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The Matter of Forensic Psychiatry: A Historical Enquiry

Published online by Cambridge University Press:  26 July 2012

Svein Atle Skålevåg
Svein Atle Skålevåg
Affiliation:
Stein Rokkan Senter, Nygårdsgaten 5, N-5015 Bergen, Norway
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Since antiquity, some men have not been considered accountable for their actions when they transgressed the law, and were exempted from legal penalties, or given lesser ones. Why? The rationale for legal exemption has varied over time. So have the labels assigned to such lawbreakers, and even the personnel involved in the labelling process. For centuries, settling the question of deviant mental states of relevance to the court seemed relatively unproblematic. It was thought that personal acquaintance would easily discover such states of mind and the court could then be notified. It was not until the nineteenth century that western society felt a need to regulate this problematique. As a result, or as a precondition for this process of settling the question of legal accountability, the matter came to be construed in part as a medical problem. Physicians, and later psychiatrists, came to be regarded as possessing specific knowledge in this area which qualified them to judge a person's legal accountability. Personal knowledge of the deranged defendant was supplanted by professional knowledge of sanity and insanity as the basis for authority on the matter of accountability.

Type
Articles
Information
Medical History , Volume 50 , Issue 1 , 01 January 2006 , pp. 49 - 68
Copyright
Copyright © The Author(s) 2006. Published by Cambridge University Press

References

1 Roger Smith, Trial by medicine: insanity and responsibility in Victorian trials, Edinburgh University Press, 1981, p. 72.

2 Ibid., p. 124.

3 Ibid., p. 141.

4 Joel P Eigen, Witnessing insanity: madness and mad-doctors in the English court, New Haven, Yale University Press, 1995.

5 Ibid., p. 5.

6 This argument is particularly elaborated in Michel Foucault, Les anormaux: cours au Collège de France, 1974–1975, Paris, Gallimard; Seuil, 1999, passim. See also Michel Foucault, Surveiller et punir: naissance de la prison, Paris, Gallimard, 1975, pp. 21–9.

7 In the round table talk ‘Confession of the flesh’, printed in Michel Foucault, Power/knowledge: selected interviews and other writings 1972–1977, ed. Colin Gordon, New York, Pantheon, 1980, pp. 194–228, quotation on pp. 204–5. The incredulity versus the idea of a interest-driven imperialist quest is repeated in the recent French study of crime and madness by Renneville: “one can validly ask what specifically has been gained by this” (“on peut se demander ce qu'ils avaient à y gagner concrètement”); Marc Renneville, Crime et folie: deux siècles d'enquêtes médicales et judiciaires, Paris, Fayard, 2003, p. 131.

8 “All sorts of subjects intervened, administrative personnel for example, for reasons of public order, but above all it was the doctors and magistrates.” Foucault, op. cit., note 7 above, p. 204.

9 Jan Goldstein, Console and classify: the French psychiatric profession in the nineteenth century, 2nd ed., University of Chicago Press, 2001 (first ed. 1987), p. 168.

10 Ibid. 414.

11 For the documents in this case see the unpublished manuscript: Tingbok 41 (1819–1824), Nedenes sorenskriverembete, held in the Statsarkivet i Kristiansand (regional archive, Kristiansand). The relevant section is transcribed on the website: www.museumsnett.no/jernverksmuseet/masovnsmordet.html. In 1819, the “sworn men” still combined the functions of witnesses and of judges, though the magistrate was the principal judge. (The documents declare the sentence was pronounced by the magistrate and the sworn men together.) The number of sworn men varied, not just from case to case, but from meeting to meeting in the same case. At the time of the sentence in this case, there were four of them.

12 “… ikke ved sin fulde Fornuft”, “ikke ved Forstandsens fulde Brug”, “forvirret i Hovedet”, “vanvittig”, from; transcription at Tingbok 41, Nedenes sorenskriverembete at www.museumsnett.no/jernverksmuseet/masovnsmordet.html.

13 This pairing echoes the much older co-operation between priests and medical men in the investigation procedures concerning people suspected for possession, as laid down in the Norwegian church rituals of 25/06 1685; Paul Winge, Den norske sindssygeret: historisk fremstillet. Første bind., 3 vols, Kristiania, Dybwad, 1913, vol. 1, p. 32.

14 The complementarity between theology and medicine witnessed in this case is also evident in early scientific practices such as mesmerism and phrenology, and in early modern literature where the figure of the physician is frequently doubled by that of the priest.

