{"id":2756,"date":"2020-10-01T02:58:19","date_gmt":"2020-10-01T02:58:19","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/abnormalpsych\/?post_type=chapter&#038;p=2756"},"modified":"2022-07-26T20:07:15","modified_gmt":"2022-07-26T20:07:15","slug":"legal-and-forensic-issues-in-abnormal-psychology","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/chapter\/legal-and-forensic-issues-in-abnormal-psychology\/","title":{"raw":"Legal and Forensic Issues in Abnormal Psychology","rendered":"Legal and Forensic Issues in Abnormal Psychology"},"content":{"raw":"<div class=\"textbox learning-objectives\">\r\n<h3>Learning Objectives<\/h3>\r\n<ul>\r\n \t<li style=\"font-weight: 400;\">Explain forensic issues in psychological treatment, such as the insanity defense, competency to stand trial, and understanding the purpose of punishment<\/li>\r\n<\/ul>\r\n<\/div>\r\n\r\n[caption id=\"\" align=\"alignright\" width=\"272\"]<img class=\"\" title=\"Front view of federal mug shot of Jared Lee Loughner taken while in custody of U.S. Marshals in Phoenix, Arizona.\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/8\/82\/Jared_Loughner_USMS.jpg\" alt=\"Jared Loughner USMS.jpg\" width=\"272\" height=\"340\" \/> <strong>Figure 1<\/strong>. Jared Lee Loughner, a convicted mass murderer, was originally ruled incompetent to stand trial due to a diagnosis of paranoid schizophrenia but was later ruled competent and sentenced to life plus 140 years in federal prison.[\/caption]\r\n\r\nJared Lee Loughner (born September 10, 1988) is a convicted American mass murderer who pled guilty to 19 charges of murder and attempted murder in connection with the January 8, 2011, Tucson shooting. After his arrest, two medical evaluations diagnosed Loughner with paranoid schizophrenia and ruled him incompetent to stand trial. Punishment or treatment? What should we do when someone who is mentally ill but commits a horrendous crime?\r\n\r\nIn this section, we will discuss the forensic issues in psychological treatment, such as the insanity defense, competency to stand trial, and the purpose of punishment. We will also examine the ethical and legal issues in providing service and the rights of mentally ill patients. What is the legal responsibility or duty of mental health care providers to protect individuals who are being threatened with bodily harm by a patient in their care. Should we honor the right to refuse treatment when someone is psychologically disturbed? Should psychiatrists administer antipsychotics or any other drug deemed necessary to treat patients against their will? Should mentally ill clients with a history of violent behavior be recommended for commitment or involuntary hospitalization?\u00a0<span style=\"font-size: 1em;\">How do we balance the rights of the individual with the rights of society?<\/span><span style=\"font-size: 1em;\">\u00a0D<\/span><span style=\"font-size: 1rem; text-align: initial;\">oes the answer to these questions lie with the criminal justice system or with the mental health system?<\/span>\r\n\r\nBelow, we begin by summarizing the major perspectives on ethical and forensic issues in psychological treatment.\r\n<div class=\"textbox exercises\">\r\n<h3><b>Tarasoff v.\u00a0Regents of the University of California<\/b><\/h3>\r\n<i><b>Tarasoff v.\u00a0Regents of the University of California<\/b><\/i>, (Cal.\u00a01976), was a case in which the\u00a0Supreme Court of California\u00a0held that\u00a0mental health professionals\u00a0have a\u00a0<strong>duty to protect<\/strong>\u00a0individuals who are being threatened with bodily harm by a patient. The original 1974 decision mandated warning the threatened individual, but a 1976 rehearing of the case by the California Supreme Court called for a \u201cduty to protect\u201d the intended victim. The professional may discharge the duty in several ways, including notifying police,\u00a0warning the intended victim, and\/or taking other reasonable steps to protect the threatened individual.\r\n<h2><span id=\"History\" class=\"mw-headline\">History<\/span><\/h2>\r\nProsenjit Poddar was a student from\u00a0Bengal,\u00a0India.\u00a0He entered the\u00a0University of California, Berkeley, as a graduate student in September 1967 and resided at International House. In the fall of 1968, he attended folk dancing classes at the International House, and it was there that he met Tatiana Tarasoff. They dated, but apparently had different ideas about the relationship. He assumed their relationship was serious. This view was not shared by Tarasoff who, upon learning of his feelings, told him that she was involved with other men and that she was not interested in entering into an intimate relationship with him. This statement gave rise to feelings of resentment in Poddar. He began to stalk her.\r\n\r\nAfter this rebuff, Poddar underwent a severe emotional crisis. He became depressed and neglected his appearance, his studies, and his health. He kept to himself, speaking disjointedly and often weeping. This condition persisted, with steady deterioration, throughout the spring and into the summer of 1969. Poddar had occasional meetings with Tarasoff during this period and tape-recorded their various conversations to try to find out why she did not love him.\r\n\r\nDuring the summer of 1969, Tarasoff went to\u00a0South America. After her departure, Poddar began to improve and at the suggestion of a friend sought psychological assistance. Prosenjit Poddar was a patient of Dr. Lawrence Moore, a\u00a0psychologist\u00a0at UC Berkeley\u2019s Cowell Memorial Hospital in 1969. Poddar confided his intent to kill Tarasoff. Dr. Moore requested that the campus police detain Poddar, writing that, in his opinion, Poddar was suffering from\u00a0paranoid schizophrenia, acute and severe. The psychologist recommended that the defendant be\u00a0civilly committed\u00a0as a dangerous person. Poddar was detained but shortly thereafter released, as he appeared rational. Dr. Moore\u2019s supervisor, Dr. Harvey Powelson, then ordered that Poddar not be subject to further detention.\r\n\r\nIn October, after Tarasoff had returned, Poddar stopped seeing his psychologist. Neither Tarasoff nor her parents received any warning of the threat. Poddar then befriended Tarasoff\u2019s brother, even moving in with him. Several weeks later, on October 27, 1969, Poddar carried out the plan he had confided to his psychologist, stabbing and killing Tarasoff. Tarasoff\u2019s parents then sued Moore and various other employees of the university.\r\n\r\nPoddar was subsequently convicted of\u00a0second-degree murder, but the conviction was later appealed and overturned on the grounds that the jury was inadequately\u00a0instructed. A second trial was not held, and Poddar was released on the condition that he would return to\u00a0India.\r\n<h2><span id=\"Opinion_of_the_court\" class=\"mw-headline\">Opinion of the court<\/span><\/h2>\r\nThe California Supreme Court found that a\u00a0mental health professional\u00a0has a duty not only to a patient, but also to individuals who are specifically being threatened by a patient. This decision has since been adopted by most states in the United States and is widely influential in jurisdictions outside the United States as well.\r\n<h2><span id=\"Subsequent_developments\" class=\"mw-headline\">Subsequent developments<\/span><\/h2>\r\nAs of 2012, a <strong><em>duty to warn or protect<\/em><\/strong> is mandated and codified in legislative statutes of 23 states, while the duty is not codified in a statute but is present in the common law supported by precedent in 10 states. Eleven states have a permissive duty, and six states are described as having no statutes or case law offering guidance.\r\n\r\nIn 2018, the Court held that universities should protect students in the\u00a0<em>Regents of University of California v. Superior Court of Los Angeles County.<\/em>\r\n\r\n<\/div>\r\n<h2>Commitment of Clients<\/h2>\r\nStarting in the 1960s, there has been a worldwide trend toward moving psychiatric patients from hospital settings to less restricting settings in the community, a shift known as \"deinstitutionalization.\" Because the shift was typically not accompanied by a commensurate development of community-based services, critics say that deinstitutionalization has led to large numbers of people who would once have been inpatients as instead being incarcerated or becoming homeless.