value <0.05 indicated statistical significance. ResultsCompared to general psychiatrists who did not study structured forensic psychiatry educational modules during their residency training, those exposed to such modules reported confidence in conducting forensic psychiatric evaluations in the following cases: insanity defense in cases of violence, insanity defense, fitness to stand trial, malingering, capacity to consent to treatment, risk of recidivism, guardianship, and parenting capacity. Furthermore, those with higher self-confidence were less likely to experience difficulties in conducting forensic psychiatric evaluations. ConclusionStructured forensic psychiatry educational modules during general psychiatry residency training played an important role in the development of psychiatrists’ self-confidence.

Outpatient Conditions of Release following NGRI Acquittal

In Janakievski v. Executive Director , 955 F.3d 314 (2d Cir. 2020), the Second Circuit Court of Appeals considered whether a person acquitted by by reason of insanity can challenge the outpatient conditions of release. The U.S. District Court for the Western District of New York had ruled that Mr.

Insanity of Kenya’s ‘Guilty but Insane’ Verdict

A person may be insane while committing an unlawful act, leading them to raise the defence of insanity in court. This defence argues that the person’s illness prevented them from having the criminal intent needed to satisfy the mens rea requirement for criminal responsibility. The successful establishment of this defence in Kenya leads to the court issuing a special verdict of ‘guilty but insane’ (GBI). This verdict sees that the defendant is incarcerated in a place of safe custody where they can be treated for the illness that contributed to their commission of the offence. While isolation and treatment of the defendant form the primary aims of the verdict, this paper demonstrates that they are barely achieved in Kenya. This is because the conditions crucial to the verdict’s implementation–medication and therapy, a place of custody and the presence of psychiatrists–are wanting in the country. After examining the institutional barriers to the realisation of the verdict’s objectives, the paper studies various responses to these challenges by Kenya and Ghana. It finds solutions that promote the realisation of the verdict’s aims such as the provision of educational opportunities in forensic psychiatry.

“Trapped in their Shame”: A Qualitative Investigation of Moral Injury in Forensic Psychiatry Patients

Individuals who engage in criminal behavior for which they are found not criminally responsible (NCR) may be at increased vulnerability to experience moral pain and, in extreme circumstances, moral injury after regaining insight into the consequences of their behavior. Yet, almost no research exists characterizing the nature, severity, or impact of moral pain in this population. Semi-structured interviews were conducted with nine forensic psychiatric patients and 21 of their care providers. Narratives were explored using thematic analysis. Findings demonstrate that NCR patients endorse symptoms consistent with moral injury, including feelings of guilt toward victims, shame for one’s behavior, and a loss of trust in one’s morality. Moral pain is a strong driver of behavior and must be understood as part of a constellation of factors influencing criminality, risk, and recovery. Future research must develop adequate tools to measure and characterize offense-related moral injury to understand its impact on this population.

Hormonal response to perceived emotional distress in incarcerated men with sexual sadism

Sexual sadists derive pleasure from humiliation, domination and infliction of pain on victims. They display increased penile arousal and activation of brain regions involved in sexual arousal and emotional states when viewing stimuli depicting individuals in physical distress. Neuroactive hormones modulate these regions, but it is unknown if sexual sadists also have endocrine responses to depictions of individuals in distress. The present study examined endocrine responses, elicited by viewing a video depicting an individual in extreme emotional distress, in incarcerated adult male sexual offenders (n = 23) with varying levels of sadistic traits. Sadism, was measured by the Severe Sexual Sadism Scale (SeSaS). Testosterone (T), adrenocorticotropic hormone (ACTH), and oxytocin (OT) were assayed before and after participants watched a video depicting an individual in emotional distress. T responses to the video were significantly and positively associated with SeSaS scores. There were no significant associations between sexual sadism and OT or ACTH. Our findings provide physiological evidence of atypical processing of distress cues in sadism consistent with the role of testosterone in sexual arousal and aggressive behaviors. These findings have implications for the evaluation and treatment of sexual sadists.

Criminal Responsibility in Geropsychiatry: Competence, Culpability, and Care.

Elderly persons can get involved in the criminal justice system as victims or as perpetrators. The interaction of elderly persons with mental illness at various cross-sections of the judicial process needs thoughtful consideration. Through this review, the authors approach this less studied aspect of forensic psychiatry. Concerning the evaluation of a prisoner, three scenarios need focused consideration: evaluation for fitness to stand trial before a competent court, evaluations for an insanity defense, and fitness for sentencing. At the same time, incarcerated elderly who developed dementia or a severe mental illness at any point of time during the trial or in prison need specific approaches. In this article, the authors discuss the acts and case laws relevant to navigating these legal scenarios. We discuss existing mental health care provisions for protecting the health interests of elderly care in prison.

