Thinking About Insanity, Religion, and Terrorism

This volume provides a clear and compelling introduction to one of the most
controversial topics in society. Focusing on the dynamic interplay among
mental illness, religion, and terrorism, it directs attention to questions of
criminal responsibility raised by the general reader and by students of law,
psychology, religion, neuroscience, terrorism, and public policy.

Questions and examples address:

insanity defense basics and issues of legal responsibility, including

the impact of neuroscience and psychology
disputes about free will and determinism

the balance among mental illness, religion, and law, including

the two trials of the mother who drowned her fi ve children
the defense of men who killed abortion providers

the relation among mental illness, religion, terrorism, and law, including

possible defenses for the Army major who killed thirteen at Fort Hood
motivations of other Islamic, Christian, and secular extremists

the role of brainwashing and the effect of deprogramming, including

their early use with the heiress who joined in terrorist crimes
their influence on cult leaders and followers

Varying responses address

juror comments on their verdicts in two mock trials
what the insanity defense standard should be
whether guilty but mentally ill should be an added test
what role standard, extremist, or individualistic religion should play in the law
whether the insanity defense standard should be different for terrorists

The extensive bibliography directs students and general readers interested in further material to the important world where psychology and law, religion and terror, and public policy interact. This brief and readable book is the first
place to look for what most people want to know about this volatile mix in today’s world.

About the Insanity, Religion, and Terrorism Book

This volume grew out of my Harvard seminar on The Insanity Defense. The seminar reconsidered and updated earlier attention to mental disorder in relation to the law and also expanded its focus to examine at greater length the roles of religion and terrorism in conceptualizing and implementing the insanity defense. The contributors reviewed the earlier book, Thinking About the Insanity Defense, as well as current research and comment on the broader topics of this volume. All participants discussed these topics and cases and research and collaboratively wrote these materials. Profiles of all appear in About the Contributors.

This book follows the format of the earlier ones by posing and answering basic and additional frequently asked questions. Because the answer to each question is self-contained and because readers may choose to explore the book in various ways, some materials are repeated where necessary to answer each question. For simplicity, the masculine pronoun has been used throughout when both males and females may be involved. On some occasions, a plural accompanies a singular to make the same point.

Embedded within the questions and answers are a number of case examples which illustrate the general points about the topics. Although this volume includes an extensive bibliography, it does not refer specifically to the listings within the text itself. To facilitate reading, specific references were removed. The effort of the contributors while preparing this volume was to summarize what others discovered,
learned, thought, and presented, and then, finally, to offer some of their own reflections. As with a New Yorker piece on psychopathy or a New York Times Magazine piece on neurolaw, this volume is intended for the general reader and not for the researcher or for the scholar.

The aim of this volume is to assist that reader in thinking about the insanity defense in its relation to mental disorder, religion, and terrorism by presenting a number of competing materials. The book includes as many alternatives as possible in order to address the widely varying approaches to this controversial interaction between legal and psychological approaches to human behavior. At the same time, the bibliography provides a complete list of references for those who may wish to examine further some aspect of the overall topic. All who have been involved with this volume urge those who read it to explore at length many of the contributions of those authors and others, and to continue the important work of following the controversies surrounding the use in law and in psychology of the insanity defense. It is the hope of everyone who contributed to Thinking About Insanity, Religion, and
Terrorism that the book will encourage all readers to pursue cases and concepts in the exciting world where psychology, neuroscience, genetics, law, religion, terror, and public policy interact.

Contributors to Insanity, Religion, and Terrorism

Josh Abram concentrates in Psychology at Harvard University and pursues a secondary field in Economics. He has worked in several social psychology laboratories as a research assistant. He has conducted research under Professor Daniel Schacter on the relationship between sleep and memory and under Professor Joshua Greene on how people make moral decisions.

Aditi Balakrishna concentrates in Neurobiology with a secondary field in Psychology at Harvard University. She serves as the Associate Managing Editor for The Harvard Crimson, where she reported on the Dean of the College. She also served as Managing Editor for Content for The Harvard Undergraduate Research Journal.

Ellsworth Lapham Fersch has taught at Harvard University, in the Medical and Extension Schools and in the College, during the three decades since receiving his J.D. in law and his Ph.D. in clinical psychology there. He has been a visiting faculty member at various colleges and universities, including Boston University, Yale University, and the University of Massachusetts. A licensed clinical psychologist and member of the Massachusetts bar, he served as the long-time director of The Massachusetts Court Clinic and practiced clinical and forensic psychology. He has written about topics at the intersection of psychology and law. As General Editor of this volume, he guided its preparation in his seminar on The Insanity Defense, contributed material, and wrote the Introduction.

Rachel Flynn studies Comparative Religion at Harvard University, with secondary fieldwork in the Dramatic Arts. An active member of the Harvard Radcliffe Dramatic Club, she has directed, designed and acted in over thirty productions on campus. She completed her religion coursework with a thesis on the construction of social meaning through religious ritual, utilizing the letters and sermons of Martin Luther and the works of theorists Rene Girard and Catherine Bell. She is the 2009 recipient of the Radcliffe Doris Cohen Levi Prize for Musical Theater.

Justin Hall concentrates in Psychology and has received a citation in Spanish at Harvard University. He has worked as a research assistant in Professor Wendy Mendes' Psychophysiology Laboratory studying emotion, health, and stress. He has also been involved in community service with the Big Brother Big Sister Boston program weekly and plays junior varsity basketball for Harvard.

Eesir Kaur studies Psychology at Harvard University with a focus on social and cognitive neuroscience. She has coached the Boston Urban Debate League for three years and is actively involved with the Crimson Summer Academy.

Patrick Lahue concentrates in Psychology at Harvard University, where he has worked in psychology laboratories at both the Business School and the Kennedy School. He has spent much of his time at Harvard singing with his co-ed a cappella group, the Harvard Opportunes, and participating in a variety of English teaching programs in Asia.

Alex Lipton concentrates in Psychology with a secondary field in Economics at Harvard University, where he has worked as a research assistant in Professor Steven Pinker’s Social Psychology Laboratory. For two years he composed the annual show for The Hasty Pudding Theatricals and conducted it and other productions as well. He also serves as a Peer Advising Fellow.

Kevin Mee concentrates in Economics with a secondary field in Psychology and a foreign language citation in German at Harvard University. He is the chair of the Harvard College Events Board and also serves as a coordinator for the Mission Hill After School Program and is a Peer Advising Fellow.

Tara Moross is an English and American Literature concentrator at Harvard University. She is primarily interested in dramatic literature and wrote a thesis on the works of Tom Stoppard, focusing on Arcadia and The Invention of Love. She is also involved in several theatrical organizations including the Harvard Radcliffe Dramatic Club and The Hyperion Shakespeare Company.

Renée Pastel concentrates in Visual and Environmental Studies in the Film Studies track, with a secondary field in Psychology and a citation in French at Harvard University. She participates in the Harvard-Radcliffe Dramatic Club in various roles including actor, director, and dramaturg, and in Cinematic, Harvard’s film journal, as Theory Editor. Her senior thesis involved the editing and manipulation of memory in terms of impact on personal identity as portrayed in film. She has also served as research assistant to Visual and Environmental Studies faculty members David Rodowick and Dominique Bluher.

Joseph Peter Resnek studies Government at Harvard, where he competes on the Mock Trial Team. He also participates in the Model Congress. His principal interest is in contemporary American political theory.

Danielle Schnur concentrates in Sociology with a secondary field in Psychology at Harvard University, focusing on gang violence and juvenile delinquency. She is the director of Franklin After School Enrichment and South Boston Outreach Summer, and serves as an adviser to first year students through the Peer Advising Fellows program.

Eric Schultz concentrates in Psychology with a secondary field in Economics at Harvard University. A former Harvard football player, he played linebacker during all his four years with the Crimson. He is also a member of Veritas Financial Group, a student organization focused on providing financial education for undergraduates through Harvard Business School.

Barry Shafrin is a Psychology concentrator with a secondary field in Dramatic
Arts at Harvard University where he has spent most of his time performing. An active member of the Harvard Radcliffe Dramatic Club, he has worked on two dozen shows as an actor, director, producer, and dramaturg. Additionally, he has traveled the world with his a capella group, the Harvard Krokodiloes, performed in drag with the Hasty Pudding Theatricals, and taught local middle schoolers with Citystep.

Tracy Spetka concentrates in Psychology with a secondary field in Human Evolutionary Biology and a foreign language citation in Spanish at Harvard University. She is the treasurer of Kappa Kappa Gamma sorority and the Yardfest Coordinator for the Harvard College Events Board. She has participated as a tutor for English as a Second Language adults and works in Professor Christine Hooker’s Social Neuroscience and Psychopathology Laboratory.

Roberta Steele concentrates in Economics with a secondary field in Government at Harvard University. During her time at Harvard, she served on the Executive Board of the Harvard Undergraduate Women in Business, as well as the Executive Board of her sorority, Kappa Alpha Theta. During her senior spring, she chaired the Senior Gift Campaign for Kirkland House.

