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PubMed2001

The insanity defense: examination of the extent of congruence between psychiatric recommendation and adjudication.

The insanity plea is a known defense often utilized in courts of law. In such cases the accused may be referred for an outpatient psychiatric examination or for hospital observation. In this study, we examined the extent of the accord between the medical recommendations of the forensic unit of the Yehuda Abarbanel Mental Health Center and judicial decisions. It was found that in 99.4% of the cases, the court accepted the psychiatric recommendation. In only 2 cases the recommendations were not accepted. We discuss this issue and recommend improvements and strengthening of the relationship between the psychiatric and court systems.

Adolescent↗
PubMed1996

Insanity defense pleas in Baltimore City: an analysis of outcome.

OBJECTIVE: The authors studied all defendants in Baltimore City's circuit and district courts who pleaded not criminally responsible, Maryland's version of the not guilty by reason of insanity plea, during a 1-year period. The study was designed to compare the perception that the insanity plea is misused to actual outcome data. METHOD: The cohort of defendants who pleaded not criminally responsible in both the circuit and district courts during calendar year 1991 was identified. Data on demographic characteristics, crimes committed, diagnoses, and psychiatrists' opinions on criminal responsibility were collected. Trial outcome data were obtained through a search of the circuit and district court computer systems. RESULTS: Of the 60,432 indictments filed in the two courts, 190 defendants (0.31 per 100 indictments) entered a plea of not criminally responsible. All but eight defendants (0.013 per 100 indictments) dropped this plea before trial. For these eight cases, both the state and the defense agreed that the defendant should be found not criminally responsible, and the plea was uncontested at trial. The remaining defendants had their charges dropped before trial, remained not competent to stand trial at the time of the study, or withdrew their pleas of not criminally responsible before trial. CONCLUSIONS: There were no trials that contested the plea of not criminally responsible. The state and defense agreed with each other for all of the defendants who actually retained the plea at trial. The perception that the insanity defense is overused and misused is not borne out by data.

Adult↗
PubMed1993

Recasting Florida's insanity defense. Two modest proposals.

Three states have established psychiatric security review boards mandated to primarily provide protection from the potentially destructive behavior of insanity acquitees. Each year in Florida there are 100 of these patients; 5% have been involved in capital offenses. These boards, as compared with the extant judiciary system, are more effective and parsimonious and serve the end of primary prevention. It is recommended that the plea, "not guilty by reason of insanity," be changed to "guilty but insane." The change is largely semantic but should result in greater prosecutorial and public acceptance of the insanity plea and be more in keeping with individual freedom for patients as provided under the Constitution.

Adult↗