December 4, 2023 • 39 mins
What does the insanity defense mean in a court of law? And is there such a thing as temporary insanity? Is the twinkie defense a real thing? Can someone use premenstrual syndrome as a defense? And what does the legal wrestling around insanity tell us about the differences between brains: yours and other people’s, or even yours one day and yours the next day? How does law comport with science, and how are they sometimes like two people with quite different ways of looking at the world? Join to find out what happened to Andrea Yates, how the legal system deals with mental illness, and so much more.
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Speaker 1 (00:05):
Is there such a thing as temporary insanity? Is there
such a thing as the twinkie defense, or using pre
menstrual syndrome as a criminal defense? And what does this
tell us about the differences between brains yours and other people's,
or even between yours one day and yours the next day.
(00:26):
How does the legal system wrestle with the science, and
how are the law and the science like two different
people with very different ways of looking at the world.
Welcome to the inner Cosmos with me, David Eagleman. I'm
a neuroscientist and author at Stanford, and in these episodes
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we sail deeply into our three pound universe to understand
why we believe the things we do and behave in
the ways that we do, and why there's such a
variety in the ways that people see the world, and
how we try to structure legal systems around that fact. Now,
(01:12):
today we're picking up on the trial of Andrea Yates,
who was a young woman in Houston, Texas, who had
five beautiful children, and one day she murdered them one
by one by drowning them in the bathtub. Now, if
you haven't heard the previous episode, please go back to
that one to get the full background on that story.
Andrea was suffering from a psychosis, which is a mental
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disorder characterized by a disconnection from reality, and at her trial,
her lawyers pled the insanity defense, or specifically, not guilty
by reason of insanity. Now as a reminder, the prosecution
hired on a psychiatrist who said, yes, Andrea clearly has
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mental troubles, but I think she did this particular act
more purposefully because if she was unable to distinguish right
from wrong, which is one of the prongs of the
insanity defense, then she wouldn't have made sure she waited
until her husband was gone before doing it, and she
wouldn't have suffered regret. And Deet said, there was an
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episode of Law and Order, which is a show that
Andrea watched regularly, in which a woman drowns her children
in the bathtub so she can be free to be
with her lover. So Andrea's case brings to the forefront
some of the deep questions about the insanity defense. How
do we know when we should judge someone's actions to
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stem from a mental disorder like a psychosis, versus judging
the person to just be more devious? We can't really
know what is happening inside someone's head. So how do
we make these judgments as a society, and how do
we canonize these decisions into law. I mentioned in the
last episode that in eighteen forty three a Scottish man
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named Daniel McNaughton suffered from a deep psychosis and he
shot and killed a man that he erroneously thought was
the British Prime Minister, and a court of judges sat
down and defined what came to be known as the
McNaughton rules, which essentially said that if you want to
establish an insanity defense, you have to clearly prove that
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at the time of committing the act you had a
disease of the mind such that you didn't understand the
nature and quality of the act, like if you pull
a trigger a bullet comes out, or you didn't know
that what you were doing was wrong. In other words,
you were unable to distinguish between right and wrong. Okay,
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So these McNaughton rules caught on in England and America
and around the world. But in the late nineteenth century,
legal scholars began to worry that maybe the McNaughton rules
were too narrow. Why because These rules only ask whether
a person knows the difference between right and wrong and
understands the nature and consequences of the actions, and that
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invited concerns for psychiatrists and lawyers. First, can a psychiatrists
really testify to absolute knowledge of right versus wrong or
about absolute freedom of choice? And even if they can
in extreme cases, the rule only allows for total incapacity.
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But what if you're just a little confused about the
difference between right and wrong? And what if you know
the difference just fine, except for during a small window
of time. So let's dig into that. On a February
day in eighteen fifty nine, there was a United States
congressman named Daniel Sickles who murdered the US attorney for
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the District of Columbia, a guy named Philip Barton Key.
Sickles caught a glimpse of Key outside his house, and
he furiously chased Key into Lafayette Square, across the street
from the White House, and he shot him in the groin,
reportedly yelling quote, you villain, you have dishonored my house
and you must die. Sickles then fatally shot Key in
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the chest as he begged for his life, So what
led up to that? Well, before these events in Lafayette Square,
Sickles had been informed by a friend that his wife,
Teresa was having an affair with Key Now. Sickles lawyer
Edward Stayton, who went on to become Lincoln's Secretary of War,
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painted Sickles as a betrayed spouse driven crazy by grief
and what he claimed was quote temporary insanity. For the
first time in the United States history, this plea was successful,
and Sickles was declared not guilty. In the United States,
a temporary insanity defense can be raised to argue that
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a defendant is not responsible for their actions because a
severe mental disease or defect prevented them from appreciating the
wrongness of their acts at the time. So different jurisdictions
treat this differently, but the standard from the Supreme Court
of Iowa states that quote in order to be an
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excuse and defense for a criminal act, the person accused
and who claims temporary insanity as a defense must prove
that the crime charged was caused by mental disease or
unsoundness which dethroned, overcame, or swayed her reason and judgment.
With respect to that act which destroyed her power rationally
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to comprehend the nature and consequences of that act end quote.
So the temporary insanity defense often gets linked with intoxication,
and in certain jurisdictions, intoxication can be grounds for a
reduced penalty because of temporary insanity. Now, Sickles act as
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an example of what we commonly refer to today as a
crime of passion. Under this kind of interpretation, Sickles would
have been said to have been experiencing extreme emotional disturbance,
and his crime would likely be reduced from murder to
voluntary manslaughter. Why because crimes of passion are not punished
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to the same degree. Because there are certain circumstances under
which we think it's reasonable for someone in extreme emotional
distress to lose their self control. While we don't condone
the crime, we intuitively think that a person acting during
a moment of extreme emotional distress is less culpable than
the cool headed and calculating criminal. Unlike the insanity defense,
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extreme emotional distress doesn't absolve the defendant of all culpability,
but it can lessen the degree of the crime. Now,
you may have heard the term twinkie defense, and this
is used to describe a seemingly absurd, yet somehow successful
legal defense, and what this originates from is the nineteen
seventy nine trial of Dan White for the deaths of
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the San Francisco Mayor George Moscone and supervisor Harvey Milk,
and the term twinkie defense refers to this commonly held
but actually inaccurate belief that White's lawyers successfully argued that
his consumption of Twinkies put enough sugar into his body
to send him into a murderous state. In actuality, White's
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lawyers argued diminished capacity from depression and his sugary diet
only played a small role in explaining his mental decline. Nevertheless,
the term twinkie defense continues to be applied to legal
defenses that seem ludicrous. Now there are many kinds of
defenses that people try, and sometimes they're successful. A woman
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in Virginia in nineteen ninety one argued that pre menstrual
syndrome caused her erratic behavior, and she was able to
avoid being found guilty of driving under the influence this way,
and a decade before that, two women in England were
similarly able to reduce their criminal responsibility from murder to
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manslaughter based on a pre menstrual syndrome defense. Okay, so
these are the concerns that people have about whether insanity
can be temporary or not. But let's zoom back out
to the really big picture about the McNaughton rules and
what the problems are. The bigger problem with the mcnotton
rule is that it's too narrowly cognitive. You might know
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the difference between right and wrong, and you might know
the nature and consequences of your action. But what if
that's not the problem. What if the real problem is
one of the In other words, your cognitive reasoning is fine,
but you can't stop yourself. In later episodes, we'll see
a lot of examples of impaired volition. For example, there's
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a disease known as frontotemporal lowbar degeneration, where people can
know perfectly well the difference between right and wrong, but
they are totally unable to stop their impulsive behavior. They'll
expose themselves in public, they'll urinate in public, they'll touch
people inappropriately. They'll shoplift, they'll reach into garbage cans and
eat food out of it. They'll run red lights, they'll
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curse in public. They just do whatever they want. If
you ask such a person is shoplifting right or wrong,
they're perfectly capable of verifying that they're not supposed to
do it. If you ask you understand when you steal
it costs someone else money, they'll genuinely agree that. They understand.
