Ongwen and Mental Health Defenses at the International Criminal Court.

The International Criminal Court (ICC) case against Lord's Resistance Army commander and former child soldier Dominic Ongwen of Uganda resulted in a guilty verdict and 25-year prison sentence. Mr. Ongwen unsuccessfully raised defenses based on mental health. These included fitness to stand trial, insanity under Article 31(1)(a) of the Rome Statute (a first at the ICC), mitigation in sentencing based on diminished mental capacity, duress (also a first), and the cumulative effects of mental health and duress. These defenses were hampered by limited and ambiguous textual support, which occurs in a politico-legal context that is cautious regarding such defenses. Another group of challenges comes from the inherent difficulty of international forensic practice. In regard to how mental health affects the duress defense, the text of the Rome Statute and the Ongwen decision create a burdensome legal framework for defendants, particularly where mental illness limits but does not "destroy" decision-making, as Article 31(1)(a) requires for an insanity acquittal. Going forward, defense teams may attempt to address the court's all-or-nothing conception of mental illness, perhaps arguing a diminished mental capacity theory that accounts for psychiatric function that is reduced but not destroyed.

Combat-related PTSD in military court: a diagnosis in search of a defense.

As more veterans return from Iraq and Afghanistan, Posttraumatic Stress Disorder (PTSD) often returns with them. As a result, PTSD has quickly become the most prevalent mental disorder diagnosis among active duty United States (U.S.) military. Although numerous studies have not only validated PTSD but have chronicled its negative behavioral impact, it remains a controversial diagnosis. It is widely diagnosed by all types of mental health professionals for even minimal trauma, and DSM-IV PTSD criteria have wide overlap with other mood and anxiety disorders. This, however, has not stopped PTSD from being used in civilian courts in the U.S. as a mental disorder to establish grounds for mental status defenses, such as insanity, diminished capacity, and self-defense, or as a basis for sentencing mitigation. Not surprisingly, PTSD has recently found its way into military courts, where some defense attorneys are eager to draw upon its understandable and linear etiology to craft some type of mental incapacity defense for their clients. As in the civilian sphere, this has met with mixed success due to relevance considerations. A recent court-martial, U.S. v. Lawrence Hutchins III, has effectively combined all the elemental nuances of PTSD in military court.

Personality disorders and criminal law: an international perspective.

At the International War Crimes Tribunal for the Former Yugoslavia (ICTY), a detention camp guard, charged with acts of murder and torture, advanced a plea of diminished responsibility. Defense psychiatrists testified that he had a personality disorder that influenced his ability to control his behavior, but a prosecution expert testified that the guard did not meet Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria. Thus, the unresolved question of how the law defines a mental disease or defect for purposes of mitigation or excuse was transposed to an international setting. It has been argued in a variety of jurisdictions and national legal systems that exculpatory mental disorders must be serious, and personality disorders should not qualify. In fact, it has been proposed that the volitional aspect of excuse defenses be eliminated, and definitions of mental disease or defect narrowed. Others have argued that such exclusions are too restrictive and arbitrary. This article examines the criminal defense at ICTY and traces its origin in national jurisdictions. Mental incapacity defenses based on personality disorders are more often used in The Netherlands, England, Germany and Belgium, but seldom in Canada and rarely in the United States and Sweden.

Mental incapacity defenses at the War Crimes Tribunal: questions and controversy.

Following a report from the Secretary General in May 1993, the United Nations Security Council adopted Resolution 827 and its Statute establishing an International War Crimes Tribunal for the Former Yugoslavia (ICTY) located in The Hague, The Netherlands. Although such action has been discussed in the past, this is the first time the international community has established a tribunal to indict and try individuals for war crimes. The crimes had been previously "created" by multilateral international treaties. The ICTY Rules of Procedure and Evidence allowed for "any special defense, including that of diminished or lack of mental responsibility." Precise legal parameters of the defense were not specified. In 1998, a defendant at the ICTY "Celebici" Trial named Esad Landzo raised the defense of diminished mental responsibility. The Celebici Trial Chamber thus became the first legal body to consider reduced mental capacity as it applies to international criminal law. This article is an examination of the application of the affirmative defense of diminished responsibility at the ICTY and relates the process to the need for further definition of mental incapacity defenses at the newly established International Criminal Court (ICC). At the ICC preparatory commission, drafting material elements of crimes was emphasized, with less consideration given to mental elements. That diminished capacity and diminished-responsibility defenses have often confused scholars and practitioners alike is explored in this article with suggestions for further directions.

Post-traumatic stress disorder and memory: prescient medicolegal testimony at the International War Crimes Tribunal?

