Opinion ID: 307716
Heading Depth: 3
Heading Rank: 2

Heading: the need to depart from the product formulation

Text: 293 The questions initially raised on this appeal pertained to our decision in Washington v. United States, 129 U.S.App.D. C. 29, 390 F.2d 444 (1967), barring conclusory expert testimony on the issue of productivity. Appellant insisted at the outset that Washington's prohibition had been disregarded at trial, and he asked us to demonstrate our opposition to expert domination of the process by enforcing the Washington rule. This Court, sua sponte, altered the focus of the inquiry by calling into question our test of responsibility, and by asking the parties and amici curiae to canvass the arguments for and against a change in the Durham-McDonald rule. 294 In examining the ALI test now adopted by this Court, it is important to keep in mind the origins of this case and the problem which the adoption of a new test is designed to solve. The great bulk of the Court's opinion is devoted to an explication of the ALI test as adopted in this jurisdiction. Since the clarification of ambiguous language now may minimize litigation later, that is, of course, an important undertaking. But the critical question before us is whether or not the adoption of the ALI test is likely to make any significant inroad on the problem of expert domination. The answer to that question depends in large part upon an understanding of the reasons why Durham's productivity requirement became a convenient handle for expert domination. 295 Durham did not invent the question of causality. Every responsibility test demands (or assumes) some link between the defendant's act and his impairment; Durham merely gave explicit recognition to the issue. Thus, the critical question is not whether the act must be related to the impairment (mental disease, defect of reason, or whatever), but rather how directly, if at all, the jury's attention should be focused on the question. 296 It is still not clear precisely what the concept of causality means in this context, or whether it is an intelligible concept at all. Yet Durham forced the concept out from its hiding place behind the murky language of other responsibility tests and made the productivity question the ultimate issue for the jury. In our effort to clarify the question we held that an act was to be considered the product of a mental disease only if it would not have been committed but for the disease-the disease must have made the effective or decisive difference between doing and not doing the act. Carter v. United States, 102 U.S.App. D.C. 227, 236, 252 F.2d 608, 617 (1957). That definition gave the false impression that we understood the concept of causality fully and could draw meaningful and distinct lines between sufficient and insufficient cause-between acts that were caused by mental illness and acts that were not. 297 Notwithstanding the expectations to the contrary of the courts and commentators who examined the Durham rule, 34 the productivity requirement became a formidable obstacle to the presentation of a successful responsibility defense. Even as recently as 1970 one federal court suggested that the product portion of the test seems superfluous, reasoning that once a disability had been established, it would ordinarily be impossible to prove that it had no relationship to the unlawful act. Wade v. United States, 426 F.2d 64, 69 (9th Cir. 1970). Nevertheless, psychiatrists in this jurisdiction have often concluded-and convinced juries-that a mentally ill defendant should be convicted because his act was not the product of his illness. See United States v. Eichberg, 142 U.S.App.D.C. 110, 113, 439 F.2d 620, 628 (1971) (Bazelon, C. J., concurring). 298 This development may have allayed the fears of some who expected Durham to produce a vast increase in the number of insanity acquittals. After all, it was only the productivity requirement that stood between the liberalized concept of mental illness and acquittal; insistence on a rigid, and often impossible, showing of causal connection was an obvious means of reining in the defense. But the primary drawback of the productivity requirement was not that it reduced the number of insanity acquittals, for it is extremely unlikely, in my opinion, that juries would have acquitted many more defendants if the product formulation had never been devised. The real difficulty was that the superficial simplicity of the productivity question made it seem susceptible of an unambiguous medical or scientific answer. As a consequence, jurors too often relied on the conclusions of the experts, failing to see that the gravity of an impairment and its relevance to the acts charged are both questions of degree, which can only be resolved with reference to the community's sense of when it is just to hold a man responsible for his act. United States v. Eichberg, 142 U.S.App. D.C. 110, 113, 439 F.2d 620, 623 (1971) (concurring opinion). 