They can discriminate right from wrong, and they understand the
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nature and consequences of their actions. They just can't do
anything about it. This comes up not only in cases
of degenerative brain disease, but also in cases of traumatic
brain injury or from brain disorders that people are sometimes
born with. In all these cases, a person can understand
the difference between right and wrong, and they simply don't
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have the proper brain function to stop their transgressions. So
by the eighteen eighties, scholars wondered whether the legal definition
of insanity would need to evolve, and to that end,
an additional prong was added to the insanity defense in
some jurisdictions, and this was the concept of an irresistible impulse.
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Was the defendant able to control his behavior at the
time of the offense. I'll give you an example of
this from eighteen eighty five, a woman named Nancy Parsons
believed that she knew why she had been sick and
in bad health for a long time, and her assessment
was that her husband, Bennett possessed supernatural powers that caused
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her illness and put her at risk of death. So
she encouraged her daughter to shoot and kill Bennett. Now,
both Nancy and her daughter sought to employ the insanity defense.
Nancy was experiencing a quote insane delusion and the daughter
quote was at the time of said killing and always
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had been an idiot. Now, applying the McNaught rules, the
jury initially found Nancy and her daughter guilty of murder
in the second degree. On appeal, however, the state Supreme
Court reversed the decision and added a component to the
insanity defense. Someone is not guilty if she was subject
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to quote the dress of such mental disease that she
had lost the power to choose between right and wrong,
and her free agency was at the time to destroyed.
So this was not about knowing the difference between right
and wrong. Instead, it was about losing the power to
choose between right and wrong. A person has an impulse
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to act that cannot be resisted. In this way, the
additional prong makes the McNaughton test slightly broader, although the
legal defense still has to demonstrate that the crime was
connected with a mental disease and was directly the product
of it. So to understand this notion of an irresistible impulse,
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consider a case that you probably remember. LORRAINA. Bobbitt. In
the wee hours of June twenty third, nineteen ninety three,
she pulled back the covers on her sleeping husband, John
Wayne Bobbitt, and cut off his penis with an eight
inch kitchen knife. She fled from their apartment in her car,
and she tossed the severed organ into a field. Now
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what led to this moment? At trial, her defence team
alleged that she had spent the years of their marriage
being repeatedly raped and beaten and sodomized by her husband,
and this was verified by expert witnesses on both the
prosecution and the defense, who validated that she quote lived
in constant fear of him. In light of this, her
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lawyers argued that she had an irresistible impulse. After many
hours of deliberation, the jury found lorrain and Bobbitt not
guilty by reason of temporary insanity based on their conclusion
that she was unable to resist her impulse to wound John.
In this way, she was not held liable for her assault. Instead,
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she was sent for a forty five day evaluation at
a local state hospital. So by the end of the
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nineteenth century it seemed that bases were covered with the
McNaughton rules plus the notion of an irresistible impulse, But
legal experts agonized that this version of insanity might still
be too narrow because the rules only allowed for total incapacity,
they were insensitive to partial problems, and many people on
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trial were seen to be in a gray area in between,
not completely unaware of right and wrong, or maybe they
were subject to impulses that might not be one hundred
percent irresistible. In the late nineteen forties, there was a
young man named Monty Durham who had years of petty
crimes and mental illness, and this familiarized Durham with both
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the criminal justice system and the state asylum. So in
July of nineteen fifty one, Durham was convicted of housebreaking
in Washington, d c. And he appealed his case and
as a result, a new test emerged in nineteen fifty four,
which is called the Durham rule, and the idea was
to broaden the mcnot rules such that now the task
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was merely to conclude whether a defendant's criminal act was
quote the product of mental disease or mental defect. If
it was, then he would not be criminally responsible. But
there was a problem here. How do you ever prove
that some act was the product of a disease or
a defect. One might claim the disease was related to
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the act, But what portion of the disease came from you?
And what portion from the disease? But that wasn't even
the big problem. The big problem was who gets to
decide if an act was the product of a disease.
So the Durham rule shifted the power to psychiatrists who
gave expert testimony. A psychiatrist would testify whether the act
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was the product of a mental disease, and the jury,
instead of making decisions on their own, was in a
position of just having to accept the psychiatrist's testimony. In
other words, starting in nineteen fifty four, the power was
in the physician's expert testimony instead of in the juror's hands. Now,
at first blush, that doesn't seem like a problem, because,
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after all, the psychiatrists are the experts. But the problem
was that their testimony could be ambiguous and two experts
could contradict one another. Imagine the defense pulls up their
favorite psychiatrists who asserts that mister Smith has clear evidence
of a mental illness, and then the prosecution puts up
their psychiatrists who says the opposite. Suddenly, the fact finding
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job of the jury becomes complexified. Relying on expert witness
testimony turned out to be much more problematic than they
had originally envisioned. So the Durham rule held sway in
US Corps for eighteen years. But then one night at
a party, a man named Archie Brauner got into a fight.
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He left bleeding and returned with a gun, and after
shooting and killing a man, Bronner was arrested. The court
tested for insanity using a standard that's now known as
the Bronner rule, and the rule states a person is
not responsible for criminal conduct if, at the time of
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the action, as a result of mental disease or defect,
he or she lacks the substantial capacity either to appreciate
the criminality of his conduct, or to conform his conduct
to the requirements of the law. The key thing about
the Bronner rule is that expert witnesses no longer decided
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whether the crime resulted from a mental defect. Instead, that
was now up to the jurors. If a defendant wanted
to claim that he wasn't liable for a crime, his
argument had to meet two prongs. He has to lack
the capacity to appreciate that his conduct was wrongful, and
he has to lack the capacity to conform his conduct.
