The Insanity Defense
How does the system react to people diagnosed with an inability to reason?
The insanity defense allows a defendant to admit their actions without actually pleading guilty, due to mental illness. Despite centuries legal precedent, the insanity defense is repeatedly challenged and contradicted, in cases where the public feels defendants are wrongfully let off the hook. In fact, nowadays it is almost never successfully used at all.
Why is it so contentious? Here is one example.
Richard Rojas
With Richard Rojas, the insanity defense succeeded. In 2017 Rojas drove a car through Times Square, which killed a teenager and injured several other people. The jury cleared responsibility, citing that Rojas was “disturbed” and did not understand what he was doing at the time of action.
The family of the victim resented the verdict, while Rojas’s lawyer felt Rojas would finally get the humane treatment he deserved after being discharged from the navy.
The verdict was largely based on testimonies from relatives and psychiatrists, who discussed a disembodied voice, “James,” that had commanded Rojas to do the act.
How far could the insanity defense extend?
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The temporary insanity defense is sometimes not distinguished from the regular insanity defense. However, there are some cases where the court cannot prove the defendant has impaired judgment on a regular basis, and did only at the time of the crime. For example, state laws differ on whether they consider voluntary intoxication a viable use of the temporary insanity defense. Temporary insanity is often associated with “crimes of passion”; in 1859 U.S. Congressman Daniel Sickles shot and killed Philip Barton Key after finding out he was having an affair with his wife, and was acquitted (the first official use of the temporary insanity defense in the United States).
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For neurological disorders such as Parkinson’s disease, new technologies, mainly Deep Brain Stimulators (DBS) are emerging with the potential to drastically reduce symptoms and improve quality of life. For Parkinson’s, DBS targets the subthalamic nucleus (STN) to reduce tremmors. The STN is crucial to motor-control, but also cognition and emotion (specifically reward and decision-making circuits).
Parkinson’s disease is linked to low levels of dopamine, which is often replaced through medication. Dopamine replacement medications can disrupt reward circuits and lead to impulse control disorders, which produce behaviors like gambling addictions, hypersexuality, and inappropriate/uninhibited social behavior. In some cases, DBS is thought to replace dopamine therapies and therefore alleviate problems with impulse control. Stimulating the dorsal STN, which is linked to motor control, does not seem to produce any separate issues. However, stimulating the ventral STN, which is linked to emotional processing, can lead to decreased impulse control.
While it seems possible to mitigate this risk by adjusting the voltage and target area of the DBS treatment, patients still have to assume risk of behavioral changes, some of which can be linked to violence and crime due to lack of inhibition. This risk comes both through the known treatment of dopamine replacement therapy, and the novel treatment of DBS. Balancing the need for medical treatment with the risk of harmful behavior is ethically very difficult, and could be another example of diminished agency in criminal activity.
Read this Nature study on different areas of the STN and how they can distinctly impact behavior
Consider…