299 As I understand the Court's opinion, the rationale for the switch from Durham-McDonald to ALI-McDonald can be summarized as follows: The primary flaw of our prior test was its emphasis on productivity, which permitted undue dominance by the expert witnesses who testified on the issue of responsibility. Majority opinion at 981. The remedy is not to depart from the product requirement (which would hardly be possible in any case since the requirement is an integral part of every responsibility test), but to depart from the product formulation. The ALI test retains the core requirement of productivity, in the sense that there must be a meaningful relationship between the mental illness and the incident charged. Id. at 983. But the question of causality does not occupy a position of prominence under ALI comparable to the position that the product requirement occupied under Durham. By eliminating the term product we can eliminate the vocabulary which was conducive to a testimonial mystique permitting expert dominance and encroachment on the jury's function. Id. The foregoing reasoning of my brethren represents the primary articulated justification for adoption of the ALI test, and the validity of the analysis must, therefore, be considered with great care. 300 1. The Court's reasoning suggests that our primary goal is to deemphasize the question of productivity or causality. Yet there is strong reason to suspect that adopting the ALI test will not bring us closer to that goal. The difficulty of applying the ALI productivity requirement -and hence the amount of attention which the requirement will attract-is likely to vary with the nature of the defendant's impairment. If the defendant cannot distinguish 'good and evil,' i. e., if he 'doth not know what he is doing, no more than    a wild beast,'  35 he may well lack the capacity to appreciate the wrongfulness of any act or to conform any act to the requirements of law. In that case, a jury is likely to conclude that the defendant's impairment caused his act, irrespective of the act he allegedly committed. If the defendant's impairment is not so severe as to render him a wild beast, the question of productivity is still unlikely to present great difficulty so long as the impairment is deep enough and pervasive enough to compel the conclusion that most of his acts are substantially affected by the impairment. A finding of non-productivity will not often be made where the defendant is suffering from a psychosis or other severe disorder, because the defendant's act will, in all probability, bear a strong and obvious relationship to the impairment. 36 And even where the question is close, juries may often resolve their doubts in favor of a finding of causality in order to insure that the defendant is committed to a hospital rather than a penitentiary. 301 The real difficulty with the causality requirement arises when the defendant's impairment is a neurotic condition or personality disorder. It appears that these conditions are often encapsulated, in the sense that they may have a significant impact on some aspects of the defendant's behavior, while leaving his personality substantially intact. 37 In these cases disputes will often arise concerning the relationship of the act to the impairment. And snce the impairment may be much less severe than a psychosis, the defense will often not be aided by a presumption that hospitalization is the appropriate disposition. In fact, the jury may be convinced that the non-psychotic defendant deserves criminal punishment even though the experts consider him mentally ill. And they may use the productivity requirement as a handle for the rejection of the responsibility defense. 302 In short, the most efficient means of eliminating the productivity problem (but not the productivity question) is to limit the definition of exculpatory mental illness to those conditions which are so severe that in most cases a finding of productivity can readily be made. It can reasonably be argued that the intent of the ALI draftsmen was to make the responsibility defense available only to defendants suffering from psychoses or other severe disabilities. 38 Under that interpretation, which is apparently accepted by at least some other federal jurisdictions, 39 the productivity issue should rarely present great difficulty. But that interpretation is plainly not the one adopted by the Court in today's opinion. As I read the Court's opinion, the retention of the McDonald definition of mental illness reaffirms our longstanding view that, in the words of Mr. Dempsey's amicus brief, the defense is not restricted to persons suffering from the gravest types of mental disorders. While the jury must find that the defendant's 'mental or emotional processes' have been 'substantially affected' and his 'behavior controls' 'substantially impaired,' the jury is not bound by whether those consequences flow from what the psychiatrists label a 'psychosis,' 'pyschoneurosis,' a 'sociopathic personality,' an 'emotionally unstable personality,' or whatever. 40 If we are indeed to retain the expansive definition of mental illness implicit in Durham and formalized in McDonald, then the productivity question will remain a source of controversy and debate. 