Personality Disorders as Grounds for Reduced Sentence in Murder Cases

Article excerpt

Abstract: Clause 300 A (A) of the Israel penal code stipulates that severe mental disorder may serve as grounds for reduced sentence in cases of murder. There is an unresolved debate in the forensic psychiatric field whether severe personality disorders are included in this category. We present a set of criteria for applying this clause to offenders with personality disorder and demonstrate through three cases how these criteria can be used. All three cases had the following basic characteristics: A. Established diagnosis of severe personality disorder on the basis of historical data from multiple sources and in accordance with the evidence presented to the court. B. Presentation of a coherent description of the content of the murder as it directly affected the offender's severe impairment, with a strong link between the pathology and the offender's reduced capacity to understand or avoid the act. C. Establishment of the significantly limiting impact of the personality disorder on the offender's capacity to avoid the act, as based on the evidence presented to the court. We conclude that guidelines for formulating the psychiatric assessment and court report are feasible and necessary in these cases. Further experience in this area is needed until definite conclusions can be reached. Further studies are needed to confirm the suitability of this method.

Introduction

The 1995 amendment to the Israeli penal code [clause 300 A (A)J stipulates that individuals found guilty of murder can have their sentences reduced on proof of an impairment in their ability to understand (cognitive element), and/or to avoid (the affective/drive clement) the criminal act of murder. Some argue that personality disorders (PDs) are one of the psychiatric conditions that might be included within the bounds of this law (for a detailed review see 1).

This has evoked mixed reactions in the legal and medical communities, challenging the basic aspects of psychiatric classification and placing psychiatrists in a very powerful but dubious position. In contrast to the major psychiatric illnesses like schizophrenia and bipolar disorder where validity, reliability and boundaries from the normal state are established, PD as a diagnosis is far from this stage. Grounds (2), an eminent forensic psychiatrist in Britain, stated that the diagnosis of "psychopathic disorder" (i.e., PD) has no explanatory, descriptive, prognostic or therapeutic function. It is in effect a "pseudodiagnosis," used to get patients "through the customs-barrier of the courts." Furthermore, people with PDs can induce such powerful, negative reactions in the assessing psychiatrists, their professional view becomes clouded. For these reasons, we have devoted this paper to the assessment of PDs within the context of the law.

Definition of Personality Disorder

The fourth edition of the DSM (DSM-IV) (3) defines personality disorders as an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture. The diagnosis is made only when the personality traits are inflexible and maladaptive, cause either significant functional impairment or subjective distress, and are manifested in at least two of the following areas: cognition, affect, interpersonal functioning and impulse control. According to the ICD-10 (4), such deviation must be manifested in more than one of the following areas: 1) cognition (i.e., ways of perceiving and interpreting things, people and events; forming attitudes and images of self and others); 2) affectivity (range, intensity and appropriateness of emotional arousal and response); 3) control over impulses and gratification of needs; and 4) manner of relating to others and handling interpersonal situations.

PD and the Legal Definition of Severe Mental Disorder

The inclusion of PDs in the legal definition of severe mental disorder harbors several problems. Before the enactment of section 300A, it was common for judges to articulate, both in judicial decisions and in academic forums, their support for a doctrine of diminished responsibility in murder cases on the basis of mental defects suffered by the defendant. …