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January 31, 1992

Transcript # 499

Sane or Insane - The Insanity Defense


Forensic psychiatrist Dr. Richard Ratner and Richard Vatz of Towson State University debate whether the insanity defense should be disallowed in light of the Jeffrey Dahmer case.

ANNOUNCER: From Washington, Crossfire. On the left, Mike Kinsley. On the right, Robert Novak. Tonight, Sane or Insane? In the crossfire, forensic psychiatrist Richard Ratner. And Richard Vatz of Towson State University.

MIKE KINSLEY: Good evening. Welcome to Crossfire. Jeffrey Dahmer has admitted killing 17 people and doing grotesque things with the bodies, but his lawyer is arguing that he should not go to jail because he was insane.

GERALD BOYLE, Defense Attorney: This is not an evil man, this was a sick man whose sickness rose to the level of mental illness.

KINSLEY: No one would call cannibalism and necrophilia sane behavior but should the very depravity of the acts mean the murderer goes unpunished? If the jury finds Dahmer sane he goes to jail for life, if he's found insane he could be released from the mental hospital in as little as a year. Less than 1 percent of all felony cases involve an insanity plea and three times out of four it doesn't even work, but when it does, as it did for John Hinckley, would-be assassin of President Reagan, there is public outrage. Is there such a thing as being too crazy to be guilty? Bob?

ROBERT NOVAK: Dr. Ratner, let me get this straight. Is it a fact that if a psychiatrist such as yourself goes into court and says that this beast was pursued by Satan, in other words the devil made him do it, there's a chance he might get off as not guilty by virtue of insanity?

Dr. RICHARD RATNER, Forensic Psychiatrist: There is indeed such a chance, yeah.

NOVAK: Doesn't that appall you?

Dr. RATNER: No, it doesn't necessarily appall me at all.

NOVAK: Why not?

Dr. RATNER: Because if somebody commits a crime but does not do it with intent, does not do it on purpose, does it because of a mental illness that makes him not recognize that he's doing something criminal, then society in general believes that people like that should not be punished.

NOVAK: All right. Let's say you examine this person, this Dahmer, and he says, Dr. Ratner, you know, I didn't want to do these things but there was this devil whispering in my ear. You'd take his word for it?

Dr. RATNER: I wouldn't put it that simply. I- it's-

NOVAK: Well, you either do or- there's no corroborating witnesses, I mean, I don't think you're going to get the devil in there.

Dr. RATNER: No, that's true but that is only about a five second portion of the kind of extensive mental examination that I would perform.

KINSLEY: Mr. Vatz, isn't there such a thing as being too crazy to know what you're doing, too crazy to know right from wrong, too crazy to control your actions and isn't it such a person who is that crazy not morally culpable, not morally guilty in the way we normally think of guilt in this society?

RICHARD VATZ, Towson State University: Well, you've asked a lot of questions at once. I think the insanity plea goes to the issue as to whether people have control over their behavior. People can certainly be crazy and still have control over their behavior.


Mr. VATZ: One of the problems I have with this concept and one of the problem with Dr. Ratner's response is that we can measure the ability to control behavior. As a matter of fact, one of the questions I'd like to ask Dr. Ratner is how he can maintain psychiatrists have the ability to measure-

KINSLEY: But before we get to that, I'd like to just get you on the record. Is it possible- is it not possible to be so crazy that you really can't control you behavior, you don't know what you're doing, you don't know right from wrong?

Mr. VATZ: I think you could contrive a situation, maybe even find-

KINSLEY: Aren't there such people who exist?

Mr. VATZ: Right, well, I'd like to answer your question. I think you can probably find people that we would agree cannot rightfully be said to understand the nature of what they do, which is called the cognitive component of the insanity plea, or maybe even can't control it. I don't think you need psychiatrists and I don't think psychiatrists can ascertain which people can or can't control their behavior.

Dr. RATNER: But I was-

KINSLEY: Who will if not psychiatrists?

Mr. VATZ: Well, let me make the point that I'd like to hear Dr. Ratner respond do because the American Psychiatric Association itself in 1983 in its statement on the insanity disavowed the ability of psychiatrists to ascertain whether people could control their behavior. Consequently how can Dr. Ratner maintain that psychiatrists have this ability when the APA itself denies it has the ability.

NOVAK: That's a good question. What's the answer?

Dr. RATNER: I think that misstates what the APA has said. The APA did discuss the difference between the different prongs of the insanity defense as they were used at the time and said that our ability to gain evidence about the volitional prong was not nearly as good as our ability to gain some knowledge about the cognitive prong.