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So why have I told you this whole history of
the insanity defense. It's because this illustrates a really key point,
which is that it's not easy to take something as
complex as mental life and reduce it cleanly into a
yes or no decision in the courtroom. The endeavor to
build the right definition relies on a collaboration of psychiatry
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and legal scholarship and the public, and because of the
inherently diversified goals, the road to definitive rules didn't even
end with the Broader rule. Over a century after McNaughton
committed his homicide, there was a troubled twenty five year
old American named John who was developing an increasing obsession
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with the actress Jody Foster, and so he repeatedly watched
this movie Taxi Driver, in which the young Foster played
a twelve year old prostitute. And in the movie, the
protagonist Travis Bickle, who is played by Robert de Niro,
hatches a plot to assassinate a politician for public admiration.
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So John, with his unshakable love for Jody Foster, began
to send letters to her and stalk her, and he
somehow got a hold of her phone number, and he
rang her several times, and every time she hung up.
And he wrote in his final letter to her, quote,
as you very well know by now, I love you
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very much. The past seven months, I have left you
dozens of poems, letters, and messages in the faint hope
that you would develop an interest in me. Although we
talked on the phone a couple of times, I never
had the nerve to simply approach you and introduce myself.
Desides my shyness, I honestly did not wish to bother
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you with my constant presence. I know that many messages
left at your door and in your mailbox were a nuisance,
but I felt it was the most painless way for
me to express my love to you. I will admit
to you that the reason I'm going ahead with this
attempt now is because I just cannot wait any longer
to impress you. End quote. Now. The attempt he's referring
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to there was the assassination of President Ronald Reagan. So
on March thirtieth, nineteen eighty one, John Hinckley fired six
shots as the president and his entourage exited the Hilton
Hotel in Washington, d c. None of Hinckley's bullets directly
hit Reagan, but one ricochet off the limousine and hit
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the president under his left armpit, and three other people
in the party were wounded, including the Press secretary James Brady,
who spent the rest of his life partially paralyzed on
the left side of his body. Now, this act of
senseless violence led to a national uproar, people thirsted for
a swift and effective punishment for Hinckley. The federal trial
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was quickly set into motion, and at the end the
jury gathered in their room with their coffee cups and
spent a long time deliberating over everything they had seen,
and they agreed that Hinckley was indeed deeply psychotic. He
was disconnected from reality and was unable to conform to
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the requirements of the law. So on June twenty first,
eighty two, Hinckley was declared not guilty by reason of insanity.
But this pill was a jagged one for the public
to swallow, just as in Queen Victoria's Day, which I
talked about in the last episode, the air was filled
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with outcries and citizens had just witnessed an assassination attempt
on their president, and they were enraged. They felt that
they were being denied their right to see punishment. After all,
people asked, how do we know if Hinckley truly had
an impulse that was irresistible or simply an impulse not resisted.
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All this national anger sparked action at the congressional level. Lawmakers,
responding to all this ire came together to pass the
Insanity Defense Reform Act of nineteen eighty four. The act
stripped the insanity defense back to a simpler version. A
defendant could now escape criminalizability only if he was unable
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to appreciate the nature and quality, or the wrongfulness of
the Act. In other words, it got rid of the
irresistible impulse prong. It brought it back to the McNaughton rules.
It got rid of the consideration of whether you were
able to appropriately conform your behavior. All that mattered now
is whether a defendant could appreciate right from wrong. If
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there was some reason he couldn't help himself, from frontal
low problems to psychosis, he was out of luck and surfing.
On top of this wave of national anger, Congress went
even further beyond removing this volitional component. They also added
conditions to raise the bar for the insanity defense. They
specified that the defendant has to suffer from a severe
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mental illness, and the defendant has to prove by clear
and convincing evidence the alleged insanity, which was higher than
before which was just a preponderance of evidence. So, in
addition to raising the standard of proof, the Act further
complicated things by shifting the burden of proof from the
prosecution to the defense. In other words, before Hankley, the
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prosecution had to prove that the defendant was not insane,
but now the defendant had to prove that he was insane.
And part of the difficulty here is that a. The
central feature of psychosis is a lack of insight. So
consider the unibomber ted Kaczynski, who killed three people and
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injured twenty three others by sending them explosives in the mail.
Although he clearly had paranoid schizophrenia, he took offense to
any suggestions or implications that he was mentally ill. He
wouldn't follow his lawyer's suggestion to take the insanity plea
because he was angered that anyone would be suggesting that
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something was wrong with his thinking. So a lack of
insight is a hallmark characteristic of people with psychosis. They
have no discernment that something is strange about their behavior. Instead,
they believe they're seeing the world correctly while others are not.
So it's no surprise that many defendants have a mental
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illness but will not take an insanity plea because they
see a full justification for their actions, whether that was
divine commandment or revenge for imagined political wrongdoings, or other
fantastical reasons. So I'm telling you all this to make
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it clear that the legal definition of insanity is more
complicated than the road which began with Daniel McNaughton. In America,
if a defendant suffers from a mental disease, you might
have four different tests used in different places, and cases
can conclude very differently depending on which test is employed.
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Some jurisdictions still use the McNaughton rule. One still uses
the Durham rule almost half free line on the broader rule.
The Federal Core and several other jurisdictions employ the Insanity
Defense Reform Act, and the state by state bespoke nature
doesn't even end there. In nineteen ninety five, Kansas abolished
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the affirmative insanity defense and established what's known as the
mensrea approach. Under this approach, mental illness is only considered
to the extent that it prevents the defendant from having
the required mensrea or guilty mind. For example, if a
defendant knowingly commits a crime but couldn't know what she
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was doing because of her mental illness, that would satisfy
the mens rea approach. The defendants act to judge the
wrongfulness of her acts just doesn't matter. So Kansas's decision
rose to the US Supreme Court in twenty twenty after
a guy named James Craig Kaylor killed his wife and
two teenage daughters, and his wife's grandmother. He had a
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major depression an obsessive personality disorder, but he was not
allowed to use an affirmative insanity defense and he was
given a death sentence. So his team appealed to the
Kansas Supreme Court, and they argued that the prosecution had
violated his right to a fair trial by denying him
the right to leverage the insanity defense. But Kansas said
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that they were within their rights to craft their insanity
defense however they chose. So this went all the way
up to the US Supreme Court, and his council argued
that a state government shouldn't be able to impose cruel
and unusual punishment, and a lack of insanity defense fit
this description. Additionally, they argued that Kansas's approach violated his
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due process, which calls for the fair treatment by the
judicial system. They argued that ignoring this question of could
you distinguish right from wrong equated to an unfair system.
