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Introduction In Sweden all offenders are convicted of their crime, regardless if suffering from mental illness. The penalty can however be forensic psychiatric care instead of prison if the offender suffers from a severe mental disturbance (allvarlig psykisk störning). The Swedish legislation on mentally ill offenders differ from internationally where mentally ill are evaluated on accountability and can be acquitted in court if seen as non-accountable. Aim The aim of this study was to evaluate accountability in relation to mental illness including comparison of Swedish and international legislation. Method A hermeneutic method was used and selection of references was based on relevancy to widen and enlighten different perspectives in order to answer the research questions. Results The results show that the decision on who should be convicted to care in Sweden and who should be acquitted internationally is difficult, possibly because the connection between mental illness and criminal behavior is not fully understood. Both pros, such as opinions that it is unfair to convict someone acting criminally because of illness, and cons, such as mentally ill themselves identifying as accountable, exist when evaluating accountability and acquitting mentally ill. Conclusions Sweden differ from other countries regarding the legislation on mentally ill offenders. Both pros and cons exist with evaluating accountability among mentally ill offenders, however the pros seem to dominate but further research is needed to decide whether accountability should be considered when prosecuting mentally ill offenders.

Introduction In Sweden all offenders are convicted of their crime, regardless if suffering from mental illness. The penalty can however be forensic psychiatric care instead of prison if the offender suffers from a severe mental disturbance (allvarlig psykisk störning). The Swedish legislation on mentally ill offenders differ from internationally where mentally ill are evaluated on accountability and can be acquitted in court if seen as non-accountable. Aim The aim of this study was to evaluate accountability in relation to mental illness including comparison of Swedish and international legislation. Method A hermeneutic method was used and selection of references was based on relevancy to widen and enlighten different perspectives in order to answer the research questions. Results The results show that the decision on who should be convicted to care in Sweden and who should be acquitted internationally is difficult, possibly because the connection between mental illness and criminal behavior is not fully understood. Both pros, such as opinions that it is unfair to convict someone acting criminally because of illness, and cons, such as mentally ill themselves identifying as accountable, exist when evaluating accountability and acquitting mentally ill. Conclusions Sweden differ from other countries regarding the legislation on mentally ill offenders. Both pros and cons exist with evaluating accountability among mentally ill offenders, however the pros seem to dominate but further research is needed to decide whether accountability should be considered when prosecuting mentally ill offenders.

Philosopher and psychiatrist Lawrie Reznek’s five books all examine various aspects of the foundations of medicine, psychiatry, and insanity law. The first defends a definition of pathological condition on which all the rest at least partly rely: namely, as an abnormal, involuntary, usually harmful condition for which medical treatment is both necessary and appropriate. I first argue in detail that his abnormality element is redundant, while none of the other four is either necessary or sufficient for pathologicity. Independently, Reznek is also mistaken about the environmental relativity of disease and the “political dimension” of disease judgments. His last three books employ a simpler version of his analysis: that a disease is an abnormal harmful involuntary process without obvious external cause. Besides my previous objections to the first three of these elements, I argue that his new analysis has a new defect. It is either too narrow or too 24 Christopher Boorse teorema XL/1, 2021, pp. 23-65 broad, depending on whether he keeps or discards his normal-process thesis that “reacting normally to abnormal circumstances” cannot be pathological. By that thesis, he excludes the vast range of pathology which is the typical effect of unusual environmental insults; but without it, he would make every harmful, atypical, typically acquired, empirically unrefuted belief a mental disorder. Still, though Reznek is wrong in nearly all his major claims about the concept of disease, a great deal of the content of his last four books can survive this deficiency, Los cinco libros del filósofo y psiquiatra Lawrie Reznek examinan diversos aspectos de los fundamentos de la medicina, la psiquiatría y las leyes sobre la locura. El primero defiende una definición del concepto de condición patológica sobre el que descansan, al menos parcialmente, todos los demás. Tal concepto puede enunciarse como una condición anormal, involuntaria, usualmente dañina para la que el tratamiento médico es a la vez necesario y apropiado. En primer lugar, argumento de forma detallada que el elemento de anormalidad es redundante y que ninguno de los otros cuatro es ni necesario ni suficiente para la patologicidad. Independientemente de esto, Reznek se equivoca también sobre la relatividad de la enfermedad y la respecto del entorno y la “dimensión política” de los juicios relativos a la enfermedad. Sus últimos tres libros emplean una versión muy simple de su análisis: que una enfermedad es un proceso anormal y dañino e involuntario sin una causa externa obvia. Además de mis objeciones previas al primero de esos elementos, argumento que su nuevo análisis tiene un nuevo defecto. Es o demasiado estricto, o demasiado amplio, dependiendo de si mantiene o descarta su tesis del proceso normal de que “reaccionar normalmente a circunstancias anormales” no puede ser patológico. Por medio de esta tesis, excluye una amplia gama de patologías que es el efecto típico de agresiones ambientales inusuales; pero si ella, convierte en un desorden mental a cualquier creencia dañina, atípica, adquirida normalmente y empíricamente no refutada. Con todo, y a pesar de que Reznek está equivocado en casi todas sus principales afirmaciones sobre el concepto de enfermedad, gran parte del contenido de sus últimos cuatro libros pueden sobre vivir a esta deficiencia.

