Forensic Assessments of Alcohol, Cannabis and Methamphetamine Intoxication in Cases of Violent Offending.

Whether a person was voluntarily or intentionally intoxicated at the time of commission of a violent offence is a common question in forensic contexts. While a person who was intoxicated may not be able to form the requisite specific intent to commit some offences, voluntary intoxication usually disentitles a person from an insanity or "mental impairment" defence. However, a person may also consume alcohol or use a substance without becoming intoxicated and the presence of alcohol, substances or metabolites of substances in a person's urine or blood is not conclusive when the question of intoxication is relevant. A jury (or a judge sitting without a jury) may require expert opinion evidence when cannabis or methamphetamine intoxication are implicated in the alleged offending.

Plausible subjective experience versus fallible corroborative evidence: The formulation of insanity in Nigerian criminal courts.

Insanity as a defence against criminal conduct has been known since antiquity. Going through significant reformulations across centuries, different jurisdictions across the globe, including Nigeria, have come to adopt various strains of the insanity defence, with the presence of mental disorder being the causative mechanism of the crime as their central theme. A critical ingredient in the Nigerian insanity plea is the presence of 'mental disease' or 'natural mental infirmity' as the basis for the lack of capacity in certain cognitive and behavioural domains resulting in the offence. Mental disorders, which are the biomedical formulations of this critical legal constituent are primarily subjective experiences with variable objective features. Using illustrative cases based on psycho-legal formulation as well as reform-oriented and fundamental legal research, it is shown that Nigerian courts have held that claims of insanity based on the accused person's evidence alone should be regarded as "suspect" and not to be "taken seriously." Thus, Nigerian judicial opinions rely on non-expert accounts of defendants' apparent behavioural abnormalities and reported familial vulnerability to mental illness, amongst other facts while conventionally discountenancing the defendants' plausible phenomenological experiences validated by expert psychiatric opinion in reaching a conclusion of legal insanity. While legal positivism would be supportive of the prevailing judicial attitude in entrenching the validity of the disposition in its tenuous precedential utility, legal realism invites the proponents of justice and fairness to interrogate the merit of such preferential views which are not supported by scientific evidence or philosophical reasoning. This paper argues that disregarding the subjective experience of the defendant, particularly in the presence of sustainable expert opinion when it stands unrebutted is not in the interest of justice. This judicial posturing towards mentally abnormal offenders should be reformed on the basis of current multidisciplinary knowledge. Learning from the South African legislation, formalising the involvement of mental health professionals in insanity plea cases, ensures that courts are guided by professional opinion and offers a model for reform.

Professional dynamics of the forensic evaluation of mental states in eighteenth-century Denmark-Norway.

This study examines criminal cases related to blasphemy under the absolute monarchy of Denmark-Norway, and presents the evaluation of mental states within a forensic context between 1713 and 1733. First, the article explains how the legal framework and normative guidelines for pastoral care envisaged the interplay between judges, priests and doctors in evaluating mental states. Then, an examination of selected cases is provided, showing the dynamics and the role assignment in the evaluation of mental states in practice. Covering a period characterized by a gradual differentiation of theology, law and medicine, this case study enhances understanding of what preceded the development of psychiatry as a medical speciality during the nineteenth century.

A narrative review of international legislation regulating fitness to stand trial and criminal responsibility: Is there a perfect system?

Mentally ill offenders have a right to a fair trial and adequate treatment in terms of the law. The diversion of mentally ill offenders between the criminal justice and the mental health care systems is linked to the forensic psychiatric assessment and based on two psycho-legal constructs, fitness to stand trial (FTST) and criminal responsibility (CR). Forensic psychiatric assessment is therefore an important element in criminal law and plays a major role in the court's decisions regarding the sentence, detention, placement, or treatment of mentally ill offenders. The legislation aims to ensure balancing the rights of mentally ill offenders to psychiatric care and society's safety. A narrative overview of the literature summarizing the findings on legislation regulating FTST and CR assessment and their practice in different areas of the world was conducted. It offers insight into the advantages and disadvantages of the various approaches and examines the way court proceedings function in these different geographical and psychosocial-legal contexts. This may have policy implications for individual systems and allow countries to consider feasible mechanisms to refine the relevant legislation to improve their practices in forensic psychiatric assessments. Worldwide, relevant legislation is considered as essential in protecting mentally ill offender's right; it has been established for many years regarding specifying the procedures and responsibilities for the mental health care and criminal justice systems. Despite similarities in the principles of the psycho-legal constructs in different countries, there are differences in the way legislations are implemented, often depending on the available resources.

