WEBVTT - Ep36 "What is Insanity?" Part 1 0:00:05.200 --> 0:00:09.440 What is the insanity defense? Are some people's brains so 0:00:09.640 --> 0:00:13.399 different from yours that it makes sense to categorize them 0:00:14.040 --> 0:00:18.680 differently under the legal system? How could a mother kill 0:00:18.720 --> 0:00:22.840 her children? Can you commit a crime without meaning to? 0:00:23.520 --> 0:00:27.159 How does a legal system decide how to rule on 0:00:27.200 --> 0:00:33.120 these issues? And how are science and law strange? Bedfellows? 0:00:36.440 --> 0:00:39.199 Welcome to the Inner Cosmos with me, David Eagleman. I'm 0:00:39.240 --> 0:00:43.360 a neuroscientist and author at Stanford and in these episodes 0:00:43.440 --> 0:00:47.640 we sail deeply into our three pound universe to understand 0:00:48.040 --> 0:01:00.320 why and how our lives look the way we do. Now, 0:01:00.560 --> 0:01:04.600 we all hear the word insane, somebody is acting insane, 0:01:04.680 --> 0:01:06.760 something like that. But the first thing to note is 0:01:06.800 --> 0:01:10.760 that insanity is not a medical term. It's not used 0:01:10.760 --> 0:01:15.160 in psychiatry or neuroscience. It's instead a term used by 0:01:15.280 --> 0:01:18.560 the legal system. And I'm going to do a two 0:01:18.720 --> 0:01:24.080 part episode about the insanity defense, where it comes from, 0:01:24.600 --> 0:01:27.920 and why it is so difficult as a society to 0:01:28.040 --> 0:01:32.000 decide where we want to draw our lines in the sand. 0:01:32.600 --> 0:01:35.160 What I mean is, sometimes a person commits a crime 0:01:35.800 --> 0:01:39.280 and we say they're clearly different from us, but we're 0:01:39.280 --> 0:01:41.880 not sure quite how and we're not sure if that 0:01:42.080 --> 0:01:46.240 should release them from culpability. As we're going to see, 0:01:46.440 --> 0:01:50.280 there is no hard and fast line where we as 0:01:50.280 --> 0:01:52.480 a society can say, oh, that person is on this 0:01:52.560 --> 0:01:55.520 side of the line and this person isn't. Now, this 0:01:55.640 --> 0:01:58.520 is a theme I've expressed in various ways in all 0:01:58.560 --> 0:02:02.120 of these episodes, which is, but brains are very different 0:02:02.160 --> 0:02:05.760 from one another, and most everything that we are interested 0:02:05.760 --> 0:02:09.320 in lives on a spectrum, and more than a spectrum, 0:02:09.520 --> 0:02:14.160 on a very complicated landscape. People are very different on 0:02:14.200 --> 0:02:17.280 the inside, and the question is how do we build 0:02:17.440 --> 0:02:22.400 rules as a society to make things run well. So 0:02:22.480 --> 0:02:25.320 let's get started. What I want to tell you about 0:02:25.400 --> 0:02:28.639 is a young woman named Andrea So. By the time 0:02:28.840 --> 0:02:32.760 Andrea was a teenager, she held the world by the tail. 0:02:32.880 --> 0:02:35.520 She was the valedictorian of her high school. She was 0:02:35.560 --> 0:02:38.160 the captain of her swim team. She was a member 0:02:38.200 --> 0:02:41.800 of the National Honor Society. By twenty two years old, 0:02:41.880 --> 0:02:44.680 she became a registered nurse and she worked at M. D. 0:02:44.800 --> 0:02:49.000 Anderson Cancer Center in Houston, Texas. And her life got 0:02:49.120 --> 0:02:51.520 even better when she met the man of her dreams, 0:02:51.560 --> 0:02:54.960 a guy named Rusty, at their apartment complex and Four 0:02:55.040 --> 0:02:58.400 years later, they got married, and they announced to friends 0:02:58.440 --> 0:03:02.280 and family that they were going to have as many babies. 0:03:01.919 --> 0:03:03.080 As nature allowed. 