FORENSIC PSYCHIATRY

Forensic Psychiatry

Forensic Psychiatry

Forensic psychiatry is a sub-speciality of psychiatry. It encompasses the interface between law and psychiatry. A forensic psychiatrist provides services - such as determination of competency to stand trial - to a court of law to facilitate the adjudicative process. (Konrad N, 2002)

Forensic psychiatrists also take care of prisoners in prisons as well as jails.(Appelbaum, 1994) What are the professional ethics to which forensic psychiatrists are expected to adhere?All forensic psychiatrists are expected to adhere to the general ethics of the medical profession, such as the Oath of Hippocrates and the Oath of Geneva. Apart from this, they must also meet many requirements of the state licensing agencies. Most forensic psychiatrists belong to the basic professional organizations of psychiatry, such as the American Academy of Psychiatry and Law (AAPL) and the American Psychiatric Association (APA). Both these organizations have a formal code of ethics. (www.forensicpsychonline.com)

A relationship between mental constructs and the Law has existed since antiquity and is already found in the Baba Ramma, an ancient codification of texts. In Egypt, Imhotep, the grand vizier of the Pharaoh Zoser may have been the first “medico-legal expert”. In the Bible, the book of Deuteronomy makes reference to crime and punishment - God's punishment for transgressions of His commands was to visit on the violator “madness, and blindness, and astonishment of the heart” (mania, dementia, stupor). (Arboleda-Flórez, 1998)

The Romans codified the close relationship between mental states and the Law in the Corpus Iuris Civilis that contains a list of mental conditions that could serve as defense for criminal responsibility. Some other Roman legislation included the Twelve Tables, in which provisions are made for a system of guardianship of the insane; the Lex Aquila that exonerated those who caused damage not by negligence or malice, but by accident and the Lex Cornelia that excused children and the insane from punishment. (Appelbaum, 1994)

Henry de Bracton, around 1256, may have been the first legal scholar to attempt to identify the degree of legal impairment needed to exculpate an offender. In the first systematic treatise on English Law, written in the thirteenth century, he stated, “an insane person is one who does not know what he is doing and is lacking in mind and reason”.

Medical experts were used in court proceedings in Bologna and other Italian cities during the XV century and in Freiburg, Germany. (www.psychiatry.uc.edu) The scientific understanding of criminal behaviour and the expected legal proofs of wrongdoing as opposed to hearsay evidence were considered extensively in the Constitutio Carolina (1532). In 1654, Zachia, possibly the father of legal medicine, upgraded the Corpus Iuris Civilis with his Questiones medico-legales for use by the Sacred Rota, the highest judicial body of the Roman Catholic Church. In 1736 Matthew Hale published, posthumously, his History of the Pleas of the Crown in which he introduced the concept of partial insanity (Prosono, 1994).

Bracton's legal definition of insanity based on the concept of “does not know” still reverberates, as it constitutes the basic formula in the McNaughton rule, ...