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ARTICLE |

Tighten but Do Not Discard

Loren H. Roth
JAMA. 1984;251(22):2949-2950. doi:10.1001/jama.1984.03340460027019.
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ALTHOUGH the Hinckley verdict brought the insanity defense under attack, controversies about insanity have raged for a long time. Because the defense touches on the symbolic and practical functions of the criminal law (and ultimately on our individual, deeply held views about justice) it is not surprising that professional organizations, legislatures, and the informed public recommend differing pathways to reform. Reasonable men differ in their views about the insanity defense. While medicine as a whole has some role to play, the most important considerations are those of social policy and our moral sentiments about what is fair and just. In its 1982 Statement on the Insanity Defense, the American Psychiatric Association (APA) recommended a somewhat different future course than does the American Medical Association. However, it is important to note agreements between the positions of these two medical organizations. Both the AMA and the APA agree that the insanity defense

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