Opinion ID: 2550767
Heading Depth: 2
Heading Rank: 2

Heading: Different Mental Disease or Defect Than Acquittal

Text: ¶ 41 Klein alternatively argues that even if she continues to suffer from a mental disease or defect, she must nonetheless be released because she no longer suffers from the same mental disease or defect that justified her original acquittal. We reject this assertion. ¶ 42 An insanity acquittee must be released if it is demonstrated by a preponderance of the evidence that he or she no longer presents, as a result of a mental disease or defect, a substantial danger to other persons, or a substantial likelihood of committing criminal acts jeopardizing public safety or security .... RCW 10.77.200(2) (emphasis added). Use of the indefinite article a suggests that the continuation of the same condition that justified the original acquittal is not necessary for continued custody. Cf. Ruiz-Guzman v. Amvac Chem. Corp., 141 Wash.2d 493, 499, 7 P.3d 795 (2000) (`[b]y using the indefinite article a rather than the definite article the ... the Act, read literally, permits reliance on the existence or feasibility of a product different from the challenged product to establish ... that the challenged product is not reasonably safe.'). ¶ 43 It does not follow, however, that any mental disease or defect is sufficient to justify continued custody. Rather, [d]ue process requires that the nature of commitment bear some reasonable relation to the purpose for which the individual is committed. Foucha v. Louisiana, 504 U.S. 71, 79, 112 S.Ct. 1780, 118 L.Ed.2d 437 (1992) (citing Jones v. United States, 463 U.S. 354, 368, 103 S.Ct. 3043, 77 L.Ed.2d 694 (1983)). Undoubtedly, a reasonable relation exists between Klein's original diagnosis of psychoactive substance-induced organic mental disorder (also referred to as a cocaine-induced delusional disorder) and the current diagnosis of polysubstance dependence, both of which derive from Klein's continued addiction to controlled substances. ¶ 44 Our conclusion is also strengthened by the fact that [t]he purpose of commitment following an insanity acquittal, like that of civil commitment, is to treat the individual's mental illness and protect him and society from his potential dangerousness. Jones, 463 U.S. at 368, 103 S.Ct. 3043. If our sole inquiry focused on whether the release candidate continued to suffer from the exact same condition, one of the central purposes of commitment, the protection of society, could be undermined. For it is quite conceivable that an insanity acquittee could partially recover from the originally diagnosed condition, yet maintain a related condition that manifests itself in equally dangerous behavior. ¶ 45 In addition, Klein's construction of the statute would require difficult, if not impossible, comparisons between the original and present mental conditions of an acquittee. The feasibility of such comparisons is doubtful in light of the uncertainty of diagnosis in this field and the tentativeness of professional judgment. The only certain thing that can be said about the present state of knowledge and therapy regarding mental disease is that science has not reached finality of judgment. Jones, 463 U.S. at 365 n. 13, 103 S.Ct. 3043 (quoting Greenwood v. United States, 350 U.S. 366, 375, 76 S.Ct. 410, 100 L.Ed. 412 (1956)). The DSM-IV-TR candidly acknowledges, for example, that each category of mental disorder is not a completely discrete entity. DSM-IV-TR at xxx. In other words, the subjective and evolving nature of psychology may lead to different diagnoses that are based on the very same symptoms, yet differ only in the name attached to it. [9] Construing RCW 10.77.200 to mandate release based on mere semantics would lead to absurd results and risks to the patient and public beyond those intended by the legislature. We decline to substitute our judgment for that legislative determination.