\u00a0In some jurisdictions, laws authorizing court-ordered outpatient treatment have been passed in an effort to compel individuals with chronic, untreated, severe mental illness to take\u00a0psychiatric medication\u00a0while living outside the hospital (see\u00a0<a title=\"Laura's Law\" href=\"https:\/\/en.wikipedia.org\/wiki\/Laura%27s_Law\" target=\"_blank\" rel=\"noopener\">Laura's Law<\/a>,\u00a0<a title=\"Kendra's Law\" href=\"https:\/\/en.wikipedia.org\/wiki\/Kendra%27s_Law\" target=\"_blank\" rel=\"noopener\">Kendra's Law<\/a>).\u00a0<sup id=\"cite_ref-21\" class=\"reference\"><\/sup>\r\n\r\nIn most jurisdictions, <strong>involuntary commitment<\/strong> is applied to individuals believed to be experiencing a mental illness that impairs their ability to reason to such an extent that the agents of the law, state, or courts determine that decisions will be made for the individual under a legal framework. This is a proceeding distinct from being found\u00a0incompetent and\u00a0limits involuntary treatment to individuals who meet statutory criteria for presenting a danger to self or others.\u00a0<b>Involuntary commitment<\/b>\u00a0is a legal process through which an individual who is deemed by a qualified agent to have symptoms of severe\u00a0mental disorder\u00a0is detained in a\u00a0psychiatric hospital\u00a0(inpatient) where they can be\u00a0treated involuntarily. This treatment may involve the administration of\u00a0psychoactive drugs\u00a0including involuntary administration. In many jurisdictions, people diagnosed with mental health disorders can also be forced to undergo treatment while in the community, this is sometimes referred to as\u00a0outpatient commitment\u00a0and shares legal processes with commitment.\r\n\r\nA number of civil and human rights activists, anti-psychiatry\u00a0groups, medical and academic organizations, researchers, and members of the\u00a0psychiatric survivors movement\u00a0vigorously oppose involuntary treatment on\u00a0human rights\u00a0grounds or on grounds of effectiveness and medical appropriateness, particularly with respect to involuntary administration of mind-altering substances, ECT, and psycho-surgery. Some criticism has been made regarding cost, as well as of conflicts of interest with the pharmaceutical industry. Critics, such as the\u00a0New York Civil Liberties Union, have denounced the strong\u00a0racial\u00a0and\u00a0socioeconomic\u00a0biases\u00a0in forced treatment orders.\u00a0Supporters of involuntary treatment include organizations such as the\u00a0National Alliance on Mental Illness\u00a0(NAMI) and the\u00a0American Psychiatric Association.\r\n<h2>Right to treatment and Refusal of Treatment<\/h2>\r\nIn October 1970, Ricky Wyatt was a fifteen-year-old who had always been labeled a \"juvenile delinquent.\" Despite not being indicated with a mental illness, he was a patient at Bryce Hospital (first known as the\u00a0<em>Alabama State Hospital for the Insane<\/em>) and became the named plaintiff in a landmark class-action\u00a0lawsuit, <i>Wyatt v. Stickney<\/i>.\u00a0His aunt, W. C. Rawlins, was one of the employees at Bryce who had been laid off. Together they testified about intolerable conditions and improper treatments designed only to make the patients more manageable. In 1971, the plaintiff class was expanded to include patients at Alabama's two other inpatient mental health facilities. The <b>right to treatment\u00a0<\/b>emerged as the\u00a0outcome and resulted in federal minimum standards for the care of people with mental illness or mental retardation who reside in institutional settings.\r\n\r\nThe standards elaborated in that agreement have served as a model nationwide. Known as the \"Wyatt Standards,\" they are founded on four criteria for evaluation of care:\r\n<ul>\r\n \t<li>humane psychological and physical environment<\/li>\r\n \t<li>qualified and sufficient staff for administration of treatment<\/li>\r\n \t<li>individualized treatment plans<\/li>\r\n \t<li>minimum restriction of patient freedom.<\/li>\r\n<\/ul>\r\nThe case of\u00a0<i>Wyatt v. Stickney<\/i>\u00a0came to a conclusion after 33 years, through the tenure of nine Alabama governors and fourteen state mental health commissioners, the longest mental health case in national history. The State of Alabama estimates its litigation expenses at over $15 million.\r\n\r\nJust as clients have a right to treatment, they also have a right to refuse unwanted treatment.\u00a0<b>Informed refusal<\/b>\u00a0is where a person has refused a recommended medical treatment based on an understanding of the facts and the implications of not following the treatment.\u00a0Informed refusal is linked to the\u00a0informed consent\u00a0process, as a patient has a right to consent, but also may choose to refuse.\r\n\r\nThe individual needs to be in possession of the relevant facts as well as of their reasoning faculties, such as not being\u00a0intellectually disabled\u00a0or\u00a0mentally ill\u00a0and without impairment\u00a0of\u00a0judgment\u00a0at the time of refusing. In cases where an individual is considered unable to give informed refusal, another person (a guardian) may be authorized to give consent on their behalf.\u00a0<b>Substituted judgment<\/b>\u00a0generally is a decision made by a person on behalf of a person who is incompetent and unable to decide for himself or herself.\u00a0Substituted judgment\u00a0with regard to guardianship is the standard that directs the decision making of a guardian.<sup id=\"cite_ref-Goodman_2-2\" class=\"reference\"><\/sup>\r\n\r\nWhen refusal of treatment may result in significant damage or death, the interaction needs to be documented to protect the care giver in a potential later\u00a0litigation\u00a0against the allegation that the recommendation was either not made or not understood. On occasion, a patient will also refuse to sign the \"informed refusal\" document, in which case a witness would have to sign that the informed process and the refusal took place. The pregnant patient represents a specific dilemma in the field of informed refusal as her action may result in harm or death to the fetus. Ethicists disagree on how to handle this situation.\r\n\r\nClients also have the right for placement in a\u00a0<b>least restrictive alternative\u00a0<\/b>to treatment in an institution.\u00a0<i><b>O'Connor v. Donaldson<\/b><\/i>, 422 U.S. 563 (1975), was a\u00a0landmark decision\u00a0of the\u00a0U.S. Supreme Court\u00a0in\u00a0mental health law\u00a0ruling that a state cannot constitutionally confine a non-dangerous individual who is capable of surviving safely in freedom by themselves or with the help of willing and responsible family members or friends.\u00a0Kenneth Donaldson (confined patient diagnosed with paranoid schizophrenia and civilly\u00a0committed) had been held for 15 years in\u00a0Florida State Hospital\u00a0at\u00a0Chattahoochee, due to needs of \"care, maintenance, and treatment.\" He filed a\u00a0lawsuit\u00a0against the hospital and staff members claiming they had robbed him of his constitutional rights, by confining him against his will.\u00a0Donaldson won his case since the trial court jury found, upon ample evidence, that the petitioner had violated Donaldson's right to liberty.\u00a0A finding of mental illness alone cannot justify a State's locking a person up against his will and keeping him indefinitely in simple custodial confinement. Assuming that that term can be given a reasonably precise content and that the mentally ill can be identified with reasonable accuracy, there is still no constitutional basis for confining such persons involuntarily if they are dangerous to no one and can live safely in freedom.\r\n<h2>The Insanity Defense<\/h2>\r\nThe\u00a0<b>insanity defense<\/b>\u00a0is an affirmative\u00a0defense\u00a0by\u00a0excuse\u00a0in a\u00a0criminal case, arguing that the defendant is not responsible for their actions due to an episodic or persistent\u00a0psychiatric disorder\u00a0at the time of the criminal act.\u00a0Legal definitions of insanity or mental disorder are varied, and include the\u00a0<strong>M'Naghten<\/strong> <strong>Rule<\/strong>, the\u00a0<strong>Durham<\/strong> <strong>rule<\/strong>, the\u00a0<strong>ALI<\/strong> <strong>rule<\/strong>\u00a0(American Legal Institute Model Penal Code rule), and other provisions, often relating to a lack of\u00a0<i>mens rea<\/i>\u00a0(\"guilty mind\").\r\n\r\nBeing\u00a0<b>incapable of distinguishing right from wrong<\/b>\u00a0is one basis for being found to be legally insane as a\u00a0criminal defense.\u00a0It originated in the\u00a0<i>M'Naghten Rule,\u00a0<\/i>formulated as a reaction to the acquittal in 1843 of\u00a0Daniel M'Naghten, a Scottish\u00a0woodturner\u00a0who assassinated an English civil servant\u00a0while suffering from\u00a0paranoid\u00a0delusions.