303 Unlike Durham, which focused on the relationship between the defendant's mental illness (impairment) and his act, the ALI test focuses on the relationship between the defendant's mental illness and his impairment. In the words of the test, the impairment must exist as a result of mental illness. But productivity in the Durham sense-the relationship between the impairment and the act-is not abolished; it is concealed in two questions which are implicit in the test: Could the defendant appreciate the wrongfulness of the particular act he committed? Could he have conformed that particular act to the requirements of law? So long as the defendant's impairment is a psychosis or other severe disability and is roughly consonant with his act, the answers to those questions should be sufficiently obvious that the questions will not even seem to arise. But where the defense is predicated on a less severe form of impairment-as it apparently can still be in this jurisdiction-those questions will assume the burden that has been carried up to now by Durham's explicit requirement of productivity. 304 The operation of the causality requirement implicit in the ALI test can be illustrated by considering how Brawner would have been tried under the new test. The expert witnesses would presumably characterize his condition as an explosive personality disorder, manifested in an inability to deal with provocation. The act which Brawner committed-shooting through a closed door in retaliation for a blow to his jaw a short while before-is surely consistent with his condition. It could thus be said that in at least some situations Brawner apparently lacked substantial capacity to conform this kind of behavior to the requirements of law. But I have little doubt that the government would seek to introduce expert testimony, as it did under Durham, that Brawner committed this act not because of his personality disorder, but rather because he wanted to get even with somebody who broke [his] jaw. See page 1014 supra. The issue raised by this line of testimony need not be called a productivity or causality question. But whatever it is called, it is functionally identical to the productivity question that routinely arose under Durham. 305 The Court undoubtedly recognizes that retention of McDonald's open-ended definition of mental illness will require an inquiry into causality in a large number of cases. In marked contrast to the opinions of the other federal courts that have adopted the ALI test, 41 the Court's opinion places great emphasis on the causality question. Superficially, the Court's references are directed only at the first stage of the causality question under the ALI test-the relationship between the illness and the impairment rather than the relationship between the impairment and the act. But the question raised by that first stage is so trivial and the Court's references to causality are so numerous that it is hard to avoid the implication that the references are primarily aimed at the second stage of the productivity question. Those references carry an implicit assurance that acquittal under the ALI test will be no less difficult for a defendant without a pervasive disability than it has always been under Durham. 306 The critical question, therefore, is how the productivity issue will be presented to the jury. As I pointed out above, the Durham formulation gave the false impression that the question required a medical or scientific answer. The ALI language could fare better, since it does not invite the expert witnesses to offer a flat and seemingly scientific answer that the impairment did or did not cause the act. But while there is some promise in the language of the ALI test, I fear that the Court's construction of that language may dissipate much of that promise. The ALI test provides that a person is not responsible for criminal conduct if at the time of such conduct as a result of mental disease or defect he lacks substantial capacity    (Emphasis supplied.) The Court maintains that the causality requirement lurks in the term as a result, suggesting that the mental disease of a kleptomaniac does not entail as a 'result' a lack of capacity to conform to the law prohibiting rape. Majority opinion at 991. The term as a result does, of course, contain a requirement of causality. But it refers only to the first stage of the requirement under the ALI test, indicating that the impairment must be caused by the mental disease. But the crucial question of causality-the link between the impairment and the act-is not reflected in the term as a result. It inheres in the concepts of appreciating wrongfulness and conforming conduct. Thus, if kleptomania is an abnormal condition of the mind, then for purposes of the ALI test a kleptomaniac lacks substantial capacity as a result of mental disease regardless of the act he allegedly committed. But if he is charged with rape, his responsibility defense would presumably fail because, even though he may lack capacity to appreciate the wrongfulness of theft or to conform his conduct to the requirements of the law prohibiting theft, he may in fact have substantial capacity to appreciate the wrongfulness of rape and to conform his conduct to the requirements of the law prohibiting rape. 307 My concern with the source of the ALI productivity requirement is not intended as an exercise in the splitting of hairs. By making the term as a result carry not only the unimportant first stage of the causality