0:03:03.720 --> 0:03:06.560 So their first child was born ten months later, and 0:03:06.639 --> 0:03:10.000 over the next six years they had four more handsome 0:03:10.040 --> 0:03:14.560 and healthy children. One June morning in two thousand and one, 0:03:15.160 --> 0:03:18.480 Rusty left the house for his work at NASA, and 0:03:18.560 --> 0:03:22.559 as soon as he left, Andrea turned on the bathtub, 0:03:23.200 --> 0:03:26.600 and one by one she held her beloved children down 0:03:26.800 --> 0:03:31.240 under the water until they drowned. Her oldest child, who 0:03:31.280 --> 0:03:34.200 was seven years old, saw his six month old sister 0:03:34.320 --> 0:03:36.880 face down in the bathtub, and he tried to flee, 0:03:37.320 --> 0:03:40.800 but Andrea chased him and caught him and drowned him 0:03:40.840 --> 0:03:44.800 next to his sister's floating body. She laid the bodies 0:03:44.920 --> 0:03:47.960 of the youngest four on the bed, and she left 0:03:47.960 --> 0:03:51.520 the eldest in the bathtub. And Andrea later told a 0:03:51.560 --> 0:03:54.880 homicide sergeant that she had considered killing her. 0:03:54.840 --> 0:03:58.720 Children for two years now. 0:03:59.040 --> 0:04:04.280 People often grabbedavitate towards stories of crime, saft's, assaults, murders, 0:04:04.280 --> 0:04:07.920 and so on. Because these acts are so distant from 0:04:08.240 --> 0:04:12.400 what they could contemplate themselves. We are tantalized that someone 0:04:12.440 --> 0:04:16.040 could behave in a particular way, and we are always 0:04:16.080 --> 0:04:22.479 confronted with a question how should society respond? So our 0:04:22.480 --> 0:04:26.640 intuition seems to provide ready answers to these questions. But 0:04:27.040 --> 0:04:29.760 new light on a lot of these questions comes from 0:04:29.800 --> 0:04:33.440 a field that at first blush seems far away from 0:04:33.440 --> 0:04:37.960 the prison system, and that is neuroscience. The past century 0:04:38.000 --> 0:04:41.200 has made it really clear that a person's behavior and 0:04:41.279 --> 0:04:46.200 a person's brain are inextricably linked. When someone goes on 0:04:46.279 --> 0:04:49.839 a new medication, their behavior can change. When they get 0:04:49.880 --> 0:04:54.400 a degenerative brain disorder, their behavior can change when they 0:04:54.400 --> 0:04:58.320 develop a brain tumor, or they get a traumatic brain injury. 0:04:58.760 --> 0:05:04.040 Their behavior can change in the presence of drugs or alcohol, 0:05:04.360 --> 0:05:10.240 or stress, or strokes or schizophrenia. There are alterations in 0:05:10.640 --> 0:05:15.000 decision making and the appetite for risk, and this is 0:05:15.000 --> 0:05:20.120 why questions about crime inevitably lead to the doorstep of 0:05:20.240 --> 0:05:25.160 brain science. Now, when we're children, we try to understand 0:05:25.200 --> 0:05:29.400 how a criminal must feel. From our own point of view, 0:05:29.440 --> 0:05:33.359 we often conclude that a criminal must feel bad for 0:05:33.440 --> 0:05:36.599 what he or she has done. But as we mature, 0:05:36.680 --> 0:05:40.000 it becomes clearer that people can be really different on 0:05:40.040 --> 0:05:44.320 the inside. Although we all look similar, we each live 0:05:44.400 --> 0:05:49.360 in a somewhat different cosmos inside our skulls, and this 0:05:49.440 --> 0:05:54.279 understanding has led legal systems to try to contend with 0:05:54.480 --> 0:05:58.560 this variety. Now, the simple approach is to assume that 0:05:58.640 --> 0:06:01.560 each perpetrator sees the world the same way. The reason 0:06:01.600 --> 0:06:04.479 this is a simple and straightforward approach is because it 0:06:04.520 --> 0:06:07.960 allows everyone to get equal punishment for the same crime. 0:06:08.880 --> 0:06:12.400 But it has become clear to societies over a long 0:06:12.480 --> 0:06:17.160 time that this viewpoint falls short. Now in many episodes 0:06:17.160 --> 0:06:20.280 in this podcast, we've seen that different people can have 0:06:20.800 --> 0:06:24.200 very different realities on the inside. And in today's episode 0:06:24.240 --> 0:06:27.680 and next week's will come to understand what this teaches 0:06:27.800 --> 0:06:32.080 us about crime, and what crime teaches us about the brain. 