Mr. VATZ: Let me quote you from the statement. The statement said that the ability to discern between an irresistible urge and resisting the urge is the difference between- is the difference that is almost absolutely so fine that nobody could make the distinction. As a matter of fact the words they used were the difference between twilight and dusk.

Dr. RATNER: Well, nobody pretends that in any but the most obvious cases that you yourself conceded exist and probably exist about one quarter of 1 percent of the time at least-

KINSLEY: Which is how often this defense is used successfully.

Dr. RATNER: Exactly. It is one of those situations where you have to make a decision with imperfect knowledge-

Mr. VATZ: You-

Dr. RATNER: Let me point out that it was not American psychiatry that cooked up the insanity defense. The insanity defense has a long history that grows out of society's response.

Mr. VATZ: Fine, so, why not disavow it? Why can't the American Psychiatric Association's members as the association did itself in the insanity plea take the same position that the American Medical Association has taken, that the American Bar Association has taken and disavow it?

NOVAK: Well, let me- I want to get back to Jeffrey Dahmer and away from the psychiatric association for a moment. Jeffrey Dahmer is a guy who really as far as this brutal nauseating behavior was concerned, he was very well organized, wasn't he?

Dr. RATNER: It would appear that way.

NOVAK: All right. Now, if he- he seems to be pretty intelligent from what you've seen, can't you say that?

Dr. RATNER: At least of normal intelligence from what we know.

NOVAK: And I think he sees a guy like you coming in to investigate him, I think perhaps he doesn't want to- I think he's smart enough to know he's got one chance of beating this and that's the insanity plea. Do you think he is not above fooling you in making you think that by your own standards-I don't know what the standards of insanity are, I want to get that in a minute-don't you think he's got a good chance of conning you, Dr. Ratner?

Dr. RATNER: Before I even answer that I want to say that the insanity defense is not 'beating it.' The big question here as most commentators have said is not whether he will get off or be in prison; the question is whether he will be confined in a hospital or whether he will be confined in prison.

NOVAK: But that's disingenuous, Dr. Ratner, 'cause you know that the minute he gets into the hospital people are going to start saying, hey, he's not insane anymore and he can get released, can't he?

Dr. RATNER: It is a theoretical possibility, Bob, but the likelihood of that happening is about as likely as it is that John Hinckley would have gotten out-

KINSLEY: Isn't that what-

NOVAK: Well, don't- talk about-

KINSLEY: Let's get into that. Isn't that true? We start out with the fact that one out of 100 people even try this defense, we go on with the fact that only one out of four of them get away with it, to use the term you don't like. So, you got one out of 400. Of those, they all go to the mental hospital, how many of them ever get out without long, long time served?

Mr. VATZ: You know, I hear this argument all the time.

KINSLEY: Well, give me an answer.

Mr. VATZ: Well, I'll tell you the answer. It's so raised so infrequently why worry about it? Well, Dahmer's kinds of crimes are committed so infrequently, why worry about it? But let me also quote a statement by Irving R. Kaufman, former chief judge of the United States Court of Appeal for the Second Circuit, who said that the statistical infrequency of the insanity plea and its use, quote, 'belie the true impact the insanity defense has on our criminal justice system and the public faith in-

KINSLEY: Maybe I didn't make myself clear. I was asking a different question. When someone successfully pleads the insanity defense and is sent away like Hinckley to a mental institution, how often do they get out after just a few years? Don't they in practice spend many, many years in jail?

Mr. VATZ: In fact, Hinckley was given weekend passes-

NOVAK: We're going to talk about Hinckley in the next section, but no, I think the fact is- he is asking, does anybody ever get out and the answer is yes, of course, they do.

KINSLEY: How often?

Mr. VATZ: Incidentally-

NOVAK: How often?


NOVAK: It's irrelevant how often.

Mr. VATZ: You can ask Dr. Ratner for a statistic on how often.

Dr. RATNER: I don't think that that's a sign that there's anything wrong with the insanity defense. If a person commits a crime when he is psychotic and he gets better, he ought to be let out.

NOVAK: Dr. Ratner, isn't it a fact that in modern psychiatry the concept of being insane is obsolete? In other words, if Dahmer came to you and he had- you didn't know he killed anybody and he said, I have Satan talking to me, you wouldn't say, hey, boy, you are insane, you've got to go to a mental hospital. You wouldn't say that, would you?

Dr. RATNER: I wouldn't in part because insanity is not a psychiatric term, it's a legal term.

NOVAK: Well, that's what's ridiculous and you've got people like you, psychiatrists going into the legal system and saying the guy is insane when we know that modern psychiatry doesn't even recognize insanity, does it?

