Monday, 27 January 2014

Not  guilty  by  reason  of  insanity
There is nothing that infuriates me more than learning about a criminal who had murdered someone and then is classed by psychiatrists as being insane when he or she deliberately committed the murder.                                                                                                                                                
Now it is easy to accept their opinions if it has been established by an MIR examination of the skull of an accused killer that there is definitely something wrong with his or her brain. It is also easy to accept their opinions if the killer was suffering from a recognized psychiatric illness for a long period of time.
But what about those killers in which there is no physical abnormality in the killer’s brain and no history of any form of psychiatric illness? Why must jurors except the opinions of psychiatrists that the killer was insane at the time of the murder, especially when the same psychiatrists are called upon by the defence lawyers time and time again because these lawyers know that these psychiatrists will testify that their clients were insane when they committed the murders. These kinds of psychiatrists in my opinion are no different than prostitutes on the street. Both offer services to anyone who will pay them to give them what they want.
Two major questions put to these psychiatrists who are giving testimony in court are as follows: “Does the accused have a mental disorder (psychic injury)? Is the mental disorder related to the crime (causation)?”                   
As a ‘profession’ psychiatrists tend to occupy the ‘bottom’ of the class of the medical schools judging by their grades. They are simply not as bright as other medical professionals, and this compounded with an already very complex diagnostic subject results in divergent opinions, diagnosis and treatments. This subject is very far from being a ‘science’ of any sort. I personally wouldn't place my well-being in the hands of any of them. That’s asking for trouble. As an alternative, a good counselor or psychologist who is well versed in human relationships and the complexities of life will do quite satisfactorily.
A medical doctor who is a practicing physician or surgeon had to know a great deal about medicine when they began working fulltime as physicians and/or surgeons where as a psychiatrist (especially in the United States) can simply refer to the Diagnostic and Statistical Manual of Mental Disorders (DSM) for his answers.
Mental disorders and illnesses are largely a failure to take responsibility and exercise control over one’s own mind, emotions, behavior and environment. Even when diminished control over one's behavior is a feature of the disorder, having the diagnosis in itself does not demonstrate that a particular individual was unable to control his or her behavior at a particular time. There is simply no way of making that determination unless the psychiatrist was present when the crime was committed.
Here is an excellent example of the absurdity of psychiatric classification and diagnosis; in their own words no less! A person who hears or sees a dead relative is NOT considered to have a mental disease in one culture, because the culture accepts this phenomenon whereas in a culture that doesn't accept the phenomena, the person is labeled with psychosis. More importantly, what if he really is hearing or seeing the dead in his own mind, it makes no difference to the psychiatrists.  The index for deciding is what does the culture consider normal and acceptable?
It is usual to assume when in a court of law, that the goal is to place the discovery of truth above all else. Psychiatry's standard DSM bible on disorders is incapable of strict application in ascertaining whether a person actually has any of these disorders. The psychiatrist is apparently much more comfortable under a less stringent environment where questions of truth and actuality aren't relevant. Also, the law involves responsibility and competence—two subjects which again seem to be out of the realm of psychiatry's relevance.
There are significant risks that diagnostic information will be misused or misunderstood. These dangers arise because of the imperfect fit between the questions of ultimate concern to the law and the information contained in a clinical diagnosis. In most situations, the clinical diagnosis of a DSM-IV mental disorder is not sufficient to establish the existence for legal purposes of a ‘mental disorder’, ‘mental disability’, ‘mental disease’, or ‘mental defect’.
In determining whether an individual meets a specified legal standard (e.g., for competence, criminal responsibility, or disability), additional information is usually required beyond that contained in the DSM-IV diagnosis. This might include information about the individual's functional impairments and how these impairments affect the particular abilities in question. It is precisely because impairments, abilities, and disabilities vary widely within each diagnostic category that assignment of a particular diagnosis does not imply a specific level of impairment or disability.
Even the United States Supreme Court recognizes that psychiatry is not science—it is opinion.  A recent Supreme Court decision stated that a psychiatrist or psychologist is no more qualified than any other person to give an opinion about someone's mental condition. And that is why it is left up to a jury to make a finding of innocence or guilt. They are the ones who have to assess the opinions of the psychiatrists and then form their own opinion.
Honest psychiatrists will admit that there is no science to psychiatry and that they cannot cure their patients.  But many psychiatrists choose to prescribe heavy mind-altering drugs with a reckless abandon that has become a growing concern to the Federal Drug Administration  and similar agencies abroad
Though they are classified as physicians, psychiatrists—unlike real medical doctors—don't conduct any tests to substantiate the use of a mental disorder label; they possess no more skill or knowledge than the man on the street when it comes to diagnosing the causes of patients' problems. This statement doesn’t apply to those psychiatrists who are fully fledged medical doctors.