0:06:33.279 --> 0:06:36.840 Dozens of new questions and new issues spring from the 0:06:36.920 --> 0:06:40.040 intersection of neuroscience and the law, and this is what 0:06:40.080 --> 0:06:42.960 these next couple episodes are about. And I want to 0:06:42.960 --> 0:06:46.200 make one critical note first, which is that a deeper 0:06:46.400 --> 0:06:50.280 understanding of the brain and its related behavior doesn't let 0:06:50.400 --> 0:06:56.960 anyone off the hook. Explanation is not exculpation. Our society 0:06:57.040 --> 0:07:00.400 still needs to keep violent aggressors and bad acts durs 0:07:00.680 --> 0:07:04.960 off the streets. Instead, a meaningful understanding of the brain 0:07:05.720 --> 0:07:09.600 can provide a rational basis for sentencing, and it can 0:07:09.640 --> 0:07:16.360 provide customized rehabilitation. When crimes arise from biological problems, there 0:07:16.400 --> 0:07:22.040 are often meaningful rehabilitative strategies available. Sometimes we have better 0:07:22.160 --> 0:07:27.560 options than assuming that incarceration is the single available solution. 0:07:28.920 --> 0:07:32.720 So let's return to Andrea. Although she was a top 0:07:32.760 --> 0:07:38.200 student and a popular athlete, her success is masked deeper problems. 0:07:38.240 --> 0:07:40.000 She suffered from bolimia. 0:07:40.480 --> 0:07:44.480 She was routinely caught in the cogwheels of depression, and 0:07:44.600 --> 0:07:47.400 at least once in her teenage years, she admitted to 0:07:47.440 --> 0:07:51.680 a friend that she was considering suicide. And what developed 0:07:51.680 --> 0:07:54.800 over time is that after the birth of her fourth child, 0:07:55.400 --> 0:08:00.000 Andrea fell under the grip of postpartum depression. Postpartum means 0:08:00.200 --> 0:08:05.120 after birth. So one day, in tears, she called her husband, 0:08:05.200 --> 0:08:09.440 Rusty at work. He came rushing home to find Andrea distraught. 0:08:09.520 --> 0:08:10.960 She was shaking. 0:08:10.800 --> 0:08:14.480 Uncontrollably, she was chewing on her fingers, and the next 0:08:14.520 --> 0:08:19.120 day she attempted suicide by overdosing on pills. So Rusty 0:08:19.160 --> 0:08:23.400 looked around desperately for psychiatric care. And Andrea was admitted 0:08:23.400 --> 0:08:27.840 to Houston's Methodist Hospital psychiatric unit, but then she was 0:08:27.880 --> 0:08:32.000 discharged six days later because of insurance restrictions, and so 0:08:32.040 --> 0:08:36.960 things continued to get worse for Andrea. She was prescribed 0:08:37.000 --> 0:08:40.880 an antidepressant, but the medicine only slightly improved her condition, 0:08:41.520 --> 0:08:45.319 and her doctor gave her samples of an antipsychotic drug 0:08:45.360 --> 0:08:48.640 and she flushed those pills down the toilet. So four 0:08:48.679 --> 0:08:53.360 weeks after being discharged from the hospital, Andrea attempted suicide again. 0:08:53.640 --> 0:08:56.280 This time she held a knife to her throat before 0:08:56.320 --> 0:09:00.880 her husband intervened. So she returned to psychiatric care and 0:09:00.920 --> 0:09:05.280 she was diagnosed with a major depressive disorder, and eventually 0:09:05.600 --> 0:09:11.040 it was determined that Andrea suffered from postpartum psychosis. Postpartum 0:09:11.080 --> 0:09:15.480 meaning after birth, and psychosis is a condition in which 0:09:16.080 --> 0:09:20.720 thought and emotions are so affected that one loses contact 0:09:20.800 --> 0:09:25.680 with reality. So as you can imagine, postpartum psychosis is 0:09:25.760 --> 0:09:29.160 a mental health emergency in which a mother has a 0:09:29.280 --> 0:09:32.959 distorted sense of reality after giving birth. She can have 0:09:33.400 --> 0:09:38.440 delusions and hallucinations and paranoia, and in the worst cases, 0:09:38.559 --> 0:09:43.880 mothers work to harm themselves or their babies. Now, thankfully, 0:09:43.960 --> 0:09:46.920 this is rare. It's something like one in a thousand births, 0:09:47.160 --> 0:09:50.600 but this is what Andrea suffered from. So she was 0:09:50.600 --> 0:09:55.200 put on antipsychotic medications and her mental state improved, and 0:09:55.240 --> 0:09:58.840 that allowed her to return to a normal life. And 0:09:58.880 --> 0:10:04.000 she eventually gave to her fifth child and everything seemed okay. 0:10:04.040 --> 0:10:08.840 But shortly after that birth, her father died and that 0:10:09.000 --> 0:10:11.880 was very hard on her, and it took her hard 0:10:11.920 --> 0:10:15.719 won composure and it smashed it. She stopped taking her 0:10:15.720 --> 0:10:21.400 antipsychotic medications. So one morning in June, Rusty left the 0:10:21.440 --> 0:10:25.720 house for work, which left Andrea alone with the children. 