Criminal Justice
Forensic psychiatrists are trained to evaluate defendants for evidence
or absence of psychiatric disorders that impair competence or diminish
capacity. Following the Daubert decision,
guidelines for reliability and relevance of expert evidence have evolved.
Thus, experts today need additional preparation (e.g. literature review)
prior to offering courtroom testimony. The following articles provide
a deeper analysis of forensic psychiatry.
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Article: The Rebirth
of Forensic Psychiatry in Light of Recent Historical Trends in Criminal
Responsibility. Psychiatrists are sometimes misunderstood as "hired
guns" whose purpose is to have the guilty exonerated. This widely
circulated article by Dr. Bursztajn explains the validity of forensic
psychiatric evidence.
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Case: Carvajal
v. Mihalek, et al. Dr. Bursztajn's reference to an antisocial
history in the course of his examination, opinion, and testimony
was affirmed on appeal by a panel which included one of the better
senior judge writers in the federal judiciary, Guido
Calabrese, whose book, Tragic
Choices deals with many of the issues of Dr. Bursztajn's book Medical
Choices, Medical Chances in a legal context.
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Video: Psychology
Behind Unthinkable Crimes. Dr. Bursztajn comments in a Fox News
story on unthinkable crimes between loved ones and family members.
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Death Penalty and Mental Illness: Dr. Bursztajn
presents evidence of mental illness in a manner jurors can easily
understand.
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In State
of Illinois v. Chris Coleman (2011) Dr. Bursztajn's work
the death penalty mitigation phase on this case overlapped
with the abolishment of the death penalty by the Illinois
legislature and the promised commutation of any death penalty
decieded on after this act by Governor Pat Quinn. Despite
this, the prosecution chose to pursue the death penalty which
was ultimately denied by Judge Milton Wharton who may be
the last Judge in Illinois to be faced with this decision.
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In State of Iowa
v. June Lyman (2007) Dr. Bursztajn presented to
the jury his opinion that Ms. Lyman had no general criminal
intent at the time of the shooting. Though the prosecution
argued for a first-degree murder conviction, the jury returned
with a verdict of second-degree which is defined as non-premeditated
in the state of Iowa. Articles and video from local television
stations are available and here.
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In State of Illinois
v. Aubrey Tucker (2007) Dr. Bursztajn testified
in three phases of the trial: A hearing to suppress Tucker's
confession that the defense alleged was coerced, in the guilt/innocence
phase regarding Tucker's ability to form specific intent,
and in the sentencing phase where the jury found that sufficient
mitigating factors were present to preclude a death-penalty
verdict.
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In State of Washington
v. Kevin Cruz (2000) Dr. Bursztajn testified that
the defendant was suffering from a variety of symptoms consistent
with those of schizophrenic disorders. After a five month
trial, defendant's life was spared.
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Case: Silverstein v. U.S. Dr. Bursztajn's review
of the plaintiff's, Thomas Silverstein, mental state through review
of medical and case records and a forensic psychiatric interview
of the plaintiff lead to his opinion: "...I do not find evidence
of damage to Mr. Silverstein's mental health resulting from the conditions
of confinement." This opinion led to the court's granting the
Bureau of Prison's Motion for Summary Judgment dismissing the case
as reported by the Denver
Post.
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Case: State of New York v. Nixzaliz Santiago. (2008)
Dr. Bursztajn was retained by the prosecution for examination of
defendant. Articles on
the verdict in
the New York Times
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Case: US v. Jane
Doe. Mental Illness Creates Eligibility for a Lower Sentence.
Dr. Bursztajn testifies in Federal Court that defendant suffered
from diminished capacity and complex PTSD (vs. simple PTSD) which
often presents itself in compulsive self-destructive behavior. (January
2004)
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Article: Outings
for Hinckley: Wellness vs. Safety. Dr. Bursztajn is quoted in
a Boston Globe article responding to questions on the possible release
of Ronald Reagan's would-be assasin, John Hinckley, Jr., who was
committed to St. Elizabeth's Hospital suffering from schizophrenia.