\u00a0M'Naghten had mistaken him as the UK Prime Minister, the intended target, and believed he was following the commands of a higher power. The central issue of the\u00a0<em>M'Naghten Rules <\/em>may be stated as, \"did the defendant know what they were doing, or, if so, that it was wrong?\"\r\n\r\nLegislators added the\u00a0<b>irresistible impulse<\/b>\u00a0defense, in which the defendant argues that they should not be held\u00a0criminally\u00a0liable\u00a0for their\u00a0actions\u00a0that broke the\u00a0law, because they could not control those actions, even if they knew them to be wrong.<span style=\"font-size: 13.3333px;\">\u00a0<\/span><sup id=\"cite_ref-CL_1-1\" class=\"reference\"><\/sup>In 1994,\u00a0Lorena Bobbitt\u00a0was found not guilty when her defense argued that an <em>irresistible impulse<\/em> led her to cut off her\u00a0husband's\u00a0penis<span style=\"font-size: 1em;\">\u00a0<\/span><span style=\"font-size: 1em;\">with a knife while he was asleep in bed<\/span><span style=\"font-size: 1rem; text-align: initial;\">. The husband-wife<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0relationship made world-wide headlines in 1993 and revealed that Lorena has been subjected to years of being raped, beaten, and sodomized by her husband. It is a variant of the\u00a0M'Naghten Rules\u00a0that addresses the situation in which defendants knew that what they were going to do was wrong, but had no ability to restrain themselves from doing it.<\/span>\r\n\r\nThe\u00a0<b>Durham rule\u00a0<\/b>later expanded the insanity defense and established that a jury\u00a0may determine a defendant is\u00a0not guilty by reason of insanity\u00a0because the criminal act\u00a0was the product of a mental disorder.\u00a0Examples in which such rules were articulated <i>State v. Pike<\/i>\u00a0(1869) and\u00a0<i>Durham v. United States<\/i>\u00a0(1954).\u00a0After the 1970s, U.S. jurisdictions have tended to not recognize this argument as it places emphasis on \"mental disease or defect\" and thus on testimony by\u00a0psychiatrists\u00a0and is argued to be somewhat ambiguous. It gave psychiatric and psychological experts too much influence in a decision of insanity and not enough to jurors.\r\n\r\n[caption id=\"\" align=\"alignright\" width=\"247\"]<img class=\"\" title=\"Mugshot taken by the FBI of Hinckley shortly after he attempted to assassinate President Reagan\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/d\/d9\/John_Hinckley%2C_Jr._Mugshot.png\" alt=\"John Hinckley, Jr. Mugshot.png\" width=\"247\" height=\"357\" \/> <strong>Figure 2<\/strong>. On March 30, 1981, United States President Ronald Reagan was shot and wounded by John Hinckley Jr. in Washington, D.C. as he was returning to his limousine after a speaking engagement at the Washington Hilton Hotel. Hinckley believed the attack would impress actress Jodie Foster, with whom he had become obsessed.[\/caption]\r\n\r\nThe\u00a0<b>ALI rule<\/b>, or\u00a0<b>American Law Institute Model Penal Code rule<\/b>, is a recommended rule for\u00a0instructing juries\u00a0how to find a\u00a0defendant\u00a0in a\u00a0criminal trial\u00a0is\u00a0not guilty by reason of insanity.\u00a0It broadened the\u00a0M'Naghten rule.\u00a0It arose from the case of\u00a0<i>United States v. Brawner.\u00a0<\/i>The case overturned the\u00a0Durham rule\u00a0(\u00a0that put substantial dominance on the testimony of experts) gave jurers a specific framework for the insanity defense. The focus is on the acts and mental state of a defendant at the time he committed the acts constituting the crime.\r\n<dl>\r\n \t<dt>The ALI rule is:<\/dt>\r\n \t<dd><i>\"(1) A person is not responsible for criminal conduct if at the time of such conduct as a result of mental disease of defect he lacks substantial capacity either to appreciate the criminality of his conduct or to conform his conduct to the requirements of the law.<\/i><\/dd>\r\n \t<dd><i>\"(2) As used in this Article, the terms \"mental disease or defect\" do not include an abnormality manifested only by repeated criminal or otherwise antisocial conduct [Section 4.01].\"[footnote]Criminal Law\u2014Cases and Materials, 7th ed. 2012, Wolters Kluwer Law &amp; Business; John Kaplan, Robert Weisberg, Guyora Binder, ISBN 978-1-4548-0698-1[\/footnote]<\/i><\/dd>\r\n<\/dl>\r\nJohn Hinckley, Jr.\u00a0is an American who, on March 30, 1981,\u00a0attempted to assassinate U.S. President Ronald Reagan\u00a0in Washington, D.C. He wounded Reagan with a bullet from a revolver that ricocheted and hit Reagan in the chest. He also wounded police officer\u00a0Thomas Delahanty\u00a0and\u00a0Secret Service\u00a0agent\u00a0Tim McCarthy, and he critically wounded Press Secretary\u00a0James Brady, who was permanently disabled in the shooting and later died from those injuries.\u00a0Hinckley was reportedly seeking fame in order to impress actress\u00a0Jodie Foster, on whom he had an obsessive fixation. He was found\u00a0not guilty by reason of insanity\u00a0and remained under institutional psychiatric care until September 10, 2016.\u00a0Public outcry over the verdict led to the\u00a0Insanity Defense Reform Act\u00a0of 1984, which altered the rules for consideration of mental illness of defendants in Federal Criminal Court proceedings in the United States.\u00a0<span style=\"font-size: 1em;\">In January 2015, federal prosecutors announced that they would not charge Hinckley with Brady's death, despite the medical examiner's classification of his death as a homicide.\u00a0<\/span><span style=\"font-size: 1rem; text-align: initial;\">Along with\u00a0<\/span><span style=\"font-size: 1rem; text-align: initial;\">Lynette Fromme<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0and\u00a0<\/span><span style=\"font-size: 1rem; text-align: initial;\">Sara Jane Moore<\/span><span style=\"font-size: 1rem; text-align: initial;\">, Hinckley is one of three attempted presidential assassins currently living who are not in prison.\u00a0Hinckley is portrayed by Steven Flynn in the American television film,\u00a0<em>Without Warning:<\/em><i> The James Brady Story<\/i>\u00a0(1991).<\/span>\r\n<h2>Competence to Stand Trial<\/h2>\r\nThe word\u00a0<b>incompetent<\/b>\u00a0is used to describe persons who should not undergo or partake in certain judicial processes, and also for those who lack the mental\u00a0capacity\u00a0to make\u00a0contracts, handle their\u00a0financial\u00a0and other personal matters such as consenting to medical treatment, etc. and need a\u00a0legal guardian\u00a0to handle their affairs. When it comes to <strong>competence to stand trial<\/strong> and the\u00a0law, the right to not be prosecuted while one is incompetent to stand trial has been ruled by the\u00a0United States Supreme Court\u00a0to be guaranteed under the\u00a0due process clause, which acts as a safeguard from arbitrary denial of life, liberty, or property by the government outside the sanction of law.\u00a0<i><b>Dusky v. United States<\/b><\/i>, (1960), was a\u00a0landmark\u00a0United States Supreme Court\u00a0case in which the Court affirmed a defendant's right to have a\u00a0competency evaluation\u00a0before proceeding to trial.\r\n\r\nIf the court determines that a defendant's mental condition makes him unable to understand the proceedings, or that he is unable to help in his defense, he is found incompetent.\u00a0Being determined incompetent is substantially different from undertaking an\u00a0insanity defense; competence regards the defendant's state of mind at the time of the trial, while insanity regards his state of mind at the time of the crime.\u00a0A ruling of incompetence may later be reversed. A defendant may recover from a mental illness or disability, and a court may require a defendant to undergo treatment in an effort to render the defendant competent to stand trial.\u00a0For example, in 1989,\u00a0Kenneth L. Curtis\u00a0of\u00a0Stratford, Connecticut, was found mentally incompetent to stand trial following the murder of his estranged girlfriend. But years later, as he had attended college and received good grades, this ruling was reversed, and he was ordered to stand trial.\r\n<h2>Understanding the Purpose of Punishment<\/h2>\r\nIs a mentally ill person convicted of a capital offense able or competent enough to understand the nature and purpose of the death sentence?\u00a0The case of\u00a0Alvin Bernard Ford highlights the complexity of the issue.\u00a0<i><b>Ford v. Wainwright<\/b><\/i>, 477 U.S. 399 (1986), was a\u00a0landmark\u00a0case that upheld the\u00a0common law\u00a0rule that t<em>he insane cannot be\u00a0executed.