Law and Psychiatry part two

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I wrote in an earlier article about the complexity of the interface of psychiatry and the law and touched on  case 2 (below). I think the following three cases will provide  further insight. One case is civil,the other two are criminal. The latter describe the so called psychiatric defences in more detail.

Attachment Theory
This civil matter centered around adoption, bonding and attachment. The case was of a young  single mother who had a child that she had planned to adopt  due to socio economic circumstances and  her parents rejection of the child. Her intent was private adoption.

Several months after birth she changed her mind. The planned adoptive parents objected and a legal battle ensued. The mothers case was rejected by the initial trial judge and the decision was upheld on appeal and finally upheld again by the Supreme Court of Canada.

“A psychiatrist (me) also gave evidence. He stressed the importance of bonding, described its nature, and made reference to reports submitted by the welfare worker and gave his opinion that the author had correctly defined the phenomenon and had observed reactions on the part of the child which were typical of the developing process. He also expressed the opinion that it would be harmful to the child to break the bond thus formed and to place the child in a home which would be strange and foreign and where the mother would be a stranger to him.”
Bonding begins to accelerate around 6-8 months congruent with the occurrence of separation anxiety. The critical separation individuation phase picks up steam between 2-3 and ends at age 3. Attachment to the primary caregivers is complete.

Had the child been returned early on, the biological mother  and baby could have bonded but the usual court delays led to the foster parents being the primary bonding objects. The court decided that blood ties were therefore superseded.
As it turned out the mother did have later contact with the child.

The Reptile Brain
A young man and his friend are drinking at a bar. They leave into the parking lot where upon witnesses observed a fight break out between them. The accused pulls a knife, stabs the other in the chest and he is dead before he hits the ground with a ruptured left ventricle.

Charge: 2nd degree murder. This was one of only 2 times I worked for the prosecution. The defence claimed lack of specific intent to commit a crime due to alcohol intoxication thus reducing the charge to manslaughter.
I was not called but rather was sitting beside the crown attorney helping him cross-examine the psychiatrist called by the defence. The doctor indicated quite plausibly that due to alcohol his higher brain was shut down and the ‘reptilian’ brain took over. He therefore lacked the capacity to form specific intent. My counterpoint was that the accused had pretty good recall for the offense thus having sufficient wherewithal to maintain impulse control and thus he could form specific intent.

Furthermore no one poured the alcohol down his throat, that was his decision and thus he was culpable.  The jury on instruction from the judge concluded that alcohol plus apparent provocation reduced intent capacity and so manslaughter was the conviction….6years.

When the Mind Stops but the Body Doesn’t
This case concerns an Inuit man who was depressed after his friend’s death and the loss of his girlfriend leading to a series of serious assaults for which he claimed no recall. Alcohol was not a factor and provocation was minimal.  The attacks were preceded by a visual distortion of faces and he would “awake” with his hands on the victim.

Having ruled out an organic cause, and with the aid of sodium amytal,  the diagnosis was dissociation disorder. The legal defence was psychological blow non insane automatism. The crown was aiming for the insane variety. The Rabey case was used as precedent.

This defence is tricky and controversial but was supported by the traditional cultural  propensity of the Inuit towards dissociation under stress. He was kept in Toronto after acquittal for therapy and vocational training and later returned to North Baffin as a welder at a mine eventually raising a family. Only a few years ago I discovered that he was awarded a Governor General medal for bravery saving a family he did not know from a house fire. Apparently the judicial decision was the correct one.

These three cases illustrate the intersection of law and psychiatry. What the two disciplines share in common is hermeneutics: an interpretation of the meaning of events. The science however is not much further along than stone knives and bearskins on occasion. Compliments of a lawyer who shall remain anonymous…”a psychiatrist who provides expert testimony shall henceforth wear a cone-shaped hat not less than two feet tall, the surface of which shall be imprinted with stars and lightning bolts. He shall done a white beard no less than 18″ in length and punctuate testimony by stabbing the air with a wand. At intervals during psychiatric pontificating the bailiff shall contemporaneously administer strikes to a Chinese gong”.

This is state of the art from a legal perspective.

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2 Responses to “Law and Psychiatry part two”

  1. Carole Kocian says:

    A US mass shooting by a lizard brained human perpetrated yesterday.

    • Allan Seltzer says:

      Well he may have a chromosomal glitch as a result of a straight line family tree. Indeed there is an XYY configuration that leads to aggression, tall height, and acne due to x/s testosterone. Hard to say in this case. I have seen a few that have been violent sex offenders.

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