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Kaimowitz v. Michigan DMH (1973)

August 14, 2011 By Comments

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Kaimowitz v. Michigan DMH (1973)

42 U.S.L.W. 2063

Civil No. 73-1934-AW

Nature of Case

Whether involuntarily committed psychiatric patients can voluntarily consent to psychosurgery.

Facts of Case

On January 11, 1955, the Kalamazoo County Circuit Court committed John Doe to Ionia State Hospital in Michigan, as a sexual psychopath, without a trial. At the time of his commitment, he was 18 years old and his commitment followed the charges of rape and murder of a student nurse. He was never offered a hearing, was never offered psychotherapy as a form of treatment, and he was labeled “treatment resistant.”

In 1972, at 36 years old, he was asked to participate in a state-funded experimental study, which aimed to determine the efficacy of two treatment methods for reducing aggression. One method was a medication, cyproterone acetate (antiandrogen), which was expected to result in impotence and reduce aggression. The other method was a psychosurgical procedure called an amygdalotomy, which was also expected to reduce aggression. Doe and his parents gave consent for Doe to participate in the study. His consent was reviewed by a committee of three neurologists and a human rights review committee, which consisted of a law and psychiatry professor, a clergyman, and a community representative. His consent was considered valid and he was the only consenting subject involved in the study. The consent form discussed that the patients may receive psychosurgery and described potential risks; however, the consent form did not mention the right to withdraw from the study.

Gabe Kaimowitz, a Michigan Legal Services attorney, unrelated to the Doe case, learned of the experiment and informed the media. Kaimowitz filed a petition that Doe and others were being held for experimental surgery. Doe was appointed independent counsel and a habeas corpus petition was submitted on his behalf asserting that he was being illegally detained because the Michigan criminal sexual psychopath statute was unconstitutional. The statute had previously been repealed; however, those already committed under the statute were retained in custody. On March 23, 1973, Doe was granted his freedom, because the court held the statute could not withstand the challenge of the equal protection clause. Following his notification of release, Doe retracted his consent. He did not commit any additional acts of violence, earned a job, and became engaged; however, the state of Michigan then pursued criminal prosecution against him for the 19-year-old charges of rape and murder. Even without Doe, the Circuit Court for Wayne County, Michigan decided to pursue the hearing of the case concerning the ability to voluntarily consent to psychosurgery, as it applied to all current and future involuntary patients.

Issue

Can involuntarily hospitalized psychiatric patients voluntarily consent to psychosurgery?

 

Holding

The Circuit Court for Wayne County, Michigan ruled that involuntarily detained mental patients could not give informed consent for psychosurgery. The court decided that basic elements of informed consent could not be obtained reliably due to their involuntary status. The court indicated that involuntarily committed patients were incapable of giving competent, voluntary, and knowledgeable consent to experimental psychosurgical operations. The court also asserted that 1st Amendment rights to speech and expression could be destroyed or impaired by psychosurgery, and the constitutional right to privacy could be infringed upon by the psychosurgical intrusion into an individual’s brain.

Rationale

The court cited provisions of the Nuremberg Code and indicated voluntary consent was absolutely essential for psychosurgery. The court indicated that the consent of involuntarily committed patients for psychosurgery generally would not meet the requirements because their consent was not 1) competent, 2) voluntary, and 3) knowledgeable. The court defined competency as “the ability of the subject to understand rationally the nature of the procedure, its risks, and other relevant information.” The court argued the legal capacity to consent was diminished by the nature of incarceration, which made the individual more vulnerable to coercion. The court asserted that “involuntarily confined mental patients live in an inherently coercive institutional environment” and “are not able to voluntarily give informed consent because of the inherent inequality in their position.” The court concluded that any attempt at obtaining voluntary consent for psychosurgery would be invalid. Valid consent requires the knowledge of the risks and ill effects that may come from participation. The court stated that since much was still unknown concerning the brain and brain surgery, that the “lack of knowledge on the subject makes a knowledgeable consent to psychosurgery literally impossible.” Therefore, the court made an absolute ban on psychosurgery for involuntarily committed psychiatric patients.