Jennifer Sullivan concentrates in Psychology at Harvard University. She has spent three years working Professor Elizabeth Spelke's Laboratory for Developmental Studies, focusing primarily on implicit social bias in toddlers and its relationship to reciprocity. She has also spent time as a child rights advocate in Geneva, Switzerland, and is an active member of the Harvard Radcliffe Dramatic Club and a member of Harvard Ladies’ Improvisational Troupe.

Camden Vilkin studies Government at Harvard University, with a particular interest in law and public policy. She has served as President of the Harvard College Law Society and as a research assistant to Senator Jeanne Shaheen and the Institute of Politics. She has written a book entitled Profiles in Service: Young Americans Ask What They Can Do for Their Country.

Clement Wright concentrates in English with a secondary field in Psychology at Harvard University. He has worked in Professor Marc Hauser’s Cognitive Evolution Laboratory, studying economic decision making in common marmosets, and has completed a book of original poetry for his English thesis.

Introduction to Insanity, Religion, and Terrorism

Five years after the publication of Thinking About the Insanity Defense, the insanity defense remains as controversial and current as it was then, and as much in the public view. With the publicity over the December 2009 Fort Hood massacre of military personnel by a major in the service, that scrutiny will continue and undoubtedly intensify. And with such continuing interest, this volume answers the need to review briefly the essentials of the defense and to go beyond the earlier volume by including materials on terrorism, by expanding the focus on religion, by addressing the impact of neuroscience on the legal foundations of free will and criminal responsibility, by reassessing the role that psychopathy may play in the defense, and by considering what each of the insanity defense standards offers or does not offer to the law.

The insanity defense spurred a storm of controversy when John Hinckley, Jr., who attempted to assassinate President Reagan, was found not guilty by reason of insanity. And now, a quarter century later, a similar controversy has emerged in efforts to understand the motivation of the Fort Hood killer and to determine how legally to proceed . In fact, the insanity defense, though rarely invoked, is, when entered in high profile cases, the most prominent and controversial interaction between the mental health and the legal systems.

The insanity defense remains one of the most talked about and controversial interactions between a deterministic psychological approach to human behavior and a free will based legal approach. An excellent example of the way in which our legal system has emphasized psychology rather than religion or sociology or economics or biology, the insanity defense 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.

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 legal insanity prevented them from choosing the lawful act, knowing what they were doing, or understanding that their action was wrong. Two incompatible, contradictory theories about what motivates human meet in the insanity defense: 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.

As stated in the earlier volume, 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. When terrorism is added to the volatile mix the controversy captures even more public interest and concern.

Much has happened since that earlier book was published in 2005. At the time of its publication, there was controversy over the conviction of Andrea Yates for killing her children. Andrea Yates had then been recently convicted of murder for killing her children by methodically drowning them in the bathtub. Her insanity defense had failed. Insanity, as that book detailed and this volume summarizes, is a legal, not a psychological concept, and the law provides tests or standards to determine whether the facts of a case fit that legal defense. The general public as well as those who represented Yates and those they engaged to testify for the prosecution or the defense pointed to varying explanations for her motivation to kill. Among the most prominent explanations for her behavior were those derived from psychology, an increasing mental illness for which she had been hospitalized and received some, though often inadequate, treatment; from biology, postpartum depression leading to psychosis; from religion, as she had received religious instruction from a radical preacher whose teachings she had followed; from simple opportunity, afforded by the hour-long time she had daily between her husband's leaving for work and her mother-in-law's arrival to help and to supervise her; from suicidology, as her previous suicidal ideation and gestures had now turned outward to homicide; and from the media, especially as one psychiatrist testified that Yates had copied a television drama in which a mother drowned her children and then escaped punishment through a successful insanity plea. After listening to the many explanations and to expert testimony about them, the jury concluded that Yates was not insane, but was guilty of murder.

Yates was sentenced to prison but sent to the mental health unit of the state correctional system. While she was legally guilty, the state recognized her serious mental problems. The Texas appellate court, however, overturned her conviction that year. It concluded that the testimony of the psychiatrist about the television drama, for which he had been a consultant, but which had not aired, was false. Yates's motivation could not have derived from the acts and the successful insanity plea in that television drama.

In a later, second trial of Andrea Yates, everything was the same inside the courtroom except for a different jury and the testimony of that psychiatrist which did not then include anything about that television drama. But outside the courtroom, starting with the horrific events in the case and continuing through all the pretrial, trial, and posttrial coverage, the intense and widespread comments about it caused many to reconsider the entire case including the jury's verdict. Some considered her husband or her preacher or her clinicians or any number of others to have been central to her debilitated condition and to her extreme acts, and that led some to consider the jury's verdict mistaken.

As the materials in this volume indicate, the jury in her second trial found Andrea Yates not guilty by reason of insanity. Though not guilty, she remained in a secure mental hospital setting. So, aside from the labeling of her as either guilty or not guilty by reason of insanity, the practical consequence of the two trials remained much the same for Andrea Yates. And the intermingling of psychological, religious, and related factors in her case remain relevant to this volume, though the addition of terrorism does not. Because Andrea Yates did not seek to spread fear to other mothers or to those suffering from postpartum depression or psychosis, or to society in general, no one considered her acts to be those of a terrorist. Undoubtedly, fear and terror seized her victims as she drowned them, but her motive did not appear to derive from terrorism. In that respect she is similar to many others who have killed while motivated by rage or jealousy or any other human emotion. Some have had mental disorders as well and have pleaded not guilty by reason of insanity. Despite those disorders, most of those who enter such a plea have been found criminally responsible.

Now, as this book is published, equally notorious cases are capturing the public attention and raising new controversies, about the definition of a terrorist and about whether those considered terrorists are mentally ill enough to have an insanity plea available to them. The earlier volume dismissed that suggestion in a brief answer, but the current case of the Fort Hood killer most explicitly, and potentially of some of the other cases as well, has brought it up in a more significant way, raising all of the issues that this volume on insanity, religion, and terrorism considers. Throughout 2010s and well beyond, this new case and others will resonate whenever the insanity plea is considered.

In briefly summarizing the most relevant case, these facts seemed important to the subject of this book. Nidal Hasan, then 39 years old, an Army major, a military psychiatrist, was the son of Muslim parents who emigrated from Palestine to Virginia. He was unmarried and characterized as a loner. His military service involved treated military personnel who were suffering psychological disorders from their tours of duty in Iraq and Afghanistan. He wrote and spoke favorably about jihadists, corresponded with an influential Islamist terrorist, contacted prosecutors to inform them of acts his patients had committed which he considered illegal. He had business cards printed with SoA (SWT) on them, the one referring to Soldier of Allah and the other meaning Subhanahu Wu Ta'ala or Glory to God. He used a first name on his official email of Abduwall, meaning slave of God, rather than his actual first name. It was said that he shouted Allahu Akbar as he opened fire in a military installation building in Texas killing thirteen and wounding thirty-two. He was charged with thirteen counts of premeditated murder and thirty-two counts of attempted murder. These and other emerging facts make clear that discussion of the case will involve all three elements in the title of this book, insanity, religion, and terrorism. In this instance, insanity stands for both the mental disorders used to advance the legal defense and the insanity defense itself. A more detailed presentation of the case later in the book explains the variety of responses that have been made to a discussion of his motivation. Suffice it to say here that Hasan's defense lawyer has indicated he will consider an insanity defense.

While the earlier volume filled a special need as it answered almost one hundred of the most frequently asked questions about the defense, this volume fills an additional need. It answers in a concise and easily available format the most frequently asked questions about the insanity defense and its relation to religion and to terrorism as well as to mental disorder. Beyond the expansion of discussion to include more about terrorism and religion and mental disorder, this volume revisits an earlier topic of brainwashing and its related deprogramming or reeducation, as well as the emerging influence of neuroscience and law on the continuing controversy about free will and responsibility. Finally, this volume summarizes the various arguments favoring each of the possible insanity defense standards. And, like the earlier volume, this book encourages further exploration of the subject through a comprehensive bibliography as it focuses, in the editor’s view, on the importance of thinking about the insanity defense.

Thinking About Law and Ethics

This volume provides a clear and compelling introduction to the most controversial moral and legal problems in society. Focusing on ethical and legal decision making, it directs attention to the issues raised by the general public and by students of law, philosophy, justice, and social policy.

Some frequently asked questions and examples address basic life and death issues:

abortion and infanticide;
care of children, at risk because of predatory priests or alternatives to medicine;
capital punishment, in general and excluding juveniles and the mentally retarded;
right to die, including physician-assisted suicide and euthanasia.

Other frequently asked questions and examples address administrative practices:

affirmative action, especially in higher education;
professional conduct of lawyers, doctors, and educators;
sexual conduct, including homosexual behavior and same-sex marriage;
privacy, as a personal problem and a Constitutional right.The materials examine many controversies in ethical and legal decision making:
where competing moral and ethical values come from;
how to balance reason and faith as significant factors;
what the role of personal religious, political, and philosophical views is in deciding;
which method is of use in interpreting the U.S. and State Constitutions;
what factors to use in the confirmation of Justices and others;
the importance of stability v. the necessity for change in addressing moral problems;
whether legislatures or courts can better solve contemporary problems;
the wide variety of views of ethical and legal decision making.