The foregoing cases and thousands of others like them bear testament to the fact that psychiatry is a profession of willful negligence, refusing at nearly every turn to search out and treat the actual conditions that manifest as ‘mental illness’.
Marta Urbaniak of Michigan, had been referred to Henry Ford Hospital's behavior health department for treatment due to a difficult merger at work.  She was diagnosed as being bipolar by one of the many psychiatrists who treated her.  She was in her third year of psychiatric treatment when she realized she was only getting worse with each new psychiatric drug prescribed.  Marta went from being active and employed to having to take a leave of absence from her work due to inability to function in a drug-induced stupor.  When she questioned this drug approach to mental health, her psychiatrist assured her that alternatives didn't work and told her it could take 20 years to see an improvement in her condition.  Urbaniak was smart enough to get a second opinion from a real medical doctor who detected severe food and environmental allergies on her first visit.  Once properly treated, her physical and mental health quickly returned to normal.
In 1996, mother-of-five Kathy Nisley of Mishawaka, Indiana, began to feel depressed following the birth of her twins (her fifth pregnancy).  She went to Madison Center, a psychiatric facility, for treatment.  From June 1996 to October 2003, she was labeled with ‘severe depression’, then ‘bipolar’, then ‘borderline personality disorder’ and finally ‘post-traumatic stress disorder’. Kathy was given psychotropic drugs in increasing doses and combinations that caused her to become psychotic.  She ended up being hospitalized five times in a psychiatric ward.  Her family witnessed her psychiatric drug-induced psychosis and self-mutilation. In November 2004, she experienced a grand mal seizure.  A few days later, a neurosurgeon removed a tennis ball-sized meningioma (tumor) from her left frontal lobe.  Her depression subsequently disappeared.  Her surgeon estimated it to have been growing in her skull for between 10 and 15 years even while she was being treated by psychiatrists for her so-called mental disorders.
As a young boy, Johnnie Tillson of Wisconsin had allergies to several medications, including penicillin.  By the age of five, he had become a difficult child and his mother tried to find out why.  Her pediatrician could find no reason.  She sought a second and third opinion.  She was told Johnnie had a ‘conduct disorder’.  She was referred to Milwaukee psychiatrist Eric Schwietering, who interviewed Johnnie (with no medical exam) and diagnosed him with ‘bipolar disorder’ and prescribed him the anti-psychotic drug Risperdal (which was not then or now approved for use in children).  The drug made Johnnie very tired and caused horrible, abnormal weight gain.  During the period he was on this drug, Mrs. Tillson often complained to Dr. Schwietering about the side effects of the drug and asked about alternatives. She asked, “Isn't there another route besides the drug? Couldn't it be allergies or something?” Dr. Schwietering assured her that Johnnie's behavior and attention problems in school were not allergy related, even despite Johnnie's previous medical history of allergies to drugs.  Johnnie's schoolwork and his behavior declined as he continued on the drug.  Whenever she would inquire of Dr. Schwietering about it, he assured her that Johnnie's problems were characteristic of ‘bipolar disorder’ and that if it were not treated with psychiatric drugs, Johnnie would grow up to be a drug or alcohol abuser.  Schwietering switched him to the psychiatric anti-seizure drug Trileptal, to which Johnnie had a severe adverse reaction known as ‘Stevens-Johnson Syndrome’; full body rash and ulcers in his mouth and throat and in the mucous membranes of his eyes (3-15% of patients die from this reaction).  He was taken off all psychiatric drugs but continued to have rashes, especially on the parts of his body covered by clothing.  Through some admirable research and testing by his mother, it was ultimately discovered that Johnnie was allergic to chlorine.  When it was eliminated from the household, his problems vanished.
In March 2002, Brad Ammerman was in his early 20s.  He'd worked for the last two years as a metal parts grinder in a factory in upstate New York.  He was making good money, had bought a car, and was getting ready to move in to his own apartment.  Without warning, he began hallucinating.  Over the next four or five days, he began to feel increasingly strange and started hearing voices.  His father took him to the local emergency room and told the doctor that Brad worked with metals and felt that contact with metal could be the cause of his son's condition (Mr. Ammerman himself had experience with metal toxicity).  The blood test showed higher than usual levels of aluminum in his blood.  However, due to his behavior, Brad was sent to a psychiatric unit where he was labeled schizophrenic and placed on antipsychotic drugs.  He remained on outpatient psychiatric treatment but the drugs did not help and in fact, caused him to have psychotic episodes that resulted in him being hospitalized.  It was later found that work conditions were such that Brad was inhaling vapor from the metal he was grinding, as well as from the metal coolants.  A neurologist confirmed that his apparent "schizophrenia" was indeed due to heavy metal toxicity.  Though he suffered brain damage from the metal, he was weaned off all psychiatric drugs and has been put on high doses of fish oils and vitamin B, which have improved his condition.