So the US Supreme Court affirmed that Kansas was not
required to take on in the sanity defense that depended
on a defendant's ability to recognize that their crime was
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morally wrong. In other words, the court concluded that it
was the state's decision and that decisions surrounding criminal liability
and mental illness were left to them. So, as of
twenty twenty, there are four states that have committed to
the men's rea approach rather than a traditional insanity defense.
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Here's the thing, there's no single right answer that everyone
should use, and this underscores the difficulty, both legal and psychiatric,
of deciding who is criminally liable and who is not.
And this is not just a current challenge. It's not
as though in another few decades scientists are going to
announce that we've got it all worked out. Why not
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because humans are complex and mental life varies along many axes.
Some people suffer deep mental illnesses, and most thinkers believe
that they should be treated differently. But how do we
draw a bright line in the sand of a very
complex landscape. The legal system, after all, is forced to
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be categorical. The judge and jury are tasked with deciding
whether a defendant is or is not insane. And the
fact is that science and the law are strange bedfellows
because science does not see things in binary categories like that.
So the legal system has been wrestling for many decades
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about how a person's cognition and volition matter in their culpability.
But every time a famous person gets attacked, society's generous
interest in this issue gets scaled back. Why because many people,
perhaps most have little to know experience with mental illness,
and therefore they see the insanity plea as simply an
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excuse that people people are trying for bad behavior. After all,
how would you know with certainty whether lorraina Bobbits act
was an irresistible impulse or justin urge that had not
been repelled. So with the intersection of neuroscience and law,
there is not always a clear solution. But we know
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enough about human variation to know that the search has
to continue, and so, as it stands, different jurisdictions make
individualized choices about how they think insanity should be handled.
So what happened to Andrea Yates, the woman who drowned
her children in the bathtub. Her council pled the insanity defense.
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They argued that she had suffered from severe mental illness,
that she'd attempted suicide many times, that she'd shuttled in
and out of psychiatric hospitals, and that she had this
belief that she was saving her children from hell by
killing them. Her plea was unsuccessful. On the one year
anniversary of her father's death, Andrea Yates was found guilty
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of murder, but Andrea's defense counsel found reason to hope
for a mistrial. Remember, the prosecutor mentioned an episode of
Law and Order in which a woman drowned her children
in the bathtub. As it turned out, there was no
episode with that plot. Whether this was by deception or
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just misremembering, Dietz's claim had been totally false. In two
thousand and five, Andrea's conviction was reversed because of Dietz's
false testimony. A four week retrial ensued, and this time
the jury found Andrea not guilty by reason of insanity.
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Andrea is locked away for life, but in a psychiatric
institution where she has a roommate, she gets care, she's
on medications, the public is safe, she presents no danger
to anybody, and she can obtain the help that she needs.
So why is there a public resistance to the insanity defense. Well, first,
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there's often this misunderstanding about the not guilty part of
the plea, and the public is often horrified by the
notion that some person, whether that's McNaughton or Hinckley, is
not culpable for a horrific crime. There's a feeling that
they're not appropriately punished for their actions if they're simply
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sent to a cushy hospital. And also a lot of people,
especially those with no direct connection to someone with mental illness,
they think that everyone is the same on the inside,
and that the insanity defense is just an invitation to deceive. Now,
one thing to note here is that only one percent
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of felony cases in the US involve the insanity defense.
It's not generally a part of public knowledge that this
is such a very rare plea. Instead, a lot of
people have the opinion that everyone who murderers is simply
going to plead insanity to try to get away with that,
and of those who plead the insanity defense, only about
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thirty cases or successful each year. Even in these successful cases,
the sentences are often longer because a person can be
sentenced to a prison hospital for a long time, and
it's not uncommon that those sentences end up being worse
than prison itself. What worse means depends on the decade
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you're in, but sometimes In these prison hospitals, a person
is kept in a drug induced stupor for the remaining
years of their life. So, in the same way that
prisons can often lead to more crime, some mental health
institutions are thought to actually worsen a psychosis. For this reason,
there was a push for the institutionalization in nineteen sixties America.
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The country used to run a large mental health care
system of what were called insane asylums, but these asylums
proved less than perfect. In many instances, men and women
in hospital gowns led meaningless lives. They were just bodies
being kept alive. So these mental institutions were shut down
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with plans to have a network of halfway houses and
other mechanisms to help people back into productive society, but
that part was never fully implemented, and so the shutdown
led to a large homeless population and to many of
the former inhabitants of the asylums flowing into the prison system.
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So some people argue that the insanity defense is not
often invoked, in part because prison hospitalizations can be worse
and lasts longer than prison sentences. And there's another problem
that some scholars point to about the not guilty by
reason of insanity plea, which is that jurors find themselves
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in a tough spot when they have to deal with
the words not guilty. After all, the person did commit
the crime, right. It turns out that when juries are
given other options, they come to more nuanced decisions. So
to this end, some states have adopted the term guilty
(36:29):
but mentally ill, and that gives an option to root
someone to mental health care while not making the jury
feel as though they're letting someone off scot free. So,
in this way, when a defendant with a psychosis shoots
somebody in the back, we can come to the slightly
more satisfying conclusion that he is guilty of the crime.
(36:51):
But there's another issue that requires consideration of the best
root forward. So how we phrase things matters. So where
is Andrea Yates today? Well, she still resides at the
Kerville State Hospital in Texas. Her husband, Rusty, went to
law school with the aim of improving the societal response
(37:13):
to the criminal behavior of mentally ill defendants and improving
the healthcare system for the mentally ill. Part of Andrea's
time in Kerville is devoted to craftmaking, the fruits of
which she sells anonymously at craft shows. Andrea donates the
majority of her earnings from the sales to the Yates
(37:34):
Children Memorial Fund. So to wrap up, we've been seeing
throughout these episodes how different people's internal models can be,
and therefore how different their realities can be. We've talked
elsewhere about synesthesia or a fantasia, or different levels of empathy,
(37:55):
or a hundred other ways that people can see the
world differently on some sort of spectrum. And for Andrea,
her internal model told her I believe quite genuinely that
her children were going to hell, and so she did
what she believed was the right thing given her reality.
(38:17):
And all of this emphasizes the complexity of putting together
billions of brains to work and live together in a
massive collaboration that we call society. Go to Eagleman dot
com slash podcast for more information and to find further reading.
(38:41):
Send me an email at podcasts at Eagleman dot com
with questions or discussions, and then making episodes in which
I address those until next time. I'm David Eagleman, and
this is Inner Cosmos.
Is there such a thing as temporary insanity? Is there
such a thing as the twinkie defense, or using pre
menstrual syndrome as a criminal defense? And what does this
tell us about the differences between brains yours and other people's,
or even between yours one day and yours the next day.
(00:26):
How does the legal system wrestle with the science, and
how are the law and the science like two different
people with very different ways of looking at the world.
