Psychiatric opinion as to a defendant's criminal responsibility is divided far less often than press coverage suggests. Evaluations are influenced by the settings in which they occur, the ideology and qualifications of the examiner, and the techniques of interviewing, investigation, and decision making used. If the insanity defense is as important a foundation of the criminal law as legal commentators argue, it is important to improve psychiatric evaluations by improving evaluative settings, the qualifications of evaluators, and the resources devoted to investigation and other elements of evaluations. These improvements would not, however, eliminate disagreement, which would still arise as an inevitable consequence of heterogeneity in the theories, methods, and interpretations of psychiatrists evaluating defendants.
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References
1.
Kenneth K. Fukunagaet al. , “Insanity Plea: Interexaminer Agreement and Concordance of Psychiatric Opinion and Court Verdict,”Law and Human Behavior, 5(4):325 (1981).
2.
2. Seymour L. Halleck, Psychiatry and the Dilemmas of Crime: A Study of Causes, Punishment and Treatment (New York: Harper & Row, 1967), pp. 206-216; Alan A. Stone, Mental Health and Law: A System in Transition (New York: Jason Aronson, 1976), pp. 218-232.
3.
American Psychiatric Association Insanity Defense Work Group , “Statement on the Insanity Defense,”American Journal of Psychiatry, 140(6):681 (June 1983).
4.
4. Learned Hand, “Historical and Practical Considerations Regarding Expert Testimony,”Harvard Law Review, 15:40 (1901); James E. Needell, “Psychiatric Expert Witnesses: Proposals for Change,”American Journal of Law and Medicine, 6(3):425 (Fall 1980).
5.
5. Bernard L. Diamond, “The Fallacy of the Impartial Expert,”Archives of Criminal Psychodynamics, 3(2):221 (Spring 1959); Abraham S. Goldstein, “The Psychiatrist and the Legal Process: The Proposals for an Impartial Expert and for Preventive Detention,”American Journal of Orthopsychiatry, 33:123 (Jan. 1966).
6.
6. Jonas R. Rappeport, Nicholas P. Conti, and Barry Rudnick, “A New Pretrial Screening Program,”Bulletin of the American Academy of Psychiatry and the Law, 11(3):239 (1983).
7.
7. Joyce K. Labenet al., “Reform from the Inside: Mental Health Center Evaluations of Competency to Stand Trial,”Journal of Community Psychology, 5:52 (1977).
8.
8. Gary B. Melton, Lois A. Weithorn, and Christopher Slobogin, Community Mental Health Centers and the Courts: An Evaluation of Community Based Forensic Services (Lincoln: University of Nebraska Press, forthcoming).
9.
9. Henry J. Steadmanet al., “Mentally Disordered Offenders: A National Survey of Patients and Facilities,”Law and Human Behavior, 6(1):31 (1982).
10.
10. Bill Thomas and S. L. Stebel, The Shoe Leather Treatment (Los Angeles: J. P. Tarcher, 1980); Wendell Rawls, Jr., Cold Storage (New York: Simon & Schuster, 1980); Tom Ryan and Bob Casey, Scres: A Guard's View of Bridgewater State Hospital (Boston: South End Press, 1981); Michael Norman, “Criminal and Crazy,”New Jersey Monthly, pp. 41-113 passim (Apr. 1979).
11.
11. C. Leslie Peterson and Roger S. Kiger, “An Open Security Ward,”Mental Hygiene, 51:223 (1967); Roy A. Ettlinger, Ulrich B. Jacobsohn, and Millard A. Howard, “Security Without Bars: Closing a Facility for Mentally Ill Offenders,”Hospital and Community Psychiatry, 26(6):344 (June 1975).
12.
12. Robert Bluglass, “Regional Secure Units and Interim Security for Psychiatric Patients,”British Medical Journal, 1(6111):489 (25 Feb. 1978).
13.
B. O'Connell , “Court Clinics—The American Experience,”Medicine, Science and the Law, 4(4):266 (Oct. 1964).
14.
14. Robert L. Sadoff, “Comprehensive Training in Forensic Psychiatry,”American Journal of Psychiatry, 131(2):223 (Feb. 1974); Browning Hoffman, Robert Showalter, and Charles Whitebread II, “A Forensic Psychiatry Clinic in Evolution,”Journal of Psychiatry and Law, 4(4):423 (Winter 1974).
15.
15. Jeffrey L. Geller and Eric D. Lister, “The Process of Criminal Commitment for Pretrial Psychiatric Examination: An Evaluation,”American Journal of Psychiatry, 135(1):53 (Jan. 1978).
16.
16. Theodric Romeyn Beck, Elements of Medical Jurisprudence (Albany, NY: Websters and Skinners, 1823), 1:334-390; Allan McLane Hamilton, A Manual of Medical Jurisprudence, with Special Reference to Diseases and Injuries of the Nervous System (New York: Bermingham, 1883), pp. 17-169; Henry C. Chapman, A Manual of Medical Jurisprudence and Toxicology (Philadelphia: W. B. Saunders, 1892), pp. 155-170.
