Stone A A
Hosp Community Psychiatry. 1982 Aug;33(8):636-40. doi: 10.1176/ps.33.8.636.
What was once a great romance between law and psychiatry has ended in disenchantment on both sides. Legal rulings during the 1950s intended to increase the psychiatric presence in the courtroom have been repudiated, and there is now a mood to abolish the traditional insanity defense. Abolitionists charge that the insanity defense has been successfully employed by large numbers of dangerous criminals to avoid punishment, that psychiatrists are dishonest because they serve as expert witnesses for both sides, and that the existence of the defense is evidence of a permissive society that coddles violent criminals. Each of these charges is rebutted by the author, who contends that until recently the insanity defense was a profound hypocrisy: the courts found the defendants not guilty by reason of insanity and then relied on psychiatry to confine them for the rest of their lives. But legal reforms and changes in psychiatric practice during the past 20 years have made it more difficult to confine such persons, and thus the insanity defense has real meaning for the first time. The author believes that despite the loss of protection to society, there are important legal and moral barriers to abolishing the insanity defense.
法律与精神病学之间曾经伟大的浪漫关系如今在双方的幻想破灭中告终。20世纪50年代旨在增加精神病学在法庭上影响力的法律裁决已被推翻，如今有一种废除传统精神错乱辩护的倾向。废除论者指责，大量危险罪犯成功利用精神错乱辩护来逃避惩罚，精神病医生不诚实，因为他们为双方充当专家证人，而且这种辩护的存在证明社会过于宽容，对暴力罪犯过于娇惯。作者反驳了上述每一项指责，认为直到最近精神错乱辩护都是一种严重的虚伪：法院判定被告因精神错乱无罪，然后依靠精神病学将他们终身监禁。但过去20年里的法律改革和精神病学实践的变化使得监禁这类人变得更加困难，因此精神错乱辩护首次具有了真正意义。作者认为，尽管社会失去了这种保护，但废除精神错乱辩护存在重要的法律和道德障碍。