Philosopher and psychiatrist Lawrie Reznek’s five books all examine various aspects of the foundations of medicine, psychiatry, and insanity law. The first defends a definition of pathological condition on which all the rest at least partly rely: namely, as an abnormal, involuntary, usually harmful condition for which medical treatment is both necessary and appropriate. I first argue in detail that his abnormality element is redundant, while none of the other four is either necessary or sufficient for pathologicity. Independently, Reznek is also mistaken about the environmental relativity of disease and the “political dimension” of disease judgments. His last three books employ a simpler version of his analysis: that a disease is an abnormal harmful involuntary process without obvious external cause. Besides my previous objections to the first three of these elements, I argue that his new analysis has a new defect. It is either too narrow or too 24 Christopher Boorse teorema XL/1, 2021, pp. 23-65 broad, depending on whether he keeps or discards his normal-process thesis that “reacting normally to abnormal circumstances” cannot be pathological. By that thesis, he excludes the vast range of pathology which is the typical effect of unusual environmental insults; but without it, he would make every harmful, atypical, typically acquired, empirically unrefuted belief a mental disorder. Still, though Reznek is wrong in nearly all his major claims about the concept of disease, a great deal of the content of his last four books can survive this deficiency, Los cinco libros del filósofo y psiquiatra Lawrie Reznek examinan diversos aspectos de los fundamentos de la medicina, la psiquiatría y las leyes sobre la locura. El primero defiende una definición del concepto de condición patológica sobre el que descansan, al menos parcialmente, todos los demás. Tal concepto puede enunciarse como una condición anormal, involuntaria, usualmente dañina para la que el tratamiento médico es a la vez necesario y apropiado. En primer lugar, argumento de forma detallada que el elemento de anormalidad es redundante y que ninguno de los otros cuatro es ni necesario ni suficiente para la patologicidad. Independientemente de esto, Reznek se equivoca también sobre la relatividad de la enfermedad y la respecto del entorno y la “dimensión política” de los juicios relativos a la enfermedad. Sus últimos tres libros emplean una versión muy simple de su análisis: que una enfermedad es un proceso anormal y dañino e involuntario sin una causa externa obvia. Además de mis objeciones previas al primero de esos elementos, argumento que su nuevo análisis tiene un nuevo defecto. Es o demasiado estricto, o demasiado amplio, dependiendo de si mantiene o descarta su tesis del proceso normal de que “reaccionar normalmente a circunstancias anormales” no puede ser patológico. Por medio de esta tesis, excluye una amplia gama de patologías que es el efecto típico de agresiones ambientales inusuales; pero si ella, convierte en un desorden mental a cualquier creencia dañina, atípica, adquirida normalmente y empíricamente no refutada. Con todo, y a pesar de que Reznek está equivocado en casi todas sus principales afirmaciones sobre el concepto de enfermedad, gran parte del contenido de sus últimos cuatro libros pueden sobre vivir a esta deficiencia.