15 Winge, op. cit., note 13 above, vol. 1, pp. 24–32.

16 Henrik A Th Dedichen, Paa begge sider af sindssygdommenes grænse, Kristiania, 1898. Dedichen gives an account of the case, including long extracts from the relevant documents. The poor board was a local administrative unit charged with the responsibility of caring for the poor, established in 1845. Apart from the minister, the board's members were elected by popular vote. In some communities the poor law was equipped with a salaried officer. (Anne-Lise Seip, Sosialhjelpstaten blir til. Norsk sosialpolitikk 1740–1920, Oslo, Gyldendal, 1984, pp. 54–64.)

17 Throughout the nineteenth century the term “psychiatrist” was used interchangeably with that other term sinnssygelæge (analogous with the German term irrenärtze, literally the “physician of the insane”),which is here translated as “alienist”. Though it may be argued that the term psychiatrist had stronger scientific connotations, whereas sinnssygelæge primarily referred to the occupation of running an insanity asylum, in this essay the terms are used synonymously.

18 For the Norwegian legal system, see Ditlev Tamm, Jens Christian V Johansen, Eyvind Næss and Kenneth Johansson, ‘The law and the judicial system’, in Eva Österberg and Sølvi Sogner (eds), People meet the law: control and conflict-handling in the courts: the Nordic countries in the post-reformation and pre-industrial period, trans. Alan Crozier, Oslo, Universitetsforlaget, 2000, pp. 27–6.

19Gulatingslovi, Mannhelgebolk, ch. 15, translated by Knut Robberstad, Oslo, Samlaget, 1937, p. 165; see also Innstilling I fra Straffelovkomiteen (Report from the Parliamentary Committee on Penal Law), 1925, p. 43. Someone killing their next of kin under this legal regime was normally submitted to a double punishment: economically compensating the relatives and being forced into exile (outlawed). The mad murderer, on the other hand, should just lose his right to inheritance.

20 “Ef faðer verðr svá œrr, at han drepr son sinn …”, Frostatingsloven, IV 31, see also Innstilling I fra Straffelovkomiteen (Report from the Parliamentary Committee on Penal Law), 1925, p. 44.

21 The conditions mentioned are alternatives, not necessary conditions. Innstilling I fra Straffelovkomiteen, 1925, p. 44.

22 Ibid., p. 44.

23 “Il n'y a ni crime ni délit lorsque le prévenu était en état de démence au temps de l'action, ou lorsqu'il a été contraint par une force à laquelle il n'a pu résister”, Frédéric Chauvaud, Les experts du crime: la médecine légale en France au XIXe siècle, Paris, Aubier, 2000, p. 263, n. 13.

24 Foucault, Surveiller, op. cit., note 6 above, p. 25.

25 “De handlinger er straffrie, som forøves af galne eller afsindige, eller af dem, som Forstandens brug ved Sygdom eller Alderdoms-svaghed er berøvet”, Norwegian Criminal code of 1842, ch. 7 § 2.

26 Winge, op. cit., note 13 above, vol. 1, ch. 4.

27 1875–90: 140 examinations; 1890–95: 253 examinations; 1895–1900: 292 examinations; 1900–1904: 398 examinations. (Numbers from Hans Evensen, Lovbestemmelserne om retsmedicinske forretninger, særlig med hensyn til lægernes pligter og honorarer: en historisk-kritisk fremstilling, Den norske lægeforenings smaaskrifter, Kristiania, 1910.) In the years 1900 to 1914, i.e. the first fourteen years of the commission of forensic medicine, 777 expert testimonies were delivered (concerning 763 different persons), i.e. 55 cases a year (numbers from Beretning fra den rettsmedicinske kommission for aaret 1914).

28 Major studied for a brief period with Peter W Jessen (1793–1875), professor at Kiel and the founder of the Hornheim asylum in Schleswig. Jessen allegedly belonged to the school of “somaticists”, with Maximilian Jacobi and Johannes B Friedreich, and this affiliation is supposedly the background for Major's insistence on insanity being a disease of the mind. Major's proposal for an “insanity law” was based on the equivalents from France (initiated by Esquirol, ratified 1838), Belgium (initiated by Joseph Guislain, ratified 1850, but the draft from 1842 was available to Major) and Holland (initiated by Schroder van der Kolk, ratified 1842). Winge, op. cit., note 13 above, vol. 3, Kristiania, Dybwad, 1917, pp. 15–24.

29 I label alienists as “professional” because they were a group of trained personnel associated with a set of formal positions, constituting a specific hierarchy. They were medical men by education, but asylum superintendents by position—sharing certain common experiences and interests. Hence we have a kind of “profession inside the profession” decades before general medicine became fragmented by a number of specialist branches.

30 The two readings occur in a debate in the Norwegian Medical Society in 1859. Significantly, the first reading is made by Ole Aa R Sandberg, medical superintendent of the then modern Gaustad asylum near Christiania, whence the second reading is made by F C Faye, professor of obstetric and paediatric medicine (Norsk Magazin for Lægevidenskaben, 1859, pp. 388–421, 423–38, 523–39, 618–63, 747–56, and 827–49.

