In Moore v. Texas, which I discussed here, the Supreme Court of the United States held that courts must rely on current clinical standards when determining whether a defendant is intellectually disabled and so exempt from the death penalty. Must courts also defer to clinical standards when determining whether a defendant is insane and so exempt from criminal culpability? I don’t think so, for the reasons below. Insanity isn’t a clinical concept. Intellectual disability is a diagnosis, but insanity isn’t. As forensic psychologist Charlton Stanley explains here, “insanity is a legal term found nowhere in any psychiatric or psychological diagnostic manual.” This Psychology Today article likewise explains that insanity is not a clinical term or condition. Because the concept of insanity is not a clinical one, there are no clinical standards to which courts could defer. Lay testimony may be sufficient to show insanity. Even without established clinical standards for determining insanity, mental health experts may form opinions about a defendant’s mental state. But courts do not afford any special deference to such opinions, as shown by the fact that a defendant may establish insanity without presenting expert testimony. See, e.g., Francis C. Amendola et al., Insanity Evidence, 23A C.J.S. Criminal Procedure and Rights of Accused § 1572 (Mar. 2017 update) (“The facts of the case, the prosecution’s witnesses, lay testimony or any combination thereof is sufficient to raise the issue of insanity. Expert psychiatric testimony is not necessary to raise the issue of insanity, nor is it necessary for the [...]
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