Facing the Interface: forensic psychiatry and the law

As we know from history, in court cases experts used to be called in when the defendant showed symptoms of a psychiatric illness. This was necessary, as the law itself did not provide rules about how to define abnormality. Mental illness needed an explanation for it to fit into the framework of the criminal justice system. With the emancipation of the empirical psychology and progress in the examination of patients’ brains with modern imaging techniques, a separation has developed between the naturalistic man-oriented view of offending, and empiricism, in which facts are true if they are measured with reproducible tests. This is the case with judicial rulings about responsibility for a crime, the presence of illness at the time of the offence and the risk of recidivism concerning the length of treatment of mentally ill offenders and their targets. These aspects in the debate between the court and expert witnesses are discussed separately. The conclusion is that the field of law has been extended into the field of empirical sciences for more objectivity, and that the influence of these sciences on juridical reality can play an auxiliary role only. It is therefore necessary that judges and lawyers be trained in the use of empirical data. Still, forensic reality requires an interpretation, in which the forensic psychiatrist has different loyalties to the relevant parties in the court proceedings. But he is above all a medical man with ethical restrictions.