0:10:26.120 --> 0:10:29.120 Now this was directly against the advice of their psychiatrist, 0:10:29.200 --> 0:10:33.440 who advised him to never leave Andrea alone, but Rusty 0:10:33.480 --> 0:10:35.960 assumed he could do it just this once because his 0:10:36.080 --> 0:10:38.400 mother was driving over to the house to take over 0:10:39.040 --> 0:10:41.880 and she would be there in an hour. But it 0:10:42.000 --> 0:10:45.520 was in that hour that Andrea filled the tub and 0:10:45.720 --> 0:10:49.520 murdered all their children. After she laid the children on 0:10:49.559 --> 0:10:53.120 the bed, she called the police, saying she needed an officer. 0:10:53.880 --> 0:10:57.160 She then called Rusty and said to him, it's time. 0:10:58.640 --> 0:10:58.960 Now. 0:10:59.679 --> 0:11:02.360 What happens when a case like this goes to a 0:11:02.400 --> 0:11:06.000 court of law. In the case of Andrea, both the 0:11:06.040 --> 0:11:09.800 prosecution and the defense agreed that she was mentally ill. 0:11:10.120 --> 0:11:13.800 Why was that straightforward for them to agree because thousands 0:11:13.840 --> 0:11:19.439 of pages documented her successive psychiatric hospitalizations, So neither party 0:11:19.440 --> 0:11:22.840 in the trial raised any question about that her postpartum 0:11:22.880 --> 0:11:26.640 depression had blossomed into a full psychosis, and she had 0:11:26.679 --> 0:11:30.320 been suffering under this for years, and the media attention 0:11:30.600 --> 0:11:34.880 surrounding Andrea's story led the whole nation to consider difficult 0:11:35.000 --> 0:11:40.880 questions about mental illness and criminal responsibility. Was Andrea culpable 0:11:41.280 --> 0:11:44.800 in the normal sense that we think about culpability? What 0:11:45.040 --> 0:11:48.040 is the right thing to do with a person like Andrea? 0:11:48.840 --> 0:11:51.760 On the one hand, her psychology just wasn't like other peoples. 0:11:51.840 --> 0:11:53.120 She was delusional. 0:11:53.760 --> 0:11:56.160 On the other hand, a lot of women faced difficult 0:11:56.200 --> 0:11:59.040 emotions and thoughts after the birth of their children, but 0:11:59.080 --> 0:12:02.840 most of them would come close to imagining an active murder. 0:12:03.840 --> 0:12:06.640 What happened in the trial is that digging into Andrea's 0:12:06.720 --> 0:12:10.400 history revealed even more. She confessed that she had not 0:12:10.640 --> 0:12:13.840 been a good mother to her children, and she worried 0:12:14.240 --> 0:12:17.280 that they weren't developing correctly. Now, she didn't mean this 0:12:17.320 --> 0:12:19.600 in a general way. She meant this in a very 0:12:19.600 --> 0:12:24.600 specific way. In her view, she had been marked by Satan, 0:12:25.000 --> 0:12:27.480 and the only way to save her children from the 0:12:27.640 --> 0:12:32.240 fires of hell was to kill them. If she didn't 0:12:32.400 --> 0:12:35.640 drown them in the tub, she believed they would be 0:12:35.800 --> 0:12:42.160 doomed to eternal punishment. For Andrea, murdering her children was 0:12:42.200 --> 0:12:48.040 the only path to their salvation. So Andrea's lawyers pled 0:12:48.679 --> 0:13:09.200 not guilty by reason of insanity. Now, the idea of 0:13:09.240 --> 0:13:13.240 that plea is that because of her mental illness, she 0:13:13.440 --> 0:13:18.320 is absolved of culpability. That means she's not blameworthy. In 0:13:18.360 --> 0:13:22.280 other words, the plea of not guilty by reason of 0:13:22.280 --> 0:13:27.280 insanity translates to, yes, I committed the crime, but I 0:13:27.360 --> 0:13:31.960 have the mitigating circumstance that I was legally insane. 0:13:32.040 --> 0:13:32.640 This type of. 0:13:32.640 --> 0:13:35.679 Argument is known in the law as an excuse. It's 0:13:35.720 --> 0:13:40.240 a type of defense that reduces the defendant's culpability or blameworthiness. 0:13:41.320 --> 0:13:44.960 So let's dig into this notion of culpability. How do 0:13:45.000 --> 0:13:48.800 we assess culpability? Why do we ever consider anybody culpable? 