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Jaffee v. Redmond (1996)

August 11, 2011 By Comments

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Jaffee v. Redmond (1996)

United States Supreme Court

518 U.S. 1, 116 S. Ct.

Nature of Case

Whether it is appropriate for federal courts to recognize a “psychotherapist privilege” under Rule 501 of the Federal Rules of Evidence.

Facts of Case

On June 27, 1991, Officer Mary Lu Redmond responded to a call at an apartment building concerning a “fight in progress.” She was the first officer to arrive at the scene. Two women (sisters of the deceased) ran towards Redmond’s car stating there had been a stabbing. Two men then ran out of the building, one wielding a pipe. They ignored her orders to get to the ground and she allegedly drew her gun. Two additional men came running out, with Ricky Allen (the deceased) chasing another, allegedly brandishing a butcher knife. Allen disregarded Redmond’s statement to drop the knife, and she shot Allen, before he could stab the other man. Allen died at the scene. Petitioners of his estate filed suit in federal court alleging Redmond had violated Allen’s constitutional right against the use of excessive force. Allen’s family offered a different version of the events, stating Redmond drew her gun before exiting her car and that Allen was unarmed when he emerged from the building. During pretrial discovery the petitioner learned that Redmond had sought counseling with a licensed social worker and sought access to the notes of their sessions. The district court ordered disclosure of the social worker’s notes for the therapy sessions; however, neither the therapist nor Redmond complied with the court order. Additionally during deposition and on the witness stand, both refused to answer certain questions and reported an inability to recall details of their conversations. At the end of the trial, the judge instructed the jury that the refusal to release the notes had no “legal justification” and informed the jury they could presume the information contained within the notes was most likely unfavorable to the defendant. The jury awarded the petitioner $45,000 on the federal claim and $500,000 on the state-law claim. The defendant appealed.

The Court of Appeals for the Seventh Circuit reversed and remanded the district court decision, stating that there was a psychotherapist-patient privilege; however, this privilege could be negated if the evidentiary need for disclosure outweighed the patient’s interests. In this case, because of numerous eyewitnesses, the appellate court decided that Redmond’s privacy interests outweighed the evidentiary needs. The United States Supreme Court granted cert due to the importance of the question and the conflict among appellate courts regarding psychotherapist privilege.

Issue

Did the Federal Court of Appeals for the Seventh Circuit err in determining that federal courts should recognize a psychotherapist privilege under 501, but do so on a case-by-case basis contingent upon whether the interests of justice outweigh the privacy interests of the patient?

Holding

In a 7 to 2 decision, with an opinion delivered by Justice Stevens, the Court affirmed the appellate court decision and concluded Rule 501 of the Federal Rules of Evidence recognized privilege protecting confidential communications between psychotherapist and patient, and this privilege extended beyond psychiatrists and psychologists to social workers. The court held that statements that Redmond made to her therapist and the notes taken by her therapist were protected from compelled disclosure. However, the Court rejected the balancing component of the privilege implemented by the appellate court, stating that “it would eviscerate the effectiveness of the privilege by making it impossible for participants to predict whether their confidential conversations would be protected. The court also stated that it was “neither necessary nor feasible to delineate its full contours in a way that would govern all future questions.” The Court mentioned only that “the patient may of course waive the protection,” and that there was no doubt that there would be situations in which the privilege could be broken, such as “serious threat of harm to the patient or to others” which could only be averted by “means of a disclosure by a therapist.”

Rationale

The court reasoned that all 50 states and the District of Columbia had adopted some form of the psychotherapist-patient privilege. Therefore, “any State’s promise of confidentiality would have little value if the patient were aware that the privilege would not be honored in a federal court,” and denial of the privilege in federal court would frustrate the purpose of state legislation on the matter. Furthermore, the Court noted that “reason and experience” has persuaded the Court that confidential communications between the parties “promotes sufficiently important interests to outweigh the need for probative evidence.” The Court indicated the need for trust in their therapeutic relationship is paramount and “the mere possibility of disclosure may impede development of the confidential relationship necessary for successful treatment.” The Court also indicated that this protection applies broadly beyond psychologists and psychiatrists in many states and federal privilege should extend to social workers, such as the one involved in this case.