The current study sought to explore the provision and implications of the insanity defense in Pakistani laws. This research aims to find the lacunae in the law that aids mentally ill offenders. It also proposes to identify the role of lawyers and forensic psychologists and government institutions in the insanity defense. The study includes understanding and implementing the insanity defense in Pakistani laws and the law system. The study sample involved nine lawyers and four forensic psychologists whose interviews were conducted using a semi-structured questionnaire. Participants were contacted through the snowball sampling technique. The current study concluded that more than one key factor hindered the law system's understanding of insanity defense and mental health. The absence of psychiatric or psychological assessments in the court system suggests a common knowledge of insanity defense and mental health. The case studies overall present the different sides of mental health in Pakistan. The results also inferred that the key factors that had played the role of hindering the development of insanity defense could also enhance the development of insanity defense. The psychosocial factors that influence the hindering of insanity defense are highlighted. The results of the present study indicate a completely different point of view regarding insanity defense for lawyers and forensic psychologists, who can use this knowledge in their professional endeavors.

Many legal systems have an insanity defense, which means that although a person has committed a crime, she is not held criminally responsible for the act. A challenge with regard to these assessments is that forensic psychiatrists have to rely to a considerable extent on the defendant's self-report. Could neuroscience be a way to make these evaluations more objective? The current value of neuroimaging in insanity assessments will be examined. The author argues that neuroscience can be valuable for diagnosing neurological illnesses, rather than psychiatric disorders. Next, he discusses to what extent neurotechnological 'mind reading' techniques, if they would become available in the future, could be useful to get beyond self-report in forensic psychiatry.

Many legal systems have an insanity defense, which means that although a person has committed a crime, she is not held criminally responsible for the act. A challenge with regard to these assessments is that forensic psychiatrists have to rely to a considerable extent on the defendant's self-report. Could neuroscience be a way to make these evaluations more objective? The current value of neuroimaging in insanity assessments will be examined. The author argues that neuroscience can be valuable for diagnosing neurological illnesses, rather than psychiatric disorders. Next, he discusses to what extent neurotechnological 'mind reading' techniques, if they would become available in the future, could be useful to get beyond self-report in forensic psychiatry.

Demonstrations of a link between genetic variants and criminal behavior have stimulated increasing use of genetic evidence to reduce perceptions of defendants' responsibility for criminal behavior and to mitigate punishment. However, because only limited data exist regarding the impact of such evidence on decision makers and the public at large, we recruited a representative sample of the U.S. adult population (n=960) for a web-based survey. Participants were presented with descriptions of three legal cases and were asked to: determine the length of incarceration for a convicted murderer; adjudicate an insanity defense; and decide whether a defendant should receive the death penalty. A fully crossed, between-participants, factorial design was used, varying the type of evidence (none, genetic, neuroimaging, both), heinousness of the crime, and past criminal record, with sentence or verdict as the primary outcome. Also assessed were participants' apprehension of the defendant, belief in free will, political ideology, and genetic knowledge. Across all three cases, genetic evidence had no significant effects on outcomes. Neuroimaging data showed an inconsistent effect in one of the two cases in which it was introduced. In contrast, heinousness of the offense and past criminal record were strongly related to participants' decisions. Moreover, participants' beliefs about the controllability of criminal behavior and political orientations were significantly associated with their choices. Our findings suggest that neither hopes that genetic evidence will modify judgments of culpability and punishment nor fears about the impact of genetic evidence on decision makers are likely to come to fruition.

It is intended to briefly introduce the military practitioner to the modern mental health evaluation and acquaint him or her with the fundamental adds of presenting or opposing an insanity defense. Users must keep in mind that a thorough treatment of the subject is beyond the scope of this pamphlet; it is but an introduction. The first section discusses the legal aspects of the insanity issue, examining subjects from mental responsibility to mental evaluations under the Military Rules of Evidence. Section two contains the notetaking guide for a Naval Justice School lecture on this topic. Three appendices are included. The first two contain samples of material mentioned in the text and commonly encountered in the evaluation process, while the last is a brief bibliography for further reference., Supersedes report dated Sep 83, AD-A136 697.

As the plans for the debate began to unfold I was concerned about the possibility that the subject matter might already be jaded, or in any event no longer would be a "hot topic" for our potential audience. Being quite familiar with the writings of our Advocates and therefore particularly susceptible to the reader-listener rehash syndrome, I was nonetheless hopeful that what had the potential for being old-hat would instead be new and interesting to those members of the audience not professionally committed to intimate familiarity with the subject matter. While I had expected that these issues, aired in the setting of a debate, would be more exciting and immediate than even the extraordinary written scholarship of both erudite visitors, I hadn't expected the remarkable level of intensity, originality and profundity to which all of us were treated.