It is these kinds of psychiatrists who are in the profession of quackery that are also called upon by a desperate lawyer hoping to get a psychiatrist to declare that even though his client was eating the face of his victim, he didn’t know what he was doing and therefore he or she should be found not guilty by reason of insanity.
Judges and juries often possess limited expertise regarding psychological and psychiatric disorders. In other words, they don’t have the knowledge or the experience to evaluate a psychiatric or psychological diagnosis or to think critically about diagnostic criteria. And to make matters worse, they have to choose which of two psychiatrists and psychologists (defence and prosecution) evaluation of the mental condition of the accused are the correct ones. Asking a plumber, an electrician and a carpenter serving on a jury (although intelligent people) to evaluate the findings of two psychiatrists who come up with two different conclusions, is ridiculous.

The question that crops up in the mind of an examining psychiatrist in cases where someone has committed a murder is whether or not the accused is faking insanity? How can a psychiatrist honestly make that determination if he wasn’t present at the time of the murder?  It is also ironic when you think about it. A psychiatrist claims that the accused was insane when the crime was committed, and yet, another psychiatrist claims that he is sane enough to stand trial. 
Brian David Mitchell, an accused kidnapper of a Mormon teenager Elizabeth Smart, was presented in court by his lawyer’s choice of a psychiatrist as being too incompetent to stand trial. A Forensic Panel was retained by the United States Attorney’s Office for the District of Utah to address questions of the defendant’s competency, which had been rendered more complex by his refusal to speak to examiners and forensic staff and his singing in court. Mitchell was repeatedly found incompetent and the case contemplated for dismissal in state court. The Forensic Panel engaged the distinction between extreme beliefs that render one incompetent and religious ideals of a fundamentalist who exercises tactical choices, especially as it applies to the LDS and splinter sects. In addition, he unearthed long ignored elements of Mitchell’s personal behavioral history that had been heretofore ignored by the defense, drew out dramatic distinctions of Mitchell’s in-hospital behavior to illustrate how he was intentionally avoiding scrutiny by examiners, and identified key evidence to prove a defense witness had lied in earlier testimony to bolster her opinion that Mitchell was competent. The Forensic Panel found that the defendant suffered from disorders including pedophilia, antisocial personality disorder and narcissistic personality disorder, but that he was not psychotic. The Forensic Panel's methodology was referenced by court opinions as “best practices in forensic psychiatry and psychology” and pivotal to a finding that the accused was competent to stand trial. Mitchell was convicted at a later trial in which he then claimed legal sanity. The defense waived all appeals.
In a case involving a racially-motivated mass killing, the Forensic Panel was retained by prosecutors to assess insanity claims by the defendant, and to review mitigation evidence being proposed by the accused’s lawyer for a capital sentencing proceeding. For many months, the high profile case stagnated while the accused remained silent and uncooperative in a forensic hospital. Despite obstacles created by the accused’s unwillingness to speak to examiners, the Forensic Panel demonstrated evidence for the his competency, his attempted claims of retardation, psychosis, and legal insanity. The Panel recognized contemporary understandings of black rage, and unearthed evidence that a defense mitigation specialist was tampering with witnesses. Numerous interviews and review of evidence brought about a definitive 134 page report and testimony at the sentencing proceeding. Along the way, the Forensic Panel successfully educated attorneys for cross examination of defense witnesses, so much so that prosecutors needed no testimony at trial. The accused was convicted of capital murder, and the subsequent death verdict was upheld on appeal.
Many forensic evaluations are unreliable because the history upon which they are based is erroneous, inadequate or incomplete. All too often, the medical and social history relied upon by mental health professionals is cursory at best and comes exclusively from the accused whose purpose is to convince the court that he or she was insane when the crime was committed.
In 2009, a former doctor, (Guy Turcotte) stabbed his five-year-old son to death immediately after the boy had just wrapped his arms around him and said he loved him. Then he did the same to his three-year-old daughter. He later said he was despondent because his wife was leaving him. That is why he killed his children. He claimed he had no reason to live and therefore his children had to die also. He then drank windshield wiper fluid. He lived. His children didn’t. He was found not guilty by reason of insanity. He didn’t deny killing his two children; he simply said that he didn’t have the intent to kill them. He said that he killed them because he didn’t want them to see him dead.
When the police arrived, they found Turcotte under the bed. If he was hiding from them, then he knew that he had done something wrong and knowing that he did something wrong means that he was sane when he killed the two children. The jury bought the defence argument presented to them by the defence’s psychiatrist that he was insane when he committed that horrible crime.  
Can you believe this? He spent 46 months in the Pinel Institute (a psychiatric hospital in Quebec) and now his psychiatrists are saying that he is well enough to go on escorted trips in the nearby community. He has been given permission to go into town unescorted so that he can go to movies, spend some time with his wife, shop and go to church as much as 72 hours each month. He has also said that he wants his medical licence back so that he can practice cardiology again.