The extensive bibliography directs students and the public interested in further material to the important world where ethics and law, morality and public policy interact. This brief and readable book is the first place to look for what most people want to know about law and ethics.

About the Law and Ethics book

This volume grew out of my Harvard course on Law and Ethics, subtitled Making the Moral Decision, and is modeled on three earlier books that answered approximately one hundred frequently asked questions and featured approximately fifteen case examples about the insanity defense, and the sexually dangerous, and psychopaths and psychopathy. This book follows a somewhat similar organization to those, though the case examples here are incorporated within the questions and answers, of which there are double the number in the previous books. Many of the case examples are court cases and they are surrounded by explanatory legal and ethical materials. Also, because the answer to each question is self-contained and because readers may choose to explore the book in various ways, some materials are repeated where necessary to answer each question.

Although this volume includes an extensive Bibliography, it does not refer specifically to every listing within the text itself. Intended for the general reader and student, and not for the researcher or the scholar, this volume assists that reader in thinking about legal and moral decision making by presenting varying approaches to the materials. At the same time, it provides a more comprehensive list of references for those who may wish to examine further some aspect of the topics. Everyone who reads this book is encouraged to explore at length the original sources from the U.S. Supreme Court and elsewhere for their interpretations, rationales, and particular styles. It is my hope that this volume will encourage all readers to pursue further the many topics in law and ethics about which we hear and see so much, and which impact so many lives, including our own.

Because the gathering of the materials included in this volume had to rely on reports from a variety of sources, and because those who participated directly in the various cases and examples presented as well as those who commented on and analyzed them, a cautionary note is in order about the material in this book. The facts and the conclusions in all of the topics may interact in limited or biased ways. Facts may lead toward conclusions, or conclusions may require the refitting of facts. The arguments for each side of each of these controversial topics may use facts in a relatively straight-forward way or they may bend them to bolster conclusions drawn with or without them. The inclusion of any individual or organization is not meant to imply that their views are necessarily fully represented. Their inclusion, instead, is meant to signal that this volume attempts to explore as broadly as possible the important topic of moral and legal decision making.

Once again, Alexander Blenkinsopp assisted in the editing of this volume as he had with the three previous books in the Thinking About series. His studies at and degrees from Harvard University and the University of Oxford combined criminology, law, ethics, and social studies; and his prowess in international debate and in written work won him outstanding honors in European competitions as they had in American competitions.

Author of Law and Ethics

Ellsworth Lapham Fersch has taught at Harvard University, in the Medical and Extension Schools and in the College, during the three decades since receiving his J.D. in law and his Ph.D. in clinical psychology there. He has been a visiting faculty member at a number of colleges and universities. A licensed clinical psychologist and member of the Massachusetts bar, he served as the long-time director of The Massachusetts Court Clinic and practiced clinical and forensic psychology. He has written about topics at the intersection of law and ethics and public policy.

Introduction to Law and Ethics

Almost everyone has an opinion about almost every topic contained in this book, and even after reading such a book or taking a course that incorporates these materials, most do not, in my experience, change their overall view of these topics. Though some may vary their view a bit, the weight of their history and family and environment and experience, even their brains and genes, has solidified their views. Their views may be consistent with one another or even contradictory, but on each topic they consider their conclusion to be the moral one. For almost everyone, then, the conclusions they reach about the most important life and death issues (as abortion, the care of children, capital punishment, and the right to die) and about the most significant administrative topics (as affirmative action, professional conduct, sexual conduct, and privacy) appear to them to be moral decisions. And they are, for them, and for a variety of reasons, that we will explore in this book.

Further, general or more detailed acquaintance with these topics is widespread. For these topics headline the news, and occupy ordinary people as well as governmental, business, educational, and other leaders. Most of them cause serious controversies between and within religions and courts and legislatures and families as they impact the autonomy of the individual when it conflicts with the wishes of the majority. All of them concern everyone who must deal with basic life and death issues, as everyone must to a larger or lesser extent; and many concern those whose lives are impacted by important administrative issues as well. Because there is misinformation in society, in the media, even among lawyers and ethicists about all the topics, this book attempts to clarify the relevant moral and legal concerns.

Because the book is about moral decision making it is instructive to ask those who are making decisions whether others who directly oppose their view can also be making the moral decision. In response, some will say no, some will say yes, some are unsure. Why this is so and what it means is the broad subject of this book.

Let me begin with an imperfect analogy. Judges instruct juries before they begin their deliberations to discuss the case at some length prior to taking any sort of vote. Jurors are cautioned against beginning with a vote of the members. The theory behind this suggested restriction is that individuals who take a position at the outset may be reluctant to back down from their stated view. They may be acting on limited information; they may have a skewed view of the case; they may be mistaken on some of the facts, theories, evidence, people in the matter. Even so, they may feel, as the deliberations proceed, that they need to justify their initial statement or view or vote. Yet the very process of coming to a unanimous verdict in a criminal case, for example, is to convince those who take a different position at the outset to move toward one consensus conclusion. And that is usually in the direction of the majority of jurors when the first vote was initially taken, whether at the beginning of deliberations or later on during them.

In the award-winning drama, 12 Angry Men, a jury's initial vote of 11-1 for a guilty verdict and the ensuing resistance to and process of change were convincingly portrayed. While the outcome of the jury deliberation was contrary to the usual result in a vote skewed as that one initially was, the psychological processes at work remain valid and compelling.

That script began with a judge giving overall instructions to jurors at the end of a murder trial where the mandatory punishment for a guilty verdict was death. Jurors then retired to the jury room, elected a foreman, and took an immediate vote. In it, all jurors save one considered the defendant guilty. The entire drama then centered around that lone juror arguing his position, questioning the evidence, and gradually persuading the others, generally one by one, to change their vote from guilty to not guilty. He did this by essentially taking the role of a defense attorney questioning the evidence brought out at the trial but presumably left unaddressed in the courtroom itself. As the jurors sized up the arguments and each other, they shifted their votes until at the end of the drama, all voted the defendant not guilty. And audiences over the more than fifty years since its first production have felt that the final verdict was a just one.

The drama was satisfying because of both the intricacies of the script and its questioning of eyewitness identification evidence and because those whose initial change encouraged others to change have been seen as more thoughtful, more balanced, less prejudiced, more humane, more moral it would appear. While psychologists often noted that that strong movement in this drama from 11-1 in one direction to all 12 in the opposite direction was highly unusual, they also noted that the social psychological processes at work in the group were the usual ones in any group. That psychological truth was what made the drama compelling and ultimately convincing for while the result may have been at odds with the likely movement within a group, the two common processes in any group were effectively portrayed.

Two psychological processes made the deliberations in 12 Angry Men and the conclusion reached at its end understandable and compelling. While each juror came to the deliberation with his own views, approaches, history, experiences, knowledge, and sense of justice, the working out of those two processes made the drama especially effective and enduring. The first of these might be termed an expansion of views and the second might be called a comparison of those who hold the differing views.

The first social psychological process opened the members of the jury to a variety of different views, approaches, comments, even tentative conclusions, so that each one of them had a broader array of views to consider than he initially brought with him into the jury room. That is the variety that a book like this, or a course, or a discussion group, or a panel, or the immersion in a college or a different culture can accomplish. This book presents an extensive array of materials and it draws on many different sources. It accepts the challenge of going beyond what many may consider the true or moral or ethical or right answers to the questions which are raised in order to show the wide array of answers others consider to be true or moral or right ones. While some of the materials may immediately strike some readers as too far apart from their own views to be worthy even of consideration, the attempt here is to present as varying a range of views as have been addressed by legal and ethical commentators, by courts, by individuals and groups. The aim is to expand those materials which may prove to be of use in thinking about moral decision making, if not in making actual moral decisions.

The second psychological process on display in 12 Angry Men was different from the presentation of an array of arguments, positions, evidence, approaches. It was more personal in that it allowed the members of the jury to experience for themselves which members held which views, which members argued more persuasively, which members had clearer understandings of the evidence, which members appeared more moral, and then having assessed the other members of the jury, to determine which persons' views they felt most comfortable with. That second process helped to explain why those who enter a new group often seek a group most like themselves or may, in entering a larger or smaller group unlike themselves, at least initially modify somewhat their own views, approaches, conclusions as they identify with some in the group more than with others.

Like the jury's deliberation, the initial purpose of this book is to expand the range of arguments, evidence, comment, approaches to topics at the intersection of law and ethics. When used in conjunction with a course its purpose is to guide that expansion so that those participating can determine which arguments seem more compelling, which persons they more easily identify with, and what influence the arguments and the persons have on the reader or the course-taker. Unlike jury deliberations, there is no need here to reach a consensus on moral decision making, and general moral views are less subject to change than are decisions about facts of a case in relation to the law governing them in a jury trial.

Originally, I compiled a draft version of some of these kinds of materials into a volume called Making the Moral Decision because that was the subtitle of the course I inherited whose main title was Law and Ethics. And yet, even at the outset, I wondered: What does it mean to make the moral decision? For that question implies strongly that there can be only one decision which is the moral one and that other offered decisions are necessarily therefore non-moral or immoral or amoral.

