insanity

insanity, mental disorder of such severity as to render its victim incapable of managing his affairs or of conforming to social standards. Today, the term insanity is used chiefly in criminal law, to denote mental aberrations or defects that may relieve a person from the legal consequences of his or her acts. The case of Daniel McNaughtan, who was found not guilty by reason of insanity after making an assassination attempt on British prime minister Robert Peel (1834), gave rise to the modern insanity defense used in many Western nations today. In the United States, the 1954 case of Durham v. the United States led to the establishment of new rules for testing defendants. Today, psychologists may perform tests to determine whether or not the defendant is mentally stable. Such tests try to ascertain whether or not a defendant can distinguish right from wrong, and whether or not he acted on an "irresistible impulse." John Hinckley's assassination attempt on Ronald Reagan (1981) became another landmark in the history of the insanity defense. The court's initial verdict of "not guilty by reason of insanity" generated public outcry and renewed interest in the verdict of "guilty but mentally ill," which is permissible in some states. This verdict allows defendants deemed mentally ill to be hospitalized but requires them to carry out a reasonable prison sentence as well. In 1983, the Supreme Court ruled it permissable to keep a mentally ill defendant hospitalized for a term longer than the maximum sentence for the crime with which the defendant was charged. Many have contended that the insanity defense is nothing more than a legal loophole, allowing serious criminals to escape imprisonment. In fact, the plea is rarely employed in the United States, and it is estimated that less than 1% of defendants have used it successfully. Recent years have seen the restrictions surrounding insanity defense considerably narrowed, with the sole criteria for a successful plea being the determination of whether or not the defendant knew he was breaking the law.

In criminal law, a disease, defect, or condition of the mind that renders one unable to understand the nature of a criminal act or the fact that it is wrong. Tests of insanity are not intended as medical diagnoses but rather only as determinations of whether a person may be held criminally responsible for his or her actions. The most enduring definition of insanity in Anglo-American law was that proposed by Alexander Cockburn (1843). Many U.S. states and several courts have adopted a standard under which the accused must lack “substantial capacity either to appreciate the criminality of his conduct or to conform his conduct to the requirements of the law.” Some states have abolished the insanity plea, and others allow a finding of “guilty but mentally ill.” Seealso diminished responsibility.

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Traditionally, insanity or madness is the behaviour whereby a person flouts societal norms and may become a danger to himself and others. Greek tragedies and Shakespeare often refer to madness in this sense. Psychologically, it is a general, popular and legal term defining behaviour influenced by mental instability. In modern usage, it is most commonly encountered as an informal, unscientific term, or in the narrow legal context of the insanity defense. In the medical profession the term is now avoided in favour of more specific diagnoses of mental illness such as schizophrenia and other psychotic disorders. When discussing mental illness in general terms, "psychopathology" is also considered a preferred descriptor.

Linguistic roots

In English, the word "sane" derives from the Latin adjective sanus meaning healthy. The phrase "mens sana in corpore sano" is often translated to mean a "healthy mind in a healthy body". From this perspective, insanity can be considered as poor health of the mind, not necessarily of the brain as an organ (although that can affect mental health), but rather refers to defective function of mental processes such as reasoning. A Latin phrase for "sane" is "compos mentis" (lit. "of composed mind"), and a euphemistic term for insanity is "non compos mentis". In law, mens rea means having had criminal intent, or a guilty mind, when the act (actus reus) was committed.

In medicine

Insanity is no longer considered a medical diagnosis but is a legal term in the United States, stemming from its original use in common law. The disorders formerly encompassed by the term covered a wide range of mental disorders now diagnosed as organic brain syndromes, schizophrenia, bipolar disorder and other psychotic disorders.

Historical treatment

During the 18th century, the French and English introduced humane treatment of the clinically insane, though the criteria for diagnosis and placement in an asylum were considerably looser than today, often including such conditions as speech impediments and epilepsy.

Europe's oldest asylum is The Bethlem Royal Hospital of London, also known as Bedlam, which began admitting the mentally ill in 1403. The first American asylum was built in Williamsburg, Virginia, circa 1773. Before the 19th century these hospitals were used to isolate the mentally ill or the socially ostracized from society rather than cure them or maintain their health. Pictures from this era portrayed patients bound with rope or chains, often to beds or walls, or restrained in straitjackets.

Legal use of the term

In United States criminal law, insanity may serve as an affirmative defense to criminal acts and thus does not need to negate an element of the prosecution's case such as general or specific intent. The states differ somewhat in their definition of insanity but most follow the guidelines of the Model Penal Code. All jurisdictions require a sanity evaluation to address the question first of whether or not the defendant has a mental illness. Most courts accept a major mental illness such as psychosis but will not accept the diagnosis of a personality disorder for the purposes of an insanity defense. The second question is whether the mental illness interfered with the defendant's ability to distinguish right from wrong. That is, did the defendant know that the alleged behavior was against the law at the time the offense was committed. Additionally, some jurisdictions add the question of whether or not the defendant was in control of his behavior at the time of the offense. For example, if the defendant compelled by some aspect of his mental illness to commit the illegal act, the defendant could be evaluated as not in control of his behavior at the time of the offense. The forensic mental health specialists submit their evaluations to the court. Since the question of sanity or insanity is a legal question and not a medical one, the judge and or jury will make the final decision regarding the defendant's status regarding an insanity defense.

In most jurisdictions within the United States, if the insanity plea is accepted, the defendant is committed to a psychiatric institution for at least 60 days for further evaluation, and then reevaluated at least yearly after that.

Feigned insanity

Feigned insanity is the simulation of mental illness in order to avoid or lessen the consequences of a confrontation or conviction for an alleged crime. A number of treatises on medical jurisprudence were written during the nineteenth century, the most famous of which was Isaac Ray in 1838 (fifth edition 1871); others include Ryan (1832), Taylor (1845), Wharton and Stille (1855), Ordronaux (1869), Meymott (1882). The typical techniques as outlined in these works are the background for Dr. Neil S. Kaye's widely recognized guidelines that indicate an attempt to feign insanity.

Today feigned insanity is considered malingering. In a 2005 court case, United States v. Binion, the defendant was prosecuted and convicted for obstruction of justice (adding to his original sentence) because he feigned insanity in a Competency to Stand Trial evaluation.

Well known quotes

Insanity: Doing the same thing over and over again and expecting different results - Albert Einstein

References

External links

• Rosenhan, David L. "On Being Sane in Insane Places."