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Since 1843 most British and U.S. courts have followed the M'Xaghten Rule: an accused is "sane" (a legal rather than a psychiatric term), and therefore responsible for his criminal acts, unless at the time of the crime he did not know what he was doing or did not know that it was wrong. But since 1954 the law and psychiatry have been wrestling with an attempt by the U.S. Court of Appeals in the District of Columbia to liberalize the definition of "sanity" as a measure of criminal responsibility. Under this court's Durham Rule,* an accused is not responsible, and therefore not required to stand trial, if at the time of his crime he was suffering from a "diseased or defective mental condition" and the crime was a "product" of this condition.
Though the Durham Rule was designed to bring the law in line with modern psychiatric thinking, it proved as disturbing to many psychiatrists as to lawyers. Baltimore's famed Forensic Psychiatrist Manfred S. Guttmacher last week offered an explanation. The rule's broad implications, he said, presage a socio-psychiatric revolution as sweeping as that of 1792. when Philippe Pinel struck the chains from the mentally ill in Paris asylums. Many of his colleagues. Dr. Guttmacher intimated, fear a change because of their own deficiencies.
Labels Are Not Enough. The Durham court has held that "unexplained medical labels—schizophrenia, paranoia, psychosis, neurosis, psychopathy—are not enough." The psychiatrist called as an expert witness must explain also the development of the disease and how it affected the accused's behavior. This. Dr. Guttmacher said politely, is "a challenge which, I fear, few psychiatrists are equipped to meet." Encouraging progress was reported from California, where San Francisco's Dr. Bernard Diamond has helped to change the administration of justice by winning acceptance in the courts of the principle of "diminished responsibility." This is a grey shade between M'Naghten's black and white, leaves judges more latitude. As one of the two psychiatrists on a new ten-man state commission on "problems of insanity relating to criminal offenses," Dr. Diamond said he will propose that diminished responsibility be put into law. Then, after sentencing, a special board, with plenty of psychiatric help, should decide where each convicted offender should be kept and what treatment he should get. All sentences should be indeterminate.
Such a compromise course seemed the only way out for the psychiatrists. Wisconsin's Dr. Seymour L. Halleck complained that extremists like Washington's Karpman who say "there are no criminals, only the insane" are making it "more difficult for the rest of us who want to make practical progress gradually."
*Named (as was the M'Xaghten Rule) for the defendant in the case: Monte Durham, a smalltime robber and housebreaker.