31 Svein Atle Skålevåg, Fra normalitetens historie. Sinnssykdom 1870–1920, Bergen, Stein Rokkan senter for flegfaglige samfunnsstudier, 2003, pp. 179–204.

32 C D Hedegaard, Kort, dog nogenlunde tilstrækkelig, Anviisning, hvorledes man i forefaldende criminelle Tilfælde har at forholde sig 1. ved den fornødne udvortes Besigtigelse 2. ved det derhos anstillede Examinations-Forhør, efter mange aars Praxin [sic] velmeenende meddelt dem til Tieneste, som dertil kunde være trængende. Hvornæst og følge nogle Remarqver for en Voterende, Copenhagen, 1774. I am grateful to Jørn Øyrehagen Sunde for bringing this source to my attention.

33 Hedegaard had also touched on the matter of insanity and simulation in an earlier publication without even mentioning the possibility of summoning a physician (C D Hedegaard, Juridisk-practiske Anmærkninger til Danske og Norske Lov: indeholdende adskillige merkværdige Tilfælde eller Spørsmaal som ere forefaldne i eller uden Rettergang, 4 vols, vol. 2, Copenhagen, Johan Gottlob Rothe, 1765). The books of Hedegaard had their equivalents in Sweden, where the prominent jurist David Nehrman Ehrenstråle in his Inledning til then swenska processum criminalem, Lund, Berling, 1759, called for a similar legal examination as did Hedegaard in Denmark/Norway. Roger Qvarsell, Utan vett och vilja. Om synen på brottslighet och sinnessjukdom, Stockholm, Carlssons, 1993, p. 82.

34 Hedegaard, op. cit., note 32 above, pp. 84–5.

35 This case of simulation could be significant. Börjesson made a similar point in his book on forensic psychiatry in Sweden. He claims that until c.1840 medical competency in court was restricted to that of disclosing simulations of mental illness (Mats Börjesson, Sanningen om brottslingen: rättspsykiatrin som kartlägging av livsöden i samhällets tjänst under 1900–talet, Stockholm, Carlssons, 1994, pp. 38–45).

36 “… hvorfor det er best, at overlade slige Mennesker til Medicos i Henseende til Legemet, og til de Geistlige hva sindet er angaaende”, Hedegaard, op. cit., note 32 above, p. 87.

37 Hedegaard, op. cit., note 32 above, p. 87. Physical labour as a form of therapy was perhaps the most important therapeutic idea sustaining the modern asylums of the mid-nineteenth century. It was a major rationale for situating public asylums outside towns and boroughs, where farmland could be annexed to the institutions, so giving plenty of opportunity for the patients to work.

38 On the German debate, see Paul Winge, Den norske sindssygelovgivning, Kristiania, Brøggers bogtrykkeri, 1901, pp. 53–7; and also J B Friederich, Den retslige Psychologi: systematisk fremstilt for Læger og Jurister, trans. Harald Selmer, Aalborg, Rée, 1846, p. 80.

39 Immanuel Kant, Anthropology from a pragmatic point of view, transl. Mary J Gregor, The Hague, Nijhoff, 1974, §51, pp. 83–4. These lectures were given in 1772–73, and first published in 1798. See also Gerlof Verwey, Psychiatry in an anthropological and biomedical context: philosophical presuppositions and implications of German psychiatry, 1820–1870, Dordrecht, D Reidel, 1985.

40 On Friedreich, see Otto M Marx, ‘German romantic psychiatry. Part 1’, Hist. Psychiatry, 1990, 1: 351–81, pp. 377–80. Friedreich was an academic, writer and publicist, with close to no practical experience. Marx singles out Friedreich as the leader of the German somaticists, together with Maximilian Jacobi.

41 Friedreich's book, Systematisches Handbuch der gerichtlichen Psychologie für Medicinalbeamte, Richter und Verteidiger, originally published in Leipzig in 1835, was translated into Danish (which was also the literary language in Norway) in 1846 by the founding father of Danish psychiatry, Harald Selmer. The book was also translated to Swedish in 1839, by the Swedish psychiatric pioneer Georg Engström. Apparently both the translations were abridged versions.

42 Friedrich Nasse (1778–1851) was a notable “somatiker”, a professor of medicine at Bonn, director of the medical clinic there and editor of the Zeitschrift für psychische Ärzte (1818–1822).

43 “… med mindre han var Anatom, Physiolog og Patholog, og allerede have bevæget sig i en Cyklus af Erfaringer i denne Retning; det vil sige, med mindre han var baade Jurist og Læge”, Friedreich, op. cit., note 2 above, p. 87. “Psychology” is the precise term employed by Friedreich in this work. Evidently it has quite a different connotation from the modern, being a pre-positivist, pre-Freudian notion of psychology.

