Wednesday, August 30, 2006

Not Guilty by Reason of Insanity

The crimes of the few American terrorists have sparked discussion whether insanity is a reasonable explanation for their actions. The attorneys for the defendant often inject that possibility into the mix, prompting outrage on blogs and call-in shows.

It is a complicated question. This is an area where I actually have enough knowledge to offer more than a layman’s opinion. People who have pled NGRI have populated my working life for 30 years, including several high-profile cases. There are a few cases which made local headlines and national mention that I happen to know the real story on, though of course I can’t give away which ones they are because of confidentiality. Two cases which were regarded as absolutely political by the media and the general public were in fact absolutely psychiatric. In both cases political or prejudicial factors were completely absent from the patient’s state of mind, though that would seem frankly incredible to anyone reading the outlines of the stories. One case spawned candlelight vigils two thousand miles away, the other a raft of tasteless internet jokes. Both were just paranoid schizophrenics, tormented by thoughts unrelated to the stuff that gets the nation worked up.

“Anyone who uses the insanity defense must be crazy” is the old saw, and there’s a lot of truth in it. I’ve got guys who are still in the hospital or living in group homes who would have been out years ago if they’d just pled guilty and served their time. Now the burden of proof is pretty much on them, and they have to show that they are safe, rather than the state showing that they’re dangerous. Big difference.

We get more than our share in New Hampshire because of the presidential primaries every four years. I’m gearing up for having to explain to the Secret Service yet again what procedures they have to go through to get information. Which they know, by the way, better than I do, but they hope that intimidation and knowing that they’re going to win in the end anyway will prompt me to just say “The hell with it” and tell them what they’re asking.

Yet I have the same response that most of the general public does when I read about people in other places who commit these obviously political crimes and the papers mumble mentally ill…off his medications…history of psychiatric problems. Yeah right. Naveed Afzal Haq shoots Jews in Seattle because of Israeli actions. I think: He’s not crazy, he’s just a terrorist. Omeed Aziz Popal, just back from Afghanistan, is likewise troubled. The guy with the SUV in North Carolina, Mohammed Reza Taheriazar, yeah, sure, don’t try to tell me he’s crazy. And yet the thought nags at me: there may be a social worker in North Carolina whose opinion I would respect, who knows the case even though she can’t tell me, who would say “David, trust me on this. It’s not political. He’s just crazy.”

The argument could be advanced But he comes from a culture which encourages this kind of thinking. They use guys like this, but the ideology of twenty non-psychotic bastards behind him isn’t that different. And that could also be true. Paranoid schizophrenics develop their explanations from whatever is in the air at the time they are growing ill. When I started in psych in the 1970’s, the new paranoids were all wrapped up in CIA plots. Then The Godfather came out and suddenly the mafia was supposedly following all these young people for no obvious reason. The older paranoids were still insistent that radio waves were being beamed in. My 46 y/o paranoid friend is sure that her information is unsafe on all these computer networks, so she won’t let me fax things about her or apply for food stamps on her behalf. Her first break was in the 1990’s. Then satellite broadcasts were big for awhile. Ex-hippies believe that Led Zeppelin stole their songs. Religious people have religious delusions. Granolas have delusions about agribiz poisons. Women at home with TV all day develop whatever problem Oprah is talking about. So an Islamic guy who is becoming paranoid goes to Afghanistan and comes back wanting to kill people and saying it’s part of jihad – yeah, that could be true.

The issue came up years ago around Catholics and Evangelicals when nutcases started stalking and shooting abortion doctors or bombing clinics. What is the responsibility of sane people to watch what they say because of the insane among them?

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