Welcome to the inner Cosmos with me, David Eagleman. I'm
a neuroscientist and author at Stanford, and in these episodes
(00:48):
we sail deeply into our three pound universe to understand
why we believe the things we do and behave in
the ways that we do, and why there's such a
variety in the ways that people see the world, and
how we try to structure legal systems around that fact. Now,
(01:12):
today we're picking up on the trial of Andrea Yates,
who was a young woman in Houston, Texas, who had
five beautiful children, and one day she murdered them one
by one by drowning them in the bathtub. Now, if
you haven't heard the previous episode, please go back to
that one to get the full background on that story.
Andrea was suffering from a psychosis, which is a mental
(01:35):
disorder characterized by a disconnection from reality, and at her trial,
her lawyers pled the insanity defense, or specifically, not guilty
by reason of insanity. Now as a reminder, the prosecution
hired on a psychiatrist who said, yes, Andrea clearly has
(01:56):
mental troubles, but I think she did this particular act
more purposefully because if she was unable to distinguish right
from wrong, which is one of the prongs of the
insanity defense, then she wouldn't have made sure she waited
until her husband was gone before doing it, and she
wouldn't have suffered regret. And Deet said, there was an
(02:19):
episode of Law and Order, which is a show that
Andrea watched regularly, in which a woman drowns her children
in the bathtub so she can be free to be
with her lover. So Andrea's case brings to the forefront
some of the deep questions about the insanity defense. How
do we know when we should judge someone's actions to
(02:40):
stem from a mental disorder like a psychosis, versus judging
the person to just be more devious? We can't really
know what is happening inside someone's head. So how do
we make these judgments as a society, and how do
we canonize these decisions into law. I mentioned in the
last episode that in eighteen forty three a Scottish man
(03:04):
named Daniel McNaughton suffered from a deep psychosis and he
shot and killed a man that he erroneously thought was
the British Prime Minister, and a court of judges sat
down and defined what came to be known as the
McNaughton rules, which essentially said that if you want to
establish an insanity defense, you have to clearly prove that
(03:26):
at the time of committing the act you had a
disease of the mind such that you didn't understand the
nature and quality of the act, like if you pull
a trigger a bullet comes out, or you didn't know
that what you were doing was wrong. In other words,
you were unable to distinguish between right and wrong. Okay,
(03:48):
So these McNaughton rules caught on in England and America
and around the world. But in the late nineteenth century,
legal scholars began to worry that maybe the McNaughton rules
were too narrow. Why because These rules only ask whether
a person knows the difference between right and wrong and
understands the nature and consequences of the actions, and that
(04:10):
invited concerns for psychiatrists and lawyers. First, can a psychiatrists
really testify to absolute knowledge of right versus wrong or
about absolute freedom of choice? And even if they can
in extreme cases, the rule only allows for total incapacity.
(04:31):
But what if you're just a little confused about the
difference between right and wrong? And what if you know
the difference just fine, except for during a small window
of time. So let's dig into that. On a February
day in eighteen fifty nine, there was a United States
congressman named Daniel Sickles who murdered the US attorney for
(04:54):
the District of Columbia, a guy named Philip Barton Key.
Sickles caught a glimpse of Key outside his house, and
he furiously chased Key into Lafayette Square, across the street
from the White House, and he shot him in the groin,
reportedly yelling quote, you villain, you have dishonored my house
and you must die. Sickles then fatally shot Key in
(05:18):
the chest as he begged for his life, So what
led up to that? Well, before these events in Lafayette Square,
Sickles had been informed by a friend that his wife,
Teresa was having an affair with Key Now. Sickles lawyer
Edward Stayton, who went on to become Lincoln's Secretary of War,
(05:38):
painted Sickles as a betrayed spouse driven crazy by grief
and what he claimed was quote temporary insanity. For the
first time in the United States history, this plea was successful,
and Sickles was declared not guilty. In the United States,
a temporary insanity defense can be raised to argue that
(06:02):
a defendant is not responsible for their actions because a
severe mental disease or defect prevented them from appreciating the
wrongness of their acts at the time. So different jurisdictions
treat this differently, but the standard from the Supreme Court
of Iowa states that quote in order to be an
(06:23):
excuse and defense for a criminal act, the person accused
and who claims temporary insanity as a defense must prove
that the crime charged was caused by mental disease or
unsoundness which dethroned, overcame, or swayed her reason and judgment.
With respect to that act which destroyed her power rationally
(06:46):
to comprehend the nature and consequences of that act end quote.
So the temporary insanity defense often gets linked with intoxication,
and in certain jurisdictions, intoxication can be grounds for a
reduced penalty because of temporary insanity. Now, Sickles act as
(07:07):
an example of what we commonly refer to today as a
crime of passion. Under this kind of interpretation, Sickles would
have been said to have been experiencing extreme emotional disturbance,
and his crime would likely be reduced from murder to
voluntary manslaughter. Why because crimes of passion are not punished
(07:29):
to the same degree. Because there are certain circumstances under
which we think it's reasonable for someone in extreme emotional
distress to lose their self control. While we don't condone
the crime, we intuitively think that a person acting during
a moment of extreme emotional distress is less culpable than
the cool headed and calculating criminal. Unlike the insanity defense,
(07:55):
extreme emotional distress doesn't absolve the defendant of all culpability,
but it can lessen the degree of the crime. Now,
you may have heard the term twinkie defense, and this
is used to describe a seemingly absurd, yet somehow successful
legal defense, and what this originates from is the nineteen
seventy nine trial of Dan White for the deaths of
(08:19):
the San Francisco Mayor George Moscone and supervisor Harvey Milk,
and the term twinkie defense refers to this commonly held
but actually inaccurate belief that White's lawyers successfully argued that
his consumption of Twinkies put enough sugar into his body
to send him into a murderous state. In actuality, White's
(08:42):
lawyers argued diminished capacity from depression and his sugary diet
only played a small role in explaining his mental decline. Nevertheless,
the term twinkie defense continues to be applied to legal
defenses that seem ludicrous. Now there are many kinds of
defenses that people try, and sometimes they're successful. A woman
(09:05):
in Virginia in nineteen ninety one argued that pre menstrual
syndrome caused her erratic behavior, and she was able to
avoid being found guilty of driving under the influence this way,
and a decade before that, two women in England were
similarly able to reduce their criminal responsibility from murder to
(09:25):
manslaughter based on a pre menstrual syndrome defense. Okay, so
these are the concerns that people have about whether insanity
can be temporary or not. But let's zoom back out
to the really big picture about the McNaughton rules and
what the problems are. The bigger problem with the mcnotton
rule is that it's too narrowly cognitive. You might know
(09:49):
the difference between right and wrong, and you might know
the nature and consequences of your action. But what if
that's not the problem. What if the real problem is
one of the In other words, your cognitive reasoning is fine,
but you can't stop yourself. In later episodes, we'll see
a lot of examples of impaired volition. For example, there's
(10:11):
a disease known as frontotemporal lowbar degeneration, where people can
know perfectly well the difference between right and wrong, but
they are totally unable to stop their impulsive behavior. They'll
expose themselves in public, they'll urinate in public, they'll touch
people inappropriately. They'll shoplift, they'll reach into garbage cans and
eat food out of it. They'll run red lights, they'll
(10:34):
curse in public. They just do whatever they want. If
you ask such a person is shoplifting right or wrong,
they're perfectly capable of verifying that they're not supposed to
do it. If you ask you understand when you steal
it costs someone else money, they'll genuinely agree that. They understand.
