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Law, The Brain and DSM

David Badertscher
Usually four times a year I make a presentation to Psychiatric Fellows associated with our forensic psychiatric clinic. In these presentations I discuss updated reference sources including databases, and review with them various searching and other techniques useful in their research. When preparing for an upcoming session I noticed two items, one a small OP-ED article in the New York Times, and the other a review of a book published by Oxford University Press.

One book that is consulted repeatedly is the Diagnostic and Statistical Manual of Mental Disorders, or DSM, a respected reference source, currently in its fourth edition, prepared by the American Psychiatric Association. While this source is often relied upon without question, there is a concern among some that future editions may need to focus in a more precise way on issues such as symptoms and the linkage between diagnosis and treatment.

In her September 13, 2007 New York Times article, Sally Satel, a psychiatrist and resident scholar at the American Enterprise Institute frames the issue in a concise, readable manner useful to lawyers, judges and others who depend on DSM IV as a basic resource. To quote Dr. Satel, “Why aren’t we closer to understanding the relationship between manifest illness and its underlying causes? One obstacle is the staggering complexity of the brain.”

This brings me to my second source. The latest issue of Jurimetrics includes a review by Stacey Tovino of the book, Law and the Brain, edited by Samir Zeki and Oliver Goodenough. It consists of a collection of fourteen essays that explore “a range of topics at the intersection of law and neurobiology” which focus on “special challenges raised by the neuroscience-policy interface”–these challenges flowing from the basic differences ” in the orientation of the brain and brain science on the one hand, and the law on the other.”

The final four essays in the book explore the implications of advances in neuroscience for criminal responsibility and publishment. In one essay, “For the Law, Neuroscience Changes Nothing and Everything,” Joshua Greene and Jonathan Cohen “recommend shifting away from punishment aimed at retribution and moving towards ‘a more progressive, consequentalist approach to criminal law.” In the final essay “Responsibility and Punishment: Whose Mind? A Response” Oliver Goodenough “asks us to consider the law of responsibility from a unique perspective; that is, from the brain of the punisher, not the punishee.”

In their separate ways each of these sources, DSM and Law and the Brain, contribute significantly to an appreciation of the significance of relationships between psychiatry and the law, both applied and conceptual. .

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