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Article: The
Role of a Forensic Psychiatrist in Legal Proceedings. An overview
of the function of forensic psychiatry and how it differs from clinical
practice.
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Article: National
Certification for Forensic Psychiatrists: A Preview of the Post-Daubert Expert.
Dr. Bursztajn's article on the effect of the Daubert ruling
on the use of expert witnesses and its specfic effect on forensic
psychiatric testimony.
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Article: Daubert
Without Prejudice: Achieving Relevance and Reliability Without Randomness.
Dr. Bursztajn's article exploring post-Daubert developments
in standards for forensic psychiatric evaluation.
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Article: Rashomon
and the Criminal Law. While mental disabilities can affect rulings,
the legal structure that dictates how such testimony can be used
is not well understood.
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Case: Kansas
v. Crane. Finding of Complete Lack of Volition Not Required For
Civil Commitment of Dangerous Sexual Offender
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Case: Porter
v. McCollum. A unanimous Supreme Court ruled that a Korean War
veteran, who likely had PTSD, receved ineffective assistance of counsel,
where he was sentenced to death for murder and no evidence about
his mental state or other mitigating factors were introduced at the
penalty phase.
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American Association of Legal Nurse
Consultants (AALNC) offers information for RNs who are legal
nurse consultants (LNCs), for attorneys looking for an LNC, and for
RNs who want to become a member of the organization.
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Bazelon Center for Mental Health
Law supports "legal advocacy for the civil rights and
human dignity of people with mental disabilities." This site
offers information and resources to support advocacy lawyers, consumer
advocacy organizations, state protections, and others.
Aspects of criminal justice that a forensic psychiatrist works with include:
Diminished Capacity
Sentencing Guidelines
Forensic psychiatric testimony can affect sentencing. Since a defendant
found to be suffering from a psychiatric symptom often receives a less
severe sentence, accurately determining a defendant's psychiatric health
is important in judging the severity of the offense and the potential
for rehabilitation and future offense prevention.
Competency to Confess
False Confessions can be based on helplessness, hopelessness, and interrogation
dynamics. A forensic psychiatric examination can help evaluate reliability
of confession and potential confounding factors. Dr. Bursztajn's evaluated
and testified as a forensic neuropsychiatric expert on altered mental
states leading to false confessions for Luc Angier. Mr. Angier was a
city official wrongly accused of a white collar crime who while depressed
confessed to a crime he did not commit (State of Maine v. Angier). Dr.
Bursztajn's expert consultation and testimony was seriously considered
by the jury in its acquittal of the defendant. Post acquittal, further
investigation proved the defendant's innocence.
Brain Syndromes
Physical damage or abnormality in the brain can affect behavioral and
thought processes. Dr. Bursztajn was among the first experts to be allowed
to use brain imaging in the courtroom to support a forensic neuropsychiatric
evaluation and testimony.
Drugs & Addictions
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Article: "Ethical
and Legal Dimensions of Benzodiazepine Prescription"
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Article: In
a World of Hazards, Worries Are Often Misplaced. A high risk behavior is most maintained by an individual when it
is voluntary and fair. This is particularly true for highly disciplined
individuals persisting in a high risk behavior. The New
York Times, August 20, 2002.
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Article: The
Puzzling Red Wine Headache. The neuropsychiatry of red wine headaches. The New York Times,
July 17, 2002.
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Article: Compulsive
Gambling: Overlooked Addiction. The New York Times, May 4, 1999.
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Article: In
Treating Patients for Pain, a Racial Gap. The New York Times, December 28, 1999.
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Article: In J.F.K.
File, Hidden Illness, Pain and Pills. Newly disclosed medical
files covering the last eight years of Kennedy's life, including
X-rays and prescription records, show that he took painkillers, antianxiety
agents, stimulants and sleeping pills, as well as hormones to keep
him alive, with extra doses in times of stress. The New York
Times, November 17, 2002.