\u00a0<\/em>Ford was convicted of\u00a0murder\u00a0in 1974 and sentenced to death in\u00a0Florida. In 1982, while on\u00a0death row, Ford's mental health diminished to a point resembling\u00a0paranoid schizophrenia. Ford began referring to himself as Pope John Paul III and reported such accomplishments as thwarting a vast\u00a0Ku Klux Klan\u00a0conspiracy to bury dead prisoners inside the prison walls, foiling an attempt by prison guards to torture his female relatives inside the prison, and personally appointing nine new justices to the\u00a0Florida Supreme Court.\u00a0A panel of three psychiatrists was eventually called to\u00a0examine\u00a0Ford's behavior, and it concluded that while Ford suffered from\u00a0psychosis\u00a0and various\u00a0mental disorders, he was still capable of understanding the nature of the\u00a0death penalty\u00a0and the effect that such a penalty would have on him. A\u00a0death warrant was signed for Ford in 1984. Ford sued the secretary of the\u00a0Florida Department of Corrections,\u00a0Louie L. Wainwright, and\u00a0took his case to the\u00a0United States Supreme Court, declaring he was not competent to be\u00a0executed.\u00a0<span style=\"font-size: 1em;\">The court ruled in his favor, then further addressed the procedural issues present in making a determination of insanity for Eighth Amendment concerns (cruel and unusual punishment).\u00a0The Court, in an opinion by\u00a0Justice Marshall, reviewed the evolving standards of the Eighth Amendment to be those consistent with \"the progress of a maturing society,\" and one not tolerable of acts traditionally branded as \"savage and inhumane,\" as the execution of the mentally insane.\u00a0<\/span>The inmate was transferred to\u00a0Florida State Hospital\u00a0for treatment after he was reevaluated and found to be\u00a0incompetent\u00a0to be executed.\u00a0<sup id=\"cite_ref-2\" class=\"reference\"><\/sup>In 1989, a federal district judge ruled that Ford was sane, but defense lawyers appealed that ruling.\u00a0The appeal was pending when Ford died on February 6, 1991 of natural causes, at 37.\r\n\r\nToday, a<span style=\"font-size: 1em;\">n inmate on\u00a0death row\u00a0has a right to be evaluated for competency by a forensic expert\u00a0to determine if the sentence can be carried out. I<\/span><span style=\"font-size: 1em;\">f the inmate is found incompetent,\u00a0<\/span><span style=\"font-size: 1em;\">a forensic professional\u00a0<\/span><span style=\"font-size: 1em; text-align: initial;\">must provide treatment to aid in his gaining competency so the execution can take place.<\/span>\r\n<div class=\"textbox tryit\">\r\n<h3>Try It<\/h3>\r\nhttps:\/\/assess.lumenlearning.com\/practice\/efb28890-2bfb-427a-a31d-125b8728d082\r\n\r\nhttps:\/\/assess.lumenlearning.com\/practice\/e76dbb8c-60e7-49f5-9b33-f7e0148904b9\r\n\r\n<\/div>\r\n<div class=\"textbox learning-objectives\">\r\n<h3>glossary<\/h3>\r\n<strong>ALI rule:<\/strong> a recommended rule for\u00a0instructing juries\u00a0how to find a\u00a0defendant\u00a0in a\u00a0criminal trial\u00a0is\u00a0not guilty by reason of insanity; the focus is on the acts and mental state of a defendant at the time he committed the acts constituting the crime\r\n\r\n<strong>competence to stand trial: <\/strong>the right to not be prosecuted while one is incompetent to stand trial\r\n\r\n<strong>Durham rule:\u00a0<\/strong>established that a jury\u00a0may determine a defendant is\u00a0not guilty by reason of insanity\u00a0because the criminal act\u00a0was the product of a mental disorder\r\n\r\n<strong>duty to warn or protect<\/strong>: holds that\u00a0mental health professionals\u00a0have a\u00a0duty to protect\u00a0individuals who are being threatened with bodily harm by a patient\r\n\r\n<strong>guardian: <\/strong>a person authorized to give consent on behalf of a person who is unable to decide for himself or herself\r\n\r\n<strong>incompetent:<\/strong> used to describe persons who should not undergo or partake in certain judicial processes, and also for those who lack mental\u00a0capacity\u00a0to make\u00a0contracts, handle their\u00a0financial\u00a0and other personal matters such as consenting to medical treatment, etc., and need a\u00a0legal guardian\u00a0to handle their affairs\r\n\r\n<strong>insanity defense:<\/strong> an affirmative\u00a0defense\u00a0by\u00a0excuse\u00a0in a\u00a0criminal case, arguing that the defendant is not responsible for their actions due to an episodic or persistent\u00a0psychiatric disorder\u00a0at the time of the criminal act\r\n\r\n<strong>involuntary commitment:<\/strong> civil commitment or\u00a0involuntary hospitalization\u2014a legal process through which an individual who is deemed by a qualified agent to have symptoms of severe\u00a0mental disorder\u00a0is detained in a\u00a0psychiatric hospital\u00a0(inpatient) where they can be\u00a0treated involuntarily\r\n\r\n<strong>irresistible impulse:<\/strong>\u00a0defense in which the defendant argues that they should not be held\u00a0criminally\u00a0liable\u00a0for their\u00a0actions\u00a0that broke the\u00a0law because they could not control those actions, even if they knew them to be wrong\r\n\r\n<strong>least restrictive alternative: <\/strong>law\u00a0ruling that a state cannot constitutionally confine a non-dangerous individual who is capable of surviving safely in freedom\r\n\r\n<strong>right to treatment: <\/strong>federal minimum standards for the care of people with mental illness or mental retardation who reside in institutional settings\r\n\r\n<strong>substituted judgment: <\/strong>a decision made by a person on behalf of a person who is incompetent and unable to decide for himself or herself\r\n\r\n<\/div>","rendered":"<div class=\"textbox learning-objectives\">\n<h3>Learning Objectives<\/h3>\n<ul>\n<li style=\"font-weight: 400;\">Explain forensic issues in psychological treatment, such as the insanity defense, competency to stand trial, and understanding the purpose of punishment<\/li>\n<\/ul>\n<\/div>\n<div style=\"width: 282px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"Front view of federal mug shot of Jared Lee Loughner taken while in custody of U.S. Marshals in Phoenix, Arizona.\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/8\/82\/Jared_Loughner_USMS.jpg\" alt=\"Jared Loughner USMS.jpg\" width=\"272\" height=\"340\" \/><\/p>\n<p class=\"wp-caption-text\"><strong>Figure 1<\/strong>. Jared Lee Loughner, a convicted mass murderer, was originally ruled incompetent to stand trial due to a diagnosis of paranoid schizophrenia but was later ruled competent and sentenced to life plus 140 years in federal prison.<\/p>\n<\/div>\n<p>Jared Lee Loughner (born September 10, 1988) is a convicted American mass murderer who pled guilty to 19 charges of murder and attempted murder in connection with the January 8, 2011, Tucson shooting. After his arrest, two medical evaluations diagnosed Loughner with paranoid schizophrenia and ruled him incompetent to stand trial. Punishment or treatment? What should we do when someone who is mentally ill but commits a horrendous crime?<\/p>\n<p>In this section, we will discuss the forensic issues in psychological treatment, such as the insanity defense, competency to stand trial, and the purpose of punishment. We will also examine the ethical and legal issues in providing service and the rights of mentally ill patients. What is the legal responsibility or duty of mental health care providers to protect individuals who are being threatened with bodily harm by a patient in their care. Should we honor the right to refuse treatment when someone is psychologically disturbed? Should psychiatrists administer antipsychotics or any other drug deemed necessary to treat patients against their will? Should mentally ill clients with a history of violent behavior be recommended for commitment or involuntary hospitalization?\u00a0<span style=\"font-size: 1em;\">How do we balance the rights of the individual with the rights of society?<\/span><span style=\"font-size: 1em;\">\u00a0D<\/span><span style=\"font-size: 1rem; text-align: initial;\">oes the answer to these questions lie with the criminal justice system or with the mental health system?<\/span><\/p>\n<p>Below, we begin by summarizing the major perspectives on ethical and forensic issues in psychological treatment.<\/p>\n<div class=\"textbox exercises\">\n<h3><b>Tarasoff v.\u00a0Regents of the University of California<\/b><\/h3>\n<p><i><b>Tarasoff v.\u00a0Regents of the University of California<\/b><\/i>, (Cal.