We are More Than our Executive Functions: on the Emotional and Situational Aspects of Criminal Responsibility and Punishment

In Responsible Brains (MIT Press, 2018), Hirstein, Sifferd and Fagan apply the language of cognitive neuroscience to dominant understandings of criminal responsibility in criminal law theory. The Authors make a compelling case that, under such dominant understandings, criminal responsibility eventually ‘translates’ into a minimal working set of executive functions (MWS) that are primarily mediated by the frontal lobes of the brain. In so arguing, the Authors seem to unquestioningly accept the law’s view of the “responsible person” as a mixture of cognitive capacities and mechanisms—thereby leaving aside other fundamental aspects of individuals’ human agency. This commentary article offers a critique of the Authors’ rationalist and individualist approach. The critique can be summarized through the following claim: We humans, as responsible beings, are more than our executive functions. This claim articulates through four main points of discussion: (1) role of emotions in moral judgments and behavior; (2) executive functions and normative criteria for legal insanity; (3) impact of adverse situational factors on executive functions; (4) Authors’ account of punishment and, especially, rehabilitation.

‘Hardly gear for woman to meddle with’: Kriemhild’s Violence in Nineteenth-Century Women's Versions of the Nibelungenlied

This article examines the depiction of violence in early female-authored translations and adaptations of the Nibelungenlied. For sixty years, anglophone reception of this text, then frequently characterized as the German national epic, was the preserve of male writers, but in 1877, Auber Forestier published Echoes from Mist-Land, a free adaptation. By 1905 she had been followed by four other women. Margaret Armour and Alice Horton produced fairly close translations. Two others, Lydia Hands and Gertrude Schottenfels, adapted the material for children. All based their work on nineteenth-century German publications, and each took a different approach to the violence of the female protagonist, Kriemhild. These range from the exculpatory – a rewriting which eliminates female-authored violence; a legalistic defence of insanity; a subtle shifting of the blame on to male characters – to a moralizing rejection which emphasizes Kriemhild’s violence. The rationale for each approach is anchored in contemporary understandings of violent women.

Defence of Insanity: Its Scope and Application in English law

English Law of Insanity proceeds in making assessments of the legal wrongfulness of an accused by fitting the circumstances within four slots established in line with M’Naghten case.During this process, the judges’ role becomes more robust than the jury as technical and medico legal issues are beyond the grasp of lay jury members.So we offered a critical appraisal of the approach adopted in English Law to fit the psychological science' in legal moulds through vast discretion vested in judges to deal with the defense of insanity. For this purpose, the authors extracted various pieces of information from case laws, books, law commission reports, Acts, statutes, and research articles published related to the subject matter and developed a synthesis to reach a conclusion. Our findings suggest the trial judge decides the extent and types of evidence to be induced for resolving the issues in contention regarding insanity and to be decided by the jury. Some issues pertaining to insanity are too difficult for the trial judge to decide, which requires expert evidence. The application of defense of insanity rests with the evaluation to see whether the judge's discretion has proved a right mechanism to plug medico legal gaps in this process or not.

Preliminary examination of an insanity defense typology: Prevalence rates and correlates.

The present investigation was designed to systematically examine the insanity defense typology proposed by Brown (2018) using a large sample of cases wherein there was support for the insanity defense. A total of 187 court-ordered cases in which an insanity defense was supportedwere categorized based on the typology. The sample comprised of mostly single, middle-aged males who had been charged with a felony and diagnosed with a psychotic disorder. About half the sample was ultimately adjudicated not guilty by reason of insanity by the court. About two-thirds of the cases were categorized into one of the seven insanity defense subtypes using a coding scheme developed by the author of the typology. Inter-rater agreement occurred 82% of the time. The most frequent subtype was Paranoid Self-Defense, followed by "But It's Mine" and Paranoid Protection of Others. There were few differences among these subtypes based on demographic, clinical, offense, and outcome variables, except for presence of a primary psychotic disorder and offense type. Implications and ideas for future research are discussed.

Addressing the NCR System

The focus of this paper is on a potential reform that moves the Not Criminally Responsible (NCR) system from provincial to federal jurisdiction. The primary case study is centred around the province of Ontario, the history as well as the limitations of the current system. The current lack of standardization between provinces and the unanswered constitutional questions of federal authority over the NCR system are addressed within this paper. Further, the recent increase in those found NCR coupled with the revealed abuses makes this paper pertinent.