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Article: Like
Drugs, Talk Therapy Can Change Brain Chemistry. The importance of providing patients with informed and meaningful
choices as to treatment modalities is underscored by this article by Richard
A Friedman, M.D. The New York Times, August 27, 2002.
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Article: Debate
on Acne Drug's Safety Persists Over Two Decades. Can an acne
drug cause teenagers to commit suicide? This question returned to
the spotlight this month when a 15-year-old boy flew a small airplane
into a Florida skyscraper. The New York Times, January
22, 2002.
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Article: Proper Scope of Duty to
Warn Before Court. This Supreme Judicial Court of Massachusetts ruling from October 8, 2001, may expand the duty of pharmacies to include warning
against harmful side effects of medication.
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Article: Kids Using
More Psych Drugs. ADD and the need for a comprehensive psychiatric
evaluation in light of presciption drug misuse.
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Article: When
O.J. Didn't Have His Game Face. Dr. Bursztajn is quoted in New
York Magazine on the side effects of steroid abuse.
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Article: Narcotic
OxyContin: Savior or Killer? Oxycontin is the best-selling narcotic
pain medication in the United States. It earns about $1 billion every
year for its manufacturer, Purdue Pharma. Just two pills a day can
stave off the worst pain for patients who suffer from cancer or serious
injury but now the painkillers's benefits are overshadowed by reports
of addiction and death.
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The Pharmaceutical Manufacturers
Association website where consumers can
search for information about pharmaceutical products. Topics covered include the development
and use of drugs, including Medicare prescription drug coverage,
cancer medicines in development, news about biotechnology drugs,
and information on the Directory of Patient Assistance Program,
which offers medications to those who can't afford to purchase
them.
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Tobacco Cessation
Guideline. The latest drugs and counseling techniques for treating
tobacco use and dependence from the Surgeon General's Office.
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International
Network on Therapeutic Jurisprudence
Profiling
Workplace & Public Safety
Safety First: After a wave of job-site violence, including the murder
of a housing inspector on the job and shootings in hospitals, the American
Federation of State, County and Municipal Employees published a handbook
for union reps, "Preventing Workplace Violence." [Wall Street
Journal: February 17, 1998]
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Interview: Tucson
Shooting Renews Gun Control Debate. Dr. Bursztajn is interviewed
on NPR's Talk of the Nation on February 16, 2011 on the public safety
issues arrising out of the shooting of Congresswoman Gabrielle Giffords.
The January shooting of Rep. Gabrielle Giffords (D-AZ) and 18 others
in Tucson has reignited two issues in the debate over guns in America:
the legality of extended magazine clips like the one used by the
suspected shooter, and access to firearms by the mentally ill.
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Article: Never
Released, Yet Often Missing. The effects of overloading the public
sector due to managed care cutbacks on patient care and public safety.
Dr. Bursztajn quoted in The Washington Post, February
10, 2003.
Some city officials and mental health specialists questioned how St.
Elizabeths let Hilliard get away again.
"Wow. It's hard to believe that after [the] escapes, he was given
an unaccompanied grounds privilege," said Harold J. Bursztajn, a
professor of psychiatry at Harvard Medical School. "If you leave
someone unaccompanied when there's a potential of escape, you're not
providing the most adequate care."
"This," said D.C. Council member Adrian M. Fenty (D-Ward 4), "is
egregious incompetence."
The first killing tied to Hilliard took place more than 30 years ago.
For more on protecting public safety and patient care in the managed
care era please see: Protecting
Patient Care
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Letter to the Editor: The
Fateful Gamble in Moscow. Dr. Harold J. Bursztajn. Validating
or legitimizing terrorist-chosen grievances as "root causes" or
equating the deaths of those murdered by terrorists with casualties
incurred during self- defense efforts encourages copycat terrorists
internationally, New York Times, October 29, 2002.
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Article: The
Mind of a Suicide Terrorist: Experts Explain the Thinking of Suicide
Terrorists. Dr. Bursztajn quoted in an ABC News story, September
19, 2001.