Blasphemy law, mental illness and the potential for injustice: a cautionary tale from Indonesia.

This article highlights troubling recent cases in Pakistan and Indonesia involving the preferring of the criminal charge of blasphemy. It gives particular scrutiny to the charges of blasphemy and blasphemous libel brought against Suzethe Margaret, a Catholic woman with schizophrenia in Indonesia in 2019. While it applauds the fact that in February 2020 she was acquitted by the Cibinong District Court, it expresses concern about the period of time she was held in detention without resolution of her circum stances and the risk that the decision could have been less legally rigorous. It utilises the case to reflect on the risks inherent in the subjectivity in the charge of blasphemy and the particular dangers when the accused person suffers from a mental illness that may either preclude their fitness to be tried or raise the potential for them to be not guilty by reason of mental impairment/insanity.

The insanity defence without mental illness? Some considerations.

In this paper we aim to offer a balanced argument to motivate (re)thinking about the mental illness clause within the insanity defence. This is the clause that states that mental illness should have a relevant causal or explanatory role for the presence of the incapacities or limited capacities that are covered by this defence. We offer three main considerations showing the important legal and epistemological roles that the mental illness clause plays in the evaluation of legal responsibility. Although we acknowledge that these advantages could be preserved without having this clause explicitly stated in the law, we resist proposals that deny the importance of mental illness in exculpation. We argue, thus, that any attempt at removing the mental illness clause from legal formulations of the insanity defence should offer alternative ways of keeping in place these advantages.

The immolation of an Indian bus driver in Brisbane, Australia: delusional disorder, not a 'hate crime' In the matter of Anthony O'Donohue [2018] QMHC 8, Dalton J.

In October 2016, a burning liquid was thrown over a bus driver in Brisbane, Australia. It was reported across the world that the 29-year-old bus driver was a Punjabi Indian and that his killing may have been a hate crime. A subsequent independent inquiry found that 50-year-old Anthony O'Donohue, who was charged with murder and other offences, had a long history of mental illness and had been discharged from treatment from a community mental health service four-and-a-half months earlier. In August 2018, the Queensland Mental Health Court found that, at the time of the alleged offences, Mr O'Donohue was of unsound mind and acquitted him of all charges. The case provides an opportunity to consider the decision making of a mental health service in the prelude to a major critical incident. The case also highlights the tension between the principles of patient autonomy and the 'recovery model' of mental illness on the one hand and the need to assertively manage persons who have no insight into their serious mental illness and are at risk of harming themselves or others.

How does India Decide Insanity Pleas? A Review of High Court Judgments in the Past Decade.

BACKGROUND: The Section 84 of the Indian Penal Code (IPC) describes how Indian courts have to deal with 'the act of an unsound person'. This study was undertaken with the objectives of estimating the success rate of insanity pleas in Indian High Courts and determining the factors associated with the outcome of such insanity pleas. MATERIALS AND METHODS: The data was collected from the websites of 23 High Courts of India using the keywords 'insanity' and 'mental illness', and the judgments delivered between 1.1.2007 and 31.08.17 were retrieved. Information regarding the nature of the crime, diagnosis provided by the psychiatrist as an expert witness, documents used to prove mental illness, and the judgment pronounced by the High Court were retrieved. RESULTS: A total of 102 cases were retrieved from 13 High Courts for which data was available. Out of the 102 cases examined, the High Court convicted the accused in 76 cases (74.50%), thereby rejecting the insanity defense. The High Court acquitted the accused under section 84 IPC in 18 cases (17.65%), thereby accepting the insanity plea raised by the accused. Chi-square tests of independence revealed that the verdict of the lower court, documentary evidence of mental illness prior to the crime, and the psychiatrist's opinion were associated with the success of insanity pleas. CONCLUSION: Insanity pleas had a success rate of about 17% in Indian High Courts in the past decade. The factors associated with success of insanity pleas provide valuable guidance to several stakeholders who are dealing with mentally ill offenders.

The medical criterion of recognition of person's insanity defence: ukrainian and foreign experience.

OBJECTIVE: Introduction: Problems of recognition of person's insanity defence occupy borderline between jurisprudence and medicine as they are based on a combination of medical and legal criteria. This makes them relevant in the context of medical law. The aim: of the article is to determine the medical criterion of recognition of person's insanity defence on the basis of international standards, Ukrainian and foreign experience. PATIENTS AND METHODS: Мaterials and methods: International documents, national legislation of Ukraine and foreign countries, theoretical works in the field of jurisprudence and psychiatry, empirical materials on the recognition of persons's insanity defence in Ukraine. CONCLUSION: Сonclusions: As a result of the research the universal medical criterion of insanity was formulated as "mental disorder defined by the International Statistical Trauma Classification, death resulting in a person being unable to understand and direct his or her actions", that may be implemented into the criminal legislation of any state.

