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Medication Noncompliance and Criminal Responsibility: Is the Insanity Defense Legitimate?

Zachary Torry


Kenneth J. Weiss

University of Pennsylvania

December 1, 2012

Journal of Psychiatry & Law, Vol 40, Summer 2012

Noncompliance with medication therapy and mental health care is prevalent among the mentally ill. Its multifactorial dynamics can include aspects of the illness itself, such as anosognosia. Noncompliance with medication can increase risk of violent or other criminal behavior, but the law currently does not recognize it as a factor in determining culpability. The legal test of insanity that focuses on a “defect of reason from disease of the mind” presumes that the disease was not self-induced. Noncompliance with medication and voluntary intoxication can both be seen as self-induced incapacities, but their adjudication is often quite different. A psychotic condition may be the basis of an excuse, whereas simple intoxication is not. The distinction is not only the obvious one of acts of omission (medication noncompliance) and acts of commission (voluntary intoxication). There are other complicating factors, such as the knowledge of the effects of noncompliance, the mental state prior to the noncompliance, and the presence of any conditions that would excuse or justify it. These and other considerations render the assignment of criminal responsibility for the noncompliant psychiatric offender complex. A possible solution to this would be the application of therapeutic jurisprudence to the noncompliant mentally ill offender.

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Date posted: December 3, 2012  

Suggested Citation

Torry, Zachary and Weiss, Kenneth J., Medication Noncompliance and Criminal Responsibility: Is the Insanity Defense Legitimate? (December 1, 2012). Journal of Psychiatry & Law, Vol 40, Summer 2012. Available at SSRN: https://ssrn.com/abstract=2183814

Contact Information

Zachary Torry
Independent ( email )
Kenneth J. Weiss (Contact Author)
University of Pennsylvania ( email )
3535 Market St
Room 3045
Philadelphia, PA 19104
United States
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