Concerning their decision on removal of the balancing privilege, the Court reasoned that a patient “must be able to predict with some degree of certainty whether particular discussions will be protected. An uncertain privilege, or one which purports to be certain but results in widely varying applications by the courts, is little better than no privilege at all.”

Dissenting opinion

Justice Scalia, joined by Justice Rehnquist dissented on the grounds that psychotherapist-client privilege could result in occasional injustice. They reasoned that if an individual “wishes the benefits of telling the truth she must also accept the adverse consequences.” Justice Scalia questioned when it was that “the psychotherapist came to play such an indispensable role in the maintenance of the citizenry’s mental health?” It was argued that an individual’s mental health would be more impaired by preventing an individual from receiving advice from his mother, and yet no mother-child privilege existed. Additionally, it was argued that the extension of privilege should not be granted beyond psychologist and psychiatrists to social workers by the Court. It was alleged that psychologists and psychiatrists “do nothing but psychotherapy,” but social workers have multiple roles, and not all of them need to be confidential. Additionally, it was argued that the training of social workers was not of the same caliber as doctors, and they were not “experts” in the area of psychotherapy. It was also argued that the question of whether social workers should be granted the extension of a psychotherapist privilege was a matter to be handled by Congress, not the Court.

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United States v. Comstock (2010)

August 8, 2011 By Comments

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United States v. Comstock (2010)

United States Supreme Court

130 S. Ct. 1949

Nature of Case

Whether it is unconstitutional for the federal government to allow for the civil commitment of sexually dangerous persons following the completion of their federal criminal sentences.

Facts of Case

In 2006, as part of the Adam Walsh Child Protection and Safety Act, Congress enacted 18 U.S.C. §4248. Section 4248 allows district courts to order civil commitments for individuals who are presently in custody of the Federal Bureau of Prisons and who have 1) “previously engaged or attempted to engage in sexually violent conduct or child molestation,” and 2) “currently suffer from a serious mental illness, abnormality, or disorder,” and 3) “as a result of that mental illness, abnormality, or disorder is sexually dangerous to others, in that he would have serious difficulty in refraining from sexually violent conduct or child molestation if released.” If the Government proves these three criteria by clear and convincing evidence, the individual is remanded to custody of the Attorney General. Confinement in a federal facility continues until the individual’s mental condition improves so that the individual is no longer dangerous, or until a state assumes responsibility for the individual’s custody, care, and treatment.

In November and December 2006, the Government initiated civil commitment proceedings for the five respondents in this case, in the Federal District Court for the Eastern District of North Carolina. All five respondents argued for dismissal of their commitments based on multiple constitutional grounds. The District Court accepted two of the grounds and agreed that the Constitution required proof beyond a reasonable doubt and that Congress exceeded its legislative powers according to Article I of the Constitution. The District Court then granted the respondents’ motions to dismiss. The Court of Appeals for the Fourth Circuit upheld the dismissal on the legislative ground, but did not address other constitutional claims and did not decide the standard-of-proof question. The Government sought and was granted certiorari, but the request was limited to Congress’ authority to enact the §4248 statute.

Issue

Does the United States Constitution’s Necessary and Proper Clause, Article I, §8, clause 18, grant Congress the authority to enact U.S.C. §4248?

Holding

In a 7 to 2 decision, the Court concluded the Constitution “authorizes Congress to enact the statute.” The Court reversed the judgment of the Court of Appeals for the Fourth Circuit, and the case was remanded for further proceedings.

Rationale

In an opinion delivered by Justice Breyer, the Court outlined five considerations which led to their conclusion: 1) the Necessary and Proper Clause grants Congress broad authority to pass laws in furtherance of its constitutionally enumerated powers, 2) Congress has long been involved in the delivery of mental health care to federal prisoners, and has long provided for their civil commitment, 3) there are sound reasons for the enactment (protection of the public), 4) §4248 does not invade the province of state sovereignty, but rather requires accommodation of state interests, and 5) §4248 is narrow in scope, is applied to only a small fraction of federal offenders, and is far from a general police power.