This book addresses that important question of what it means to make the moral decision by focusing on a number of current moral problems, and by examining various approaches to moral decision making. But the book reframes the question as it should be, if the purpose is educational and not indoctrinal. So, at the outset, the question should be: What does it mean to make a moral decision? For it is essentially the difference between the moral decision and a moral decision that captures the controversies now surrounding such issues as abortion and affirmative action and euthanasia and capital punishment and sexual conduct and the other topics included in this volume. What is the moral decision to make concerning abortion, for example? Or what is a moral decision to make concerning abortion, and can another decision which is directly opposed to that one also be a moral decision? Or can there be only one moral decision? This broad ranging inquiry is a large part of the controversy surrounding moral decision making.

This book aims to present, explain, question, and compare the various answers given to the contemporary moral questions raised. Among them are these. Should a woman have a right to an abortion? What are the limits on parents' choice of care for their children? Should there be capital punishment? Does a person have a right to die? Should there be affirmative action? What are the limits of professional conduct? What are permissible forms of sexual conduct? How much privacy should an individual be entitled to? Which ethical theories ought to prevail? Whose religious tradition ought to be controlling? How should the U.S. Constitution be interpreted? How should Judges decide?

To all of these questions there are opposing answers strongly advocated by those of varying views. Looming over all these problem areas is the still larger question of whether all of the opposing answers to these questions are moral answers, or whether each question can only be answered by one moral answer with the other answer either less moral or even immoral? And what is totally outside the realm of moral decision making? Certainly all decent, ethical, reasonable people would agree that genocide (as in the systematic killing of Jews, gypsies, homosexuals, and others in the Holocaust) is totally immoral.

But even where there appears to be but one moral decision, there can be disagreements about moral decision making. For while it is agreed that the genocide as demonstrated in the Holocaust is immoral, there are not many issues on which there is such unanimity in moral decision making. And even with the topic of genocide, there is disagreement. While ethicists agree that genocide is immoral, there are definitional disputes as to what is or what is not genocide. One such dispute arose within the Jewish Anti-Defamation League over whether to call the slaughter of Armenians by Ottoman Turks a genocide. And the House of Representatives and the President of the United States disagreed about whether to apply that term to that historical event, the former declaring it should be applied and the latter that it should not be.

People of good will who are decent, ethical, and reasonable people argue strongly the opposing sides of the major moral problems facing societies and individuals. Many follow the dictates of their own religion or their own sense of morality. When that does not conflict with the law, individuals can follow for themselves any acceptable set of moral values. Thus, many Roman Catholics and Evangelical Christians and others argue against a woman's right to an abortion while many Protestants, Jews, and others argue for a woman's right to abortion. All feel they are religious, moral people. Some minorities argue against affirmative action while their leaders and many of them argue for it. Both groups feel they are ethical people engaged in making the moral decision, yet they take opposing views. In the larger view, all are making a moral decision; yet in the view of those who hold one view (as, for example, those who completely oppose abortion) they are making the only possible moral decision. They feel that any view other than their view is an immoral one. And when the power of religion, for example, is not strong enough to compel people of their own faith or of other faiths to follow some particular moral view, then the effort is made, through the legislature or through the courts, to enact into law that group's view of the moral course of action. In a pluralistic society, one which guarantees the freedom of religion, the decision to enforce a particular moral view cannot be directly a religious one.

But that is not to say that religion does not play a strong role in determining what view the law will incorporate into its statutes, regulations, and court decisions. In the area of basic issues religion has always played a strong, if not dominant role while in the area of administrative issues, the influence of religion has been more subtle. And, of course, in a pluralistic society such as the United States, secular humanism and various ethical constructs may be as important as or more important than religion.

Many times, people argue not about the moral decision but about which issues are within or outside the realm of moral discourse or, perhaps, near the edge of that realm. When the Pope declared at the United Nations that the protection of the environment was a moral cause for the Roman Catholic Church did that make it one to those outside the Church? Would a law mandating English as the national language, for example, be within or outside the realm of moral decision making? Whether or not something is within that realm, it may be an important issue to many people. So one might ask what difference it makes if an issue is viewed as a moral one or not. Perhaps it makes a difference in the seriousness with which the issue is taken. Perhaps it makes a difference in the kinds of arguments used to persuade. Perhaps it makes a difference in the urgency of the competing views. Not only do people argue about which issues dictate a clear decision based on a communal morality, but they take strongly divergent stances on just what is a communal morality, and who should decide what it is.

This book is designed to encourage moral reasoning, to set forth the arguments on various sides of issues, to encourage walking in others' shoes to understand more clearly the kinds of arguments being made and their implications for ethical and legal decision making. Clearly, the book is not a catechism. It attempts to avoid preaching a truth to be memorized and believed. For that exercise the reader must look elsewhere, and I have cited in the Bibliography a number of works of varying approaches to aid with that further exploration.

This book is intended for general reading on the topics covered, and for use in courses in Moral Problems, Ethical or Moral Reasoning, in Current Affairs, or in Law and Ethics. It does not presuppose prior work in either law or ethics. The focus is on cases and accompanying materials representing eight major moral problems: abortion, affirmative action, capital punishment, care of children, privacy, professional conduct, right to die, and sexual conduct. Half of these problems involve fundamental issues of life and death, while half involve important administrative practices in education, business, the professions, and at home. Some cases are drawn from contemporary events which have not found their way to court. These cases are summarized from media and other sources. Other cases have found their way to court. These cases are presented through majority and dissenting opinions of justices in courts in which the cases have been heard or to which they have been appealed.

In this book, cases have been summarized concisely to focus on the major arguments concerning the moral issues, the various lines of reasoning, and some of the examples and data used. Accompanying materials help to frame the issues, draw the arguments, and show varying approaches. The focus on the media and on courts reflects the most prominent sources for most people of guidance and debate on issues of law and ethics. This book emphasizes both the approaches to the problems and the content of the problems themselves. For in moral decision making there is controversy concerning the approaches taken as well as the conclusions drawn.

In concluding this introduction I should add that I have had direct personal experience with some of this material. Three of the case studies in this book involved me in lesser or greater ways. In one of them the son of the convicted and imprisoned judge who sought reinstatement to the Bar was my teaching assistant and then the sponsor of seminars I gave at Yale during his time there, and I came to know him and his family well. In another of them my mother was scheduled to be operated on by the same doctor whose malpractice record was the subject of a 60 Minutes broadcast I had used in my Law and Ethics course, and years later I was given his name as one of two possible consults for my own herniated disk. And in the third, I knew the judge conducting the inquest into the death of a young child of Christian Science parents, and had told him about my use of a case from the Massachusetts Cape in my Law and Ethics course.

Beyond that kind of involvement, I have followed all the cases in the book and many others over some decades of interest and teaching. My own educational background in literature, clinical psychology, and law; my experience in courts and colleges; my personal religious and secular background; and even my initial courses, as a freshman in college, in ethics and in logic, have all contributed to my own views.

The aim of this book, however, is not to display those views so much as it is to address the wide range of approaches, conclusions, and comments about these essential topics for individuals and for society. Toward that end, I attempt to present a balanced view, realizing that in our adversary system of justice, one view is inevitably pitted against its opposing view, and that the pendulum, as they say, swings from one conclusion to another over longer or shorter periods of time. That is part of what makes these topics invigorating and their study a challenge. I hope that reading this book will contribute to greater understanding of moral and legal issues, and to a wider appreciation of moral and ethical reasoning and of the role of law with individuals and with society.

Thinking About Psychopaths and Psychopathy

This volume provides a clear and compelling introduction to a most significant topic. Compiled by members of a Harvard seminar, it directs attention to issues raised by the general public and by students of social science and criminal justice.

The frequently asked questions address:

psychopaths and psychopathy, sociopathy, and antisocial personality disorder;
psychological, biological, gender-related, and other theories of causation;
psychological and other treatments and their use and effectiveness;
media portrayals of and legal responses to psychopaths.

The case examples include:

conventional criminals, thieves, killers, a head of state, a member of organized crime, a former college research subject, and characters in works of fiction and of nonfiction;
nonconventional white-collar corporate executives, authors, a professor, a politician, an imposter, the corporation, a video game, and cults and their leaders.

The extensive bibliography directs students and the public interested in further material to the important world where psychology and law, morality, and public policy interact. This brief and readable book is the first place to look for what most people want to know about psychopaths and psychopathy.

About the Psychopaths and Psychopathy Book

This volume grew out of my Harvard seminar on Psychopaths and Psychopathy
in which the contributors participated by discussing these topics and cases
and by writing these materials. Some had previously taken one or more of my courses: lectures on Psychology and Law, seminars on The Insanity Defense and Confining the Sexually Dangerous. Profiles of all appear in About the Contributors.

This volume is modeled on the earlier ones that answered approximately one hundred frequently asked questions and presented over a dozen case studies. This
book follows that general organization. Because the answer to each question is self-contained and because readers may choose to explore the book in various ways, some materials are repeated where necessary to answer each question. For simplicity, the masculine pronoun has been used throughout when both males and females may be involved. On some occasions, a plural accompanies a singular to make the same point.