\u00a01976), was a case in which the\u00a0Supreme Court of California\u00a0held that\u00a0mental health professionals\u00a0have a\u00a0<strong>duty to protect<\/strong>\u00a0individuals who are being threatened with bodily harm by a patient. The original 1974 decision mandated warning the threatened individual, but a 1976 rehearing of the case by the California Supreme Court called for a \u201cduty to protect\u201d the intended victim. The professional may discharge the duty in several ways, including notifying police,\u00a0warning the intended victim, and\/or taking other reasonable steps to protect the threatened individual.<\/p>\n<h2><span id=\"History\" class=\"mw-headline\">History<\/span><\/h2>\n<p>Prosenjit Poddar was a student from\u00a0Bengal,\u00a0India.\u00a0He entered the\u00a0University of California, Berkeley, as a graduate student in September 1967 and resided at International House. In the fall of 1968, he attended folk dancing classes at the International House, and it was there that he met Tatiana Tarasoff. They dated, but apparently had different ideas about the relationship. He assumed their relationship was serious. This view was not shared by Tarasoff who, upon learning of his feelings, told him that she was involved with other men and that she was not interested in entering into an intimate relationship with him. This statement gave rise to feelings of resentment in Poddar. He began to stalk her.<\/p>\n<p>After this rebuff, Poddar underwent a severe emotional crisis. He became depressed and neglected his appearance, his studies, and his health. He kept to himself, speaking disjointedly and often weeping. This condition persisted, with steady deterioration, throughout the spring and into the summer of 1969. Poddar had occasional meetings with Tarasoff during this period and tape-recorded their various conversations to try to find out why she did not love him.<\/p>\n<p>During the summer of 1969, Tarasoff went to\u00a0South America. After her departure, Poddar began to improve and at the suggestion of a friend sought psychological assistance. Prosenjit Poddar was a patient of Dr. Lawrence Moore, a\u00a0psychologist\u00a0at UC Berkeley\u2019s Cowell Memorial Hospital in 1969. Poddar confided his intent to kill Tarasoff. Dr. Moore requested that the campus police detain Poddar, writing that, in his opinion, Poddar was suffering from\u00a0paranoid schizophrenia, acute and severe. The psychologist recommended that the defendant be\u00a0civilly committed\u00a0as a dangerous person. Poddar was detained but shortly thereafter released, as he appeared rational. Dr. Moore\u2019s supervisor, Dr. Harvey Powelson, then ordered that Poddar not be subject to further detention.<\/p>\n<p>In October, after Tarasoff had returned, Poddar stopped seeing his psychologist. Neither Tarasoff nor her parents received any warning of the threat. Poddar then befriended Tarasoff\u2019s brother, even moving in with him. Several weeks later, on October 27, 1969, Poddar carried out the plan he had confided to his psychologist, stabbing and killing Tarasoff. Tarasoff\u2019s parents then sued Moore and various other employees of the university.<\/p>\n<p>Poddar was subsequently convicted of\u00a0second-degree murder, but the conviction was later appealed and overturned on the grounds that the jury was inadequately\u00a0instructed. A second trial was not held, and Poddar was released on the condition that he would return to\u00a0India.<\/p>\n<h2><span id=\"Opinion_of_the_court\" class=\"mw-headline\">Opinion of the court<\/span><\/h2>\n<p>The California Supreme Court found that a\u00a0mental health professional\u00a0has a duty not only to a patient, but also to individuals who are specifically being threatened by a patient. This decision has since been adopted by most states in the United States and is widely influential in jurisdictions outside the United States as well.<\/p>\n<h2><span id=\"Subsequent_developments\" class=\"mw-headline\">Subsequent developments<\/span><\/h2>\n<p>As of 2012, a <strong><em>duty to warn or protect<\/em><\/strong> is mandated and codified in legislative statutes of 23 states, while the duty is not codified in a statute but is present in the common law supported by precedent in 10 states. Eleven states have a permissive duty, and six states are described as having no statutes or case law offering guidance.<\/p>\n<p>In 2018, the Court held that universities should protect students in the\u00a0<em>Regents of University of California v. Superior Court of Los Angeles County.<\/em><\/p>\n<\/div>\n<h2>Commitment of Clients<\/h2>\n<p>Starting in the 1960s, there has been a worldwide trend toward moving psychiatric patients from hospital settings to less restricting settings in the community, a shift known as &#8220;deinstitutionalization.&#8221; Because the shift was typically not accompanied by a commensurate development of community-based services, critics say that deinstitutionalization has led to large numbers of people who would once have been inpatients as instead being incarcerated or becoming homeless.\u00a0In some jurisdictions, laws authorizing court-ordered outpatient treatment have been passed in an effort to compel individuals with chronic, untreated, severe mental illness to take\u00a0psychiatric medication\u00a0while living outside the hospital (see\u00a0<a title=\"Laura's Law\" href=\"https:\/\/en.wikipedia.org\/wiki\/Laura%27s_Law\" target=\"_blank\" rel=\"noopener\">Laura&#8217;s Law<\/a>,\u00a0<a title=\"Kendra's Law\" href=\"https:\/\/en.wikipedia.org\/wiki\/Kendra%27s_Law\" target=\"_blank\" rel=\"noopener\">Kendra&#8217;s Law<\/a>).\u00a0<sup id=\"cite_ref-21\" class=\"reference\"><\/sup><\/p>\n<p>In most jurisdictions, <strong>involuntary commitment<\/strong> is applied to individuals believed to be experiencing a mental illness that impairs their ability to reason to such an extent that the agents of the law, state, or courts determine that decisions will be made for the individual under a legal framework. This is a proceeding distinct from being found\u00a0incompetent and\u00a0limits involuntary treatment to individuals who meet statutory criteria for presenting a danger to self or others.\u00a0<b>Involuntary commitment<\/b>\u00a0is a legal process through which an individual who is deemed by a qualified agent to have symptoms of severe\u00a0mental disorder\u00a0is detained in a\u00a0psychiatric hospital\u00a0(inpatient) where they can be\u00a0treated involuntarily. This treatment may involve the administration of\u00a0psychoactive drugs\u00a0including involuntary administration. In many jurisdictions, people diagnosed with mental health disorders can also be forced to undergo treatment while in the community, this is sometimes referred to as\u00a0outpatient commitment\u00a0and shares legal processes with commitment.<\/p>\n<p>A number of civil and human rights activists, anti-psychiatry\u00a0groups, medical and academic organizations, researchers, and members of the\u00a0psychiatric survivors movement\u00a0vigorously oppose involuntary treatment on\u00a0human rights\u00a0grounds or on grounds of effectiveness and medical appropriateness, particularly with respect to involuntary administration of mind-altering substances, ECT, and psycho-surgery. Some criticism has been made regarding cost, as well as of conflicts of interest with the pharmaceutical industry. Critics, such as the\u00a0New York Civil Liberties Union, have denounced the strong\u00a0racial\u00a0and\u00a0socioeconomic\u00a0biases\u00a0in forced treatment orders.\u00a0Supporters of involuntary treatment include organizations such as the\u00a0National Alliance on Mental Illness\u00a0(NAMI) and the\u00a0American Psychiatric Association.<\/p>\n<h2>Right to treatment and Refusal of Treatment<\/h2>\n<p>In October 1970, Ricky Wyatt was a fifteen-year-old who had always been labeled a &#8220;juvenile delinquent.&#8221; Despite not being indicated with a mental illness, he was a patient at Bryce Hospital (first known as the\u00a0<em>Alabama State Hospital for the Insane<\/em>) and became the named plaintiff in a landmark class-action\u00a0lawsuit, <i>Wyatt v. Stickney<\/i>.\u00a0His aunt, W. C. Rawlins, was one of the employees at Bryce who had been laid off. Together they testified about intolerable conditions and improper treatments designed only to make the patients more manageable. In 1971, the plaintiff class was expanded to include patients at Alabama&#8217;s two other inpatient mental health facilities. The <b>right to treatment\u00a0<\/b>emerged as the\u00a0outcome and resulted in federal minimum standards for the care of people with mental illness or mental retardation who reside in institutional settings.<\/p>\n<p>The standards elaborated in that agreement have served as a model nationwide. Known as the &#8220;Wyatt Standards,&#8221; they are founded on four criteria for evaluation of care:<\/p>\n<ul>\n<li>humane psychological and physical environment<\/li>\n<li>qualified and sufficient staff for administration of treatment<\/li>\n<li>individualized treatment plans<\/li>\n<li>minimum restriction of patient freedom.