Dr. RATNER: It's not a matter of recognizing. Insanity is not a psychiatric concept. Insanity means something-

Mr. VATZ: So, why do psychiatrists willingly participate endlessly attesting to whether a person is insane? If it's not a psychiatric concept, why don't psychiatrists refuse to so testify?

KINSLEY: Let him answer.

Dr. RATNER: I think that it is our responsibility to go to court so that we can present to a jury enough psychiatric information and expertise so that they can make decisions.

NOVAK: All right. We've got to take a break right now, and when we return we'll go to that fellow that everybody thinks about when it comes to insanity defense, the man who tried to kill Ronald Reagan, Mr. Hinckley.

[Commercial break]

NOVAK: Welcome back to Crossfire. Nobody denies Jeffrey Dahmer is a brutal heartless serial killer, but his lawyers say he is not guilty of a crime because he's insane, just as a court decided that John Hinckley, the attempted assassin of Ronald Reagan, was not guilty by virtue of insanity. Opposing the insanity defense is Professor Richard Vatz of Towson State University who is also associate psychology editor of U.S. Today magazine. Defending the insanity defense is Dr. Richard Ratner, a psychiatrist who is clinical professor at George Washington University School of Medicine. Dr. Ratner, be one of the regular guys for once. There is not a thing mentally ill with John Hinckley. He was just a bad dude with an obsession for Jodie-what's her name?-Jodie Foster, the movie actress, isn't that right?

Dr. RATNER: I wouldn't say that. I don't know whether I personally would have found him insane but it was a jury decision and I think he may well have been found insane, not because of what the psychiatrist said, Bob, but because of where the burden of proof was in that matter.

NOVAK: Well, isn't it a fact, though, that the psychiatrist who testified, he had no knowledge of what Mr. Hinckley thought when he was talking Ronald Reagan, when he was writing letters to Jodie Foster. The only thing he knew is what people like you are paid to come into court and tell the court. That's the sole knowledge of the jury, isn't that correct?

Dr. RATNER: Well, there's no way of actually getting into the mind of a person when he committed a crime three months ago or six months ago, but there's a lot of other stuff that you can tell about him by-

NOVAK: Well, I-

Dr. RATNER: -reviewing his history, by talking to him extensively, by performing psychological tests-

NOVAK: But if he's a bad dude, if he is a guy, as Hinckley was, who had caused a lot of trouble- I mean, I knew a lot of bad dudes back in my home town, I thought they were nuts, but if they went and killed my mother or my father I would sure want them to fry. I wouldn't want them to go- to say they're insane. What's the difference?

Mr. VATZ: The Hinckley case, by the way, is a good example of the extent to which forensic psychiatrists unlike Dr. Ratner will go to to make a case. The major psychiatrist testifying-

NOVAK: You're saying he's a good guy?

Mr. VATZ: I think he's a good guy.

NOVAK: All right.

Mr. VATZ: But the major psychiatrist testifying for the defense went over the diagnostic and statistical manual description for schizophrenia with John Hinckley before John Hinckley testified. Another psychiatrist tried to bring in pictures of Hinckley's brain sulci saying that the distance of his brain sulci indicated that he was- he has process schizophrenia.

NOVAK: What did you think of that?

Dr. RATNER: I think that there- he raised an important point and there is more and more information available that there are differences in the brain structure of schizophrenics.

KINSLEY: Let me take-

Mr. VATZ: That's not true.

NOVAK: He's a witch doctor.

Mr. VATZ: There is no specific neurophysiological or neurochemical reality that is specific to schizophrenia.

KINSLEY: Wait a minute.

Mr. VATZ: Not even schizophrenia researchers indicate that.

KINSLEY: Let's keep this on a layman's level.


KINSLEY: And I want to do what they call in law school salami slicing, taking a bunch of examples just to help us flesh out-

NOVAK: Oh, boy.

KINSLEY: -flesh out what is and is not insane.

Mr. VATZ: You should tell him that a month before tuberculosis bacillus was discovered, people were still attributing tuberculosis to personality and to-


Mr. VATZ: -and to climate and to attitude.

KINSLEY: Let's talk about the brain.

Mr. VATZ: And then they discovered the cause.

Dr. RATNER: Yeah, but that's not-

KINSLEY: Isn't it possible that someone could have actual physical brain damage to the extent they can't control their behavior?

Mr. VATZ: Yes.

KINSLEY: And if someone who had that kind of brain damage-

Mr. VATZ: Hey, we think of someone who- responsible for their behavior-

KINSLEY: So- committed a crime, you would say that person is not guilty?