In addition to the questions and answers, to which everyone contributed, this volume also includes a number of case examples. As the members of the seminar began to explore their own potential cases, they realized that the topic is often examined elsewhere in too narrow a manner. Only the most extreme conventional criminals tend to be labeled as psychopaths. This volume reflects an expansion from a more narrow psychological and legal focus on ordinary street crime and criminals to include non-conventional white-collar crime and criminals as well and the problems of morality, and political and social policy which accompany those white-collar psychopaths.

Each contributor then explored a case illuminating an important aspect of the
broader topic of psychopathy and wrote an individual study about it. These Case Studies are arranged alphabetically. Their subtitles reflect the nature of the primary issue each addresses. In addition, the participants in the seminar explored collectively two case examples. The first involved two conventional criminals and the author who wrote about them, and the second, a corporation and the individuals within it, as well as the related professionals and organizations, many accused of non-conventional white-collar offenses against individuals and society itself.

Although this volume includes an extensive Bibliography, it does not refer specifically to each listing within the text itself. Intended for the general reader and not for the researcher or the scholar, this volume assists that reader in thinking about psychopaths and psychopathy by presenting varying approaches to the materials. At the same time, it provides a comprehensive list of references for those who may wish to examine further some aspect of the topic. All involved with this volume urge those who read it to explore at length these other works for their interpretations and particular styles. It is the hope of everyone who contributed to Thinking About Psychopaths and Psychopathy that this volume will encourage all readers to pursue further the many cases and concepts about which we hear and see so much.

Because the contributors conducted no interviews, clinical or otherwise, with any of the subjects in these cases, and because attempts to describe and to label the subjects depend on and thereby reflect what others have said and written, a strong cautionary note is in order about the material in this book. The inclusion of any individual or organization is not meant to imply that the diagnostic label of psychopath or psychopathy is necessarily applicable. The inclusion, instead, is meant to signal that this volume attempts to explore as broadly as possible the important topic of psychopaths and psychopathy and its legal, psychological, moral, and social relation to psychoforensic issues.

Contributors to Psychopaths and Psychopathy

Christopher Benway concentrates in biology at Harvard University, where his areas of interest include genetics and molecular biology. He has worked with Dr. Alan Michelson’s Drosophila lab at Harvard Medical School, and plans to further explore Drosophila development and to investigate the relationship between genetic control, behavior, and memory with Dr. Sam Kunes’ laboratory at Harvard’s Biology Laboratories. He enjoys recreational soccer and basketball and is a member of the Harvard Republican Club. For this book, he contributed the case study on Ted Bundy and addressed questions concerning the biological and genetic aspects of psychopathy. He resides in Milton, Massachusetts, and is an avid Boston Red Sox fan.

Alexander Blenkinsopp concentrated in Social Studies at Harvard University and is pursuing further study in Criminology at the University of Oxford. While at Harvard, he worked as a research assistant for Frankfurter Professor of Law Alan Dershowitz and was Executive Editor for the Harvard Crimson. His thesis on the civil commitment of sex offenders and the legal rights associated with punishment won the twenty-five-hundred-dollar Thomas Temple Hoopes Prize. He also contributed to and was the Associate Editor of the earlier Harvard seminar books, Thinking About the Insanity Defense and Thinking About the Sexually Dangerous. He was Associate Editor of this entire book.

Marina Bontkowski studies psychology in conjunction with the Mind, Brain, and Behavior Interdisciplinary Initiative at Harvard University. She has worked in Professor Daniel Schacter’s laboratory on the neuropsychology of aging where she aided in research on baseline memory functions of older adults. A member of the Radcliffe varsity crew team, she also assists with statistics for the varsity men’s and women’s hockey teams. She wrote the Frank Abagnale, Jr. case study and contributed primarily to the section on theories of causation.

Jane Brinkley concentrates in psychology at Harvard University where she has worked for Professor Todd Pittinsky’s social psychology laboratory at the Kennedy School of Government’s Center for Public Leadership. Her areas of interest include abnormal psychology and social psychology. She has worked on the technical crew of The Hasty Pudding Theatricals and also helped address issues facing women on Harvard’s campus as a member of The Seneca. For this book, she contributed the case study on Gary Leon Ridgway, the Green River Killer. Hailing from Seattle, Washington, she found this case to be particularly interesting. She also contributed to several of the frequently asked questions.

Irene Choi concentrates in Psychology, with an interest in legal issues, and is pursuing a foreign language citation in Spanish at Harvard University. An active member of student government and an all-girl rock band she has also played violin in the Harvard-Radcliffe Orchestra and the Mozart Society Orchestra. She has hosted an underground rock radio show for the Harvard radio station and has done volunteer work for the Small Claims Advisory Service. She also contributed to the earlier Harvard seminar book, Thinking About the Sexually Dangerous. For this book, she wrote the Martha Stewart case.

Ellsworth Lapham Fersch has taught at Harvard University in the Medical and Extension Schools and in the College since receiving his J.D. in law and his Ph.D. in clinical psychology there. He has been a visiting faculty member at various colleges and universities, including Boston University, Yale University, and the University of Massachusetts. A licensed clinical psychologist and member of the Massachusetts bar, he served as a long-time director of the Massachusetts Court Clinic. As General Editor of this volume, he guided its preparation in his seminar, contributed material, and wrote the Introduction. He was also General Editor of the other volumes in this series: Thinking About the Insanity Defense and Thinking About the Sexually Dangerous.

Alexander Gordon concentrates in Psychology at Harvard University where he has also pursued music studies. He counts Bach and Thelonious Monk among his primary musical influences. He directed the music for a spring production of Chicago in the historic Agassiz Theater and played in the Harvard Jazz Band as well as in jazz clubs and with groups in the Cambridge area. A resident of Norwell, Massachusetts, he will be a non-resident music tutor in John Winthrop House and plans to pursue further music studies at the University of Massachusetts Boston. He spent a year studying and practicing Tibetan Buddhism at the Gampo Abbey in Nova Scotia. For this book, he wrote the Ted Kaczynski and Henry Murray case, contributed to the collective cases, and to the frequently asked questions.

Christine Mathieson concentrates in Psychology at Harvard University where her interests range from social psychology to psychopathology. She has worked in the Professor Daniel Wegner Laboratory aiding in the research of ideas surrounding mental control. On the board of Pleiades Society, a Harvard women’s group, where she is the head of a non-profit community service branch, she is a Leverett House senior gift agent. She was also a part of the NCAA Championship Radcliffe crew team. She spent a semester abroad at the University of St. Andrews where she became interested in the theoretical perspectives of psychology. She also contributed to the earlier Harvard seminar book, Thinking About the Sexually Dangerous. For this book, she wrote the Scott Peterson case study, and contributed to the characteristics and legal response sections in the frequently asked questions.

Erin McGuirk concentrates in English and American Literature and Language at Harvard University, where she is pursuing a foreign language citation in French. She has been a member of the cross-country and track teams and has volunteered at St. James Homeless Shelter through the Phillips Brooks House Association. She plans to pursue a career in journalism, and also has a special interest in screenwriting. For this book, she wrote the case study on the Whitey and Billy Bulger brothers, and contributed to the frequently asked questions and the collective case studies. She is a resident of Boston, Massachusetts.

Olivia Milian-Rodriguez concentrates in Psychology at Harvard University where her primary focus is on psychopathology, particularly self-destructive behaviors. She has worked in Professor Matthew Nock’s Laboratory as a research assistant studying self-injury in adolescents and has done additional coursework in computer programming. She is an active member of the Harvard Anime Society. She contributed the case study of Velma Barfield and answered several of the frequently asked questions. She was born and raised in Miami, Florida.

Mark Musico concentrates in Philosophy and is part of the Mind, Brain, and Behavior Interdisciplinary Initiative at Harvard University. His philosophical interests span philosophy of mind, including accounts of rationality, disjunctivism, epiphenomenalism, and evolutionary ethics. He has studied music perception and cognition under Dr. Mark Tramo. His non-academic endeavors include volunteer work with the Small Claims Advisory Service, which provides legal assistance to greater Boston residents, and service as accompanist and music director for theatrical productions at various regional theaters. At Harvard, he has directed Carousel on the mainstage of the Loeb Drama Center as well as productions in many other locations. For this book, he wrote the Saddam Hussein case study, contributed to the frequently asked questions on neurobiological research into psychopathy, and edited the frequently asked questions on statutory, judicial, and legal responses to psychopathy. He was Associate Editor of this entire book.

Cindy Nguyen concentrates in Psychology at Harvard University where her academic and research interests include the cognitive interface between bipolar disorder and creativity, the biological causes of schizophrenia, and psychological and legal issues involved in recovered memories. She has worked for female empowerment through a domestic violence clinic and for enabling disadvantaged communities through self-education. She enjoys Victorian literature. For this book, she wrote the case study on The Corporation. She also contributed to the frequently asked questions and the collective cases.