question, but also the critical second stage, the Court repeats precisely the mistake it correctly identifies in Durham: the articulation of a catchphrase that facilitates conclusory expert testimony and that obscures the moral and legal overtones of the productivity question. Where a psychiatrist would formerly have testified that the act was not the product of the disease, he can now assert that the disease of the defendant does not entail as a result the kind of impairment that could have produced the act in question. Under my view of the ALI language, a psychiatrist attempting to present a conclusory no-productivity argument would have to lead the jury through the murky waters of appreciating wrongfulness and conforming conduct, and in all likelihood the jury would be lost almost from the outset. If the causality requirement cannot readily be expressed as an uncomplicated yes-no question, there is a good chance that juries would begin to recognize that the requirement subsumes the moral and legal questions which lie at the heart of the responsibility defense. 308 2. Our opinion in Washington recognized that the productivity requirement can lead to domination by the expert witnesses not so much because they testify about the issue, but because they testify about the issue in conclusory terms. For that reason, we barred conclusory testimony on this issue, and urged the experts to disclose the factual data from which the jury could draw reasonable inferences about the defendant's condition. Inexplicably, the Court now concludes that Washington is superseded-on this point-by our change today of the ultimate rule, majority opinion at 1003. Yet, as the Court repeatedly makes clear, the change of the ultimate rule leaves standing the causality requirement. The net effect of today's decision is, therefore, to require the experts to drop the term product in favor of the term result, and to permit them once again to tell the jury in conclusory terms that the act was not caused by the defendant's impairment. 42 To be sure, a mystique has developed around the term product, and the elimination of that term should undercut the mystique. But I see no reason to assume that the term result is immune to the identical development, especially in view of the Court's unexplained determination that experts should once again be permitted to testify in conclusory terms on the issue of causality. 309 3. If our primary goal is, in fact, to achieve a reduction in expert domination of the process, the gratuitous overruling of one aspect of Washington v. United States 43 is not the only-and perhaps not the most important-step backward. The Court identifies the productivity requirement as the chief villain that permits the experts to encroach on the jury's function. But there is another aspect of the test which is at least as susceptible to expert domination. Like Durham, the ALI test demands a mental disease as a condition of non-responsibility. And the Court today holds that the definition of mental disease announced in McDonald will be applicable to the ALI test. Nevertheless, Brawner's discussion of the term suggests at least a partial erosion of the McDonald view that mental disease is a legal concept, and that neither the court nor the jury is bound by ad hoc definitions or conclusions as to what experts state is a disease or defect. 114 U.S.App.D.C. 120, 124, 312 F.2d 847, 851 (1962). 310 The Court today asserts that it has rejected suggestions to adopt a rule that disentangles the insanity defense from a medical model, and adds that a successful responsibility defense must be predicated on the existence of an ascertainable condition characterized by 'a broad consensus that free will does not exist.'  Majority opinion at 995. I fear that counsel, the experts, and the trial courts will view that requirement as a delegation of sweeping new authority to the medical experts. 311 Of course, the Court does point out that a defendant can make a broad presentation to the jury, offering all of the evidence, even if not strictly medical, which is pertinent to an abnormal condition of the mind. But that broad presentation is already guaranteed by the traditional rules of evidence. The real impact of the Court's decision is to establish a barrier which will prevent some defendants from taking any evidence at all to the jury on the issue of responsibility. The power to open and close that barrier is effectively delegated to the psychiatric experts. 312 We can only speculate on the impact of this requirement, but it seems likely to produce very substantial distortions of the process. First, it focuses attention on an entirely irrelevant issue. If a defendant is prepared to present evidence that his mental or emotional processes and behavior controls were in fact impaired, it is not clear why anything should turn on the experts' view of his condition in the abstract. 