Mr. VATZ: Well, I think-

NOVAK: Would you-

Mr. VATZ: -you contrive an oversimplified case. If you give me an actual example of a case- are you saying, for example, a person who has Alzheimer's and a person goes out-

KINSLEY: I'm saying a guy who was in a traffic accident, banged the front of his brain, lost a bit of it, as a consequence is subject to violent rages and commits a crime. Wouldn't you that person is-

NOVAK: He should go to prison, don't you think?

Mr. VATZ: In this completely atypical contrived example you give-

KINSLEY: This is called legal- this is called analytical reasoning.

NOVAK: Give him the answer.

Mr. VATZ: You could probably bring in a neurologist. What you have no need of is a psychiatrist attesting to completely nonmedical circumstances.

KINSLEY: Mr. Vatz-

Mr. VATZ: No, it's very important to make this point, Mr. Kinsley, and that is the example you give actually involves measurable neurological damage.

KINSLEY: All right, let's-

Mr. VATZ: All of these insanity cases involve no measurable neurological damage.

KINSLEY: -keep going. Is it not possible that someone without having been in a traffic accident is so crazy-

Mr. VATZ: Manifestly out of it, yes, and you don't need psychiatrists for that sort of testimony. You could have the jury make that determination without psychiatrists.

NOVAK: All right.

KINSLEY: Why is it-

NOVAK: I want to ask-

KINSLEY: Why shouldn't the jury- the jury does make the determination, they are free to decide whatever they want, why shouldn't they have the added testimony of experts-

Mr. VATZ: Because-

KINSLEY: -whatever that experts-

Mr. VATZ: Because psychiatrists are not expert in assessing the extent to which people can control their behavior and the better psychiatrists admit that.

NOVAK: All right. I want to ask a- I want to try to find out how the system works. If I am a lawyer watching this program tonight, I see you, you're a really impressive man, and I've got a guy who has just killed three or four people. Can I call you up and say, will you examine my witness and go into court?

Dr. RATNER: Absolutely.

NOVAK: Would you do that?

Dr. RATNER: Absolutely.

NOVAK: How much would you charge?

Dr. RATNER: It depends on the circumstances.

NOVAK: Well, roughly, give me a ballpark figure.

Dr. RATNER: I'd say anywhere from $ 150 to $ 250 an hour.

NOVAK: You make a substantial part of your living doing that, don't you? I mean, you and a lot of psychiatrists, isn't that correct?

Dr. RATNER: Yeah.

NOVAK: And so the question is there is a vested interest by your profession in going into court and testifying on an issue that you say is medically irrelevant, whether the man's insane or not. Nobody- no psychiatrist would say, gee, this guy's insane.

Dr. RATNER: I didn't- no, I didn't say it was medically irrelevant, I just said that insanity is not a medical term. What is the difference between a psychiatrist going into court and allowing the jury the benefit of his expertise and any other kind of expert from going into court?

KINSLEY: That's-

Mr. VATZ: Because psychiatrists have no expertise.


Mr. VATZ: And psychiatrists admit that if you read what they write.

Dr. RATNER: That-

NOVAK: Are you a Freudian?

KINSLEY: He doesn't admit that.

Mr. VATZ: It's right in the APA's own statement on the insanity defense.

KINSLEY: Look, I don't agree with everything some society of journalists might say, why are psychiatrists so-

NOVAK: Because the difference is not analogous. Are you a Freudian?

Dr. RATNER: Very few people are Freudians anymore. Most people are updated versions-

NOVAK: Is that a no or a yes?

Dr. RATNER: It's a question- no.

KINSLEY: All right. On that note, let's take a break. When we come back, we'll talk about: aren't one out of 400 people crazy anyway?

[Commercial break]

E. MICHAEL McCANN, Prosecutor: You will see one of the tests we'll talk about is whether he knew it was right or wrong. Mr. Boyle did not address that issue because I don't think there's really much dispute about that issue at all. I think you will find from the evidence that Mr. Dahmer knew at all times what he was doing was wrong.

KINSLEY: Mr. Vatz, less than one out of 400 people who are tried on felonies get off on the grounds that they're insane. I must tell you, looking around Washington it strikes me that more than one out of 400 people simply walking around the streets are insane. It doesn't seem to me, therefore, that this is a terrible social problem that people are getting off when they shouldn't have, just the law of averages.

Mr. VATZ: Well, the fact that an outrage is infrequent doesn't mean it's not significant and secondly-

KINSLEY: But I'm saying it's not an outrage at all if only one out of 400 people who commit heinous crimes is determined to be insane, looking around it looks like one out of 400 people who don't commit heinous crimes is insane.

