Vol. 34, No. 5, 60. For Your Health.

• Author: by Sukhpreit Sohi, MD Behavioral Health Services Cheyenne Regional Medical Center

Wyoming Bar Journal

2011.

Vol. 34, No. 5, 60.

For Your Health

Wyoming LawyerIssue: October, 2011For Your Healthby Sukhpreit Sohi, MD Behavioral Health Services Cheyenne Regional Medical CenterMcNaughten's Rule: The Role of Psychiatry and the Law

In the fields of psychiatry and mental health there is always a significant overlap with the legal system. A psychiatrist plays a vital role in the way the legal system provides the most appropriate care for patients suffering from debilitating mental illness. The controversial medicolegal McNaughten's rule, also referred to as not guilty by reason of insanity (NGRI), is one example.

McNaughten's rule came about after the trial of Daniel McNaughten, a Scottish laborer who assassinated the British Prime Minister's secretary in 1843 after mistaking him for the Prime Minister. McNaughten was suffering from severe paranoid delusions and believed the Prime Minister was responsible for his financial and personal misfortunes. These fixed false beliefs led to his acquittal and McNaughten's rule, which states, "Every man is to be presumed to be sane, and...that to establish a defense on the ground of insanity, it must be clearly proved that, at the time of the committing of the act, the party accused was laboring under such a defect of reason, from disease of mind, as not to know the nature and quality of the act he was doing; or if he did know it, that he did not know he was doing what was wrong."

More recent controversial and high profile NGRI acquittal cases include John Hinckley, Andrea Yates, and Lorena Bob-bitt. John Hinckley attempted to assassinate then-President Ronald Reagan in 1981. Hinckley suffered from delusions that led him to believe he had a special relationship with actress Jodie Foster. He felt the need to do something "courageous" as a declaration of his devotion to her.

Public and political outcry occurred after his not guilty verdict. Montana, Utah and Idaho dropped the insanity defense entirely, and Kansas joined them in 1995. This also led to the passing of the Insanity Defense Reform Act by Congress in 1984...