17.
17. Irene Butter and Janet Grenzke, “Training and Utilization of Foreign Medical Graduates in the United States,”Journal of Medical Education, 45:607 (Aug. 1970); Irene Butter and R. G. Sweet, “Licensure of Foreign Medical Graduates: An Historical Perspective,”Milbank Memorial Fund Quarterly, 55:315 (1977).
18.
18. E. Fuller Torrey and Robert L. Taylor, “Cheap Labor from Poor Nations,”American Journal of Psychiatry, 130(4):428 (Apr. 1973).
19.
19. H. Pardes, P. Sirovatka, and J. W. Jenkins, “Psychiatry in Public Service: Challenge of the Eighties,”Hospital and Community Psychiatry, 30:756 (1979).
20.
20. Louis Y. Cheng, “On Being a Foreign Psychiatric Resident,”Canadian Psychiatric Association Journal, 19(5):523 (Oct. 1974); Yoosuf A. Haveliwala, “Problems of Foreign Born Psychiatrists,”Psychiatric Quarterly, 51(4):307 (1979).
21.
21. L. Gurel, A Survey of Academic Resources in Psychiatric Residency Training (Washington, DC: American Psychiatric Association, 1973), p. 42.
22.
22. D. J. Knesper, “Documenting a Shortage of Psychiatrists: The Repair Shop Model,”American Journal of Psychiatry, 137:1439 (1980).
23.
23. Park Elliott Dietz, Psychiatrists and Their Treatments: A Study in the Sociology of Psychiatry (Ann Arbor, MI: University Microfilms, 1984), pp. 130-134.
24.
24. Myron R. Sharaf and Daniel J. Levinson, “Patterns of Ideology and Role Definition among Psychiatric Residents,” in The Patient and the Mental Hospital: Contributions of Research in the Science of Social Behavior, ed. M. Greenblatt, D. J. Levinson, and R. H. William (New York: Free Press, 1957), pp. 263-285.
25.
25. Myron R. Sharaf and Daniel J. Levinson, “The Quest for Omnipotence in Professional Training: The Case of the Psychiatric Resident,”Psychiatry, 27:135 (1964).
26.
John Maciver and Fredrick C. Redlich, “Patterns of Psychiatric Practice,”American Journal of Psychiatry, 115:692 (Feb. 1959).
27.
27. Norman Kreitman, “Psychiatric Orientation: A Study of Attitudes among Psychiatrists,”Journal of Mental Science, 108:317 (1962).
28.
Leonard I. Pearlin and Gerald S. Klerman, “Career Preferences of Psychiatric Residents,”Psychiatry, 29:56 (Feb. 1966).
29.
Dietz , Psychiatrists and Their Treatments, pp. 211-239.
30.
30. Dietz, Psychiatrists and Their Treatments, pp. 302-387.
31.
31. Seymour L. Halleck, The Politics of Therapy (New York: Science House, 1971), pp. 150-151.
32.
32. Jesse Simon and Jack Zusman, “The Effect of Contextual Factors on Psychiatrists' Perception of Illness: A Case Study,”Journal of Health and Social Behavior, 24:186 (June 1983); Jack Zusman and Jesse Simon, “Differences in Repeated Psychiatric Examinations of Litigants to a Lawsuit,”American Journal of Psychiatry, 140(10):1300 (Oct. 1983).
33.
33. P. E. Dietz, “Educating the Forensic Psychiatrist,”Journal of Forensic Sciences, 24(4):880 (Oct. 1979).
34.
34. Ibid.
35.
35. Richard J. Bonnie and Christopher Slobogin, “The Role of Mental Health Profesionals in the Criminal Process: The Case for Informed Speculation,”Virginia Law Review, 66(3):427 (Apr. 1980).
36.
36. Alan A. Stone, Law, Psychiatry, and Morality: Essays and Analysis (Washington, DC: American Psychiatric Press, 1984), pp. 88-89.
37.
37. It is possible to concoct improbable factual situations in which these latter disorders would form the basis of a legitimate insanity defense; I have never seen such a case and am unconvinced by the cases my psychiatric colleagues offer as examples.
38.
38. Ben Karpman, “Iniquities and Inconsistencies Existing in Criminal Law and Psychiatric Testimony,”Archives of Criminal Psychodynamics, 1:397 (Spring 1955); John Petrilaet al., “The Pre-Trial Examination Process in Missouri: A Descriptive Study,”Bulletin of the American Academy of Psychiatry and the Law, 9(1):60 (1981).
39.
39. Lewis Thomas, The Youngest Science: Notes of a Medicine-Watcher (New York: Viking Press, 1983), pp. 19-35.
40.
40. Wen-Shing Tseng, “Psychiatric Study of Shamanism in Taiwan,”Archives of General Psychiatry, 26:561 (June 1972).