Dissenting opinion

Justice Thomas, joined by Justice Scalia dissented on the grounds that §4248 did not execute a specific enumerated power, thus the Necessary and Proper Clause did not empower Congress to enact this statute, and this rendered §4248 unconstitutional. Justice Thomas argued that “the fact that the Federal Government has the authority to imprison a person for the purpose of punishing him for a federal crime – sex related or otherwise – does not provide the Government with the additional power to exercise indefinite civil control over that person.” Justice Thomas voiced concern that allowing §4248 to be upheld based on the Necessary and Proper Clause “comes perilously close to transforming the Necessary and Proper Clause into a basis for the federal police power that we have always rejected.”

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United States v. Greer (1998)

August 5, 2011 By Comments

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ontent/uploads/2011/06/legalbrief.jpg” alt=”" width=”91″ height=”108″ />United States v. Greer (1998)

United States Court of Appeals for the Fifth Circuit

158 F.3d 228

Nature of Case

Whether a defendant who is found to be malingering can receive a sentence enhancement for obstruction of justice.

Facts of Case

In the summer of 1994, Charles Randall Greer was homeless and was allowed to stay in a garage apartment of an acquaintance, Joyce Cantrell, in Lubbock, Texas. He was allowed to use the phone in her home, but then entered her bedroom without permission and would not leave. He grabbed her wrists and told her “Don’t cause me any problems.” Cantrell offered to make Greer dinner, but when Greer retreated to the bedroom, she then escaped from the house and called police. Greer left the house before police arrived; however, feces had been smeared in the bathroom and a gun was missing from Cantrell’s home. Greer then proceeded to the home of Arthur Fellows, another acquaintance, and asked if he would be allowed to shower. Follows at first allowed Greer into his home; however, Greer began to curse loudly and when Follows asked him to leave, Greer struck Follows, bound him at gunpoint, and ordered him to drive him to New Mexico. Greer pointed the gun at Follows with his hand on the trigger for the entire drive. Greer had Follows bring him to a hotel in Albuquerque and paid for the motel with Follows’ credit card. Upon arrival, Greer stated he achieved the purpose of the kidnapping, which was to be far away from family and friends when he committed suicide. He apologized to Follows, allowed Follows to leave, and entered the motel room alone. Follows contacted police and Greer was arrested at the motel. A federal grand jury indicated Greer on five counts, including kidnapping, using and carrying a firearm during and in relation to a crime of violence, possession of a stolen firearm, transporting a stolen firearm in interstate commerce, and being a felon in possession of a firearm.

Greer was found incompetent to stand trial on New Mexico state charges for Follows’ kidnapping. On November 14, 1994 Greer was ordered to undergo a federal competency evaluation. He underwent a one and a half month competency evaluation at the U.S. Medical Center, and a competency hearing was held on April 21, 1995. The forensic evaluator for Greer’s case, Dr. Richard Frederick, was called to testify and gave the opinion that Greer was competent and feigning a psychotic disorder. Preston Shaw, a local psychiatrist testified that Greer was incompetent, but the district court found Greer competent. Defense counsel filed another request for a competency evaluation prompted by Greer’s continued bizarre behavior. A Texas Department of Corrections psychiatrist evaluated Greer and gave the opinion he was incompetent. On February 8, 1996, the Government acquiesced and the district court ordered Greer to be committed to the custody of the Attorney General for competency restoration. He was sent to the Federal Medical Center in Rochester, Minnesota for competency restoration. On July 17, 1996 Greer had another competency hearing based on a competency evaluation received from FMC Rochester. Dr. Mary Alice Conroy evaluated Greer at FMC Rochester and she gave the opinion that he was competent, was malingering, and had a personality disorder with antisocial and borderline features. The day before the trial, the district court found Greer competent and that he had feigned mental illness.