0:13:49.640 --> 0:13:53.520 To understand this, we need the concept of mensreea, which 0:13:53.559 --> 0:13:58.480 is Latin for guilty mind. So the standard test for 0:13:58.640 --> 0:14:02.960 criminal liability is often summarized in the phrase the act 0:14:03.120 --> 0:14:06.640 does not make the person guilty unless the mind is 0:14:06.800 --> 0:14:11.199 also guilty. In other words, let's say my arm knocks 0:14:11.320 --> 0:14:14.559 somebody off of a cliff. Well, I'm liable for that, 0:14:15.400 --> 0:14:19.000 but I'm not if I have a neurological disorder that 0:14:19.160 --> 0:14:23.240 causes my arm to spasm and sporadically swing around outside 0:14:23.280 --> 0:14:27.160 my control. The act has clearly happened, which is I 0:14:27.240 --> 0:14:29.960 knocked a person off the cliff, but as there was 0:14:30.000 --> 0:14:34.880 no guilty intent behind it, I wouldn't be criminally liable. 0:14:35.440 --> 0:14:39.320 The concept of mens rea allows us to not punish 0:14:39.400 --> 0:14:43.080 people for acts that are committed reflexively. For example, things 0:14:43.120 --> 0:14:46.040 that have come up in courts are a military veteran 0:14:46.080 --> 0:14:50.720 who reflexively shoots an intruder or a man who stabs 0:14:50.760 --> 0:14:53.120 somebody while he is sleepwalking. 0:14:53.160 --> 0:14:55.280 I'm going to do an episode on that legal case soon. 0:14:56.200 --> 0:14:59.520 The idea of doing an act but not having mens 0:14:59.600 --> 0:15:03.040 rea a guilty mind. This also applies if I commit 0:15:03.120 --> 0:15:07.400 a criminal act under duress. For example, if someone holds 0:15:07.400 --> 0:15:10.720 a gun to my head and says, shoplift that laptop, 0:15:10.800 --> 0:15:14.280 or I'm going to kill you. If I shoplift the laptop. 0:15:14.320 --> 0:15:18.200 In that situation, I'm not considered criminally liable because I 0:15:18.240 --> 0:15:21.360 don't have a guilty mind, my life is under threat. 0:15:22.320 --> 0:15:25.480 So with any criminal case, the first question is whether 0:15:25.960 --> 0:15:29.040 the mind is guilty. In other words, is there mensrea. 0:15:29.560 --> 0:15:33.600 If not, the defendant is not criminally liable. Now, as 0:15:33.640 --> 0:15:36.600 it turns out, there are levels of complexity to the 0:15:36.800 --> 0:15:40.720 concept of mensrea. There are levels of having a guilty mind, 0:15:41.160 --> 0:15:45.400 and the legal system concludes that there are different degrees 0:15:45.480 --> 0:15:48.560 to which a person can be liable. So let's dig 0:15:48.600 --> 0:15:51.000 into this for a moment. Let's say that you walk 0:15:51.000 --> 0:15:54.640 into a dark room and you end up destroying a 0:15:54.680 --> 0:15:59.200 bunch of porcelain statues. Now, let's say you knew that 0:15:59.320 --> 0:16:02.800 the room can contained the statues, and your aim was 0:16:02.840 --> 0:16:05.800 to cause as much damage as possible. In this case, 0:16:06.120 --> 0:16:08.840 the intuition of the legal system is that you are 0:16:08.960 --> 0:16:14.280 clearly liable for the damage. But now imagine a second scenario. 0:16:14.640 --> 0:16:18.040 You entered the dark room and you were aware that 0:16:18.120 --> 0:16:21.240 it was full of valuable statuary, but you didn't mean 0:16:21.280 --> 0:16:24.520 to break the statues. You understood that it was almost 0:16:24.520 --> 0:16:26.560 certain that you would break some of them as you 0:16:26.720 --> 0:16:30.720 fumbled around for the switch. In this scenario, we're inclined 0:16:30.720 --> 0:16:32.520 to think that you are guilty, but that you're not 0:16:32.920 --> 0:16:36.760 as culpable as the first scenario, in which you purposely 0:16:36.840 --> 0:16:41.160 sought to cause damage. Now, let's consider a third scenario. 0:16:41.840 --> 0:16:46.480 You skateboard into the dark room knowing that their statuary inside, 0:16:46.840 --> 0:16:49.560 but this time your intention was to ride to the 0:16:49.640 --> 0:16:53.280 light switch without damaging anything. But things went wrong and 0:16:53.320 --> 0:16:56.400 you ended up breaking some statues, despite the fact that 0:16:56.480 --> 0:16:59.920 you had good intentions to only turn on the light switch. 