“Doctor, I don’t think I have to remind you that there is a difference between clinically insane and legally insane”.
This was uttered by fictional prosecutor Jack McCoy on one of the Law & Order series’ episodes – no doubt during cross-examination, given his tone.
I’ve thought about this duality by and by for many years – at least as far back as when I first heard the news reports back in November of ’86 of then 15-year-old Rod Matthews bludgeoning his classmate Shaun Ouillette to death in Canton, MA.
The physical proximity to my own hometown of Hanover didn’t faze me, nor did the fact that Matthews is my senior by a matter of months and Ouillette was a year younger than I was when he was killed. What did bother me was the disconnect between definitions of terminology in that and many cases I’ve pondered since. The two most striking (and potentially confusing) dichotomies center around issues of sanity, and of adulthood. Unfortunately, for reasons of time, coherence, and proper respect and depth of discussion, I must give short shrift herein to the latter issue, as it is quite complicated and controversial in its own right.
So, aside from the borderline politically incorrect nature of the term insane, so characterized by this author for its connotatively derisive potential and for its utter sloppiness in conveying any real information regarding the psychological and/or psychiatric health (or pathology) of the individual so broad-brushed, why should we be concerned that the realms of jurisprudence and criminal trial should recognize this health and social concern to the point of altering this term (again, notwithstanding its sloppy and derisive nature) by tagging it with an adjective that claims ownership within the its predominant nomenclature commonly dubbed as “legalese”, and thus so simplifying what this sentence already proves is a very convoluted and tangled issue?
Because it is downright inaccurate.
Have you ever heard of being “legally diabetic”? How about “legally Leukemic”? “Legally deaf”? No.
This is just more proof that society has yet to “be convinced” that mental illness IS real illness. If you can’t see it, touch it, smell it, taste it, hear it, or quantify its existence under a microscope or on some X-ray or MRI film, many people p-shaw such an illness’s legitimacy.
It is duplicitous on its face for suggesting that there is some room for criminal responsibility to be assessed even upon somebody who would otherwise be judged incompetent and even determined to be unable to function as an independent and personally liable individual in one or more (or all) areas of his life.
There is no such thing as being conveniently impaired! If a person is able to function in life such that he can make his own decisions, support and sustain his own welfare, and otherwise self-regulate, then he is “sane”.
Nobody is “diagnosed” as “insane” for the purposes of avoiding legal responsibility, at least accurately so as compared to a comprehensive, clinical evaluation utilizing the tools and criteria contained within the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), and the suggestion that this takes place is a vomitously incendiary slur, or worse, a justified indictment of the integrity of both the medical and legal professions.
For to determine that an individual is (merely) “legally inane”, and as such, to imply that there is or should be a dichotomy between one’s personal responsibility and his genuinely medically assessed level of mental health, belies the very diagnosis in question, and would or will have long-term consequences that extend far, and quite unfairly and tragically, beyond the courtroom venue, or even beyond any legal concern whatsoever.
To “water down” the diagnostic criteria, and thus the clinical significance of any condition identified therefrom, not to mention the effectiveness of those treatment modalities when they are misapplied and subsequently erroneously assessed (based on the corrupt data from those cases where malady has been inappropriately concluded), is to thumb our noses at the rule of law, as well as to subvert and devastate the development and practice of sound medicine for as long as said fuzziness remains, and for thousands and thousands of hours of laborious reversal and needless waste of resources on what would be an absolute scientific and public health necessity for decades thereafter.
It is way past high time that we sever, under no ambiguous terms, the jurisdictions of criminal prosecution and medical diagnosis and practice.
We already recongize the need for separation of church and state. We don’t declare that the two never converge, but that each has its own jurisdiction which the other must respect and abide. Sometimes there are matters where their concerns and jurisdictions intersect, and where a cooperation or symbiosis is necessary if we are to maintain the integrity and public legitimacy of both arenas. Some scenarios this author can fathom go WAY beyond the scope of this piece, but I might suggest that “the right thing to do” is NOT at all easy or obvious when, for instance, a priest takes the confession of a murderer. If his priestly and legal/civic obligations contradict each other, well then don’t we have even more serious and pressing human dilemmas filling our plates!
But don’t then take the fatally flawed leap to logical fallacy that we must conceive of two different standards of right and wrong, just so that two separate entities can keep their turf! The *correct* response, dare I say, is to reassess our definitions and conclusions, and do the hard work of both reason and faith that does result in a clear answer for each manifestation of the human condition. Just because we cannot figure out an answer, and especially not *RIGHT NOW*, does not mean that one does not exist.
Often it is merely a matter of respecting definitions, and of the intense precision and tenacity that finding and confirming the truth demands. There is and there should never be a “moral” definition of death and separate and different “legal” definition of death, for example.
Likewise, there is (or there should be!) *NO* double standard with regard to how an individual’s health is assessed and treated.
The public citizenry has the right to demand a response to certain acts that confirm their unlawfulness and threat to the public good. But, the asssessment of an action, and any corrective, preventive or retributive response is separate from, but MUST consider the individual accussed.
And, when matters of criminal culpability are confounded by the medically sound conclusion that an individual is somehow, specifically – mentally) compromised, it is appropriate and just to find that responsibility is mitigated.
The correct and scholarly practice that is sound, sober, comprehensive diagnosis is not and must never BE corrupted by nonmedical concerns. How the legal system chooses to respond to or recognize a medical finding is its own perilous responsibility.
But, science and public health demands, and so must we, that medicine and law retain their respective autonomy, so that each can function correctly.
And the truth, nor justice, must never, EVER be compromised. Dual definitions and convoluted meanings serve nobody, and do a tremendous disservice to both truth and justice.