Medical Insanity:

Medical insanity is a term used to describe serious mental disorders that greatly hinder a person's ability to think, feel, or behave normally. These disorders, such as schizophrenia, bipolar disorder, or major depressive disorder, are characterized by symptoms like hearing or seeing things that are not real, having false beliefs, experiencing extreme changes in mood, or having impaired decision-making skills. Diagnosis and treatment of these disorders fall primarily under the medical or psychiatric field, focusing on controlling symptoms through therapy and medication. Unlike legal insanity, which pertains to criminal liability, medical insanity focuses on the clinical aspect of mental health, prioritizing the understanding, management, and reduction of symptoms in order to improve an individual's overall well-being and ability to function in daily life.

A person who suffers from hallucinations and delusions, firmly convinced of possessing supernatural abilities and being invulnerable, serves as a prime example of medical insanity. Despite being presented with proof to the contrary, they remain steadfast in their distorted perception of reality, which is a clear indication of a serious psychiatric disorder like schizophrenia.

Legal Insanity:

Legal insanity refers to a defence strategy when defendants claim that their mental illness hindered their ability to comprehend the repercussions of their actions or differentiate between right and wrong during the commission of a crime. This defence is based on the belief that individuals cannot be held accountable for their actions if they were incapable of understanding them due to their mental illness. Well-known examples include Andrea Yates, who drowned her children while experiencing a psychotic episode, and John Hinckley Jr., who tried to kill President Reagan because of his schizophrenia. Legal insanity defences bring attention to the intricate relationship between mental health and criminal responsibility within the legal system.

What Should be Done to Prove Legal Insanity?

In order to establish legal insanity, individuals must typically provide evidence that they were suffering from a mental illness or defect at the time of the crime, which impaired their ability to comprehend the consequences of their actions or differentiate between right and wrong. This often entails presenting expert testimony from psychiatric professionals, medical records, and proof of the defendant's mental state prior to, during, and after the offence. The level of proof required may vary depending on the jurisdiction, ranging from a preponderance of evidence to clear and convincing evidence. Legal teams must meticulously construct a solid case showcasing the defendant's mental incapacity in order to establish legal insanity and potentially secure a favourable verdict.

The decision of the supreme court in the case of Mohd. Anwar v. State (N.C.T. of New Delhi) 2020 (8) TMI 909 highlighted that the submission of a photocopy of an OPD card and a statement from the accused's mother on affidavit are of little significance in terms of evidence.

In order to successfully invoke the defence of mental unsoundness under Section 84 of the Indian Penal Code, the accused must prove, with a greater likelihood, that they were suffering from a serious mental illness or infirmity that impaired their ability to differentiate between right and wrong.

Furthermore, it must be established that the accused was under the influence of this disability at the time of the crime and that the crime would not have been committed had it not been for the impairment.

Section 84 of IPC:

The IPC's Section 84 creates a provision that exempts individuals from being held liable for an offence if they were not of sound mind at the time of committing the act and were incapable of understanding the nature of their actions or realizing that they were wrong or illegal. However, the burden of proof on the accused, as per Section 105 of the Indian Evidence Act, 1872, is not as strict as that on the prosecution, which must prove its case beyond a reasonable doubt.

The accused only needs to prove his defence more than likely to be true as stated in Surendra Mishra v. State of Jharkhand (2011) 11 SCC 495. Once this is established, the burden shifts to the prosecution to prove that the exception does not apply.

However, not every claim of unsoundness of mind will be accepted. The standard for determining legal insanity, as held in State of Rajasthan v. Shera Ram (2012) 1 SCC 602: (2012) 1 SCC (Cri) 406, is not the same as that of medical insanity.

In the matter of Bapu @ Gajraj Singh v. State of Rajasthan 2007 8 SCC 66 the court emphasized that the concept of legal insanity is of utmost importance in criminal law. The basic principle is that an act is not guilty unless accompanied by a guilty intention.

This means that both the intent and the act must be present for an offence to be committed. However, this rule does not apply to insane individuals, as they are deemed to lack the free will to commit the act.

The law assumes that every person is of sound mind and understands the consequences of their actions, but in certain circumstances, this presumption can be rebutted. To establish a defence of insanity, it must be clearly proven that at the time of the offence, the accused was suffering from a defect of reason due to a mental illness, which rendered them unable to understand the nature and consequences of their actions.

Furthermore, even if they did understand their actions, it must be shown that they did not realize that what they were doing was wrong. It is important to note that it is the court's responsibility to determine the accused's mental state and not that of medical authorities.