313 Second, the requirement obliges the defendant to make a vastly greater showing to have the issue of reponsibility submitted to the jury than to have any other issue submitted. We held many years ago that sanity is an 'essential' issue which, if actually litigated-that is, if 'some proof is adduced' tending to support the defense-must be submitted to the jury under the guidance of instructions. Tatum v. United States, 88 U.S. App.D.C. 386, 389, 190 F.2d 612, 615 (1951). Conceding that any attempt to formulate a quantitative measure of the amount of evidence necessary to raise an issue can produce no more than an illusory definiteness, we pointed out that so long as there was some evidence relevant to the issue    the credibility and force of such evidence must be for the jury, and cannot be matter of law for the decision of the court. 88 U.S.App.D.C. at 390, 190 F.2d at 616, quoting from Kinard v. United States, 68 App.D.C. 250, 253-254, 96 F. 2d 522, 525-526 (1938). As I read the Court's opinion, a defendant who can introduce some evidence that his capacity to control his behavior was in fact impaired cannot take the responsibility issue to the jury unless he can also offer, should the question be put in issue, convincing evidence that he is suffering from a medically-recognized condition characterized by a broad consensus that free will does not exist. 44 314 Still, the greatest difficulty is not that the requirement shifts attention onto an extraneous issue or that it imposes an unwarranted obstacle to the presentation of an affirmative defense. Those difficulties could be tolerated if the requirement of a broad consensus that free will does not exist reflected the Court's effort to achieve some important purpose of the responsibility defense. At no point in its opinion does the Court explain why the boundary of a legal concept-criminal responsibility-should be marked by medical concepts, especially when the validity of the medical model is seriously questioned by some eminent psychiatrists. 45 Nor does the Court explain what it means by convincing evidence of the existence of a broad concensus. If five psychiatrists are prepared to assert that a particular condition does tend to impair free will, how many psychiatrists must be willing to testify that it does not have such an effect before we can preclude a responsibility defense on the ground that there is no broad consensus that the defendant's condition tends to impair free will? How many psychiatrists must be convinced that a particular condition is medical in nature before a defendant will be permitted, within the confines of the medical model, to predicate a responsibility defense on such a condition? 315 The Court similarly fails to explain how medical experts can be expected to provide information about the impairment of free will, when free will would seem to be a philosophical and not a medical concept. If psychiatrists will be required to frame their testimony in terms of this non-medical concept, then the Court will have resurrected M'Naghten with one ironic twist. Under M'Naghten, medical experts effectively answered moral and legal questions, and cloaked the answers in medical terminology. The Court now seems to ask experts to make moral and legal determinations about the nature of an exculpatory condition, and invites them to state their conclusions in non-medical terms. 316 It is possible, however, that the Court's reference to free will is not intended to carry moral or philosophical implications, but is nothing more than a short-hand for the component of the ALI test which refers to substantial capacity to conform conduct to the requirements of law. 46 If so, it is unclear why the Court omits reference to the second component of the ALI test: namely, the capacity to appreciate the wrongfulness of conduct. Is that omission premised on a determination that the cognitive element is irrelevant to responsibility? Or does it mean, perhaps, that the element of cognition is subsumed within the concept of behavior control? See United States v. Currens, 290 F.2d 751, 774 (3d Cir. 1961). These questions, and others which are no less extraneous to the question genuinely in issue, will have to be answered in the course of applying this new requirement. 317 Of course, the fact that the requirement is illogical, unwieldy, and an invitation to expert domination does not necessarily mean that it should not be adopted. I suggested in a recent opinion that adoption of an explicit medical model may be the only available means of fending off a number of difficult questions concerning our handling of a dangerous defendant who has been found not guilty for lack of responsibility, but who cannot be committed to a medical institution for medical care. In that same opinion I outlined several alternative approaches and attempted to point out the advantages and disadvantages of each. See United States v. Alexander & Murdock, 152 U.S. App.D.C. ____ at ____ - ____, 471 F.2d 923 at 960-965 (April 21, 1972). But the Court does not disclose the reasoning that underlies its adoption of the medical model. Nor does it provide any indication of the purpose of this limitation on the legal concept of responsibility. The disadvantages of clinging to a medical model are shouldered without acknowledgment or explanation. What does emerge clearly from the Court's opinion is that we have now turned over to the experts a substantial part of the inquiry, without making clear why expert domination in this context-as opposed to the context of productivity-is unobjectionable. 318