This brief volume answers a need I have experienced for some time in teaching courses on psychology and law to diverse students, and in answering questions from them, the general public, and those who work in court and clinical settings. That need arises from the fact that the insanity defense constitutes one of the most talked about and controversial interactions between psychology and the law. An excellent example of the way in which our legal system has emphasized psychology, the insanity defense has provided the focus for heated discussions among psychologists and psychiatrists, lawyers and judges, and the general public, and has raised questions which lie at the root of our political views of society, our moral and religious notions of good and evil, our medical and psychological conclusions about healing and sickness, our philosophical ideas about free will and determinism, and our linguistic concerns about language and semantics.
The insanity defense spurred a storm of controversy over twenty years ago when John Hinckley, Jr., who attempted to assassinate President Reagan, was found not guilty by reason of insanity. Recent attempts by Hinckley and his parents to free him from strict clinical supervision, as well as other prominent cases in which the insanity defense has been invoked, have continued to raise important issues in the relationship between criminal law, and clinical psychology and psychiatry. In fact, the insanity defense, though rarely invoked, is, especially in high profile cases, the most prominent and controversial interaction between the mental health and the legal systems.
As is generally known, the criminal law attempts to hold people accountable for their actions. The insanity defense, on the contrary, attempts to excuse some individuals from responsibility for their actions on the theory that their mental illness prevented them from choosing the lawful act, knowing what they were doing, or understanding that their action was wrong. Insanity defense cases have caused a stir at least partly because of the nature of the controversy embedded in the defense. A former president of the American Psychiatric Association concluded that the insanity defense poses an insoluble problem because it occurs at the point where two incompatible, contradictory theories cross: the modern determinist theory of causation which underlies psychology, neuroscience, and related disciplines, and the continuing free will theory of morality which underlies the criminal law.
In other words, however individual cases are resolved, the controversy remains because two great theories about human nature and human action are involved: the criminal justice theory that individuals of their own free will choose to act as they do and ought to be punished for wrongful acts; and the psychological and modern scientific theory that individuals’ actions are determined by their personality, genes, environment, and other factors largely beyond their control and ought rather to be understood and helped.
While the contradiction may be insoluble, the suggestions concerning the insanity defense range across a broad spectrum. Those who follow the approach of the American Psychiatric Association, the American Psychological Association, and the American Bar Association argue that it should be retained, accepting the deterministic view and attempting to find for those acquitted the psychological help evidently needed. They agree that the moral basis of the law requires the special defense of insanity. Yet, among those who argue for its retention, some want it available to a wide range of mentally ill defendants. Others propose limiting it to the most seriously disturbed individuals. Still others suggest adding to it a possible finding of guilty but insane or guilty but mentally ill. Further along the spectrum some argue that the finding of guilty but mentally ill should supplant the insanity defense itself. And finally some agree with the American Medical Association and argue in favor of abolishing the special defense of insanity, unifying the criminal justice and mental health responses to antisocial or illegal acts by holding individuals responsible for their behaviors subject to the limits imposed by the legal requirement of mens rea, or guilty mind.
Whichever approach one follows, other factors complicate the relation between psychological diagnosis and moral decision making. Among the most important are the varying views of the participating psychologists and psychiatrists, and the differing laws of each state and of the federal system, which set forth the test of insanity to be used. However those psychoforensic professionals approach the defense, whether they are retained by the prosecution or the defense or the court itself, and whatever conflicting conclusions their expert testimony may bring forth, the central issue of the relation between the legal and mental health approaches to and explanations of human behavior remain.
Although a great deal has been written about the insanity defense, this volume fills a special need. It answers in a concise and easily available format the most frequently asked questions about the insanity defense; it provides a variety of illustrative case examples of its use; it encourages further exploration of the subject through a comprehensive bibliography; and it focuses, in the editor’s view, on the importance of thinking about the insanity defense.