0:17:00.600 --> 0:17:03.640 The act is there, the statues are broken, but the 0:17:03.800 --> 0:17:07.399 mind seems to have had a different level of guilt. 0:17:08.160 --> 0:17:11.080 And let's consider a fourth scenario in which you walked 0:17:11.080 --> 0:17:14.240 into the dark room with no idea that statuary was 0:17:14.240 --> 0:17:16.720 in there. You walked in there with the intention to 0:17:16.880 --> 0:17:19.720 just seek some alone time to meditate because you just 0:17:19.960 --> 0:17:22.720 had an argument with someone and you needed some quiet, 0:17:23.000 --> 0:17:26.639 and you ended up accidentally breaking somebody's statuary. You didn't 0:17:26.640 --> 0:17:28.800 know there was a light switch. You were simply looking 0:17:28.880 --> 0:17:32.840 for somewhere quiet to sit. Now, all these scenarios have 0:17:32.960 --> 0:17:37.920 led to the same outcome. Somebody's beautiful porcelain statues are shattered, 0:17:38.440 --> 0:17:42.080 but the men's rea is not the same. The first 0:17:42.119 --> 0:17:46.960 case exemplifies the legal term of intentional or purposeful. You 0:17:47.040 --> 0:17:49.439 had every objective of going in there and busting up 0:17:49.480 --> 0:17:53.200 those statues. That's the highest level of mensrea. In the 0:17:53.280 --> 0:17:56.800 second case, there was knowledge. You didn't go in there 0:17:56.840 --> 0:17:58.960 intending to break stuff, but you went in knowing this 0:17:59.119 --> 0:18:03.399 was a near certain outcome of your actions. The third 0:18:03.440 --> 0:18:08.200 scenario is classified as recklessness. There was a large risk 0:18:08.320 --> 0:18:11.040 that skateboarding to the light switch was going to break 0:18:11.080 --> 0:18:14.760 some valuable statues, and choosing this action was a real 0:18:14.880 --> 0:18:18.960 difference from how the average person would act. The fourth 0:18:18.960 --> 0:18:23.480 scenario is called negligence, which assumes that a reasonable person 0:18:23.680 --> 0:18:26.920 would have taken more care when entering a dark room 0:18:27.200 --> 0:18:30.800 with which he wasn't familiar. So having a guilty mind 0:18:30.840 --> 0:18:35.280 isn't one thing, but there are different levels. Take homicide 0:18:35.400 --> 0:18:38.639 as an example. The guilty act is something that results 0:18:38.720 --> 0:18:41.960 in the death of another person. But if you intended 0:18:42.440 --> 0:18:45.240 that your conduct would result in the loss of life 0:18:45.320 --> 0:18:49.800 you shoot somebody, that's murder. But if that wasn't your intention, 0:18:50.000 --> 0:18:53.679 if something you did accidentally led to the death of 0:18:53.680 --> 0:18:58.320 somebody else, then it is classified as manslaughter. In a 0:18:58.400 --> 0:19:03.639 typical criminal case, there is a readily identifiable level of mensrea. 0:19:03.720 --> 0:19:06.080 Either someone meant to do it, or they should have 0:19:06.160 --> 0:19:08.520 known better, or they were just being reckless, or they 0:19:08.560 --> 0:19:13.040 were being negligent. That seems to cover most situations, but 0:19:13.600 --> 0:19:16.360 there are a few defenses in which one can argue 0:19:16.520 --> 0:19:20.280 that mensrea is completely absent. One of those is the 0:19:20.600 --> 0:19:23.760 infancy defense. If you are a child, it is assumed 0:19:23.800 --> 0:19:28.440 that you cannot reasonably be held responsible for your actions. 0:19:28.760 --> 0:19:33.280 So many countries have a policy called Doley incapax, which 0:19:33.359 --> 0:19:35.960 just means that if a child is under ten years old, 0:19:36.119 --> 0:19:39.720 he cannot be held legally responsible for his actions because 0:19:39.760 --> 0:19:45.360 he doesn't understand their nature and consequences. So what does 0:19:45.400 --> 0:19:51.960 it mean for Andrea or anyone to plead insanity. It means, yes, 0:19:52.040 --> 0:19:56.000 I committed the act, but the mensrea was not there. 