Ethical and Legal Issues 723
have a mental defect. And what about someone with antisocial personality disorder
(or psychopathy)—might the disorder make that individual able to use the insanity
defense? Moreover, how could the court decide whether the criminal behavior was
caused by the disorder or defect (Greene et al., 2007; Meyer & Weaver, 2006)? This
drawback is so signifi cant that most states use other defi nitions of insanity; only
New Hampshire still uses the Durham test (Wrightsman & Fulero, 2005).
The American Legal Institute Test
To address some of the thorny issues that arose from the Durham test, the American
Legal Institute (ALI) proposed two alternative criteria for insanity:
- The person lacks a substantial capacity to appreciate that the behavior was
wrong (versus has no capacity); or - the person has a diminished ability to make his or her behavior conform to the
law, that is, an irresistible impulse.
These elements comprise the American Legal Institute (ALI) test, and are some-times referred to as knowledge (cognition) andimpulse (volition) criteria. The ALI
test broadened the test for insanity because it provided these two possible criteria
(Greene et al., 2007; Meyer & Weaver, 2006). The ALI test also specifi ed that if an
individual’s only defect or disorder is criminal behavior, the insanity defense cannot
be used. This prevented people with antisocial personality disorder (or psychopa-
thy) and people whose only crime is using illegal substances from using these prob-
lems as the basis for an insanity defense. The ALI test, or defi nition, continues to be
used by many states.
Insanity Defense Reform Acts
In federal courts, the insanity test changed again in 1984 as a result of John Hinck-
ley’s 1981 assassination attempt of then-President Ronald Reagan and Hinckley’s
subsequent acquittal as not guilty by reason of insanity. Hinckley was a young man
with a history of mental illness; he reported that he shot the president in order to
impress actress Jodie Foster, about whom he had obsessive delusions (erotomanic
delusions, described in Chapter 12). In addition to wounding Reagan, Hinckley also
shot the president’s press secretary (who suffered brain damage and paralysis), as
well as a Secret Service agent and a police offi cer.
The jury found Hinckley insane on the basis of the im-pulse (volition) element of the ALI test. This means that the
jury decided that Hinckley knew it was wrong to shoot
the president, but that he was not able to restrain himself.
He was sent to a psychiatric hospital, not prison. The fact
that Hinckley would serve no prison time greatly disturbed
some lawmakers, who, through the Insanity Defense Re-
form Acts of 1984 and 1988, proceeded to restrict the test
for insanity. The new test for insanity, used only in fed-
eral court, is most similar to the M’Naghten test—it asks
whether the individual, because of a severe mental defect
or disorder, has a diminished capacity to understand right
from wrong (cognition). In an effort to make it more dif-
fi cult to enter a plea of NGBI, Congress also put an end to
the irresistible impulse element (volition) in federal courts.
Defendants with mental retardation, psychotic disorders,
or mood disorders may qualify for the insanity defense un-
der these new rules, depending on the circumstances of the
crime and the defendant’s state of mind at the time, but
having a disorder in and of itself does not constitute an
insanity defense. Table 16.2 provides an overview of the
various tests of insanity, and Case 16.1 describes a woman
who entered a plea of insanity in a murder case.
John Hinckley developed an obsessive preoccupation with actress Jodie Foster and
repeatedly tried to communicate with her by phone and letter. After his attempts
were rebuffed, he developed the delusional belief that assassinating President Ron-
ald Reagan would impress Foster and induce her to pay attention to him. In 1981, he
acted on that belief and shot the President and three other people.AFP/Getty ImagesIrresistible impulse test
The legal test in which a person is considered
insane if he or she knew that his or her
criminal behavior was wrong but nonetheless
performed it because of an irresistible
impulse.Durham test
The legal test in which a person is considered
insane if an irresistible impulse to perform
criminal behavior was due to a mental defect
or disorder present at the time of the crime.American Legal Institute test (ALI test)
The legal test in which a person is considered
insane if a defendant either lacks a
substantial capacity to appreciate that his or
her behavior was wrong or has a diminished
ability to make his or her behavior conform to
the law.