Clinical Research (MacCAT–CR); MacArthur
Competence Assessment Tool for Treatment
(MacCAT–T)Further Readings
Dymek, M., Marson, D., & Harrell, L. (1999). Factor
structure of capacity to consent in Alzheimer’s disease.
Journal of Forensic Neuropsychology, 1,27–48.
Griffith, R., Dymek, M., Atchison, P., Harrell, L., & Marson,
D. (2005). Medical decision-making capacity in two
neurodegenerative disorders: Mild AD and PD with
cognitive impairment. Neurology, 65,483–485.
Marson, D. C., Dreer, L., Krzywanski, S., Huthwaite, J.,
DeVivo, M., & Novack, T. (2005). Impairment and partial
recovery of medical decision-making capacity in traumatic
brain injury: A six month longitudinal study. Archives of
Physical Medicine and Rehabilitation, 86,889–895.
Marson, D. C., Ingram, K. K., Cody, H. A., & Harrell, L. E.
(1995). Assessing the competency of patients with
Alzheimer’s disease under different legal standards: A
prototype instrument. Archives of Neurology, 52,949–954.CAPACITY TOWAIVE
MIRANDA RIGHTS
Prior to interrogating a suspect, police officers must
inform individuals of their legal rights. Mental health
professionals are frequently called on to evaluate the
extent to which criminal suspects have understood their
legal arrest rights and made valid decisions with respect
to waiving those rights. For individuals to knowingly,
intelligently, and voluntarily waive their rights, they
must both understand and appreciate those rights.
Research has consistently indicated that rights compre-
hension is significantly more impaired for younger
adolescents than for older adolescents and adults.
Furthermore, comprehension is most impaired among
younger adolescents with lower intellectual abilities.MMiirraannddaa Warnings
Miranda v. Arizona(1966) required states to inform
suspects prior to interrogation or questioning of sev-
eral rights, which includes informing them of their
right to remain silent, that anything they say can be
used against them in a court of law, their right to the
presence of an attorney, and the right to free counselif they cannot afford the cost of an attorney. These
warnings were viewed as strengthening an individ-
ual’s protection against self-incrimination during
police interrogation. The rights provided to adults in
Mirandawere extended to juveniles in the cases of
Kent v. United States(1966) and In re Gault(1967).
For those individuals who opt to waive these rights
and undergo interrogation, any statements they make
can be admitted as evidence against them in future
court proceedings provided that the waiver is valid.
While the specific rights guaranteed to suspects
prior to arrest and interrogation are outlined in
Miranda,the specific wording and language employed
in rights warnings vary between jurisdictions and
police forces. Each warning typically contains the
four prongs outlined in Miranda. A fifth warning
prong has been added in many jurisdictions, which
informs suspects that they can choose to stop ques-
tioning and consult with an attorney at any time.
Additionally, some jurisdictions have included cau-
tionary statements to juveniles regarding the possibil-
ity of having their case remanded to adult court or
serving an adult sentence. Research has demonstrated
significant variability in the language and readability
of Miranda warnings across states, with Flesch-
Kincaid Grade reading levels ranging from 4.0 to 9.9
in one study. The typical Miranda warning is at about
the seventh-grade reading level, which is above the
reading level of many intellectually impaired individ-
uals. Also, the reading level of many adolescents in
the juvenile justice system is below that of their peers.
Many states employ separate Miranda warning cards
for juveniles in an effort to simplify the warnings and
increase comprehension.
Statements made by individuals who have waived
their rights can be ruled inadmissible if a judge deter-
mines that certain conditions have not been met.
Several U.S. Supreme Court decisions have estab-
lished a totality of circumstancestest for evaluating
the validity of a rights waiver decision. This requires
the court to consider both the suspect’s capacities and
the procedures and circumstances surrounding the
waiver. This includes whether the individual know-
ingly, intelligently, and voluntarily waived his or her
rights. The knowing component requires understand-
ing verbally or in writing the wording used in the
warning. The intelligent component goes beyond sim-
ple understanding and requires that a suspect appreci-
ate the significance of a particular right in his or
her particular situation. For example, suspects may56 ———Capacity to Waive MMiirraannddaa RightsC-Cutler (Encyc)-45463.qxd 11/18/2007 12:41 PM Page 56