0:19:56.119 --> 0:20:01.280 Because I couldn't understand the nature or consequence of my actions, 0:20:01.640 --> 0:20:05.439 I can't be said to have had a guilty mind. 0:20:06.680 --> 0:20:09.760 Why do we need an insanity defense? Well, in the 0:20:09.800 --> 0:20:12.600 case of Durham versus the United States nineteen fifty four, 0:20:13.119 --> 0:20:17.840 the circuit judges summarized the need this way, quote, the 0:20:17.960 --> 0:20:21.720 legal and moral traditions of the Western world require that 0:20:21.800 --> 0:20:24.399 those who of their own free will and with evil 0:20:24.440 --> 0:20:28.840 intent commit acts which violate the law, shall be criminally 0:20:28.920 --> 0:20:30.359 responsible for those acts. 0:20:31.480 --> 0:20:35.280 Our traditions also require that where such. 0:20:35.000 --> 0:20:38.400 Acts stem from and are the product of a mental 0:20:38.440 --> 0:20:44.000 disease or defect, moral blame shall not attach, and hence 0:20:44.320 --> 0:20:49.600 there will not be criminal responsibility end quote. In other words, 0:20:50.200 --> 0:20:54.480 we need an insanity defense because some people are incapable 0:20:54.600 --> 0:20:58.480 of normal decision making and should not be held morally 0:20:58.600 --> 0:21:03.280 or criminally responsible for their decisions in a mature system 0:21:03.320 --> 0:21:08.120 of criminal law. Everybody agrees on this. Now, in different episodes, 0:21:08.160 --> 0:21:11.639 we'll see what kind of different mental illnesses look like 0:21:12.000 --> 0:21:16.200 that makes somebody incapable of normal decision making. But from 0:21:16.200 --> 0:21:19.720 the legal point of view, this all immediately raises a question, 0:21:20.359 --> 0:21:23.000 how do you know if somebody is just faking it? 0:21:23.480 --> 0:21:26.479 Or a related question, how do you know if someone 0:21:26.960 --> 0:21:29.919 has a mental illness but that's not actually why he 0:21:29.960 --> 0:21:34.360 committed the crime. So these are the tough questions right 0:21:34.400 --> 0:21:38.840 at the intersection of brain science and the legal system. Now, 0:21:38.920 --> 0:21:41.800 as I said at the beginning, insanity is not a 0:21:41.880 --> 0:21:44.320 medical term. There's no way that you can take a 0:21:44.440 --> 0:21:48.359 person into a clinic or laboratory and perform a brain 0:21:48.440 --> 0:21:52.720 scan and confirm ah, yes, that person is insane. It's 0:21:52.760 --> 0:21:56.320 purely a legal term, so how to really think about 0:21:56.359 --> 0:21:59.480 it in a courtroom? This blossomed in the case of 0:21:59.520 --> 0:22:05.199 a young Scottish woodcutter named Daniel McNaughton in January of 0:22:05.240 --> 0:22:10.880 eighteen forty three. McNaughton was suffering from paranoid delusions. He 0:22:10.960 --> 0:22:14.680 publicly griped that he was being followed by spies from 0:22:14.680 --> 0:22:18.240 the Tory political party, and privately he was hearing a 0:22:18.359 --> 0:22:20.840 voice in his head, which he assumed to be the 0:22:20.920 --> 0:22:23.840 voice of God. The voice told him that to end 0:22:23.960 --> 0:22:28.919 this persecution by the Tories, McNaughton should assassinate the British 0:22:29.000 --> 0:22:33.720 Prime Minister, Robert Peel. So McNaughton stalked him for two days, 0:22:33.920 --> 0:22:36.600 and on the third day he waited for Peel to 0:22:36.880 --> 0:22:41.000 emerge from the Prime Minister's office, and then McNaughton followed him, 0:22:41.320 --> 0:22:43.840 and he pulled his gun out from his pocket and 0:22:44.080 --> 0:22:48.080 shot him fatally in the back. McNaught was captured right 0:22:48.119 --> 0:22:51.640 away and charged with murder. It turns out McNaughton had 0:22:51.680 --> 0:22:54.400 made a mistake. It wasn't Robert Peel he had murdered, 0:22:54.640 --> 0:22:58.280 but instead a British civil servant named Edward Drummond. This 0:22:58.480 --> 0:23:00.440 was the first sign to the police that's something was 0:23:00.480 --> 0:23:04.480 a little strange about what was happening here now. At 0:23:04.520 --> 0:23:08.600 McNaughton's trial, the prosecution called two people to the stand, 0:23:08.640 --> 0:23:10.919 his landlady and someone who had known him at school, 0:23:11.359 --> 0:23:15.000 and both testified that he generally seemed of sound mind. 0:23:15.760 --> 0:23:18.920 But then the defense came up. He had a well 0:23:18.960 --> 0:23:24.400 known and eloquent lawyer who argued that McNaughton was clearly deranged. 