The Psychiatric Witness and the Insanity Defense

Abstract

When a layperson pictures a psychiatrist in court, the most likely image is that of a doctor testifying about the nature of an offender’s mental condition at the time of committing a crime. The legal question of what should be done with a person who commits an offense when he is mentally ill and seemingly out of control of his actions has perplexed and fascinated the civilized world for centuries. Over two thousand years ago the Greeks and Romans accepted the notion that an individual must have free choice if he is to be held morally and legally responsible for his actions. In both ancient cultures, individuals who were mentally ill were sometimes viewed as deprived of free choice and, therefore, unable to have the requisite mental state (guilty mind or criminal intent) to be held responsible for criminal behavior. In Anglo-American law, proof of a mental element of criminal intent is required before a person can be found guilty of a crime, and the absence of such intent has been used to exculpate certain mentally ill people since the eleventh century. Historians are fond of commenting on the manner in which treatises on the insanity defense are characterized by a consistent focusing on the same issues regardless of the century in which they are written.¹Apparently the insanity defense has captured the imagination of legal scholars, the public, and doctors in identical ways at different times throughout history.