The law assumes that all individuals are sane and have the capacity to understand the consequences of their actions. However, there are instances where this presumption may not hold true. To successfully mount an insanity defence, it must be definitively proven that at the time of the offence, the defendant was suffering from a mental illness that impaired their ability to comprehend the nature and quality of their actions or understand that they were wrong. Additionally, it is the sole responsibility of the court to determine whether the accused is insane or not and not that of the medical authorities.

Differences between Medical Insanity and Legal Insanity:

The Differences Between Medical Insanity And Legal Insanity Are Given Below:

• The primary goal of medical insanity is to identify and manage mental illnesses, while legal insanity is concerned with determining culpability or criminal responsibility in the context of the justice system.
• Standardized diagnostic tools are utilized by mental health experts to evaluate medical insanity while evidence presented during legal proceedings is used by the court to assess legal insanity.
• The diagnosis of particular mental illnesses is associated with medical insanity, while legal insanity pertains to the legal evaluation of one's mental condition during the commission of a crime.
• The diagnosis of medical insanity is based on clinical guidelines found in diagnostic handbooks such as the DSM or ICD, while legal insanity is determined by laws and regulations set by the court system.
• The primary goal of determining medical insanity is to address and meet the mental health needs of the individual. Conversely, the main objective of legal insanity determination is to determine and assign criminal responsibility.
• The criteria for medical insanity require the presence of a mental disorder that can be diagnosed. On the other hand, the criteria for legal insanity may require the ability to comprehend the nature and repercussions of one's actions, or the capability to distinguish between right and wrong.
• Treatment and support services are provided to those with medical insanity. Those deemed legally insane may be subject to legal ramifications, including being committed to a psychiatric facility.
• The evaluation and treatment of medical insanity falls under the purview of mental health professionals, while legal insanity is evaluated by legal professionals such as judges and attorneys.
• The criteria for determining medical insanity are derived from clinical diagnostic standards, while legal insanity is determined by legal statutes and past court cases.
• In cases of medical insanity, it is the responsibility of the clinician to prove the existence of a mental disorder. However, in cases of legal insanity, the burden of proof usually falls on the defendant to demonstrate their lack of criminal responsibility.
• The evaluation process for determining medical insanity can take a significant amount of time in order to carefully observe symptoms and make a thorough diagnosis. On the other hand, legal assessments of insanity tend to concentrate on the person's mental condition during the commission of the crime.
• The evaluation of medical insanity can lead to the creation of treatment plans that aim to address symptoms and enhance overall functioning. On the other hand, legal insanity evaluations may lead to suggestions for supervision, commitment, or treatment within the legal framework.
• Treatment planning and civil commitment proceedings primarily involve the concept of medical insanity, while in criminal trials, the defense of legal insanity is utilized to challenge culpability.
• Professionals in the field of mental health offer their expertise as witnesses in medical insanity cases, where they evaluate and recommend treatment. In legal insanity cases, expert witnesses may be called upon to provide their opinions on the defendant's mental condition during the commission of the crime.
• Current diagnostic criteria and professional judgment are used to make determinations of medical insanity, while previous cases set a precedent that influences legal decisions on medical insanity.
• Medical insanity treatment can be pursued by individuals voluntarily, while legal insanity determinations can be made involuntarily during legal proceedings.
• Confidentiality laws safeguard evaluations of medical insanity, while evaluations of legal insanity become public record during legal proceedings.
• Compliance with medical insanity treatment is typically a choice, although there may be instances where treatment is enforced against one's will. In the case of individuals deemed legally insane, compliance with legal mandates may be imposed through court orders or legal oversight.
• Continuous evaluation may be necessary for medical insanity to track treatment progress and modify interventions. Legal insanity determinations are typically made once during criminal proceedings, but competency evaluations may be performed at different points in the legal process.
• Medical Insanity can impact diverse areas of a person's everyday existence, such as their job, interpersonal connections, and overall performance. On the other hand, legal insanity mainly pertains to the person's participation in legal proceedings and the potential legal ramifications.

Conclusion:
Psychiatric disorders that affect mental well-being without taking legal responsibility into account fall under the category of medical insanity. Conversely, legal insanity refers to mental illnesses that impact criminal liability, often resulting in pleas made in court. While medical insanity centres on diagnosing, treating, and providing assistance, legal insanity involves the intersection of mental health and the legal system, ultimately determining culpability in criminal trials based on the individual's mental state at the time of the offence. Both concepts highlight the intricate nature of mental health within societal structures, underscoring the need for comprehensive approaches that integrate medical knowledge, legal considerations, and ethical perspectives to ensure equitable treatment and support for those struggling with mental health issues.

Written By: Md.Imran Wahab, IPS, IGP, Provisioning, West Bengal
Email: [email protected], Ph no: 9836576565