Assessing the Link Between Schizophrenia and Antisocial Behavior in Not Guilty by Reason of Insanity (NGRI) Acquittees

Assessing the Link Between Schizophrenia and Antisocial Behavior in Not Guilty by Reason of Insanity (NGRI) Acquittees

RATHER BAD THAN MAD? A RECONSIDERATION OF CRIMINAL INCAPACITY AND PSYCHOSOCIAL DISABILITY IN SOUTH AFRICAN LAW IN LIGHT OF THE CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES

Article 12(2) of the Convention on the Rights of Persons with Disabilities requires the recognition that persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life. Such acknowledgment implies that state parties to the Convention, including South Africa, will have to reassess their existing legal provisions relating to legal capacity. These legal measures typically include a rule to the effect that where a person accused of a criminal offence lacks criminal capacity as a result of an intellectual or psychosocial disability, he or she cannot be held liable in criminal law (often referred to as the ‘insanity defence’). This article examines the potential influence of the recognition of universal legal capacity in the CRPD on the insanity defence, with specific emphasis on the current position in South African law. It commences with an overview of the normative content of article 12 of the CRPD as it relates to the notion of criminal capacity and also considers the interpretations of this provision as proposed by academic commentators. These interpretations may be described as, first, an abolitionist position (calling for boththe elimination of the insanity defence and the concomitant mandatory committal of the accused to forensic psychiatric institutions) and, second, an integrationist position (suggesting the development of disability-neutral rules on criminalcapacity). A third approach strongly argues in favour of retaining the insanity defence while at the same time reconsidering the institutionalisation of an accused person following an acquittal based on this defence. The present South African legislative dispensation regarding criminal capacity is subsequently examined and measured against the CRPD. The article concludes with a number of observations in view of potential law reform.

Not guilty by reason of insanity and dangerousness: A demographic, clinical and forensics description of the patients in the forensic inpatinent service of Coimbra

IntroductionDespite being essential for the service quality improvement, empirical research on the characteristics of people hospitalized in forensic psychiatry units and the psychopharmacological treatment instituted in this care context is scarce in Portugal.ObjectivesTo describe the sociodemographic, clinical and criminological characteristics of the patients admitted to a forensic psychiatric unit in Portugal, as well as, the psychiatric drugs prescription pattern in this care context.MethodsA retrospective observational study was carried out, through the data analysis of patients admitted to the Sobral Cid Forensic Psychiatry unit of the Coimbra Hospital and University over the past 12 years.ResultsThe sample had 194 inpatients, 153(78.9%) male and 41(21.1%) females. The mean age was 43.3 years and 74.7% had no professional, school or occupational activity. The most frequent psychiatric diagnoses were psychotic disorders (56.7%) and neurodevelopmental disorders(33.5%). 24.2% had at least two psychiatric diagnoses and 38.7% had concomitant medical conditions. 77.8% had history of psychiatric hospitalizations and 21.6% had history of self-injurious behaviors. 37.1% of the sample had a criminal record. Crimes against people were the most frequent. The use of injectable antipsychotic formulations was frequent and 18.6% of the patients were medicated with Clozapine. The prescribed daily doses were above the defined daily dose. Psychotic disorders and addictive disorders were less frequent in women. Statistically significant differences were found in the frequency of homicide between females(41.5%) and males(22.2%).ConclusionsTailored solutions are crucial to accomplish the purpose of security measures, mostly by addressing the identified needs and rethinking the approach on this specific context.DisclosureNo significant relationships.KeywordForensic Psychiatry Units

#AbolishNCR: A Qualitative Analysis of Social Media Narratives around the Insanity Defense

This article presents an analysis of social media posts by laypersons regarding a finding of Not Criminally Responsible on Account of Mental Disorder (NCRMD) for Matthew de Grood after a high-profile trial in 2016 in Canada. From trial to verdict, a total of 4,991 tweets relating to the case were harvested from Twitter. Qualitative content analysis of 365 tweets by laypersons revealed three themes – largely equating the insanity defense to a legal loophole: (1) The case exemplified a misappropriation of the legal defense (e.g., due to privilege, due to the seriousness of the offence); (2) The perception existed that the NCRMD defence is a miscarriage of justice; (3) Many comments reflected a search for answers and justice. These embodied the ABCs of NCRMD: advocating, blaming, and clarifying. A need for public education about the forensic psychiatric system is evident; misconceptions about the insanity defence appeared pervasive. Further research could focus on the efficacy of knowledge translation over new media channels, such as Twitter.