They can discriminate right from wrong, and they understand the
(10:56):
nature and consequences of their actions. They just can't do
anything about it. This comes up not only in cases
of degenerative brain disease, but also in cases of traumatic
brain injury or from brain disorders that people are sometimes
born with. In all these cases, a person can understand
the difference between right and wrong, and they simply don't
(11:16):
have the proper brain function to stop their transgressions. So
by the eighteen eighties, scholars wondered whether the legal definition
of insanity would need to evolve, and to that end,
an additional prong was added to the insanity defense in
some jurisdictions, and this was the concept of an irresistible impulse.
(11:42):
Was the defendant able to control his behavior at the
time of the offense. I'll give you an example of
this from eighteen eighty five, a woman named Nancy Parsons
believed that she knew why she had been sick and
in bad health for a long time, and her assessment
was that her husband, Bennett possessed supernatural powers that caused
(12:05):
her illness and put her at risk of death. So
she encouraged her daughter to shoot and kill Bennett. Now,
both Nancy and her daughter sought to employ the insanity defense.
Nancy was experiencing a quote insane delusion and the daughter
quote was at the time of said killing and always
(12:27):
had been an idiot. Now, applying the McNaught rules, the
jury initially found Nancy and her daughter guilty of murder
in the second degree. On appeal, however, the state Supreme
Court reversed the decision and added a component to the
insanity defense. Someone is not guilty if she was subject
(12:48):
to quote the dress of such mental disease that she
had lost the power to choose between right and wrong,
and her free agency was at the time to destroyed.
So this was not about knowing the difference between right
and wrong. Instead, it was about losing the power to
choose between right and wrong. A person has an impulse
(13:10):
to act that cannot be resisted. In this way, the
additional prong makes the McNaughton test slightly broader, although the
legal defense still has to demonstrate that the crime was
connected with a mental disease and was directly the product
of it. So to understand this notion of an irresistible impulse,
(13:32):
consider a case that you probably remember. LORRAINA. Bobbitt. In
the wee hours of June twenty third, nineteen ninety three,
she pulled back the covers on her sleeping husband, John
Wayne Bobbitt, and cut off his penis with an eight
inch kitchen knife. She fled from their apartment in her car,
and she tossed the severed organ into a field. Now
(13:56):
what led to this moment? At trial, her defence team
alleged that she had spent the years of their marriage
being repeatedly raped and beaten and sodomized by her husband,
and this was verified by expert witnesses on both the
prosecution and the defense, who validated that she quote lived
in constant fear of him. In light of this, her
(14:18):
lawyers argued that she had an irresistible impulse. After many
hours of deliberation, the jury found lorrain and Bobbitt not
guilty by reason of temporary insanity based on their conclusion
that she was unable to resist her impulse to wound John.
In this way, she was not held liable for her assault. Instead,
(14:40):
she was sent for a forty five day evaluation at
a local state hospital. So by the end of the
(15:05):
nineteenth century it seemed that bases were covered with the
McNaughton rules plus the notion of an irresistible impulse, But
legal experts agonized that this version of insanity might still
be too narrow because the rules only allowed for total incapacity,
they were insensitive to partial problems, and many people on
(15:27):
trial were seen to be in a gray area in between,
not completely unaware of right and wrong, or maybe they
were subject to impulses that might not be one hundred
percent irresistible. In the late nineteen forties, there was a
young man named Monty Durham who had years of petty
crimes and mental illness, and this familiarized Durham with both
(15:51):
the criminal justice system and the state asylum. So in
July of nineteen fifty one, Durham was convicted of housebreaking
in Washington, d c. And he appealed his case and
as a result, a new test emerged in nineteen fifty four,
which is called the Durham rule, and the idea was
to broaden the mcnot rules such that now the task
(16:13):
was merely to conclude whether a defendant's criminal act was
quote the product of mental disease or mental defect. If
it was, then he would not be criminally responsible. But
there was a problem here. How do you ever prove
that some act was the product of a disease or
a defect. One might claim the disease was related to
(16:36):
the act, But what portion of the disease came from you?
And what portion from the disease? But that wasn't even
the big problem. The big problem was who gets to
decide if an act was the product of a disease.
So the Durham rule shifted the power to psychiatrists who
gave expert testimony. A psychiatrist would testify whether the act
(17:00):
was the product of a mental disease, and the jury,
instead of making decisions on their own, was in a
position of just having to accept the psychiatrist's testimony. In
other words, starting in nineteen fifty four, the power was
in the physician's expert testimony instead of in the juror's hands. Now,
at first blush, that doesn't seem like a problem, because,
(17:22):
after all, the psychiatrists are the experts. But the problem
was that their testimony could be ambiguous and two experts
could contradict one another. Imagine the defense pulls up their
favorite psychiatrists who asserts that mister Smith has clear evidence
of a mental illness, and then the prosecution puts up
their psychiatrists who says the opposite. Suddenly, the fact finding
(17:46):
job of the jury becomes complexified. Relying on expert witness
testimony turned out to be much more problematic than they
had originally envisioned. So the Durham rule held sway in
US Corps for eighteen years. But then one night at
a party, a man named Archie Brauner got into a fight.
(18:07):
He left bleeding and returned with a gun, and after
shooting and killing a man, Bronner was arrested. The court
tested for insanity using a standard that's now known as
the Bronner rule, and the rule states a person is
not responsible for criminal conduct if, at the time of
(18:27):
the action, as a result of mental disease or defect,
he or she lacks the substantial capacity either to appreciate
the criminality of his conduct, or to conform his conduct
to the requirements of the law. The key thing about
the Bronner rule is that expert witnesses no longer decided
(18:49):
whether the crime resulted from a mental defect. Instead, that
was now up to the jurors. If a defendant wanted
to claim that he wasn't liable for a crime, his
argument had to meet two prongs. He has to lack
the capacity to appreciate that his conduct was wrongful, and
he has to lack the capacity to conform his conduct.
