The psychiatrist's guide to right and wrong: Part II: A systematic analysis of exculpatory delusions.

Although delusions are prima facie evidence of psychosis, their mere presence is not a sufficient condition for exculpation on the grounds of insanity. In most cases, a determination of insanity will depend on the specific content of the delusions and whether, as a result of these delusions, the defendant was unable to know or appreciate the wrongfulness of his or her act. Delusions may be subdivided into four types, according to their content: 1) delusions of being controlled, 2) delusions of grandiosity, 3) delusions of persecution, and 4) delusions of jealousy. An analysis is undertaken of these delusional subtypes in terms of their exculpatory effect within the jurisdictions which follow each of the three respective standards of wrongfulness (i.e., the illegality standard, the subjective moral standard, and the objective moral standard). The criminal law does not recognize a transcendent constancy in the legal insanity status of psychotic individuals whose offense was the result of their delusional ideation. In most such cases, exculpation is based primarily on the specific content of their delusions and how it comports with the law of the jurisdiction specific content of their delusions and how it comports with the law of the jurisdiction in which the act was committed (the lex loci delicti commissi).

Forensic psychiatry in private practice.

This paper presents statistical and explanatory analyses of 637 forensic psychiatry cases in a private practice setting during the past 12 years, highlighting the remarkable variety of clinical and legal issues addressed by forensic psychiatrists. Emphasis is on how and why forensic psychiatrists need to be expert diagnosticians and clinicians, and ways in which they may respond to difficult clinical and legal opinions are recommended.

What price insanity?

The insanity defence in Canada is defined by the use of Section 16 of the Criminal Code. Legal sanity is determined by the application of an outdated set of rules which require only that the accused be able to determine right from wrong in the particular circumstances that appear to have applied at the time of the alleged offence. The actual application of the defence suggests that its interpretation in practice is considerably affected by factors other than the mental state of the accused. The arbitrary and ill-understood nature of these interposed factors removes any certainty that justice, or the well-being of the accused, is to be found by use of the existing law. Psychiatry should not rest content that its understanding of the determinants of human behavior is in any way accurately represented by Canada's Criminal Code.

The legal basis of forensic psychiatry: statutorily mandated psychiatric diagnoses.

Using the Oregon statutory scheme as an example, the authors review certain areas of the law where psychiatric expertise is mandated by statute. This review points out the diversity of determinations where forensic psychiatric expertise is required by law. The authors' thesis is that forensic psychiatry draws its vitality from the law. Legal requirements, however, should not dictate psychiatric response, which should be guided by psychiatric knowledge and ethical concerns.

When it pays to be insane: three unusual legacies of insanity.

Although the law generally does not permit an individual to profit by his own wrongdoing, that equitable principle may be inapplicable in the case of an individual who has been adjudicated insane (and therefore has not committed a wrong in the eyes of the law). This paper discusses three unusual legacies of a determination of insanity: the inheritance cases (permitting the insane killer to inherit from his own victim), the life insurance cases (permitting the beneficiary to recover when the insured commits suicide while insane), and the effect of insanity on publication rights agreements in sensational criminal cases.

Persons held on Warrants of the Lieutenant Governor in Canada.

Gross demographic data are supplied on all patients held under Warrants of the Lieutenant Governor in Canada. The composition of the total population varies considerably from one province to another, with resulting differences in such important factors as total time spent on warrant. A plea is made for some kind of continuing monitoring of this expensive-to-treat group, and it is argued that the Boards of Review are, because of lack of basic statistical information, at an unnecessary disadvantage when it comes to making decisions as to whether to release individuals or not. It is suggested that a fairly simple information and tracking system could reduce treatment costs, with concomitant decreases in confinement of patients, without at the same time increasing risk of harm to the general population.