<\/li>\n<\/ul>\n<p>The case of\u00a0<i>Wyatt v. Stickney<\/i>\u00a0came to a conclusion after 33 years, through the tenure of nine Alabama governors and fourteen state mental health commissioners, the longest mental health case in national history. The State of Alabama estimates its litigation expenses at over $15 million.<\/p>\n<p>Just as clients have a right to treatment, they also have a right to refuse unwanted treatment.\u00a0<b>Informed refusal<\/b>\u00a0is where a person has refused a recommended medical treatment based on an understanding of the facts and the implications of not following the treatment.\u00a0Informed refusal is linked to the\u00a0informed consent\u00a0process, as a patient has a right to consent, but also may choose to refuse.<\/p>\n<p>The individual needs to be in possession of the relevant facts as well as of their reasoning faculties, such as not being\u00a0intellectually disabled\u00a0or\u00a0mentally ill\u00a0and without impairment\u00a0of\u00a0judgment\u00a0at the time of refusing. In cases where an individual is considered unable to give informed refusal, another person (a guardian) may be authorized to give consent on their behalf.\u00a0<b>Substituted judgment<\/b>\u00a0generally is a decision made by a person on behalf of a person who is incompetent and unable to decide for himself or herself.\u00a0Substituted judgment\u00a0with regard to guardianship is the standard that directs the decision making of a guardian.<sup id=\"cite_ref-Goodman_2-2\" class=\"reference\"><\/sup><\/p>\n<p>When refusal of treatment may result in significant damage or death, the interaction needs to be documented to protect the care giver in a potential later\u00a0litigation\u00a0against the allegation that the recommendation was either not made or not understood. On occasion, a patient will also refuse to sign the &#8220;informed refusal&#8221; document, in which case a witness would have to sign that the informed process and the refusal took place. The pregnant patient represents a specific dilemma in the field of informed refusal as her action may result in harm or death to the fetus. Ethicists disagree on how to handle this situation.<\/p>\n<p>Clients also have the right for placement in a\u00a0<b>least restrictive alternative\u00a0<\/b>to treatment in an institution.\u00a0<i><b>O&#8217;Connor v. Donaldson<\/b><\/i>, 422 U.S. 563 (1975), was a\u00a0landmark decision\u00a0of the\u00a0U.S. Supreme Court\u00a0in\u00a0mental health law\u00a0ruling that a state cannot constitutionally confine a non-dangerous individual who is capable of surviving safely in freedom by themselves or with the help of willing and responsible family members or friends.\u00a0Kenneth Donaldson (confined patient diagnosed with paranoid schizophrenia and civilly\u00a0committed) had been held for 15 years in\u00a0Florida State Hospital\u00a0at\u00a0Chattahoochee, due to needs of &#8220;care, maintenance, and treatment.&#8221; He filed a\u00a0lawsuit\u00a0against the hospital and staff members claiming they had robbed him of his constitutional rights, by confining him against his will.\u00a0Donaldson won his case since the trial court jury found, upon ample evidence, that the petitioner had violated Donaldson&#8217;s right to liberty.\u00a0A finding of mental illness alone cannot justify a State&#8217;s locking a person up against his will and keeping him indefinitely in simple custodial confinement. Assuming that that term can be given a reasonably precise content and that the mentally ill can be identified with reasonable accuracy, there is still no constitutional basis for confining such persons involuntarily if they are dangerous to no one and can live safely in freedom.<\/p>\n<h2>The Insanity Defense<\/h2>\n<p>The\u00a0<b>insanity defense<\/b>\u00a0is an affirmative\u00a0defense\u00a0by\u00a0excuse\u00a0in a\u00a0criminal case, arguing that the defendant is not responsible for their actions due to an episodic or persistent\u00a0psychiatric disorder\u00a0at the time of the criminal act.\u00a0Legal definitions of insanity or mental disorder are varied, and include the\u00a0<strong>M&#8217;Naghten<\/strong> <strong>Rule<\/strong>, the\u00a0<strong>Durham<\/strong> <strong>rule<\/strong>, the\u00a0<strong>ALI<\/strong> <strong>rule<\/strong>\u00a0(American Legal Institute Model Penal Code rule), and other provisions, often relating to a lack of\u00a0<i>mens rea<\/i>\u00a0(&#8220;guilty mind&#8221;).<\/p>\n<p>Being\u00a0<b>incapable of distinguishing right from wrong<\/b>\u00a0is one basis for being found to be legally insane as a\u00a0criminal defense.\u00a0It originated in the\u00a0<i>M&#8217;Naghten Rule,\u00a0<\/i>formulated as a reaction to the acquittal in 1843 of\u00a0Daniel M&#8217;Naghten, a Scottish\u00a0woodturner\u00a0who assassinated an English civil servant\u00a0while suffering from\u00a0paranoid\u00a0delusions.\u00a0M&#8217;Naghten had mistaken him as the UK Prime Minister, the intended target, and believed he was following the commands of a higher power. The central issue of the\u00a0<em>M&#8217;Naghten Rules <\/em>may be stated as, &#8220;did the defendant know what they were doing, or, if so, that it was wrong?&#8221;<\/p>\n<p>Legislators added the\u00a0<b>irresistible impulse<\/b>\u00a0defense, in which the defendant argues that they should not be held\u00a0criminally\u00a0liable\u00a0for their\u00a0actions\u00a0that broke the\u00a0law, because they could not control those actions, even if they knew them to be wrong.<span style=\"font-size: 13.3333px;\">\u00a0<\/span><sup id=\"cite_ref-CL_1-1\" class=\"reference\"><\/sup>In 1994,\u00a0Lorena Bobbitt\u00a0was found not guilty when her defense argued that an <em>irresistible impulse<\/em> led her to cut off her\u00a0husband&#8217;s\u00a0penis<span style=\"font-size: 1em;\">\u00a0<\/span><span style=\"font-size: 1em;\">with a knife while he was asleep in bed<\/span><span style=\"font-size: 1rem; text-align: initial;\">. The husband-wife<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0relationship made world-wide headlines in 1993 and revealed that Lorena has been subjected to years of being raped, beaten, and sodomized by her husband. It is a variant of the\u00a0M&#8217;Naghten Rules\u00a0that addresses the situation in which defendants knew that what they were going to do was wrong, but had no ability to restrain themselves from doing it.<\/span><\/p>\n<p>The\u00a0<b>Durham rule\u00a0<\/b>later expanded the insanity defense and established that a jury\u00a0may determine a defendant is\u00a0not guilty by reason of insanity\u00a0because the criminal act\u00a0was the product of a mental disorder.\u00a0Examples in which such rules were articulated <i>State v. Pike<\/i>\u00a0(1869) and\u00a0<i>Durham v. United States<\/i>\u00a0(1954).\u00a0After the 1970s, U.S. jurisdictions have tended to not recognize this argument as it places emphasis on &#8220;mental disease or defect&#8221; and thus on testimony by\u00a0psychiatrists\u00a0and is argued to be somewhat ambiguous. It gave psychiatric and psychological experts too much influence in a decision of insanity and not enough to jurors.<\/p>\n<div style=\"width: 257px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"Mugshot taken by the FBI of Hinckley shortly after he attempted to assassinate President Reagan\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/d\/d9\/John_Hinckley%2C_Jr._Mugshot.png\" alt=\"John Hinckley, Jr. Mugshot.png\" width=\"247\" height=\"357\" \/><\/p>\n<p class=\"wp-caption-text\"><strong>Figure 2<\/strong>. On March 30, 1981, United States President Ronald Reagan was shot and wounded by John Hinckley Jr. in Washington, D.C. as he was returning to his limousine after a speaking engagement at the Washington Hilton Hotel. Hinckley believed the attack would impress actress Jodie Foster, with whom he had become obsessed.<\/p>\n<\/div>\n<p>The\u00a0<b>ALI rule<\/b>, or\u00a0<b>American Law Institute Model Penal Code rule<\/b>, is a recommended rule for\u00a0instructing juries\u00a0how to find a\u00a0defendant\u00a0in a\u00a0criminal trial\u00a0is\u00a0not guilty by reason of insanity.\u00a0It broadened the\u00a0M&#8217;Naghten rule.\u00a0It arose from the case of\u00a0<i>United States v. Brawner.\u00a0<\/i>The case overturned the\u00a0Durham rule\u00a0(\u00a0that put substantial dominance on the testimony of experts) gave jurers a specific framework for the insanity defense. The focus is on the acts and mental state of a defendant at the time he committed the acts constituting the crime.