(19:12):
So why have I told you this whole history of
the insanity defense. It's because this illustrates a really key point,
which is that it's not easy to take something as
complex as mental life and reduce it cleanly into a
yes or no decision in the courtroom. The endeavor to
build the right definition relies on a collaboration of psychiatry
(19:36):
and legal scholarship and the public, and because of the
inherently diversified goals, the road to definitive rules didn't even
end with the Broader rule. Over a century after McNaughton
committed his homicide, there was a troubled twenty five year
old American named John who was developing an increasing obsession
(19:59):
with the actress Jody Foster, and so he repeatedly watched
this movie Taxi Driver, in which the young Foster played
a twelve year old prostitute. And in the movie, the
protagonist Travis Bickle, who is played by Robert de Niro,
hatches a plot to assassinate a politician for public admiration.
(20:21):
So John, with his unshakable love for Jody Foster, began
to send letters to her and stalk her, and he
somehow got a hold of her phone number, and he
rang her several times, and every time she hung up.
And he wrote in his final letter to her, quote,
as you very well know by now, I love you
(20:42):
very much. The past seven months, I have left you
dozens of poems, letters, and messages in the faint hope
that you would develop an interest in me. Although we
talked on the phone a couple of times, I never
had the nerve to simply approach you and introduce myself.
Desides my shyness, I honestly did not wish to bother
(21:03):
you with my constant presence. I know that many messages
left at your door and in your mailbox were a nuisance,
but I felt it was the most painless way for
me to express my love to you. I will admit
to you that the reason I'm going ahead with this
attempt now is because I just cannot wait any longer
to impress you. End quote. Now. The attempt he's referring
(21:28):
to there was the assassination of President Ronald Reagan. So
on March thirtieth, nineteen eighty one, John Hinckley fired six
shots as the president and his entourage exited the Hilton
Hotel in Washington, d c. None of Hinckley's bullets directly
hit Reagan, but one ricochet off the limousine and hit
(21:48):
the president under his left armpit, and three other people
in the party were wounded, including the Press secretary James Brady,
who spent the rest of his life partially paralyzed on
the left side of his body. Now, this act of
senseless violence led to a national uproar, people thirsted for
a swift and effective punishment for Hinckley. The federal trial
(22:12):
was quickly set into motion, and at the end the
jury gathered in their room with their coffee cups and
spent a long time deliberating over everything they had seen,
and they agreed that Hinckley was indeed deeply psychotic. He
was disconnected from reality and was unable to conform to
(22:32):
the requirements of the law. So on June twenty first,
eighty two, Hinckley was declared not guilty by reason of insanity.
But this pill was a jagged one for the public
to swallow, just as in Queen Victoria's Day, which I
talked about in the last episode, the air was filled
(22:53):
with outcries and citizens had just witnessed an assassination attempt
on their president, and they were enraged. They felt that
they were being denied their right to see punishment. After all,
people asked, how do we know if Hinckley truly had
an impulse that was irresistible or simply an impulse not resisted.
(23:18):
All this national anger sparked action at the congressional level. Lawmakers,
responding to all this ire came together to pass the
Insanity Defense Reform Act of nineteen eighty four. The act
stripped the insanity defense back to a simpler version. A
defendant could now escape criminalizability only if he was unable
(23:41):
to appreciate the nature and quality, or the wrongfulness of
the Act. In other words, it got rid of the
irresistible impulse prong. It brought it back to the McNaughton rules.
It got rid of the consideration of whether you were
able to appropriately conform your behavior. All that mattered now
is whether a defendant could appreciate right from wrong. If
(24:03):
there was some reason he couldn't help himself, from frontal
low problems to psychosis, he was out of luck and surfing.
On top of this wave of national anger, Congress went
even further beyond removing this volitional component. They also added
conditions to raise the bar for the insanity defense. They
specified that the defendant has to suffer from a severe
(24:26):
mental illness, and the defendant has to prove by clear
and convincing evidence the alleged insanity, which was higher than
before which was just a preponderance of evidence. So, in
addition to raising the standard of proof, the Act further
complicated things by shifting the burden of proof from the
prosecution to the defense. In other words, before Hankley, the
(24:48):
prosecution had to prove that the defendant was not insane,
but now the defendant had to prove that he was insane.
And part of the difficulty here is that a. The
central feature of psychosis is a lack of insight. So
consider the unibomber ted Kaczynski, who killed three people and
(25:10):
injured twenty three others by sending them explosives in the mail.
Although he clearly had paranoid schizophrenia, he took offense to
any suggestions or implications that he was mentally ill. He
wouldn't follow his lawyer's suggestion to take the insanity plea
because he was angered that anyone would be suggesting that
(25:32):
something was wrong with his thinking. So a lack of
insight is a hallmark characteristic of people with psychosis. They
have no discernment that something is strange about their behavior. Instead,
they believe they're seeing the world correctly while others are not.
So it's no surprise that many defendants have a mental
(25:54):
illness but will not take an insanity plea because they
see a full justification for their actions, whether that was
divine commandment or revenge for imagined political wrongdoings, or other
fantastical reasons. So I'm telling you all this to make
(26:29):
it clear that the legal definition of insanity is more
complicated than the road which began with Daniel McNaughton. In America,
if a defendant suffers from a mental disease, you might
have four different tests used in different places, and cases
can conclude very differently depending on which test is employed.
(26:52):
Some jurisdictions still use the McNaughton rule. One still uses
the Durham rule almost half free line on the broader rule.
The Federal Core and several other jurisdictions employ the Insanity
Defense Reform Act, and the state by state bespoke nature
doesn't even end there. In nineteen ninety five, Kansas abolished
(27:13):
the affirmative insanity defense and established what's known as the
mensrea approach. Under this approach, mental illness is only considered
to the extent that it prevents the defendant from having
the required mensrea or guilty mind. For example, if a
defendant knowingly commits a crime but couldn't know what she
(27:35):
was doing because of her mental illness, that would satisfy
the mens rea approach. The defendants act to judge the
wrongfulness of her acts just doesn't matter. So Kansas's decision
rose to the US Supreme Court in twenty twenty after
a guy named James Craig Kaylor killed his wife and
two teenage daughters, and his wife's grandmother. He had a
(27:59):
major depression an obsessive personality disorder, but he was not
allowed to use an affirmative insanity defense and he was
given a death sentence. So his team appealed to the
Kansas Supreme Court, and they argued that the prosecution had
violated his right to a fair trial by denying him
the right to leverage the insanity defense. But Kansas said
(28:22):
that they were within their rights to craft their insanity
defense however they chose. So this went all the way
up to the US Supreme Court, and his council argued
that a state government shouldn't be able to impose cruel
and unusual punishment, and a lack of insanity defense fit
this description. Additionally, they argued that Kansas's approach violated his
(28:46):
due process, which calls for the fair treatment by the
judicial system. They argued that ignoring this question of could
you distinguish right from wrong equated to an unfair system.