Greer’s trial began on August 7, 1996. While in a holding cell, Greer took off his clothes and attempted to flush them down the toilet and also spit up some blood from a self-inflicted abrasion in his mouth. Following this incident, the judge spoke with Greer and told Greer that he was found competent to stand trial and was believed to be a malingerer. Greer was told that if he continued to disrupt the trial process he would be removed from the court room and the case would be tried in his absence. Greer continued his misbehavior at trial and at one point lunged at his counsel in an attempt to hit him. Greer was removed from the proceedings. The court found that Greer had “consciously, deliberately, and voluntarily” waived his constitutional right to be present at his trial and the jury convicted Greer on all counts. When Greer was sentenced, the Government objected to his pre-sentence report arguing that he should receive a sentence enhancement for obstruction of justice. The district court granted the Government’s objection and Greer received a two-level offense enhancement which resulted in his receiving a 210-month sentence. Without the sentence enhancement the maximum sentence he could have received was 185 months. The defendant appealed to the United States Court of Appeals for the Fifth Circuit, and argued against the sentence enhancement on multiple grounds. He argued that the conduct that led to the obstruction of justice finding was due to his antisocial and borderline personality disorders, and therefore a sentence enhancement should not apply. He also argued that the underlying conduct for obstruction of justice must be a crime on its own. He also argued that by enhancing a sentence for feigning incompetence violates a defendant’s right to be tried only when competent. Furthermore, he argued that he should only have been cited for contempt of court and not given a sentence enhancement of obstruction of justice.

Issue

Did the district court err in enhancing the defendant’s sentence for obstruction of justice?

 

Holding

The appellate court affirmed the district court decision and held that the sentence enhancements for kidnapping and related offenses were permitted, because the defendant’s actions impeded the prosecution of the case, and met criteria for obstruction of justice according to the United States Sentencing Guidelines. Furthermore, the court indicated that for the obstruction of justice sentence enhancement, the underlying behavior need not be a crime. The court stated that the district court only needed to find by preponderance of the evidence that Greer feigned incompetence in order to delay or avoid his trial. The court stated that a sentence would be upheld on appeal unless it was imposed in violation of law. The appellate court decided that the district court did not clearly err in enhancing Greer’s sentence, and the court upheld Greer’s sentence imposed by the district court. The appellate court found “the district court did not err in finding Greer willfully feigned mental illness in a conscious and deliberate effort to delay, and perhaps avoid altogether, his day of reckoning on the grave offenses with which he was charged.”

Rationale

The Court concluded that Greer’s arguments did not have merit. First, the court determined that Greer’s personality disorders did not compel his actions, and his actions were volitional attempts to feign incompetence. The court stated that the legal system regularly permits the conviction and sentencing of individuals with personality disorders, so these diagnoses did not make him immune to a sentence enhancement.

Additionally, the court found that while the sentencing guidelines do not explicitly state that feigning incompetence to avoid trial or conviction is equivalent to obstruction of justice, the list was not exhaustive, and the court was convinced that this conduct was very similar to the conduct specified in the sentencing guidelines. Furthermore, the court stated that the conduct does not necessarily need to be criminal in and of itself.

The court concluded that allowing for sentencing enhancements for obstruction of justice due to feigning incompetence did not violate a defendant’s constitutional right to only be tried when competent. The court stated that a defendant has a constitutional right to a competency hearing if a bonafide doubt exists regarding competency; however, the defendant does not have a right to exaggerate or fabricate incompetence. Additionally, the court stated that counsel should warn their clients that feigning incompetence would trigger a sentence enhancement. This sentence enhancement was not meant for defendants who have competency hearings and are found competent, but rather those defendants who willfully and purposefully exaggerate or fabricate impairment in order to delay or avoid trial. Additionally, if a defendant challenges a sentence enhancement, the district court must provide support for its ruling.

The court reasoned that the defendant’s actions need not have imposed a burden on the government to necessitate the obstruction of justice enhancement, but rather the idea he attempted to manipulate the system and that his actions could have impacted the process were enough for the sentence enhancement.

