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Recasting Florida's insanity defense. Two modest proposals

¹Department of Psychiatry, University of Florida College of Medicine, Gainesville.

The Journal of the Florida Medical Association

|October 1, 1993

Summary

Psychiatric security review boards protect the public from individuals found not guilty by reason of insanity. Changing the plea to "guilty but insane" may improve acceptance and patient freedom.

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Area of Science:

Forensic Psychiatry
Legal Psychology
Public Health Policy

Background:

Individuals found not guilty by reason of insanity (NGRI) may pose public safety risks.
Existing judicial systems may not be optimal for managing NGRI acquittees.
Three states have implemented psychiatric security review boards.

Purpose of the Study:

To evaluate the effectiveness and efficiency of psychiatric security review boards.
To propose a modification to the insanity plea for improved societal and patient outcomes.

Main Methods:

Comparative analysis of psychiatric security review boards and the judiciary system.
Review of data on NGRI acquittees in Florida, including offense types.

Main Results:

Psychiatric security review boards are more effective and parsimonious than the judiciary system.
These boards serve the purpose of primary prevention.
A significant minority of NGRI acquittees in Florida are involved in capital offenses.

Conclusions:

The current insanity plea system could be improved.
Recommending a change from "not guilty by reason of insanity" to "guilty but insane."
This semantic change could enhance prosecutorial and public acceptance, aligning with constitutional patient freedoms.

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