Severe Personality-Disordered Defendants and the Insanity Plea in the United States

This book proposes a change in the way the legal system in the United States deals with offenders diagnosed with a severe personality disorder. Such offenders should be allowed to enter in a court of law a plea of non-responsibility or diminished responsibility if it can be shown that they offended while decompensated into a brief psychotic episode. A brief decompensation may occur under severe internal or external stress. Such a plea has not been possible since the enactment of the Federal Insanity Reform Act of 1984 following the attempted assassination of then-President Ronald Reagan by John Hinckley, who was found not guilty by reason of insanity. The proposed change is based on current clinical knowledge, new discoveries in the field of neuropsychology and on recent neuroimaging studies of the brain, as discussed in the book. The book also suggests that the prerequisite for criminal non-responsibility be changed from strict mental illness to a disease of the mind or state of mind, which, at the time of a crime, incapacitates the cognitive and decisional capacities of the offender. That would satisfy due process of law and would be in accord with present international views.