Testing Equality: Insanity, Treatment Refusal and the CRPD.

The Convention on the Rights of Persons with Disabilities is considered to be a radical international treaty that affords persons with disability recognition and protection of equal rights in socio-cultural, political, medical and legal arenas. Drawing from the Convention's core principles of equality and non-discrimination, the High Commissioner for Human Rights and the Convention's Committee have called for a replacement of the insanity defence with a disability-neutral doctrine. The rationale is that retaining this special defence is, in itself, discriminatory, given its function is necessarily based on the presence of mental disability and the assumption that such disabilities impair capacity and reasoning. This article interrogates the rationale behind 'abolitionist' views, and asks whether equality necessarily means treating all persons identically regardless of capacity to reason about conduct.

Socio-demographic, psychiatric and legal characterisation of Colombian unimputable patients, 2000-2013, / Caracterización sociodemográfica, psiquiátrica y legal de pacientes inimputables de Colombia, 2000-2013

Abstract Introduction: Mental illness has been associated with violent behaviour. Criminal behaviour in the mentally ill population in Colombia has not been well studied. Methods: This is a retrospective, descriptive study, from a secondary source. An analysis was made of the sociodemographic, clinical, and legal variables of 127 unfit to plead patients. A descriptive analysis of quantitative variables was performed by measures of central tendency, and frequencies and percentages were calculated for the qualitative variables. The software SPSS® version 21.0 was used to analyse the data, and the study was approved by the Research Committee of the CES University. Results: The median age was 34 years, interquartile range 19 years, and 92.1% were men. The primary diagnosis was schizophrenia in 63%, 66.9% consumed alcohol, and 58.3% other drugs at the time they committed the crime. Almost one/third (29.1%) had a criminal record, and the most common type of crime was murder in 44.1% of cases. Around half (50.3%) of the victims had some degree of consanguinity with the patient. Discussion: The study subjects had higher illiteracy and lower educational levels than the Colombian prison population. Schizophrenia was the main diagnosis, and homicide the most prevalent crime, which agrees with the literature where non-indictable patients are responsible for 5-20% of murder cases worldwide. Conclusions: To reduce the gap between the diagnosis and treatment of mental disorders, especially schizophrenia, should be within the specific actions to prevent violence and criminal behaviour associated with mental illness.

Resumen Introducción: La enfermedad mental se ha asociado con comportamientos violentos. En Colombia poco se ha estudiado la población de enfermos mentales con comportamiento criminal. Métodos: Estudio descriptivo retrospectivo a partir de fuente secundaria. Se analizaron variables sociodemográficas, clínicas y legales de 127 pacientes inimputables. Se realizó análisis descriptivo de las variables cuantitativas a través de medidas de tendencia central, y para las variables cualitativas se obtuvieron frecuencias y porcentajes. La información se analizó con el software SPSS versión 21.0. La investigación fue aprobada por el Comité de Investigación de la Universidad CES. Resultados: La mediana de edad fue 34 [intervalo intercuartílico, 19] años; el 92,1% eran varones. El diagnóstico principal fue esquizofrenia en el 63%. En el momento de cometer el crimen, el 66,9% consumía alcohol y el 58,3%, drogas. El 29,1% tenía antecedentes delictivos y el tipo de delito más frecuente (44,1%) fue el homicidio. El 50,3% de las víctimas tenían algún grado de consanguinidad con el paciente. Discusión: En los sujetos del estudio había más analfabetismo y menor nivel educativo que en la población general carcelaria colombiana. La esquizofrenia fue el principal diagnóstico y el homicidio, el delito más prevalente, lo cual coincide con la literatura que refleja que los inimputables son responsables de un 5-20% de los casos de homicidio en el mundo. Conclusiones: Disminuir la brecha para el diagnóstico y el tratamiento de los trastornos mentales, especialmente la esquizofrenia, estaría entre las acciones concretas para prevenir la violencia y la conducta criminal asociada a enfermedad mental.

[Socio-demographic, Psychiatric and Legal Characterization of Colombian Unimputable Patients, 2000-2013]. / Caracterización sociodemográfica, psiquiátrica y legal de pacientes inimputables de Colombia, 2000-2013.