0:23:24.440 --> 0:23:28.400 He suffered from paranoia, He had delusions of persecution from 0:23:28.400 --> 0:23:33.000 the government. He had command hallucinations, which is where you 0:23:33.200 --> 0:23:34.919 hear a voice in your head that tells you to 0:23:34.960 --> 0:23:39.040 do things. The lawyer brought nine medical experts to the stand, 0:23:39.160 --> 0:23:41.959 all of whom testified that McNaughton. 0:23:41.760 --> 0:23:44.320 Was clearly out of touch with reality. 0:23:44.960 --> 0:23:48.840 The prosecution was unable to muster a single medical experts 0:23:48.840 --> 0:23:52.040 say otherwise, so the jury didn't even need to retire. 0:23:52.359 --> 0:23:57.800 They concluded that Daniel McNaughton was clearly insane, and given 0:23:57.840 --> 0:24:01.840 this conclusion, he was sentenced to commitment for life at 0:24:01.880 --> 0:24:07.440 the State Criminal Lunatic Asylum at Bethlehem Hospital. But many 0:24:07.480 --> 0:24:11.520 British people were displeased with this outcome. Among them was 0:24:11.560 --> 0:24:15.040 a woman whose voice carried the weight of a monarch, 0:24:15.280 --> 0:24:20.160 Queen Victoria. She had previously been the target of assassination attempts, 0:24:20.480 --> 0:24:24.440 and she represented the anger of the public. How can 0:24:24.480 --> 0:24:28.240 one commit murder and just say he's not responsible. He 0:24:28.400 --> 0:24:31.520 ended the life of an innocent man. Shouldn't something be 0:24:31.640 --> 0:24:34.960 done beyond a sentencing to a hospital? And how do 0:24:35.000 --> 0:24:39.080 we know he's not simply faking insanity? So Queen Victoria 0:24:39.280 --> 0:24:42.879 drew upon an ancient right to call the judges to 0:24:42.960 --> 0:24:46.359 explain their reasoning. She put a list of questions to 0:24:46.400 --> 0:24:49.200 the panel of judges, who sat down over the course 0:24:49.200 --> 0:24:53.240 of days and shaped their response to the Queen, and 0:24:53.280 --> 0:24:56.160 in eighteen forty eight this charted the future of the 0:24:56.160 --> 0:24:59.840 insanity defense, leading to the codification of what is known 0:25:00.160 --> 0:25:01.480 as the McNaughton rule. 0:25:02.119 --> 0:25:03.720 What they wrote is this quote. 0:25:04.280 --> 0:25:07.760 To establish a defense on the ground of insanity, it 0:25:07.840 --> 0:25:10.840 must be clearly proved that at the time of committing 0:25:10.920 --> 0:25:15.200 the act, the party accused was laboring under such a 0:25:15.240 --> 0:25:19.399 defective reason from disease of the mind as not to 0:25:19.560 --> 0:25:22.639 know the nature and quality of the act he was doing, 0:25:23.119 --> 0:25:25.240 or if he did know it, that he did not 0:25:25.560 --> 0:25:28.000 know what he was doing was wrong. 0:25:28.960 --> 0:25:35.639 End quote. 0:25:45.760 --> 0:25:48.600 So let zoom in on the important words here. First, 0:25:49.119 --> 0:25:52.840 because of a disease of the mind, a person may 0:25:52.880 --> 0:25:56.840 not understand the nature and quality of his act. For example, 0:25:56.960 --> 0:25:59.520 if I have a mental illness and I pull the 0:25:59.520 --> 0:26:02.240 trigger of a gun, but I have no understanding that 0:26:02.320 --> 0:26:04.280 a bullet is going to come out of the barrel, 0:26:04.640 --> 0:26:07.040 then I don't understand the nature and quality of the 0:26:07.080 --> 0:26:10.440 act I'm committing. And the second issue they point to 0:26:10.640 --> 0:26:12.840 is the inability to distinguish. 0:26:12.400 --> 0:26:13.119 Right from wrong. 0:26:13.640 --> 0:26:16.240 So even if I know how a gun works, it's 0:26:16.280 --> 0:26:20.119 possible that my deficit leaves me unable to distinguish what 0:26:20.200 --> 0:26:22.560 I should do from what I shouldn't. And let me 0:26:22.600 --> 0:26:25.480 just fill this out with another example. Someone could fail 0:26:25.920 --> 0:26:29.200 the first part of the mcnonton test, the cognitive component, 0:26:29.480 --> 0:26:32.000 if they think that they're shooting at a target but 0:26:32.160 --> 0:26:35.200