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Article: Terrorists
Copy-Cat Minds. Dr. Bursztajn's article on terrorists around
the world who are studying our reaction to the terrorist amongst
us, hoping to take that reaction into account in the design of future
terrorist events, October 23, 2002.
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Article: New
York Shock Therapy Police Recruits. Lessons being imparted in
a classroom at the United States Holocaust Memorial Museum, as part
of a spreading police education program that the museum counts among
its most prized achievements as it celebrates its 10th anniversary,
the recruits had finished a two-hour museum tour, a history lesson
that stunned many recruits to sobered silence. There were its depictions
of Jewish ghettos and the Nazis' gleeful exercise of brutal authority,
its photographs of victims, its collection of the shoes of the exterminated,
its relentless documentation of savage cruelty and, perhaps most
stunning of all, of the world's indifference to it.
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Article: Forensic
Psychiatry and Social Issues: A British Perspective. Mental illness,
suicide in prisons and destructive behavior.
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Article: "Childhood
Abuse and Adult Stress" A study links trauma, depression
and response to anxiety.
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Bureau of
Justice Statistics The US Department of Justice provides a web
site that contains statistics on workplace violence from 1992-1996.
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Article: "Violence
in public health and preventive medicine"
Dr. Bursztajn's consulting services include prevention, crisis response,
and post-crisis post-vention for traumatized co-workers.
Violence Prevention
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Article: Grandson's
erratic behavior detailed. Dr. Bursztajn is quoted in a March
18, 2009 Boston Globe article on the recent killing of Eleanor Clark
by her grandson, James Clark.
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Article: Suspect's
Killing of Cats Was an Ominous Sign. Dr. Bursztajn's public comments
in the Boston Herald on the Capitol Hill killings. Dr. Bursztajn
was also interviewed on June 7, 1998 by the spanish speaking media
journal, the Jornal da Tarde, on these killings:
To specialists, the acts by Weston that preceded the
attack in the Capital can help to explain his psychological problems.
Right before the attack, he had killed various cats (using a
gun) in Varmeyer. His apparent motive for that was that he had
been expelled from his house by his father. The killing of animals
is many times a sign that there is a "homicidal psychosis",
says Harold Bursztajn, from the Harvard Medical School.
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Article: Preventing
Neo-Nazi Cult Violence in Our Schools. Dr. Bursztajn's comments
on the Littleton killings.
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Article: Troubled
Adolescents Need A Double Safety Net. An article by Dr. Bursztajn
and his colleague Irene Coletsos.
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Article: Attacks
Spur Call to Force Medications. Chicago Tribune article
quoting Dr. Bursztajn.
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Article: Major
Mental Illness & Violence: Quick Fix vs. Commitment to Care.
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Article: Mental
Disorder Defies Docs. Dr. Bursztajn is interviewed by the Boston
Herald regarding the Edgewater Technologies Shootings in Wakefield
on January 2nd, 2001.
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The Program
for Young Negotiators is designed to build negotiation skills
in both teachers and students. The book, Young Negotiators by
Jared R. Curhan, is a wonderful guide to negotiating conflict resolution
in the best interest of a just, non-violent community. [Houghton-Mifflin,
1998, Boston, MA].
Violence is sometimes a problem in legal proceedings. Attorneys and judges
in litigation related proceedings have been cautioned about violence
prevention. Dr. Bursztajn's work in judicial education and courtroom
violence has been widely recognized.
Domestic Violence
Bioterrorism Prevention
Nuremberg Code
Recommended Reading:
Legal Resources: The Committee for Public Counsel Services (CPCS) is
a fifteen-member body established by Chapter 211D of the Massachusetts
General Laws to oversee the provision of legal representation to indigent
persons in the Commonwealth. For more information, see the CPCS
Mental Health Litigation Home Page.
Dr. Bursztajn has an active patient care practice and consults to physicians,
institutions, judges, and plaintiff and defense counsel nationally.