![]() ![]() ![]() The M'Naughten standard for a successful insanity defense requires that as a result of “a defect of reason, from disease of the mind,” the defendant did not, at the time of the alleged crime, understand the nature and quality of his or her actions or did not know right from wrong. ![]() ![]() This article is intended to discuss the concept of settled insanity as a potential threshold condition for clinicians conducting forensic evaluations to determine whether a defendant may have a viable insanity defense. 2 While there may be some direction established through case law, attorneys and others involved with the legal process often rely on the opinion of the forensic mental health clinician in cases in which a defendant has used a mind-altering substance that could have affected behavior at the time of the alleged crime. It is particularly important for today's forensic mental health professionals, given that the correlation of major mental illness with substance abuse and substance dependence disorders is as high as 30 to 50 percent. The impact of substance use in relation to criminal behavior and case outcome has been before the courts for some time. Several physicians testified that chloroform had had a negative effect on the defendant, and the defense won the case. Spiegel and Suskind 1 discuss an 1857 trial in which the defense claimed that the defendant should not be held responsible for murder, because the chloroform that was used on the defendant during surgery before the crime was committed induced insanity. The evaluating clinician must still determine, even when a threshold condition is considered to be present, whether statutory criteria for the insanity defense (for the jurisdiction in which the crime allegedly took place) are met. Also, before the crime, the defendant had exhibited significant psychological difficulty. In the case described, psychotic symptoms persisted long after acute intoxication and beyond the time when drugs or alcohol were detected in the accused's body, requiring clinical intervention for psychosis. It is recommended that evaluators attempt to determine the timing of the onset of psychotic symptoms in relation to substance abuse, the persistence of such symptoms beyond detoxification, and whether ongoing psychiatric treatment is necessary to ameliorate the symptoms beyond intoxication. Other factors that may assist evaluators in differentiating settled insanity from the effects of acute intoxication are presented. Also discussed are potential criteria for this defense, including evidence that psychotic symptoms thought to be responsible for the crime were, in some manner, separate and apart from symptoms caused solely by voluntary acute intoxication. Statute and case law from those jurisdictions in which settled insanity is specifically allowed as an acceptable threshold condition for the insanity defense define the concept as a permanent condition resulting from substance abuse, rather than the effects of intoxication, no matter how severe. There is an urgent need to initiate formal graduation course, setup Forensic Psychiatric Training and Clinical Services Providing Centers across the country to increase the manpower resources and to provide fair and speedy trail.Ĭriminal responsibility Indian Penal Code Section-84 insanity defense legal insanity medical insanity.This article presents a case of first-degree murder for which the defendant was acquitted as not guilty by reason of insanity, based on a defense involving the concept of “settled insanity.” The literature on settled insanity is reviewed and discussed in the context of voluntary and involuntary intoxication. Researchers present a model for evaluating a defendant's mental status examination and briefly discuss the legal standards and procedures for the assessment of insanity defense evaluations. This article focuses on the recent Supreme Court decision on insanity defense and standards employed in Indian court. It is hard to determine legal insanity, and even harder to successfully defend it in court. The defendant has the burden of proving the defense of insanity by a "preponderance of the evidence" which is similar to a civil case. This means that just suffering from a mental disorder is not sufficient to prove insanity. Insanity defense is a legal concept, not a clinical one (medical one). It is based on the assumption that at the time of the crime, the defendant was suffering from severe mental illness and therefore, was incapable of appreciating the nature of the crime and differentiating right from wrong behavior, hence making them not legally accountable for crime. Insanity defense is primarily used in criminal prosecutions. ![]()
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