The nature of remembrance of traumatic events has been particularly controversial during the past decade as vigorous new research has reshaped thinking about trauma and memory. Memory alterations in traumatized individuals have been investigated within both theoretical and biological frameworks. There are different types of memory, and empirical studies have associated post-traumatic stress disorder (PTSD) with a simultaneous weakening and a strengthening of memory. Memory deficiencies in PTSD have been found to be related to problems in new learning (explicit memory), but other specific deficiencies are unvalidated. Recently, accuracy of memory has received particular scrutiny because considerable importance is attached to victims' recollections. In 1998, at the International War Crimes Tribunal in The Hague, The Netherlands, a Bosnian-Croatian soldier was tried for aiding and abetting the rape of a Muslim woman. The defendant's lawyers suggested that the woman's memory was inaccurate, having been adversely affected by her traumatic experiences, and that the defendant whom she identified was not present during her interrogation and abuse. The prosecution disagreed and argued that memories of traumatic experiences in individuals with PTSD are characteristically hyperaccessible. Expert witnesses on both sides were brought in to provide medicolegal testimony about the scientific parameters of stress and its long-term effects on brain regions associated with memory. With the expert witness discussion as background, this article reviews the most recent research about the nature of memory in the aftermath of trauma and the politics of psychological trauma and the law.

Age as a bona fide occupational qualification for firefighting. A review on the importance of measuring aerobic power.

Recent federal and judicial initiatives have led to controversy over the justification of mandatory retirement policies applied to public safety occupations. The Equal Employment Opportunity Commission has been mandated to study this issue, and a critical element of that study will be to determine the types of tests to be employed as substitutes for a mandatory retirement age. In this review, a rationale is presented for the measurement of aerobic power (VO2max) as a predictor of the physical performance capability of firefighters. We conclude that task simulations rarely replicate the environmental conditions present at structural fires that stress the cardiorespiratory capability of firefighters. VO2max is an important predictor of performance effectiveness of firefighters to be used in conjunction with task-specific testing.

Oxygen consumption during fire suppression: error of heart rate estimation.

Ten male firefighters were tested on a treadmill to determine their heart rate (HR) x oxygen consumption (VO2) relationship. These men then performed a simulated fire suppression protocol during which HR and VO2 were measured simultaneously by a portable physiological monitoring system. Average VO2 in the simulated setting was 31.0 +/- 7.0 ml.kg-1.min-1 at a HR of 176 +/- 9 bpm. This VO2 was significantly (p less than or equal to 0.05) less than the VO2 that would have been predicted by treadmill testing (38.9 +/- 5.0 ml.kg-1.min-1) at a corresponding HR. Fifty-nine per cent of this variability could be accounted for by regression analysis. Firefighters worked on average at 73 +/- 10% VO2 max with a range of 54% to 88%. There was a significant (-0.82; p less than or equal to 0.05) inverse relationship between performance time of the fire suppression protocol and the relative intensity of VO2 max at which the firefighters worked. These findings indicate that the prediction of energy expenditure from HR is not straightforward in fire suppression settings. Furthermore, the relative intensity of work firefighters self-select is variable and should be considered as an additional physiological determinant of work behaviour.

Time urgency: the construct and its measurement.

Time urgency may be an important construct in industrial and organizational psychology. Preliminary analyses have indicated that time urgency may be multidimensional, and available self-report measures have been criticized on psychometric grounds. The present research addressed the dimensionality of time urgency. Behaviorally anchored rating scales (BARS), in which behavioral statements are substituted for qualitative anchors, were used to construct time urgency measures. The BARS technique produced multidimensional measures of time urgency that possessed adequate reliability and construct validity. The scales were tested on a wide variety of subjects. It is concluded that time urgency is a multidimensional construct. Relationships between the time urgency measures, job satisfaction, and work stress are discussed in light of previous research findings.

The selection of Chinese hamster cells deficient in oxidative energy metabolism.

A selection scheme based on the nutritional requirements of a previously described respiration-deficient Chinese hamster line has been used to isolate new mutants defective in oxidative energy metabolism. Three of the primary characteristics of this type of mutant are (1) a strict dependency on the continued presence of glucose for survival; (2) a drastic reduction in the rate of oxygen consumption; (3) an inhibition of Krebs cycle activity resulting in auxotrophy for asparagine and carbon dioxide. In the case of one cell line which was used (V79), up to 65% of the survivors of a selection were found to possess this phenotype after only one round of selection. By contrast, it proved much more difficult to obtain such mutants from another cell line (CCL16). A preliminary characterization of a number of these mutants is presented.