James P. Sharp concentrates in Psychology at Harvard University, where his academic interests have revolved around psychopathology and he has focused heavily on all aspects of psychopathy. He has worked in Professor Richard McNally's Laboratory for the research of people who believe they have recovered memories from past lives. He is the Chairman of the Quincy House Committee and Director of the Quincy Collective both of which are responsible for a wide variety of social events in Harvard’s Quincy House. He is also a Director of the Cambridge Youth Enrichment Program, one of the Summer Urban Programs in the non-profit organization Phillips Brooks House. For this book, he wrote the Patrick Bateman, Bret Easton Ellis, and American Psycho case study and contributed to the treatment section of the frequently asked questions and to the collective cases. He was Associate Editor of this entire book.

Jonathan Spiker concentrates in Psychology at Harvard University, where he has served as a research assistant in Professor Daniel Wegner's Social Psychology Laboratory and in Professor Jesse Snedeker's Developmental Laboratory. He plans to pursue study in business school in order to start his own company. For this book, he wrote the Marshall Applewhite and Jim Jones case study and contributed to the frequently asked questions and the collective cases. He also contributed to the earlier Harvard seminar book, Thinking About the Sexually Dangerous. Jonathan hails from Honolulu, Hawaii, where he was a four time undefeated state high school wrestling champion and a member of the National Honor Society.

HaNhi Tran concentrates in Psychology at Harvard University where her areas of interests include drug and criminal policy and criminal behavior. She is devoted to working for refugee and immigrant groups and other underprivileged communities. In the future, she hopes to be able to work for various marginalized communities throughout her professional career. For this book, she wrote the Devin Moore and Grand Theft Auto case study and contributed to the frequently asked questions and the collective cases.

Introduction to Psychopaths and Psychopathy

This volume addresses a topic that leads the news, informs documentaries and profiles, moves from reportage to entertainment and back again, and concerns everyone who cares or writes about the harm that some do to others. Whether that harm is on an individual or a broader scale, whether it occurs down the street, across the country, or in a continuing television drama or a film, everyone knows about people scammed or injured or killed, put out of work or deprived of retirement funds, lied to or otherwise deceived, and about those people and organizations that do it to them without remorse or guilt. Yet there is also much confusion in society, in the media, even among specialists within the legal and the psychiatric and psychological communities, about the topic.

That confusion starts with the very terms psychopath and psychopathy. While they occur in the popular literature, and are deeply embedded in the public imagination, they appear only indirectly in the official scientific literature. The index to the authorized list of psychological and psychiatric illnesses, as defined by the American Psychiatric Association in its Diagnostic and Statistical Manual of Mental Disorders, does not contain the word psychopath at all. The Manual does say in its general discussion of antisocial personality disorder that the pattern of disregard for, or violation of, the rights of others has also been called psychopathy, sociopathy, or dyssocial personality disorder. In so doing, the Manual equates the four terms. But the Manual only authorizes the use of antisocial personality disorder for diagnostic, treatment, insurance, legal, and other purposes.

So in my own courses over the years, when I have shown all or part of a documentary about serial killers which labels them psychopaths, I have without any consideration of differences, simply told students that the term psychopath is interchangeable with sociopath and antisocial personality disorder and that they can use any one in answering questions, writing exams, and thinking about the issues. Until this seminar I have not considered the differences to any great extent.

Even more confusing to students and to the public at large are the connotations of the word antisocial. Many who hear the word antisocial think of the person who does not interact successfully with others, stays to himself at gatherings, appears either too shy or dismissive of others to be part of something larger than he is. Yet the Manual says, to the contrary, that the individual with antisocial personality disorder may exhibit the superficial charm of someone with the traditional label of psychopath.

To add further to the confusion, the diagnosis of antisocial personality disorder requires the labeled individual to be at least eighteen years old and to have had a diagnosis of conduct disorder before the age of fifteen. And conduct disorder also focuses on behavior rather than personality. It requires that an individual display three of four criteria: aggressivity toward people or animals, property destruction, theft or lying, serious rules violations. Because of these requirements, the label of antisocial personality disorder does not fit some who engage in that pattern of disregard for others. According to the Manual, their criminal behavior is not accompanied by the required personality characteristics, and so they can only be considered as individuals with adult antisocial behavior.

As the Manual lists them, the diagnostic criteria for antisocial personality disorder are behaviors rather than personality characteristics. The diagnosis requires three or more of seven which include repeatedly performing acts that are grounds for arrest, using aliases or lying to gain profit or pleasure from others, failing to plan ahead, engaging in many physical fights or assaults, showing a reckless disregard for one's own or others' safety, failing to sustain consistent work or to honor financial obligations, being indifferent to and lacking remorse for damage done to others. It is behavior rather than personality that determines this diagnosis.

Thus the behavior-based diagnostic criteria listed in the Manual are different from the paragraphs preceding them which describe the disorder and elaborate on personality characteristics. And the Manual's statement that antisocial personality disorder appears to be associated with low socioeconomic status and urban settings conflicts with the analysis presented first in 1942 by Hervey Cleckley, MD, in his work, The Mask of Sanity: An Attempt to Clarify Some Issues About the So-called Psychopathic Personality. He described the characteristics of nonconventional white-collar as well as conventional street psychopaths and illustrated his principles with significant case materials.

More recently, Robert Hare, PhD, registered his disagreement with, even disapproval of, the American Psychiatric Association handling of the issue. He noted that while the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders focus on behavior, the accompanying explanatory material focuses as well on personality, including the superficial charm, failure of empathy, and grandiosity which the Manual admits have been elements of psychopathy. Hare's research and writings argued that the disjunction between the diagnostic criteria presented in the Manual and the accompanying explanatory material demonstrates that psychopathy and antisocial personality disorder are not the same. In his Without Conscience: The Disturbing World of the Psychopaths Among Us, he argued that research on psychopathy showed that it was more complex and nuanced than antisocial personality disorder. It included, he determined, two explicit factors, the first of which is only implicitly presented in the Manual's discursive essay material.

As opposed to the Manual's seven limited diagnostic criteria, Hare operationalized twenty in his Psychopathy Checklist-Revised, the PCL-R. He described the first factor as an emotional one. It refers to the selfish, callous, and remorseless use of others. With information obtained from files and from semi-structured hour-and-a-half to two-hour interviews, it includes eight items: glibness and superficial charm, a grandiose sense of self-worth, pathological lying, manipulativeness, a lack of empathy, and of remorse, shallow affect, and a failure to accept personal responsibility. He described the second factor as a behavioral one. It refers to a chronic, unstable lifestyle. With information gathered from files and other ancillary sources it includes ten items: proneness to boredom, with accompanying need for stimulation, parasitic lifestyle, poor behavioral control, early behavioral problems, including juvenile delinquency, and failure to succeed with lesser forms of sanction, lack of realistic long-term goals, impulsivity, and irresponsibility. Two items, promiscuous sexual behavior and many short-term marital relationships, though they are used, do not load on either factor. And he concluded that while reliable diagnoses of psychopathic personality disorder can be made based solely on extensive file and ancillary material, interviews alone do not lead to reliable diagnoses.

The consequences of the label psychopath extend far beyond a limited diagnostic purpose. Use of the results of the diagnostic labeling occurs in the legal as well as in the mental health system. Because many practical decisions, involving diagnosis, treatment, sentencing, classification, confinement, even death, require the drawing of lines separating the degrees of psychopathy, the PCL-R scoring system accommodates that effort. Scoring each factor as 0, 1, or 2, an individual's total can range from 0 to 40. Lines then have generally been drawn at scores of 30 or more for psychopaths, 21-29 for possible or partial psychopaths, and 20 or less for non-psychopaths. Research has shown that the overall difference among these groups is highly significant.

Hare stated that what the American Psychiatric Association Manual did not do directly in its diagnostic list of criteria for Antisocial Personality Disorder but only by indirection in its paragraphs explaining the diagnosis, he did directly for psychopathy. He differentiated it from Antisocial Personality Disorder; he gave it specificity; he examined the research he and others conducted concerning it; he demonstrated that most psychopaths fit criteria for Antisocial Personality Disorder, but most people with Antisocial Personality Disorder are not psychopaths; and he argued for a revision of the psychiatric nomenclature to take all this into consideration.

Beyond descriptions of the psychological disorder for use in diagnosis and treatment in the mental health system are consequences which flow from a diagnosis of psychopathy in the legal system. Those consequences have considerable importance. The diagnosis impacts the determination of criminal guilt as questions arise about the insanity defense or diminished responsibility. It enters into determinations of sentencing, in terms of severity and of length, and of civil liability, as both may involve intent, mental illness, background factors, standing in the community, personality as well as behavior. Jurors and judges often seek indications of remorse, for example, to help them determine the appropriate consequences for damaging behavior. And when the perpetrators are white-collar and non-conventional, more affluent, perhaps more educated, and generally respected in all other areas of their lives, jurors and judges may assess them differently from conventional offenders who fit the stereotypical lower class, perhaps minority, less educated parameters. And yet both may be psychopaths. More recently, efforts to commit offenders to mental hospitals following completion of their criminal sentences may involve determinations of their psychopathic potential. Finally, questions of executability may involve predictions of future behavior based on labels such as psychopathy. Though all these legal proceedings examine the relation among psychological, familial, social, economic, and racial determinants, society often finds psychological and psychiatric factors the most compelling.

