This article is not specifically intended for legal and psychiatric professionals only, although there is legal and psychiatric terminology used throughout the article.
What exactly is the insanity defense? First a person must be found to have actually committed a criminal act. If an individual did not commit a crime, then they would not be guilty of a crime. Next, a person must have a mental disease or defect; a psychological or behavioral pattern thought to cause distress or disability that is not expected as part of normal development or culture.
Finally, a mental disease has to be found at the time of the crime(s), not at the time of the trial. If a mental disease is found then they may have lacked the capacity to know or appreciate either the nature or consequences of their criminal conduct, or that it was wrong.
It has been a tradition in western law, or ethics, that an individual should not be held morally blameworthy over something they had no control over. For, if a piece of chalk were to break, one would not punish it or hold it morally blame worthy because it was simply following the laws of physics.
Further, there is a presumption in American law that an individual will not be punished unless they are responsible. In order for this to be determined in a case involving psychiatric testimony (a medical professional’s account of an event or state of affairs), interplay develops between the psychiatrist, lawyer, jury and criminal justice system. Sometimes these four elements play different roles.
On one hand, a psychiatrist may be working for the defense or the courts on the basis of evaluating a defendant. They may also be working for prosecution. In yet another situation a defendant may be both a patient and an individual who has been brought up on charges. At this point a multi-layered interaction involving some of the more difficult issues of law and psychiatry begin, as well as, the issue of double agency. This includes two types of conflicts, or even multiple conflicts within professional obligations.
The problem first arises when a psychiatrist must be hired to support a position in an insanity defense. The prosecution may avoid hiring a doctor who will not yield the results necessary to appose a defense. For example, presume that a defendant is looking for an insanity defense in a case where they have committed a crime. A defendant then has to hire a psychiatrist who will support the position that he is not responsible for a crime.