Lastly, the court found that Greer’s outbursts in the court room were a continuation of his attempts to feign incompetence, and his prior willful attempts to feign incompetence were also sufficient for sentence enhancement, so regardless of whether he should have received a sentence enhancement for his courtroom behavior alone did not need to be decided by the court. The court was simply required to identify that Greer tried to create an appearance of incompetency with the specific intent of obstructing justice. In this case they had circumstantial evidence, but indicated that the proof need not be direct and incontrovertible, and enough evidence was available to identify he willfully and purposefully feigned incompetence.

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Washington v. Harper (1990)

July 29, 2011 By Comments

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icpsychology.org/wp-content/uploads/2011/06/legalbrief.jpg” alt=”" width=”91″ height=”108″ />Washington v. Harper (1990)

United States Supreme Court

494 U.S. 210

Nature of Case

Whether it is constitutionally required to provide a judicial hearing prior to the involuntary administration of medication to an inmate.

Facts of Case

Walter Harper was convicted of robbery in 1976. He was imprisoned in the Washington state prison system from 1976 to 1980, and was granted parole in 1980. His parole was revoked in December 1981. While temporarily on parole, he voluntarily consented to receive antipsychotic medication to treat “manic-depressive disorder.” When he discontinued use of his medication, his mental condition deteriorated and he engaged in violent behavior. He was transferred to a facility for convicted felons with mental disorder on two occasions. While at the facility he was involuntarily administered antipsychotic medications. The facility had procedures set in place for the involuntary medication of prisoners, and the facility complied with the procedures as written. Harper filed suit during his second stay at the facility, claiming that failure to provide a judicial hearing before involuntary administration of the medication violated his due process rights. The trial court rejected Harper’s claim. Washington’s State Supreme Court then reversed the trial court’s decision, concluding that a judicial hearing was necessary and the State needed to prove by “clear, cogent, and convincing” evidence that the medication was necessary and effective in order to medicate a competent, non-consenting inmate. The United States Supreme Court granted certiorari.

Issue

Did the Supreme Court of Washington err in declaring a Washington state policy unconstitutional because it did not provide a judicial hearing for inmates prior to administration of involuntary medication?

 

Holding

In a unanimous decision, the Court reversed the decision of the Supreme Court of Washington. In an opinion delivered by Justice Kennedy, the Court held that the state court erred in ruling the state procedure unconstitutional, because the procedures in place for involuntary administration of medication did not deprive inmates of due process. The Court recognized that inmates had a 14th amendment right to refuse treatment, but believed the state had balanced the inmates’ rights and the state’s interests by allowing inmates to request a hearing before a committee to review the medication decision. The policy required the following criteria to be met:

  1. A psychiatrist needed to determine a prisoner needed antipsychotic medication. If the prisoner did not consent to the medication, the prisoner was entitled to a hearing with a psychiatrist, psychologist, and associate superintendent (none of whom could be involved in the inmate’s treatment or diagnosis).
  2. Involuntary medication had to be determined by the majority vote with the psychiatrist in the majority. The prisoner had to be diagnosed with a mental disorder and also be gravely disabled, or dangerous to self or others.
  3. The prisoner had the right to be notified of the hearing, was allowed to attend the hearing, present evidence, present witnesses, cross-examine witnesses, be assisted by a lay adviser, and appeal the decision and seek judicial review. The prisoner was also entitled to periodic review and to have a new hearing every 180 days.

The Court reversed the Washington state court decision and remanded the case for further proceedings in accordance with the Court’s findings.

Rationale

The Court concluded that due process does not require a judicial hearing for the involuntary treatment of prison inmates, and the state’s regulation contained adequate procedural safe guards to protect the prisoner’s rights and balance the state’s interests in decreasing risk of danger due to the prisoner’s mental disorder. The Court said that the State does not first have to find the inmate incompetent. The Court determined that an administrative hearing met the 14th Amendment due process requirements and the other aspects of the regulation also met due process standards.

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Clark v. Arizona (2006)

July 10, 2011 By Comments

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org/wp-content/uploads/2011/06/legalbrief.jpg” alt=”" width=”91″ height=”108″ />Clark v. Arizona (2006)

United States Supreme Court

548 U.S. 735

Nature of Case

Whether it is unconstitutional to narrow the insanity test to include only moral capacity and whether it is unconstitutional to exclude evidence of mental illness which could help to negate mens rea.