INTRODUCTION: Mental illness has been associated with violent behaviour. Criminal behavior in the mentally ill population in Colombia has not been well studied. METHODS: This is a retrospective, descriptive study, from a secondary source. An analysis was made of the sociodemographic, clinical, and legal variables of 127 unfit to plead patients. A descriptive analysis of quantitative variables was performed by measures of central tendency, and frequencies and percentages were calculated for the qualitative variables. The software SPSS® version 21.0 was used to analyse the data, and the study was approved by the Research Committee of the CES University. RESULTS: The median age was 34 years, interquartile range 19 years, and 92.1% were men. The primary diagnosis was schizophrenia in 63%, 66.9% consumed alcohol, and 58.3% other drugs at the time they committed the crime. Almost one/third (29.1%) had a criminal record, and the most common type of crime was murder in 44.1% of cases. Around half (50.3%) of the victims had some degree of consanguinity with the patient. DISCUSSION: The study subjects had higher illiteracy and lower educational levels than the Colombian prison population. Schizophrenia was the main diagnosis, and homicide the most prevalent crime, which agrees with the literature where non-indictable patients are responsible for 5%-20% of murder cases worldwide. CONCLUSIONS: To reduce the gap between the diagnosis and treatment of mental disorders, especially schizophrenia, should be within the specific actions to prevent violence and criminal behavior associated with mental illness.

Putting negative attitudes on the agenda? Not Criminally Responsible Reform Act publicity and juror decision-making.

The current study examined the effect of publicity about Canada's recent Not Criminally Responsible (NCR) Reform Act - legislation surrounding accused in insanity cases that purportedly aims to enhance public safety - on juror decision-making. In line with agenda-setting theory, we expected that NCR Reform Act publicity might reinforce certain fears about the insanity defence, dependent on whether it had either a positive or negative evaluative slant. Contrary to previous work on the insanity defence, participants in this study generally favoured a NCR verdict. The evaluative slant of the NCR publicity had no effect on verdict decisions or insanity defence attitudes, but there was a significant difference in participants' evaluations of the fairness of the Reform Act, such that those exposed to a positive or control article viewed the act as fairer than those exposed to a negative article. This study may aid future researchers in evaluating potential unintended consequences of the NCR Reform Act.

Reliability of repeated forensic evaluations of legal sanity.

Criminal responsibility evaluation is a very complex and controversial issue due to the gravity of its consequences. Polish legislation allows courts to request multiple sanity evaluations. The purpose of this study was to assess the extent of agreement on sanity evaluations in written evidence provided by experts of criminal cases in Poland. A total of 381 forensic evaluation reports addressing 117 criminal defendants were analysed. In sixty eight cases, there was more than one forensic evaluation report containing an assessment of legal sanity, including forty one cases containing two assessments of criminal responsibility, seventeen containing three assessments, eight containing four assessments and two containing five assessments. We found that in 47% of the cases containing more than one sanity assessment, the initial criminal responsibility assessment was changed after a subsequent forensic evaluation. The agreement between repeated criminal responsibility evaluations was found to be fair. This study found a strong correlation between the number of forensic reports and the number of contradictory sanity assessments. There were fewer forensic opinions involved in the cases in which the same conclusion regarding criminal responsibility was reached in subsequent forensic evaluation reports compared to the cases in which more forensic opinions were involved. There is a clear need for further research in this area, and it is necessary to standardise criminal responsibility evaluations in order to improve their reliability and to shorten the legal proceedings.

Introducing a standard of legal insanity: The case of Sweden compared to The Netherlands.

A recent governmental report has suggested that the notion of insanity, which has not been a relevant concept in Swedish criminal law for the last 50years, should be reintroduced into the criminal justice system. This move has generated a debate over the most appropriate criteria to be included in a legal standard for insanity. We consider the fundamental question of whether a legal standard is required when introducing insanity, by looking at a legal system in which legal insanity is available but where no standard is used: The Netherlands. Overall, a review of advantages and disadvantages leads to the conclusion that such a standard is necessary. What exactly should that standard be? Is the development of different "grades" of insanity desirable? Legal considerations concerning what is essentially a legal notion should predominate in making these determinations-informed by psychiatric and other relevant scientific findings.

Crime Offender With Mental Retardation: A Case Report

Objective: This case report aims to discuss the diagnosis of mental retardation as insanity defence in a crime offender. Methods: We report a gentleman who committed murder and rape 9 years ago, and currently being treated at a mental institution. Results: Patient was certified to have mental retardation, and was pleaded on the defence of unsoundness of mind because he had defect of reason at the time of alleged offence. Conclusion: Mental retardation does fulfil the McNaughton’s rule. Unsoundness of mind becomes the insanity defence even for murder under section 84 of the Penal Code.