The Role of Clinical Psychiatrists in Forensic Evaluations of Legal Sanity

The assessment of criminal responsibility is complex and challenging. In the article “Reliability of repeated forensic evaluations of legal sanity” [1] we found that criminal responsibility was changed at least once in subsequent assessment in 32(27.3%) out of 117 cases. One possible explanation is, that the assessments issued by psychiatrists not employed by courts, were placed on an equal footing with opinions issued by forensic experts. These assessments, given by clinical psychiatrists, were often contrary to forensic opinions and led to the uncertainty of the court. Furthermore, due to academic and professional position of these psychiatrists, these opinions were frequently difficult to challenge by forensic experts. It resulted in prolonged proceedings, increases in costs, and especially created a possibility of legal sanity change. Clinical psychiatrist should be conscious, that every psychiatric certificate can be used for insanity defense in criminal proceeding. Every psychiatrist examining a defendant may potentially influence the final diagnosis and hence the evaluation of the defendant’ legal sanity, even if the psychiatrist does not directly participate in court proceeding.