Just what exactly constitutes a mental disorder and what makes someone criminally insane is an issue that has garnered much debate in recent years. With the release of proposed revisions to the DSM, the Diagnostic and Statistic Manual of Mental Disorders, even more attention has been given to the issue, as the fifth edition of the publication is said to be released in May of 2013. A recent blog posting in the Neuroethics & Law Blog, discusses some of the controversies regarding the revisions and its implications in the legal field. One common fear is that the new DSM includes too broad a range of conditions as mental disorders, such as “premenstrual syndrome,” which the blog comments is defined as: “a physiological conditions experienced by all women.” Clearly, including “PMS” as a mental disorder seems pretty extreme.
These same concerns are also expressed in an article by The Washington Post titled “Revision to the bible of psychiatry, DSM, could introduce new mental disorders.” This article comments on the fact that quirky teens can be diagnosed with “psychosis risk syndrome” and children with bad temperaments can be classified by “temper dysregulation with dysphoria.” Essentially some of these diagnoses just seem absurd and spark the question: then what’s normal? This distinction is important seeing that, in large part, the DSM goes to define what’s included in the spectrum of natural behavior and what’s not. Furthermore, nowadays, the DSM is utilized in many sectors of society including use by clinicians, national health agencies, private companies, policy makers, and legal authorities, which means that alterations to these standards affect each and every one of these sectors.
Looking into the effects of the DSM revision to the criminal justice system, it seems such changes will weigh heavily on the issue of culpability. As more conditions are brought under the umbrella of mental disorders, there are more “exemptions” given from culpability. The opinion of many psychiatrists and philosophers today is that criminal actions performed by individuals who qualify for a disorder under the DSM-5 should not be considered criminal since they are products of neural disorders that said individuals couldn’t control. Essentially, the reasoning is “it’s not their fault,” but where is the line drawn? As those boundaries are widened, some defenses just seem ridiculous. For example, an article by CNN titled “Murder defense: Too much caffeine,” talks about the trial of a man in Newport, Kentucky, Woody Will Smith, who killed his wife and claimed the defense of too much caffeine! His lawyer argued that an excessive amounts of soda, caffeine-laced diet pills, an energy drink, and sleep deprivation resulted in his committing the crime, therefore, he is not responsible. The aim by defense attorneys was to conclude that the defendant was suffering from a temporary psychotic disorder, but should too much caffeine really lead to a lighter sentence for a man who, with his bare hands, strangled his wife with an extension cord?
In my opinion, a key factor differentiating Smith’s situation from other individuals suffering from psychotic disorders is the fact that he brought this “caffeine-delusional” state upon himself and so his culpability for his actions should remain the same. If such a defense is permitted, then it could easily lead to others plotting criminals act than purposely placing themselves under a caffeine-excessive condition to receive a reduced sentence for their actions. For such reasons, there are obvious complications with broadening the definition of mental and psychotic disorders. The bottom line then is where do we draw the line?