Mr. VATZ: Well, tell that to Dahmer's victims. I mean, you know, when one out of a city is randomly shot, we don't say, well, it's so few, why worry about it? But I want to tell you something else about-

KINSLEY: But you agree with me that if they were truly, genuinely- if he was truly and genuinely unable to control his actions, unable to know right from wrong, then he isn't guilty and he shouldn't be punished, don't you?

Mr. VATZ: Well, that's right but that doesn't have to do with the accuracy of the determination.

NOVAK: Dr. Thomas Szasz does not agree with that, of course.

Mr. VATZ: No, he doesn't and I-

NOVAK: And I agree with him.

Mr. VATZ: And there's another interesting statistic on that. Do you know that the American Psychiatric Association's official orthodoxy indicates that 38 percent of all Americans at some point in their life are mentally ill.

KINSLEY: You were just praising the APA as the word of God a while ago. Now, you're saying they're nonsense.

NOVAK: All right. Dr. Ratner-

Mr. VATZ: When they make reluctant testimony-

KINSLEY: So, in other words you agree with them when they say things you agree with and you disagree with them when they say things you disagree with?

NOVAK: All right.

Mr. VATZ: Well, of course when they make a concession it's important.

NOVAK: Doctor- go ahead.

Dr. RATNER: I don't know why Mr. Vatz has a thing for the American Psychiatric Association or about psychiatry in general. You mentioned Dr. Thomas Szasz, he doesn't believe in the notion of mental illness.

NOVAK: I don't either.

Dr. RATNER: Nothing could be more absurd than that.

NOVAK: I don't- I want to ask you this. You know, Henry Hill wrote this book about the mob, they made a movie out of it, Good Fellas, and the interesting thing about it was the wanton killing and the actual lust of these hoodlums. They really liked to kill people, beat them up, kick them to death, shoot them in the head. Do you- don't you think that under your standards that could be determined as legal insanity?

Dr. RATNER: It's doubtful unless a jury is convinced that the person committing the crime did not realize that he was doing something wrong at the time.

NOVAK: You mean-

Dr. RATNER: Or that he couldn't control himself.

NOVAK: But they- not control himself? That's the big 'or,' that's the big 'or' because Hinckley surely knew he was doing something wrong. The only insanity you can get is that he couldn't control himself which I think is absolute bull.

Mr. VATZ: How much difficulty, Dr. Ratner-

KINSLEY: All right, last word.

Mr. VATZ: -would anybody find in securing a forensic psychiatrist to testify that he in fact was insane, how much difficulty honestly?

KINSLEY: Answer quickly, please.

Dr. RATNER: You would find little difficultly retaining somebody-

Mr. VATZ: That's right.

Dr. RATNER: -to examine him. Anybody who's worth his salt-

Mr. VATZ: And to testify-

Dr. RATNER: -will testify only to what he feels.

Mr. VATZ: You know better.

NOVAK: Feels, feels?

KINSLEY: All right.

NOVAK: It's emotional.

KINSLEY: Calm down.

NOVAK: It's emotional-

KINSLEY: All right.

NOVAK: That's an interesting comment.

KINSLEY: You don't believe in mental illness, calm down, Bob, please. Thank you, Mr. Vatz. Thank you, Dr. Ratner. Hannibal Lecter and I will be back in just a moment.

[Commercial break]

KINSLEY: Bob, less than one out of 400 people who are tried on felonies get off on this insanity defense and I dare say looking around in society at least that many truly are people who cannot control their actions and are not guilty, and a civilized society does not throw people into jail who are not guilty.

NOVAK: They are guilty and they should go to prison. You know, it's one thing for these psychiatrists to get neurotics into their office at $ 200 an hour, but to get a Hinckley as not guilty, that is a crime against society; and I will tell you one thing. If we didn't have a corrupt legislative branch, they would abolish all of this insanity defense tomorrow morning.

KINSLEY: You mean the federal government would do that and impose that on the states?

NOVAK: On the states, on the states.

KINSLEY: I'm surprised at you, Bob. From the left, I'm Mike Kinsley. Good night for Crossfire.

NOVAK: From the right, I'm Robert Novak. Join us again next time for another edition of Crossfire.

KINSLEY: PrimeNews is next. Here's Bernard Shaw with a look at the headlines. Bernie?

BERNARD SHAW, PrimeNews: Thank you, Michael. The United Nations sheds the coat of the cold war and begins to weave a new mantle of peace. Jeffrey Dahmer says he killed 17 young men, he tried for 18 but that man lived to tell his story today. And TWA becomes a victim of the recession. PrimeNews is next.

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