Many commentators have reflected on these matters. In the psychoanalytic literature, Adelaide Johnson wrote in 1949 about superego lacunae in those who commit offenses: their consciences have gaps or holes as does swiss cheese. In the criminologic literature, James Q. Wilson wrote in 1985 about those who are tempted by illegal or immoral behavior and watch to see if anything happens to others who engage in such conduct: lack of enforcement, he argued, breeds further disrespect for and violation of the law. In the behavioral psychological literature, Stanton Samenow revised in 2004 his explorations of criminal thinking patterns, which are now termed cognitive distortions. And in the increasing neuroscientific and biological literature, the influence of genes on behavior has gained added relevance.

A revealing interaction between antisocial behavior and insanity occurred in the two trials of Andrea Yates who methodically drowned her five children in the hour when she was alone with them. In the first trial, the psychiatric testimony of Dr. Park Elliott Dietz appeared influential in convincing the jury that Yates' behavior was antisocial, perhaps psychopathic, rather than the result of psychosis. He concluded that she was not out of touch with reality; in fact, he argued that she had planned their deaths, had waited for an opportune time when she was alone, had called police immediately afterwards to say she had done wrong. The jury found her guilty and she was sentenced to prison. On appeal, her conviction was overturned because of Dietz's inadvertent or deliberate misstatement concerning a television program about someone who drowned her children and then pleaded insanity which program had not even aired. On retrial, a different jury, hearing almost the same evidence and experts, found her not guilty by reason of insanity. The earlier jury had implicitly found her acts to be antisocial, perhaps psychopathic, but not the result of psychosis; the later jury found her acts to be the consequence of her psychotic mental state.

In the psychiatric literature, the American Psychiatric Association asked in its 1982 Statement on the Insanity Defense whether the legal standards in use concerning the insanity defense should be modified. It concluded that the insanity defense ought not to be available for persons primarily diagnosed with personality disorders such as Antisocial Personality Disorder, which it also termed sociopathy. To do so, it maintained, would not accord with modern psychiatric knowledge or beliefs, and it concluded that offenders with antisocial personality disorders should be considered criminally responsible for heuristic reasons if for no other. The American Psychiatric Association determined that only serious disorders, such as schizophrenia or bipolar disorder, should lead to acquittals by reason of insanity.

But a different response followed Yates' second trial. In an editorial arguing for reform, the Boston Herald responded to the second jury's verdict finding Andrea Yates not guilty by reason of insanity in the planned drowning deaths of her five young children by advocating a guilty but insane model. It said that such a verdict would provide a balance between mercy and justice because convicted offenders could receive mental health treatment until their recovery at which time they would finish their sentence in prison. In essence, it argued that a person could be both guilty as a psychopath or antisocial personality would be, and insane as a seriously mentally ill person would be. Yet the two words contradict each other.

This conflict between the words guilty and insane appears unresolvable, and in the Yates case unnecessary, for the solution the Herald sought was exactly what was happening after the first jury found Andrea Yates guilty of murder in 2002. Though sentenced to prison, she was spending most of the time in a prison mental health facility. In other words, the sentence imposed after the first trial found her guilty, as would the guilty part of guilty but insane, but confined her first to a mental health facility, as would the insane part of that verdict, where she would be treated until she was ready, if ever, to enter the prison setting itself.

The idea of guilty but insane has been around for a considerable time. Years ago a professor at Harvard Law School argued for the same thing as the Boston Herald did in response to the Yates case. He advocated the new verdict of guilty but insane to express the psychiatric truth that the offender's mental illness played a significant role in his acts. He advocated turning to modern psychiatry for essential help. But as I wrote then and more recently in Thinking About the Insanity Defense and to the Boston Herald: Why turn only to modern psychiatry for help in determining what contributed to a defendant's criminal behavior? What about modern religion and economics and sociology and philosophy and politics and literature as well as old fashioned common sense? Why should a term like insane, related to psychology though a legal not a psychological or psychiatric term, be added to the word guilty when no other word is added?

Partly insanity has been accorded special status among the excuses or explanations for antisocial conduct because it seems to negate the intent necessary to commit a criminal act; yet Yates intended to kill her children and said shortly afterwards that she knew it was wrong to do so. Partly it has, because psychology is defined as a science of the mind; yet the directly opposing testimony of forensic psychiatrists and psychologists in the Yates' and other trials suggests some lack of scientific precision. And partly it has, because ours has become a psychological society.

Yet some argue that the special status accorded insanity is actually too narrow. Given the chance, their reforms might enumerate the many factors that make it difficult or perhaps impossible in their view for an individual to conform conduct to the requirements of law. Beyond guilty but insane the expansionists might add guilty but fanatically religious, economically disadvantaged, sociologically anomic, philosophically existentialist, politically radical, literarily superior, extremely infatuated, or jealous, or even very, very sorry. They might even argue that these excuses should mandate a finding of innocent. Yet that is what psychopaths argue as they attempt to escape personal responsibility for their acts which have harmed others. The efforts of psychopaths and of defenders of the mentally ill or seriously troubled appear more similar than some might wish to acknowledge.

Others, however, would restrict the excuses that the mentally disordered or the psychopathic could offer, excluding even insanity. Their reform would return to two verdicts, guilty and innocent, so that society can determine through the criminal law what is morally tolerable and what is not. Seriously wounding or killing someone in self-defense may well be tolerable; intending to and killing one's children ought not to be. And, they say, it is unnecessary to add words to the verdict, especially if their only purposes are to make juries more likely to convict and to mandate the place for initial confinement of the defendant.

And now again, in this book about psychopaths and psychopathy, it can be noted that while psychology and psychiatry, and other fields, can help in understanding events which involve the law, the real reform is the courage to take seriously the individual's explanations and to weigh them and the acts in the balance of moral acceptability or unacceptability. That provides justice. Once the verdict is in and the sentence imposed, then every offender ought to receive the help that common sense, or psychology or religion or any other specialty, can offer to help him become better and to deter future offending. That provides mercy. This book details those efforts to understand motives, acts, and consequences through a series of case examples and a series of answers to frequently asked questions.

The cases include both ordinary street and white-collar offenses and both conventional and non-conventional offenders, who range from the completely psychopathic to the potentially or marginally psychopathic to the less psychopathic to the non-psychopathic. In some instances, cases are included simply because one or more commentators have labeled individuals or institutions as sociopathic or psychopathic or antisocial. The cases cover the widest variety of individuals and institutions, from serial killers, to imposters, to governmental officials, to a professor and his student, to corporate executives, to a literary creation, to writers and their subjects, to a video game and its player, to corporations, and cults, and their leaders. The cases attempt to examine the full array of those to whom the label of psychopath has been affixed.

These case analyses, together with the responses to frequently asked questions, are designed to help readers think more clearly about psychopaths and psychopathy. Because of psychopaths' high profile in, and their damage to, society, the effort to understand the legal, psychological, moral, and social significance of psychopaths, and of the larger topic of psychopathy itself, remains especially important.

Thinking About the Sexually Dangerous

This volume provides a clear and compelling introduction to one of the most significant topics in society today. Compiled by members of a Harvard seminar, it directs attention to psychoforensic issues most often raised by the general public and by students of social science and criminal justice.

The frequently asked questions about the sexually dangerous address:

conceptions of dangerousness
attempts to confine the sexually dangerous
psychological theories of causation
psychological contributions to treatment
media, political, social, and religious reactions, and
statutory, judicial, and other legal responses.

The case examples illustrate a variety of issues surrounding:

serial, spousal, child, date, and statutory rape
consensual sadomasochism
surgical and chemical castration
repressed memory and false confession
video voyeurism
restricting child pornography
the labeling of object and speech, and
post-imprisonment civil confinement in mental hospitals.

The extensive bibliography directs students and the public interested in further cases and analyses to the important world where psychology and law, morality, and political and social policy interact. This brief and readable book is the first place to look for what most people want to know about the sexually dangerous.

About the Sexually Dangerous Book

This volume grew out of my Harvard seminar on Confining the Sexually Dangerous in which the contributors participated by discussing these topics and cases and by writing these materials. Some had previously taken my lecture course on Psychology and Law, and others my previous seminar on The Insanity Defense. Profiles of all appear in About the Contributors.

This volume is modeled on the earlier one that answered ninety-seven frequently asked questions and presented sixteen case studies in nine chapters. This book follows that general organization. Because the answer to each question is self-contained and because readers may choose to explore the book in various ways, some materials are repeated where necessary to answer each question. For simplicity, the masculine pronoun has been used throughout when both males and females may be involved. On some occasions, a plural accompanies a singular to make the same point.

In addition to the questions and answers, this volume also includes a number of case examples. As the contributors to this book began to explore their own potential cases, they realized that the original topic was too confining in itself, and all of us in the seminar discussed expanding the scope of sexual dangerousness. This volume reflects that expansion from more narrow psychological and legal issues to include those of morality, and political and social policy as well. Each contributor then explored a case illuminating an important aspect of the broader topic of sexual dangerousness and wrote an individual study about it. These Case Studies are arranged alphabetically. Their subtitles reflect the nature of the primary issue each addresses.

