Abstract
“Mental unsoundness in a person accused of crime may give rise to two entirely distinct legal problems. The first is the question of the defendant's responsibility; whether at the time of the act charged, he was so mentally disordered as not to be punishable for it, under the legal test of responsibility; that is, whether at that time he knew the wrongfulness of the act, and, in some states, whether he was able to resist the impulse to commit it. … The other involves the defendant's mental condition not at the time of the act charged, but at the time of the criminal proceedings—whether he is presently sane enough to plead or be tried, or after trial, whether he is sane enough to undergo punishment. Since the first problem involves the 'guilt' or 'innocence' of the defendant, while the second does not, the latter has been given comparatively little consideration. Nevertheless, as a matter of procedure, it is highly important. Any reform in the method of trying persons alleged to be insane probably will come through perfecting means for preventing the trial of mentally diseased or deficient persons, rather than through a change in the substantive law or procedure relating to the question of responsibility.