Earl F. Rose


It is the purpose of this article to survey legally significant organic diseases that may be contributing factors in criminal conduct or lead to criminal incompetency. An exhaustive cataloging of diseases is not intended, but rather the goal is to create an awareness in the practicing attorney, who finds himself defending an individual of questionable mental stability, of the possible medical theories that may be argued in defending his client. It is hoped that the material presented herein will alert the attorney to the necessity of seeking an expert medical opinion whenever the attorney suspects that his client is suffering from some mental abnormality. The organic diseases to be considered are: (1) metabolic and endocrine disturbances; (2) infections; (3) neoplasia (cancer); (4) senility; (5) genetic abnormalities; (6) alcohol, delirium tremens, and drugs; and (7) organic brain lesions, rage reactions, and seizures. Before discussing the individual organic disease syndromes associated with altered mental function and aberrant behavior, it may be useful to briefly review: (1) the concepts of criminal competency and criminal responsibility; (2) the applicable principles of criminal psychiatry; (3) the legal tests for competency and responsibility; and (4) the level of medical certainty necessary to establish organic disease and to demonstrate a causal-connection between the disease and the criminal act.

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