I blame the judge for making it possible for the jury to arrive at that verdict. He didn’t fully recap all the psychiatric evidence present to the jury in his address to the jury. The Quebec Court of Appeal had ordered a new trial which will probably be held next year. He applied to the Supreme Court to have the appeal court's decision reversed. The court refused and the killer's trial will go on as planned.
Did he know what he was doing when he murdered his two children? In my opinion, he did. Did he kill them because he wanted to get back at his wife who was leaving him? We will never know for sure. Sometimes, it is just about getting away with murder and condemning the ex-spouse to a life of hell.
The public is upset by the fact that this man was found not guilty by reason of insanity and that he is eligible to be released soon from the psychiatric hospital as being sane unless at his new trial, he is classed as having been sane when he committed the crime. If that is the court’s decision, he will be going to prison for a very long time.  
There is the well-known case that happened in British Columbia in which a man in 2008 killed his three children after his separated wife refused to come back to him. He was found not guilty by reason of insanity. Three years later, the Review Board found him sane enough to return to society. But the backlash of that decision resulted in him being returned to the psychiatric institution.
A man in the United States in March 2012 faced murder charges after deputies said he killed his wife hours after he was released from a mental hospital.
There is a case in Russia where a man was tried for the murder of 15 children. For that deed, he was sent to a hospital for the insane. The irony of this case was that he had been in that hospital prior to the murders and released as cured.
In May 2005, in the United States, two psychiatrists testified that Kenneth Pierott was insane when he smothered his girlfriend's 6-year-old son and tried to cremate the body in an oven at the behest of voices in his head, according to court documents. Pierott had been previously found innocent by reason of insanity in the 1996 fatal beating of his sister, who suffered from cerebral palsy. Pierott spent about four months in a state mental hospital in 1998 before he was released. He should never have been released from the mental hospital in the first place. The psychiatyrists who claimed he had been cured in the first case didn’t know what they were doing.  
It can be readily seen that many, if not most, of the mental health evaluations conducted in criminal cases do not satisfy the applicable standard of care. Additionally, in many cases defense counsel are not sufficiently conversant with the elements of a complete, reliable mental health evaluation to educate the court and jury.
While not all accused persons have organic brain damage, many do. This can be due to poverty, abuse and neglect which characterizes so many of their lives, a substantial percentage of accused persons have mothers who abused alcohol and drugs during their pregnancies and who received poor or no prenatal care. Inadequate medical attention to head injuries and other illnesses is also common, as is exposure to various neurotoxins (e.g., lead based paint and pesticides). Long histories of substance abuse, including the use of organic solvents, are also not unusual. These, and other factors, predispose people to varying degrees of neurological impairment. Organic brain damage can and does affect behavior. It can impair judgment and rob an individual of the ability to make decisions in crises rationally and responsibly. It can destroy or diminish a person's ability to learn, to carry out a plan of action, to understand long term consequences of actions, to appreciate cause and effect, and to mediate impulse-driven behavior.
Another very common deficiency in forensic evaluations is the inattention to the possibility of organic damage, other neurological dysfunction, or a physiological basis for psychiatric symptoms. Many people are at risk for organic brain damage. They have a history of serious head injuries from chronic childhood physical abuse, car accidents, and falls. Their developmental years are plagued with chronic illness and fevers, frequently untreated, and malnutrition. Poor or nonexistent prenatal care and/or birth trauma are routinely found in their histories. Many clients had mothers who drank large amounts of alcohol or used drugs during their pregnancies, now well recognized as a cause of permanent and sometimes devastating mental disabilities in the developing fetus. Most of our clients are chemically dependent, and their early and prolonged use of drugs and alcohol, including organic solvents, can cause permanent brain damage. This may explain why most criminals in prison are suffering from some degree in mental illness. This however doesn’t mean that they are necessarily insane. 
Without first conducting the necessary life history investigation, the psychiatrist may well overlook significant factors and come to premature or erroneous conclusions. Furthermore, it is critical that the lawyer obtain the assistance of a social worker, or someone with similar skills, to assist in compiling and understanding the social and medical history of his or her client.
There was a very interesting decision rendered by a jury in the United States that bears retelling. In July, 2008, the jury was deciding on the fate of a man who had killed his grandparents. They suspected that he was insane but they were concerned that he would eventually be released from a mental hospital while still insane so they found him guilty of the murder of one of his grandparents and not guilty by reason of insanity of the other grandparent. The judge accepted their decision. He was sentenced to life in prison for the murder of one of his grandparents and if by chance he was ever released from prison, he would then be sent directly to the hospital for the insane for the murder of his other grandparent.

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