So the US Supreme Court affirmed that Kansas was not
required to take on in the sanity defense that depended
on a defendant's ability to recognize that their crime was
(29:09):
morally wrong. In other words, the court concluded that it
was the state's decision and that decisions surrounding criminal liability
and mental illness were left to them. So, as of
twenty twenty, there are four states that have committed to
the men's rea approach rather than a traditional insanity defense.
(29:29):
Here's the thing, there's no single right answer that everyone
should use, and this underscores the difficulty, both legal and psychiatric,
of deciding who is criminally liable and who is not.
And this is not just a current challenge. It's not
as though in another few decades scientists are going to
announce that we've got it all worked out. Why not
(29:52):
because humans are complex and mental life varies along many axes.
Some people suffer deep mental illnesses, and most thinkers believe
that they should be treated differently. But how do we
draw a bright line in the sand of a very
complex landscape. The legal system, after all, is forced to
(30:14):
be categorical. The judge and jury are tasked with deciding
whether a defendant is or is not insane. And the
fact is that science and the law are strange bedfellows
because science does not see things in binary categories like that.
So the legal system has been wrestling for many decades
(30:35):
about how a person's cognition and volition matter in their culpability.
But every time a famous person gets attacked, society's generous
interest in this issue gets scaled back. Why because many people,
perhaps most have little to know experience with mental illness,
and therefore they see the insanity plea as simply an
(30:59):
excuse that people people are trying for bad behavior. After all,
how would you know with certainty whether lorraina Bobbits act
was an irresistible impulse or justin urge that had not
been repelled. So with the intersection of neuroscience and law,
there is not always a clear solution. But we know
(31:20):
enough about human variation to know that the search has
to continue, and so, as it stands, different jurisdictions make
individualized choices about how they think insanity should be handled.
So what happened to Andrea Yates, the woman who drowned
her children in the bathtub. Her council pled the insanity defense.
(31:43):
They argued that she had suffered from severe mental illness,
that she'd attempted suicide many times, that she'd shuttled in
and out of psychiatric hospitals, and that she had this
belief that she was saving her children from hell by
killing them. Her plea was unsuccessful. On the one year
anniversary of her father's death, Andrea Yates was found guilty
(32:07):
of murder, but Andrea's defense counsel found reason to hope
for a mistrial. Remember, the prosecutor mentioned an episode of
Law and Order in which a woman drowned her children
in the bathtub. As it turned out, there was no
episode with that plot. Whether this was by deception or
(32:28):
just misremembering, Dietz's claim had been totally false. In two
thousand and five, Andrea's conviction was reversed because of Dietz's
false testimony. A four week retrial ensued, and this time
the jury found Andrea not guilty by reason of insanity.
(32:50):
Andrea is locked away for life, but in a psychiatric
institution where she has a roommate, she gets care, she's
on medications, the public is safe, she presents no danger
to anybody, and she can obtain the help that she needs.
So why is there a public resistance to the insanity defense. Well, first,
(33:13):
there's often this misunderstanding about the not guilty part of
the plea, and the public is often horrified by the
notion that some person, whether that's McNaughton or Hinckley, is
not culpable for a horrific crime. There's a feeling that
they're not appropriately punished for their actions if they're simply
(33:35):
sent to a cushy hospital. And also a lot of people,
especially those with no direct connection to someone with mental illness,
they think that everyone is the same on the inside,
and that the insanity defense is just an invitation to deceive. Now,
one thing to note here is that only one percent
(33:56):
of felony cases in the US involve the insanity defense.
It's not generally a part of public knowledge that this
is such a very rare plea. Instead, a lot of
people have the opinion that everyone who murderers is simply
going to plead insanity to try to get away with that,
and of those who plead the insanity defense, only about
(34:17):
thirty cases or successful each year. Even in these successful cases,
the sentences are often longer because a person can be
sentenced to a prison hospital for a long time, and
it's not uncommon that those sentences end up being worse
than prison itself. What worse means depends on the decade
(34:39):
you're in, but sometimes In these prison hospitals, a person
is kept in a drug induced stupor for the remaining
years of their life. So, in the same way that
prisons can often lead to more crime, some mental health
institutions are thought to actually worsen a psychosis. For this reason,
there was a push for the institutionalization in nineteen sixties America.
(35:04):
The country used to run a large mental health care
system of what were called insane asylums, but these asylums
proved less than perfect. In many instances, men and women
in hospital gowns led meaningless lives. They were just bodies
being kept alive. So these mental institutions were shut down
(35:25):
with plans to have a network of halfway houses and
other mechanisms to help people back into productive society, but
that part was never fully implemented, and so the shutdown
led to a large homeless population and to many of
the former inhabitants of the asylums flowing into the prison system.
(35:47):
So some people argue that the insanity defense is not
often invoked, in part because prison hospitalizations can be worse
and lasts longer than prison sentences. And there's another problem
that some scholars point to about the not guilty by
reason of insanity plea, which is that jurors find themselves
(36:08):
in a tough spot when they have to deal with
the words not guilty. After all, the person did commit
the crime, right. It turns out that when juries are
given other options, they come to more nuanced decisions. So
to this end, some states have adopted the term guilty
(36:29):
but mentally ill, and that gives an option to root
someone to mental health care while not making the jury
feel as though they're letting someone off scot free. So,
in this way, when a defendant with a psychosis shoots
somebody in the back, we can come to the slightly
more satisfying conclusion that he is guilty of the crime.
(36:51):
But there's another issue that requires consideration of the best
root forward. So how we phrase things matters. So where
is Andrea Yates today? Well, she still resides at the
Kerville State Hospital in Texas. Her husband, Rusty, went to
law school with the aim of improving the societal response
(37:13):
to the criminal behavior of mentally ill defendants and improving
the healthcare system for the mentally ill. Part of Andrea's
time in Kerville is devoted to craftmaking, the fruits of
which she sells anonymously at craft shows. Andrea donates the
majority of her earnings from the sales to the Yates
(37:34):
Children Memorial Fund. So to wrap up, we've been seeing
throughout these episodes how different people's internal models can be,
and therefore how different their realities can be. We've talked
elsewhere about synesthesia or a fantasia, or different levels of empathy,
(37:55):
or a hundred other ways that people can see the
world differently on some sort of spectrum. And for Andrea,
her internal model told her I believe quite genuinely that
her children were going to hell, and so she did
what she believed was the right thing given her reality.
(38:17):
And all of this emphasizes the complexity of putting together
billions of brains to work and live together in a
massive collaboration that we call society. Go to Eagleman dot
com slash podcast for more information and to find further reading.
(38:41):
Send me an email at podcasts at Eagleman dot com
with questions or discussions, and then making episodes in which
I address those until next time. I'm David Eagleman, and
this is Inner Cosmos.
Host
David Eagleman
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