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PAGE 1
Comer BLOCKER, Appellant, v. UNITED STATES of America,
No. 15777
UNITED STATES COURT OF APPEALS DISTRICT OF COLUMBIA CIRCUIT
110 U.S. App. D.C. 41; 288 F.2d 853; 1961 U.S. App. LEXIS
November 16, 1960, Argued
March 3, 1961, Decided
Appellee
5164
Mr. J. William Doolittle, Jr., Washington, D.C. (appointed by this court),
with whom Mr. E. Lewis Ferrell, Washington, D.C. (appointed by the District
Court), was on the brief, for appellant. Mr. James W. Davis, who was appointed
by the District Court, was on the brief for appellant but entered government
service and withdrew as counsel before the argument.
Mr. Nathan J. Paulson, Asst. U.S. Atty., with whom Messrs. Oliver Gasch, U.S.
Atty., and Carl W. Belcher, Asst. U.S. Atty., were on the brief, for appellee.
JUDGES:
OPINION BY:
OPINION:
[*853]
We reversed appellant's former conviction of first degree murder. Blocker v.
United States, 107 U.S.App.D.C. 63, 274 F.2d 572. He now appeals from another
conviction and sentence of death for the same crime. There was substantial
evidence that he was, and substantial evidence that he was not, insane at the
time of the offense.
In 1895 the Supreme Court ruled that 'if the whole evidence, including that
supplied by the presumption of sanity, does not exclude [**2] beyond reasonable
doubt the hypothesis of insanity, of which some proof is adduced, the accused is
entitled to an acquittal * * *.' Davis v. United States, 160 U.S. 469, 488, 16
S.Ct. 353, 358, 40 L.Ed. 499. That case has been law for 65 years. In the last
10 years we have applied it many times.
In 1951 we said: 'the function of the trial court in regard to the issue of
sanity [*854] is to determine whether that issue is brought into the case by
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110 U.S. App. D.C. 41; 288 F.2d 853, *854;
1961 U.S. App. LEXIS 5164, **2
evidence. If it is, then it should be submitted to the jury with instructions
that if the jury has a reasonable doubt of the defendant's sanity, there must be
an acquittal.' Tatum v. United States, 88 U.S.App.D.C. 386, 390, 190 F.2d 612,
616.
In 1954 we said: 'Whenever there is 'some evidence' that the accused suffered
from a diseased or defective mental condition at the time the unlawful act was
committed, the trial court * * * should in some way convey to the jury the sense
and substance of the following: * * * Unless you believe beyond a reasonable
doubt either that he was not suffering from a diseased or defective mental
condition, or that the act was not the product of such abnormality, you must
find [**3] the accused not guilty by reason of insanity. * * *' Durham v.
United States, 94 U.S.App.D.C. 228, 241, 214 F.2d 862, 875, 45 A.L.R.2d 1430.
In 1956 we said: 'There was evidence * * * that the accused was of unsound
mind when the robberies occurred. The prosecution therefore was under the
necessity of establishing to the satisfaction of the jury beyond a reasonable
doubt that the robberies were not the result of Douglas' insanity. * * *
Restating the matter within the rule prevailing in this jurisdiction since
Durham v. United States, * * * in order to justify a conviction the proof,
considered with the presumption of sanity, must exclude beyond a reasonable
doubt the hypothesis that the conduct indicted was the product of a diseased
mind.' Douglas v. United States, 99 U.S.App.D.C. 232, 235, 239 F.2d 5i, 55.
In 1957 we said: 'when the defendant introduces some evidence to raise the
issue of insanity, his sanity at the time of the offense becomes an element of
the crime, which, like all other elements of the crime, must be proved by the
Government beyond a reasonable doubt.' Wright v. United States, 102 U.S.App.D.C.
36, 39, 250 F.2d 4, 7. [**4]
Again we said in 1957: 'When the issue of insanity is properly raised by
evidence, as it was in this case, the burden is on the Government to prove * * *
beyond a reasonable doubt either (1) that the accused had no mental disease or
defect or (2) that, although the accused was defective or diseased, his act was
not the product of the affliction.' Carter v. United States, 102 U.S.App.D.C.
227, 233, 234, 252 F.2d 608, 614, 615.
We said this again in 1959. Hopkins v. United States, 107 U.S.App.D.C. 126,
128, 275 F.2d 155, 157.
