Insanity Defense – Medical Records are Vital

by | Published on Mar 9, 2015 | Medical Record Review

People facing federal criminal charges often plead not guilty by reason of insanity. Take the recently highlighted instance of 45-year-old SujathaGuduru who shot and killed her 17-year-old daughter Chetana last year, and is facing criminal charges. Her medical expert found that she was insane at the time she pulled the trigger. Prosecutors are still preparing their report. The state’s experts have already reviewed the defendant’s medical records, but have stated that they want to examine her. For the judgment to be in her favor, the defendant needs at least one of the state psychiatrists to agree with the defense psychiatrists that she was indeed insane at the time of the shooting.

Establishing Legal Insanity

Determining whether a federal defendant qualifies for the insanity defense is difficult. It is the onus of the defense attorney to prove that his client’s mental ailment prevented him/her from comprehending the wrongness of their action at the time of the offense. In addition, a clear connection must be established between the defendant’s mental delusion and the crime committed. To clearly determine whether a defendant was “legally insane” at the time of the crime, mental health experts interview him/her and examine “collateral information” which comprises the defendant’s arrest records, medical records and criminal history.

To establish insanity, courts utilize certain tests such as:

  • The M’Naghten Rule – the defendant did not understand his/her action, or did not distinguish between right and wrong on account of “a disease of mind”.
  • The Durham Rule – irrespective of the clinical diagnosis, the defendant’s “mental defect” resulted in the criminal act.
  • The Irresistible Impulse test – the defendant was unable to control his/her impulses because of the mental disease, which led to a criminal act.
  • The Model Penal Code Test for legal insanity – the defendant failed to understand that his/her act was criminal or was unable to act within the confines of the law because of a diagnosed mental defect.

Some states including Kansas, Idaho, Utah and Montana do not allow the insanity defense against criminal charges. Excepting Kansas, these states allow a verdict of “guilty but insane”, which in most cases provide for institutionalization of the defendant instead of prison. States that allow “legal insanity” verdict use either the M’Naghten Rule (sometimes along with the Irresistible Impulse test) or the Model Penal Code. Only New Hampshire uses the Durham standard.

Medical Records Help Establish Insanity

Medical records are vital to prove insanity. They contain enlightening and diagnostically relevant material. Attorneys depend on medical review experts such as physicians and registered nurse consultants to identify facts in the patient records that may be relevant to the case. In the absence of these documents, defense lawyers will find it tough to argue their case, as in the instance of James Charneske, a 38-year-old schizophrenic who has been living on the streets for years. He is charged with assaulting a retired police officer who was hospitalized with serious facial and head injuries for many days following the attack. According to his family, he refused mental health treatment and had left them. Charneske’s lawyer has not much chance of proving his mental instability in the absence of hospital records or other treatment records. Prosecutors may not agree to an insanity plea without those records to prove his illness. The defendant’s lawyer is planning to ask the judge to subpoena the medical documents that show his client’s illness.

If the prosecutors veto an insanity plea, the defendant will have to convince the jury that he is not guilty due to his mental state. The judge has suggested a guilty plea, which would allow the judge to make a ruling based on an examination by probation officers – whether to send the defendant to prison or to a mental health institution.

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