44 The debate is referred to in the periodical Norsk Magazin for Lægevidenskaben, 1859.

45 “… ingen har ret til at dømme en fremtid fra nogen person, fordi man har grund til at frygte udbrud af sindssygdom og voldsmhed”, Norsk Magazin for Lægevidenskaben, 1859, p. 654.

46 “… et mer barbarisk aarhundre end vort”, Norsk Magazin for Lægevidenskaben, 1859, p. 632.

47 “… det bliver lægen som i virkeligheden bliver dommer”, Norsk Retstidende, 1874, p. 368.

48 “Det psychiatriske studium forudsætter erfaring om, med hvilke materielle midler den sygelige legemstilstand, der betinger det abnorme i tankegangen, kan hæves”, Boeck in Norsk Retstidende, 1874: 368.

49Norsk Retstidende, 1874, p. 366.

50 Tove Stang Dahl has described “the victorious march of positivism” in the field of crime and punishment as a tripartite movement, consisting of the criminological movement, preoccupied with the reasons of crime, the criminalist movement, dealing with the effects of criminal law, and the penitentiary movement, seeking the most effective correctional institutions. Through these intermingling movements international networks were formed, involving psychiatrists, lawyers, judges, law makers and prison managers. (Tove Stang Dahl, Barnevern og samfunnsvern: om stat, vitenskap og profesjoner under barnevernets oppkomst i Norge, Oslo, 1978.) On the history of criminology, see also David Garland, ‘The criminal and his science: a critical account of the formation of criminology at the end of the nineteenth century’, Br. J. Criminology, 1985, 25: 109–37.

51 “Vi antager forøvrig ikke i ethvert Tilfælde Tilregnelighedsspørgsmaalet afgjort derved, at der kan føres endog fuldgyldigt Bevis for, at en Forbryder var Sindssyg i den Periode han udførte Handlingen”, Kopibok ang. responsa medica (manuscript), 1877, no. 13, Det medisinske fakultet, Universitetet i Oslo, Riksarkivet.

52 “… idet man ikke antager at sindssygdom uden videre skal udelukke tilregnelighed”, Kopibok ang. responsa medica (manuscript), 1890, no. 13, Det medisinske fakultet, Universitetet i Oslo, Riksarkivet.

53 “Sindssygelægernes erklæring og deres præsumptive sagkyndighed har her som ved tidligere leiligheder mere bidraget til at forvirre end til at klare sagen, der afgjøres bedre ved almindelige sund sands … Sindssygelægerne ved omtrent, hva vi alle ved”, Kopibok ang. responsa medica (manuscript), 1878, no. 6, Det medisinske fakultet, Universitetet i Oslo, Riksarkivet. It is remarkable the degree to which Lochmann's words echo those of a lawyer who was a staunch opponent of Georget and the French psychiatrists of monomania in the late 1820s, when Élias Regnault stated: “In order to be at the level of current knowledge in this branch of human science, plain common sense suffices” (Goldstein, op. cit., note 9 above, p. 185). The quote is from Regnault's Du degré de compétence des médecins dans les questions judiciaires relatives aux aliénations mentales, Paris, B Warée, 1878.

54 “I den moderne psykologi og den saakaldte sociale videnskab føres utilregneligheden ialfald af enkelte forfattere saa vidt, at den omfatter et menneskes samtlige handlinger betegnet som utilregnelige, fremgaaende med nødvendighed af de medfødte anlæg, ydre paavirkninger etc, med andre ord: Menneskets frie vilje benegtes fuldstændig”, Lochmann, Kopibok ang. responsa medica (manuscript), 1881, no. 3, Det medisinske fakultet, Universitetet i Oslo, Riksarkivet. This critique was elaborated by Lochmann in a separate publication: Den nyere Naturanskuelse (The Recent Perception of Nature), Christiania, Aschehoug, 1888.

55 Aina Schiøtz, ‘Medisin og juss: Ambisjoner og ulikheter. Opptakten til Den rettsmedisinske kommisjon 1880–1900’, in Edgeir Benum, et al. (eds), Den Mangfoldige velferden, Oslo, Gyldendal Akademisk, 2003, pp. 175–92.

56 “Psykiatrien er bleven biologi, medens den i sin barndom var en theologisk eller filosofisk disiplin”; Paul Winge, Hovedtræk i Pykiatriens Udvikling I de senere 3–4 Decennier, Kristiania, Alb. Cammermeyer, 1896, p. 7.

57 Molière, L'amour médecin (1665), Paris, Nouveaux Classiques Larousse, 1975, p. 53, quoted in Edward Shorter, A history of psychiatry New York, Wiley, 1997, p. 20.