Insanity and Diminished Capacity

There is an inherent conflict among medical and legal professionals over the definition and use of the term "insanity." In the courtroom, what is required is a yardstick by which the accused may be deemed responsible for his act or should not be held criminally responsible due to insanity. He is either guilty or sick; he should be punished or hospitalized. There is no middle ground.

The medical orientation is entirely different. There is no blame to be established, nor moral judgment to be made. Characterizing a person as psychotic or sociopathic is for the purpose of treatment rather than legitimizing a legal test. And in all medical fields, especially psychiatry, there are degrees of illness rather than one, all encompassing diagnosis.

Because of his expertise, the psychiatrist has an important role to play in a courtroom where insanity is an issue. But he must provide testimony that applies within legal parameters, rather than those of his own discipline. Thus the formulation of a responsibility test must take into account the adversary nature of a criminal trial, the rules of evidence and the legal presumption of personal responsibility. Recognition should be given to the composition of the lay jury while accommodating the orientation of medical experts.

Drawing the Line

Evidence of mental defect or disease does not provide protection from criminal responsibility. The defendant must be shown to be "legally insane." To get to this point, evidence must show that the impact of the mental disease is sufficient to impair the knowledge of right and wrong, thus meeting the legal definition of insanity.

It is then incumbent upon the jury to determine whether the defendant is sane or insane. However in 1975, after several instances in which several insanity-acquitees had committed serious crimes upon their release from mental institutions, Michigan passed a law authorizing an new verdict: "guilty but mentally ill." Several states have followed suit.

Idaho, Montana and Utah have abolished the insanity defense. A defendant may be acquitted, however, if it can be proved that his mental defect prevented him from having the state of mind required by the statutory definition of the crime.

A finding of "guilty but mentally ill" asserts that the defendant is in fact mentally ill, but that he was cognizant of his actions in committing the crime. He is subject to the same punishment as a sane defendant, but must be provided with mental health treatment during incarceration.

If a convicted defendant claims that he suffered from mental illness during commission of the crime, the court must consider relevant evidence on the matter and may call for additional evidence. It may then find that the defendant is ill and sentence him to an institution for treatment.

The doctrine of "diminished capacity" has also emerged. This scenario provides for a defendant to prove that his mental incapacitation, while not amounting to insanity, rendered him incapable of having the mental state required to commit a crime. Diminished capacity will often lead to conviction of a lesser crime, with mitigated punishment.