Although this volume includes an extensive Bibliography, it does not refer specifically to each listing within the text itself. Intended for the general reader and not for the researcher or the scholar, this volume assists that reader in thinking about sexual dangerousness by presenting varying approaches to the materials. At the same time, it provides a comprehensive list of references for those who may wish to examine further some aspect of the topic of the sexually dangerous. All involved with this volume urge those who read it to explore at length these other works for their interpretations and particular styles. It is the hope of everyone who contributed to Thinking About the Sexually Dangerous that this volume will encourage all readers to pursue further the many cases and concepts about which we hear and see so much.

Contributors to The Sexually Dangerous

Randall Adams is a joint concentrator in Social Studies and Psychology at Harvard University. He has worked as a research assistant in Professor Mahzarin Banaji’s Harvard Social Cognition Laboratory where he is completing a thesis on racial bias in juries. He has also served as a research assistant to Professor Todd Pittinsky in the Leadership Research Laboratory at the Kennedy School of Government. He is a member of CityStep, which mentors local youth, and the Harvard AIDS Coalition, and he acts as a peer counselor. For this book, he wrote the Mary Kay Letourneau case and contributed to the sections on Conceptions of Dangerousness, and on Media, Political, Social, and Religious Reactions to the Sexually Dangerous, and he compiled the latter section.

Alexander J. Blenkinsopp concentrated in Social Studies at Harvard University. He will pursue further study in Criminology at the University of Oxford. While at Harvard, he worked as a research assistant for Frankfurter Professor of Law Alan Dershowitz and completed a thesis on the civil commitment of sex offenders and the legal rights associated with punishment. He was Executive Editor for The Harvard Crimson. He also contributed to and was the Associate Editor of the earlier Harvard seminar book, Thinking About the Insanity Defense. For this book, he wrote the Leroy Hendricks case, and contributed to and compiled the section on Attempts to Confine the Sexually Dangerous. He was also the Associate Editor of this entire book.

Irene Choi concentrates in Psychology and is pursuing a foreign language citation in Spanish at Harvard University. An active member of student government and of an all-girl rock band called Plan B for the Type A’s, she has also played violin in the Harvard-Radcliffe Orchestra and the Mozart Society Orchestra. She has hosted an underground rock radio show for the Harvard University radio station and has boxed with the Harvard Boxing Club. For this book, she wrote the Jesse Timmendequas case and contributed to the section on Statutory, Judicial, and Other Legal Responses to the Sexually Dangerous.

Ellsworth Lapham Fersch has taught at Harvard University in the Medical and Extension Schools and in the College since receiving his J.D. in law and his Ph.D. in clinical psychology there. He has been a visiting faculty member at various colleges and universities, including Boston University, Yale University, and the University of Massachusetts. A licensed clinical psychologist and member of the Massachusetts bar, he served as a long-time director of the Massachusetts Court Clinic. As General Editor of this volume, he guided its preparation in his seminar, contributed material, and wrote the Introduction.

Elizabeth Gamble concentrates in Psychology at Harvard University with a specific interest in psychopathology. She has worked as a research assistant in Professor Matthew Nock’s Harvard Laboratory for Clinical Research, and has also volunteered for Echo, a peer counseling group that addresses concerns surrounding eating, body image, and self-esteem. She is a member of the Harvard Women’s Varsity Lacrosse Team. For this book, she wrote the Adam Lack case, and contributed to and compiled the section on Psychological Contributions to Treating the Sexually Dangerous.

Jessica Gonzalez in concentrating in Psychology at Harvard University where she is pursuing foreign language citations in both Spanish and Chinese. Her principal area of psychological interest is the development of racial biases in minority children. She also contributed to and helped compile the earlier Harvard seminar book, Thinking About the Insanity Defense. For this book, she wrote the Paul Ingram case study, and contributed to and compiled the section on Conceptions of Dangerousness.

Megan Gubbins is concentrating in Psychology at Harvard University with an emphasis on legal applications and psychopathology, where she is also pursuing a foreign language citation in Spanish. She has worked as a research assistant in Professor Wendy Berry Mendes’ Harvard Psychophysiology Laboratory, and as a volunteer tutor for Advancement Via Individual Determination, helping prepare underprivileged high school students for college eligibility and success. She is a member of the Harvard Women’s Cross Country and Track teams. She also contributed to and helped compile an earlier Harvard seminar book, Thinking About the Insanity Defense. For this book, she wrote the Michael Ross case, and contributed to and compiled the section on Statutory, Judicial, and Other Legal Responses to the Sexually Dangerous.

Janet Kwok concentrates in Psychology at Harvard University where she has worked as a research assistant in Professor Matthew Nock’s Laboratory for Clinical and Developmental Research, with a focus on self-mutilation and suicide. She is a former editor of the Harvard Independent. For this book, she wrote the Sundance Associates, Inc. v. Reno case, and contributed to the sections on Media, Political, Social, and Religious Reactions to the Sexually Dangerous, and Psychological Theories of the Causes of Sexual Dangerousness, and compiled the latter section.

Christine Mathieson concentrates in Psychology at Harvard University, where she has worked as a research assistant on ideas surrounding mental control and internal psychological states in Professor Daniel Wegner’s Laboratory. She is on the board of Pleiades Society, a Harvard women’s group, where she is the head of a non-profit community service branch. She has been a tutor in the Mission Hill After-School Program, and a member of the NCAA Championship Radcliffe crew team. She spent a semester at the University of St. Andrews where she was interested in the theoretical perspectives of psychology and the history of the Scottish castle. For this book, she wrote the Bernard Baran case, and contributed to the sections on Conceptions of Dangerousness, and Attempts to Confine the Sexually Dangerous.

Catherine Matthews concentrates in Psychology at Harvard University, where she has worked in a Cognitive Neuroscience Laboratory and is completing a thesis on the limitations of hippocampal associative learning. Originally from Honolulu, Hawaii, she is active in the Harvard Hawaii Club. She plans to pursue work in the non-profit sector. For this book, she wrote the Larry Don McQuay case and contributed to the section on Attempts to Confine the Sexually Dangerous.

Danila Musante concentrates in psychology at Harvard University where she has conducted research in the Implicit Social Cognition laboratory with a special focus on abnormal psychology. A member of the Harvard Cross-Country and Track teams, she was captain of the Cross Country team, and has taught students in Boston public schools about the Holocaust. For this book, she wrote the Francine Hughes case and contributed to the section on Statutory, Judicial, and Other Legal Responses to the Sexually Dangerous.

Zoe Savitsky is concentrating in Psychology at Harvard University, with an emphasis on the intersection of law and psychiatry, and is also pursuing a foreign language citation in French. She has worked as a research assistant in Professor Susan Carey’s Harvard Laboratory for Developmental Psychology. She is a peer counselor and an aide to a visually-impaired writer. Heavily involved in theatre, she has directed, produced, acted in, and designed close to two dozen productions at Harvard. For this book, she wrote the Ashcroft v. Free Speech Coalition case, and contributed to the section on Conceptions of Dangerousness.

Stephanie Sawlit concentrates in psychology at Harvard and has assisted with research on dreams and nightmares in Dr. Richard McNally’s laboratory. An active member of the Christian community at Harvard, she has been a leader in the campus fellowship Athletes in Action, as well as a member of the Delta Gamma women’s fraternity and a mentor for an inner-city after-school program. For this book, she wrote the John J. Geoghan case and contributed to the section on Media, Political, Social and Religious Responses to the Sexually Dangerous.

Crystal Smith is concentrating in Psychology and pursuing a foreign language citation in Classical Hebrew at Harvard University. She is active in the Harvard-Radcliffe Christian Fellowship and the Harvard chapter of Best Buddies, International, which seeks to foster friendships with intellectually disabled youth. For this book, she wrote the Aileen Wuornos case and contributed to the section on Psychological Theories of the Causes of Sexual Dangerousness.

Jonathan Spiker concentrates in Psychology at Harvard University, where he has been a research assistant in both the Wegner Social Psychology Laboratory and the Snedeker Developmental Psychology Laboratory. From Honolulu, Hawaii, he was a four time undefeated state high school wrestling champion. He plans to pursue business and to start his own company. For this book, he wrote the Salvatore Sicari and Charles Jaynes case and contributed to the section on Psychological Theories of the Causes of Sexual Dangerousness.

HaNhi Tran concentrates in Psychology at Harvard University, with interests in criminal behavior, risk and resilience in immigrant and low-income communities, and legal applications of psychology. She has worked for the Refugee Youth Summer Enrichment program, teaching English as a Second Language to refugee and immigrant high school students from the Boston area, and has volunteered as a big sister for the their Mentoring Program. An active member of the Harvard Vietnamese Association, she has served as one of the Co-Presidents of the organization. For this book, she wrote the Richard Sorrells case, and contributed to the section on Psychological Contributions to Treating the Sexually Dangerous.

Caitlin Watts-FitzGerald concentrates in Psychology at Harvard University, with emphasis on psychopathology and the human conscience. She spent a summer aiding in research at a local trauma center in Florida, and is an active and enthusiastic member of the Harvard Ballroom Dance Team where she has held a number of leadership positions. For this book, she wrote the Benjamin Davis and Stefany Reed case, and contributed to the sections on Conceptions of Dangerousness, and on Media, Political, Social, and Religious Responses to the Sexually Dangerous.