A QUESTION OF RESPONSIBILITY: THE DEVELOPMENT OF AMERICAN FORENSIC PSYCHIATRY, 1838-1930

Major efforts to systematize the relationship between law and psychiatry in the United States were undertaken in the early nineteenth century. The medico-legal publications of that era marked the beginning of a professional debate over the role of psychiatry in the adjudication and treatment of criminal offenders. One of the issues in the debate was individual responsibility. Lawyers, physicians, philosophers, theologians and social scientists have argued for generations over standards for distinguishing between criminality and mental illness. My dissertation is a history of this debate as revealed in the writings and actions of America\u27s most influential medico-legal theorists between the years 1838-1930. In 1838, the first major examination of the responsibility question written by an American physician was published. Isaac Ray\u27s Treatise on the Medical Jurisprudence of Insanity, symbolizes the entrance of American medical men into a debate which had been dominated by lawyers. Following the publication of this book, legal and psychiatric professionals established vested interests in the responsibility question. It was during this period that both professional groups came to recognize and accept the other profession\u27s claim to special knowledge about this question. More significantly, in the years between 1838 and 1930 a key intellectual shift took place. This was the movement away from traditional legal and moral views of free will and individual responsibility toward ones in which scientifically-derived determinisms play a role. The first three chapters describe the awakening of American medico-legal theorists to the fact that they had a shared interest in, but very different approaches to, the problems of the mentally ill offender. This awakening stimulated an interest in reforming the legal system and in medico-legal collaboration. In the middle two chapters my focus is the intellectual, professional and personal forces which worked against reform attempts. This struggle between law and psychiatry had implications for forensic psychiatry in the twentieth century. Nineteenth-century medico-legal theorists bequeathed a sophisticated system for dealing with the possibly insane offender, as well as a reform legacy of frustration and conflict. The last chapters delineate the institutional forms and scientific theories that transformed this legacy into a modern reform movement