<\/p>\n<dl>\n<dt>The ALI rule is:<\/dt>\n<dd><i>&#8220;(1) A person is not responsible for criminal conduct if at the time of such conduct as a result of mental disease of defect he lacks substantial capacity either to appreciate the criminality of his conduct or to conform his conduct to the requirements of the law.<\/i><\/dd>\n<dd><i>&#8220;(2) As used in this Article, the terms &#8220;mental disease or defect&#8221; do not include an abnormality manifested only by repeated criminal or otherwise antisocial conduct [Section 4.01].&#8221;<a class=\"footnote\" title=\"Criminal Law\u2014Cases and Materials, 7th ed. 2012, Wolters Kluwer Law &amp; Business; John Kaplan, Robert Weisberg, Guyora Binder, ISBN 978-1-4548-0698-1\" id=\"return-footnote-2756-1\" href=\"#footnote-2756-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a><\/i><\/dd>\n<\/dl>\n<p>John Hinckley, Jr.\u00a0is an American who, on March 30, 1981,\u00a0attempted to assassinate U.S. President Ronald Reagan\u00a0in Washington, D.C. He wounded Reagan with a bullet from a revolver that ricocheted and hit Reagan in the chest. He also wounded police officer\u00a0Thomas Delahanty\u00a0and\u00a0Secret Service\u00a0agent\u00a0Tim McCarthy, and he critically wounded Press Secretary\u00a0James Brady, who was permanently disabled in the shooting and later died from those injuries.\u00a0Hinckley was reportedly seeking fame in order to impress actress\u00a0Jodie Foster, on whom he had an obsessive fixation. He was found\u00a0not guilty by reason of insanity\u00a0and remained under institutional psychiatric care until September 10, 2016.\u00a0Public outcry over the verdict led to the\u00a0Insanity Defense Reform Act\u00a0of 1984, which altered the rules for consideration of mental illness of defendants in Federal Criminal Court proceedings in the United States.\u00a0<span style=\"font-size: 1em;\">In January 2015, federal prosecutors announced that they would not charge Hinckley with Brady&#8217;s death, despite the medical examiner&#8217;s classification of his death as a homicide.\u00a0<\/span><span style=\"font-size: 1rem; text-align: initial;\">Along with\u00a0<\/span><span style=\"font-size: 1rem; text-align: initial;\">Lynette Fromme<\/span><span style=\"font-size: 1rem; text-align: initial;\">\u00a0and\u00a0<\/span><span style=\"font-size: 1rem; text-align: initial;\">Sara Jane Moore<\/span><span style=\"font-size: 1rem; text-align: initial;\">, Hinckley is one of three attempted presidential assassins currently living who are not in prison.\u00a0Hinckley is portrayed by Steven Flynn in the American television film,\u00a0<em>Without Warning:<\/em><i> The James Brady Story<\/i>\u00a0(1991).<\/span><\/p>\n<h2>Competence to Stand Trial<\/h2>\n<p>The word\u00a0<b>incompetent<\/b>\u00a0is used to describe persons who should not undergo or partake in certain judicial processes, and also for those who lack the mental\u00a0capacity\u00a0to make\u00a0contracts, handle their\u00a0financial\u00a0and other personal matters such as consenting to medical treatment, etc. and need a\u00a0legal guardian\u00a0to handle their affairs. When it comes to <strong>competence to stand trial<\/strong> and the\u00a0law, the right to not be prosecuted while one is incompetent to stand trial has been ruled by the\u00a0United States Supreme Court\u00a0to be guaranteed under the\u00a0due process clause, which acts as a safeguard from arbitrary denial of life, liberty, or property by the government outside the sanction of law.\u00a0<i><b>Dusky v. United States<\/b><\/i>, (1960), was a\u00a0landmark\u00a0United States Supreme Court\u00a0case in which the Court affirmed a defendant&#8217;s right to have a\u00a0competency evaluation\u00a0before proceeding to trial.<\/p>\n<p>If the court determines that a defendant&#8217;s mental condition makes him unable to understand the proceedings, or that he is unable to help in his defense, he is found incompetent.\u00a0Being determined incompetent is substantially different from undertaking an\u00a0insanity defense; competence regards the defendant&#8217;s state of mind at the time of the trial, while insanity regards his state of mind at the time of the crime.\u00a0A ruling of incompetence may later be reversed. A defendant may recover from a mental illness or disability, and a court may require a defendant to undergo treatment in an effort to render the defendant competent to stand trial.\u00a0For example, in 1989,\u00a0Kenneth L. Curtis\u00a0of\u00a0Stratford, Connecticut, was found mentally incompetent to stand trial following the murder of his estranged girlfriend. But years later, as he had attended college and received good grades, this ruling was reversed, and he was ordered to stand trial.<\/p>\n<h2>Understanding the Purpose of Punishment<\/h2>\n<p>Is a mentally ill person convicted of a capital offense able or competent enough to understand the nature and purpose of the death sentence?\u00a0The case of\u00a0Alvin Bernard Ford highlights the complexity of the issue.\u00a0<i><b>Ford v. Wainwright<\/b><\/i>, 477 U.S. 399 (1986), was a\u00a0landmark\u00a0case that upheld the\u00a0common law\u00a0rule that t<em>he insane cannot be\u00a0executed.\u00a0<\/em>Ford was convicted of\u00a0murder\u00a0in 1974 and sentenced to death in\u00a0Florida. In 1982, while on\u00a0death row, Ford&#8217;s mental health diminished to a point resembling\u00a0paranoid schizophrenia. Ford began referring to himself as Pope John Paul III and reported such accomplishments as thwarting a vast\u00a0Ku Klux Klan\u00a0conspiracy to bury dead prisoners inside the prison walls, foiling an attempt by prison guards to torture his female relatives inside the prison, and personally appointing nine new justices to the\u00a0Florida Supreme Court.\u00a0A panel of three psychiatrists was eventually called to\u00a0examine\u00a0Ford&#8217;s behavior, and it concluded that while Ford suffered from\u00a0psychosis\u00a0and various\u00a0mental disorders, he was still capable of understanding the nature of the\u00a0death penalty\u00a0and the effect that such a penalty would have on him. A\u00a0death warrant was signed for Ford in 1984. Ford sued the secretary of the\u00a0Florida Department of Corrections,\u00a0Louie L. Wainwright, and\u00a0took his case to the\u00a0United States Supreme Court, declaring he was not competent to be\u00a0executed.\u00a0<span style=\"font-size: 1em;\">The court ruled in his favor, then further addressed the procedural issues present in making a determination of insanity for Eighth Amendment concerns (cruel and unusual punishment).\u00a0The Court, in an opinion by\u00a0Justice Marshall, reviewed the evolving standards of the Eighth Amendment to be those consistent with &#8220;the progress of a maturing society,&#8221; and one not tolerable of acts traditionally branded as &#8220;savage and inhumane,&#8221; as the execution of the mentally insane.\u00a0<\/span>The inmate was transferred to\u00a0Florida State Hospital\u00a0for treatment after he was reevaluated and found to be\u00a0incompetent\u00a0to be executed.\u00a0<sup id=\"cite_ref-2\" class=\"reference\"><\/sup>In 1989, a federal district judge ruled that Ford was sane, but defense lawyers appealed that ruling.\u00a0The appeal was pending when Ford died on February 6, 1991 of natural causes, at 37.<\/p>\n<p>Today, a<span style=\"font-size: 1em;\">n inmate on\u00a0death row\u00a0has a right to be evaluated for competency by a forensic expert\u00a0to determine if the sentence can be carried out. I<\/span><span style=\"font-size: 1em;\">f the inmate is found incompetent,\u00a0<\/span><span style=\"font-size: 1em;\">a forensic professional\u00a0<\/span><span style=\"font-size: 1em; text-align: initial;\">must provide treatment to aid in his gaining competency so the execution can take place.