Facts of Case

Police received complaints of an individual driving a pickup truck and blaring loud music in the early hours of June 21, 2000. Officer Moritz stopped the driver, 17-year-old Eric Michael Clark. Clark shot the officer and the police officer died soon after, but was able to call for help first. Clark ran away on foot, but was arrested later that day with gunpowder residue on his hands and the gun that killed the officer nearby. Clark was charged with first-degree murder (acted intentionally or knowingly). He was found incompetent to stand trial in March, 2001, but two years later was found restored to competence. Clark waived his right to a jury. At the bench trial Clark did not contest the shooting, but denied that he had the specific intent required by the statute, because of his mental disorder (Schizophrenia, Paranoid Type). He raised the affirmative insanity defense and had to prove by a clear and convincing standard that “at the time of the commission of the criminal act he was afflicted with a mental disease or defect of such severity that he did not know the criminal act was wrong.” He also attempted to introduce evidence of mental disorder to negate the requisite mens rea for specific intent. The court did not allow him to introduce evidence to negate specific intent and held “Arizona does not allow evidence of a defendant’s mental disorder short of insanity…to negate the mens rea element of a crime.

At his trial, Clark presented testimony from classmates, school officials, and his family describing his bizarre behavior over the past year. His behavior included keeping a bird in his car to warn of airborne poison, and he had a fishing line with chimes to alert of intruders into his home. Clark also held a belief that Flagstaff, Arizona was populated with aliens (disguised as government officials) who were trying to kill him and bullets were the only mechanism to stop them. Mr. Clark’s schizophrenia diagnosis was undisputed and all experts agreed that he was psychotic at the time of the crime; however, the judge found that at the time of the crime his mental illness “did not distort his perception of reality so severely that he did not know his actions were wrong.” He found Clark guilty of first-degree murder and he was sentenced to life imprisonment without the possibility of release for 25 years.

Clark moved to vacate the judgment and sentence arguing that the insanity standard and the Mott rule violated due process. He argued that the 1993 narrowing of the insanity standard was unconstitutional, because it eliminated the first part of the M’Naghten test (“as not to know the nature and quality of the act he was doing”). Clark argued that the elimination of this component “offends [a] principle so rooted in the traditions and conscience of our people as to be ranked fundamental.” The Court of Appeals affirmed Clark’s conviction and held that the insanity standard did not violate due process, because there is no constitutional requirement to even recognize an insanity defense. The appellate court also believed Mott barred the trial court from considered evidence of mental illness to negate mens rea and they denied further review. The United States Supreme Court granted certiorari to review whether Arizona’s narrow insanity test and Mott rule violated 14th Amendment due process rights.

Issue

Did the Court of Appeals for Arizona err in affirming the defendant’s conviction, in allowing a narrow test of insanity, and in excluding evidence of a mental illness that could have been used to rebut evidence of specific intent?

 

Holding

In a 6 to 3 decision, in an opinion delivered by Justice Souter, the Court affirmed the judgment of the Court of Appeals for Arizona. The Court held that the 14th Amendment was not violated by a narrowly defined insanity test (moral capacity to tell whether the act was right or wrong), or by limiting consideration of mental illness strictly to its bearing on insanity (Mott rule).

Rationale

The Court concluded that due process was not violated, because history showed no “deference to M’Naghten that could elevate its formula to the level of a fundamental principle, so as to limit the traditional recognition of a State’s capacity to define crimes and defenses.” Additionally, the Court found that the Mott rule did not violate due process, because, the prosecution must prove the defendant committed the crime and did so knowingly or intentionally, beyond a reasonable doubt. Therefore, if Arizona wanted to limit consideration of mental illness and capacity to bear on insanity only, it did not violate the defendant’s due process rights. The Court further stated, “because allowing mental-disease evidence on mens rea can thus easily mislead, it is not unreasonable to address that tendency by confining consideration of this kind of evidence to insanity, on which a defendant may be assigned the burden of persuasion.”

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