This article will first explore the reasons for the controversy over the insanity defense to provide insights, both historical and contemporary, into the purposes and functions of that defense. A brief examination will be made of judicial decisions in the last twenty years, which have largely, but not completely, eliminated the distinctions drawn historically between the "civilly" and "criminally" mentally ill. The article will then examine the growing numbers of "Guilty But Mentally Ill" (GBMI) laws, with some emphasis upon the Michigan statute as the archetypal GBMI law. It will be argued that the GBMI laws are fatally flawed in two fundamental respects. First, they unconstitutionally undercut a criminal defendant's due process right to present an insanity defense, by encouraging juries to reach a compromise GBMI verdict in cases of mentally ill defendants charged with particularly heinous crimes. Second, because they do not guarantee, and usually do not provide, psychiatric treatment to defendants found "guilty but mentally ill," these laws deny those defendants their constitutional right to such treatment." In conclusion, the article will explain why the insanity defense is essential to the integrity of the criminal law, and explore the alternative of conditional release as a way in which the many competing demands on the insanity defense can be reconciled while still passing constitutional muster.

This article's thesis is that given the magnitude of the insanity defendant's fundamental constitutional liberties--his constitutional right to present and conduct his defense, his privilege against self-incrimination, his constitutional right to privacy and bodily integrity, and his common law right to give informed consent to medical treatment--the state's interest in assuring the defendant's competency must give way if he chooses to waive his right to be tried while competent. Most, if not all, of the purposes of the prohibition against trying an incompetent defendant can be met even if the defendant is tried without psychotropic medication as long as he is competent to consult with his counsel at some point before trial. After such consultation, the court must permit the insanity defendant to waive his right not to be tried while incompetent, so long as adequate procedural safeguards are provided.

President Roosevelt will not take action in the Hill case because he does not sufficiently doubt the question of sanity.

In The Insanity Defence: International and Comparative Perspectives (Ronnie Mackay & Warren Brookbanks eds., Oxford, forthcoming 2022)

In Paul H. Robinson & Tyler Scot Williams, MAPPING AMERICAN CRIMINAL LAW: VARIATIONS ACROSS THE 50 STATES (forthcoming, Praeger 2018).

in Popular Punishment: On the Normative Significance of Public Opinion (Jesper Ryberg and Julian A. Roberts eds., Oxford University Press 2014).

Published in: Applied Psychology in Criminal Justice, vol. 16, no. 1, 2021.

This Article offers an unorthodox theory of insanity. According to the traditional theory, insanity is a cognitive or volitional incapacity arising from a mental disease or defect. As an alternative to the traditional theory, some commentators have proposed that insanity is an especially debilitating form of irrationality. Each of these theories faces fair-minded objections. In contrast to these theories, this Article proposes that a person is insane if and because he lacks a sense of agency. The theory of insanity it defends might therefore be called the lost-agency theory.According to the lost-agency theory, a person lacks a sense of agency when he experiences his mind and body moving but doesn’t experience himself as the author or agent of those movements. The title character in the movie Dr. Strangelove suffered from what’s known as alien hand syndrome. People suffering from this syndrome experience the moving hand as their hand but don’t experience themselves as the author or agent of its movements. The lost-agency theory portrays insanity as alien hand syndrome writ large. The insane actor is like someone possessed by an alien self. He’s not in charge of his mind or body when he commits the crime.

Published in: Applied Psychology in Criminal Justice, vol. 16, no. 1, 2021.

This Article offers an unorthodox theory of insanity. According to the traditional theory, insanity is a cognitive or volitional incapacity arising from a mental disease or defect. As an alternative to the traditional theory, some commentators have proposed that insanity is an especially debilitating form of irrationality. Each of these theories faces fair-minded objections. In contrast to these theories, this Article proposes that a person is insane if and because he lacks a sense of agency. The theory of insanity it defends might therefore be called the lost-agency theory.According to the lost-agency theory, a person lacks a sense of agency when he experiences his mind and body moving but doesn’t experience himself as the author or agent of those movements. The title character in the movie Dr. Strangelove suffered from what’s known as alien hand syndrome. People suffering from this syndrome experience the moving hand as their hand but don’t experience themselves as the author or agent of its movements. The lost-agency theory portrays insanity as alien hand syndrome writ large. The insane actor is like someone possessed by an alien self. He’s not in charge of his mind or body when he commits the crime.