<\/span><\/p>\n<div class=\"textbox tryit\">\n<h3>Try It<\/h3>\n<p>\t<iframe id=\"assessment_practice_efb28890-2bfb-427a-a31d-125b8728d082\" class=\"resizable\" src=\"https:\/\/assess.lumenlearning.com\/practice\/efb28890-2bfb-427a-a31d-125b8728d082?iframe_resize_id=assessment_practice_id_efb28890-2bfb-427a-a31d-125b8728d082\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:300px;\"><br \/>\n\t<\/iframe><\/p>\n<p>\t<iframe id=\"assessment_practice_e76dbb8c-60e7-49f5-9b33-f7e0148904b9\" class=\"resizable\" src=\"https:\/\/assess.lumenlearning.com\/practice\/e76dbb8c-60e7-49f5-9b33-f7e0148904b9?iframe_resize_id=assessment_practice_id_e76dbb8c-60e7-49f5-9b33-f7e0148904b9\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:300px;\"><br \/>\n\t<\/iframe><\/p>\n<\/div>\n<div class=\"textbox learning-objectives\">\n<h3>glossary<\/h3>\n<p><strong>ALI rule:<\/strong> a recommended rule for\u00a0instructing juries\u00a0how to find a\u00a0defendant\u00a0in a\u00a0criminal trial\u00a0is\u00a0not guilty by reason of insanity; the focus is on the acts and mental state of a defendant at the time he committed the acts constituting the crime<\/p>\n<p><strong>competence to stand trial: <\/strong>the right to not be prosecuted while one is incompetent to stand trial<\/p>\n<p><strong>Durham rule:\u00a0<\/strong>established that a jury\u00a0may determine a defendant is\u00a0not guilty by reason of insanity\u00a0because the criminal act\u00a0was the product of a mental disorder<\/p>\n<p><strong>duty to warn or protect<\/strong>: holds that\u00a0mental health professionals\u00a0have a\u00a0duty to protect\u00a0individuals who are being threatened with bodily harm by a patient<\/p>\n<p><strong>guardian: <\/strong>a person authorized to give consent on behalf of a person who is unable to decide for himself or herself<\/p>\n<p><strong>incompetent:<\/strong> used to describe persons who should not undergo or partake in certain judicial processes, and also for those who lack mental\u00a0capacity\u00a0to make\u00a0contracts, handle their\u00a0financial\u00a0and other personal matters such as consenting to medical treatment, etc., and need a\u00a0legal guardian\u00a0to handle their affairs<\/p>\n<p><strong>insanity defense:<\/strong> an affirmative\u00a0defense\u00a0by\u00a0excuse\u00a0in a\u00a0criminal case, arguing that the defendant is not responsible for their actions due to an episodic or persistent\u00a0psychiatric disorder\u00a0at the time of the criminal act<\/p>\n<p><strong>involuntary commitment:<\/strong> civil commitment or\u00a0involuntary hospitalization\u2014a legal process through which an individual who is deemed by a qualified agent to have symptoms of severe\u00a0mental disorder\u00a0is detained in a\u00a0psychiatric hospital\u00a0(inpatient) where they can be\u00a0treated involuntarily<\/p>\n<p><strong>irresistible impulse:<\/strong>\u00a0defense in which the defendant argues that they should not be held\u00a0criminally\u00a0liable\u00a0for their\u00a0actions\u00a0that broke the\u00a0law because they could not control those actions, even if they knew them to be wrong<\/p>\n<p><strong>least restrictive alternative: <\/strong>law\u00a0ruling that a state cannot constitutionally confine a non-dangerous individual who is capable of surviving safely in freedom<\/p>\n<p><strong>right to treatment: <\/strong>federal minimum standards for the care of people with mental illness or mental retardation who reside in institutional settings<\/p>\n<p><strong>substituted judgment: <\/strong>a decision made by a person on behalf of a person who is incompetent and unable to decide for himself or herself<\/p>\n<\/div>\n\n\t\t\t <section class=\"citations-section\" role=\"contentinfo\">\n\t\t\t <h3>Candela Citations<\/h3>\n\t\t\t\t\t <div>\n\t\t\t\t\t\t <div id=\"citation-list-2756\">\n\t\t\t\t\t\t\t <div class=\"licensing\"><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Original<\/div><ul class=\"citation-list\"><li>Modification, adaptation, and original content. <strong>Authored by<\/strong>: Sonja Ann Miller for Lumen Learning. <strong>Provided by<\/strong>: Lumen Learning. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Shared previously<\/div><ul class=\"citation-list\"><li>Tarasoff v. Regents of the University of California. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Tarasoff_v._Regents_of_the_University_of_California\">https:\/\/en.wikipedia.org\/wiki\/Tarasoff_v._Regents_of_the_University_of_California<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Jared Lee Loughner. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Jared_Lee_Loughner\">https:\/\/en.wikipedia.org\/wiki\/Jared_Lee_Loughner<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Involuntary commitment. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Involuntary_commitment\">https:\/\/en.wikipedia.org\/wiki\/Involuntary_commitment<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Involuntary_treatment. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Involuntary_treatment\">https:\/\/en.wikipedia.org\/wiki\/Involuntary_treatment<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Bryce Hospital. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Bryce_Hospital#Wyatt_v._Stickney\">https:\/\/en.wikipedia.org\/wiki\/Bryce_Hospital#Wyatt_v._Stickney<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Informed refusal. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Informed_refusal\">https:\/\/en.wikipedia.org\/wiki\/Informed_refusal<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>O&#039;Connor v. Donaldson. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/O%27Connor_v._Donaldson\">https:\/\/en.wikipedia.org\/wiki\/O%27Connor_v._Donaldson<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Insanity defense. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Insanity_defense\">https:\/\/en.wikipedia.org\/wiki\/Insanity_defense<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Daniel M&#039;Naghten. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Daniel_M%27Naghten\">https:\/\/en.wikipedia.org\/wiki\/Daniel_M%27Naghten<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Irresistible impulse. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Irresistible_impulse\">https:\/\/en.wikipedia.org\/wiki\/Irresistible_impulse<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>John and Lorena Bobbitt. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/John_and_Lorena_Bobbitt\">https:\/\/en.wikipedia.org\/wiki\/John_and_Lorena_Bobbitt<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Durham rule. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Durham_rule\">https:\/\/en.wikipedia.org\/wiki\/Durham_rule<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>United States v. Brawner. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/United_States_v._Brawner\">https:\/\/en.wikipedia.org\/wiki\/United_States_v._Brawner<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>ALI Rule. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/ALI_rule\">https:\/\/en.wikipedia.org\/wiki\/ALI_rule<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-nd\/4.0\/\">CC BY-ND: Attribution-NoDerivatives<\/a><\/em><\/li><li>Attempted assassination of Ronald Reagan. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Attempted_assassination_of_Ronald_Reagan\">https:\/\/en.wikipedia.org\/wiki\/Attempted_assassination_of_Ronald_Reagan<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>John Hinckley Jr.. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/John_Hinckley_Jr.\">https:\/\/en.wikipedia.org\/wiki\/John_Hinckley_Jr.<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Due Process Clause. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Due_Process_Clause\">https:\/\/en.wikipedia.org\/wiki\/Due_Process_Clause<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Competence (law). <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Competence_(law)#Competence_to_stand_trial\">https:\/\/en.wikipedia.org\/wiki\/Competence_(law)#Competence_to_stand_trial<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Dusky v. United_States. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Dusky_v._United_States\">https:\/\/en.wikipedia.org\/wiki\/Dusky_v._United_States<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Ford v. Wainwright. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Ford_v._Wainwright\">https:\/\/en.wikipedia.org\/wiki\/Ford_v._Wainwright<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">Public domain content<\/div><ul class=\"citation-list\"><li>Loughner mugshot. <strong>Provided by<\/strong>: Wikimedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Jared_Lee_Loughner\">https:\/\/en.wikipedia.org\/wiki\/Jared_Lee_Loughner<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/about\/pdm\">Public Domain: No Known Copyright<\/a><\/em><\/li><\/ul><\/div>\n\t\t\t\t\t\t <\/div>\n\t\t\t\t\t <\/div>\n\t\t\t <\/section><hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-2756-1\">Criminal Law\u2014Cases and Materials, 7th ed. 2012, Wolters Kluwer Law &amp; Business; John Kaplan, Robert Weisberg, Guyora Binder, ISBN 978-1-4548-0698-1 <a href=\"#return-footnote-2756-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":29,"menu_order":13,"template":"","meta":{"_candela_citation":"[{\"type\":\"cc\",\"description\":\"Tarasoff v. 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