On January 21, 1960, we said: 'the law in all federal jurisdictions, under a
Supreme Court ruling, is and has been for more than half a century that, when a
defendant in a criminal case introduces enough evidence of insanity to overcome
the presumption of sanity, a burden thereupon falls upon the Government to
establish sanity beyond a reasonable doubt.' Issac v. United States, 109
U.S.App.D.C. 34, 284 F.2d 168, 170.
Although these many cases made it uncommonly plain that the burden of proof
on the issue of Blocker's insanity was on the government, the prosecutor asked
the court to place the burden on the defendant. [**5] His Proposed Instruction
No. VI said: 'In order for you to find the defendant not guilty by reason of
insanity, you must find: (1) that at the time of the offense(s) the defendant
was suffering from some mental disease or defect; AND (2) that the act(s) in
question * * * was (were) the product of such mental disease or defect. * * * In
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110 U.S. App. D.C. 41; 288 F.2d 853, *854;
1961 U.S. App. LEXIS 5164, **5
order for you to acquit on the ground of insanity, you must find both these
elements present. It is not sufficient for you to find merely that the
defendant was suffering from a diseased or defective mental condition when he
committed the offense. You must further find that the act was the product of
the mental abnormality.' n1
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n1. Except for the unimportant word 'further', the last two quoted sentences
of the proposed instruction are the very words of the instruction we had
disapproved in Carter, supra.
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[*855] After thus contradicting the law, the proposed instruction
contradicted itself. It said: 'However, if there is some evidence of mental
disorder, [**6] the burden is on the Government to prove beyond a reasonable
doubt that at the time in question the defendant was of sound mind. * * * If you
should find all the elements of the offense have been proved, but you have a
reasonable doubt as to both his mental condition and the causal relation of
such mental condition to the offense charged, then you would find the defendant
not guilty by reason of insanity.' (Emphasis added.)
The net result of the proposed instruction was confusion. The burden was on
the defendant; the burden was on the government.
The court granted the proposed instruction 'in substance'. It first charged
the jury in accordance with the law; then in contravention of the law; and
finally, once more in accordance with the law:
(1) 'Basically, there is a presumption that all people are sane. * * * But,
when there is some evidence of a mental disorder, as here in this case, then
the presumption of sanity of the individual, Comer Blocker, vanishes from the
case. And the burden is upon the Government to prove beyond a reasonable doubt
that at the time in question, April 5th, 1957, the defendant, Comer Blocker, was
of sound mind, or if he suffered from a mental disease [**7] or defect, at the
time of the offense, that is, the killing of Frances Hall, that the act was not
caused by the mental disease or defect, just as the burden is on the Government
to prove beyond a reasonable doubt all of the other essential elements * * *
that is, malice, premeditation, deliberation, the same burden is on the
Government to prove the sanity of Comer Blocker on April 5th, 1957, or that if
he was suffering from a mental illness on that date, that it was not the causal
effect (sic) of the killing of Frances Hall. * * *'
Assuming 'causal effect' was meant for 'effective cause', the foregoing part
of the court's instruction is correct. It places the burden of proof where the
law places it, squarely on the government.
But the court went on to give a contrary instruction:
(2) 'Now, a person is relieved of the responsibility for a crime by reason of
insanity, where it is found, first, that he was suffering from a mental defect
or a mental disease at the time of the offense, and, second, that his act was
the product of that mental defect or disease. * * * Now, you are instructed that
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110 U.S. App. D.C. 41; 288 F.2d 853, *855;
1961 U.S. App. LEXIS 5164, **7
if you find that the defendant, Comer Blocker, committed the act complained of,
that is, [**8] the shooting of Frances B. Hall on April 5th, 1957, while he
was suffering from a mental disease or defect, then you must consider the second
requirement spoken of before you may find him not guilty by reason of insanity.
* * * Turning then to the shotting * * * if your answer to the first requirement
is yes, the defendant, Comer Blocker, was suffering from a mental disease or
defect, and if you find that the defendant, Comer Blocker, did in fact commit
such acts, then you must find that it resulted from or was produced by the
unsoundness, or by the mental illness * * *. Now, if you find that then you may
find the defendant, Comer Blocker, not guilty by reason of insanity.'
This part of the instruction is plainly erroneous. The words 'where it is
found', 'you must find' and 'if you find' informed the jury that the burden of
convincing them -- which is the burden of proof -- was on the defendant.
Finally, the court went on to place the burden, as it had at first, on the
government:
(3) 'And if you should find the Government has proved all of the elements of
either first or second-degree murder but you have a reasonable doubt as to
whether the offense was the result of a mental [**9] disease or defect existing
in the defendant at the time he committed the offense, then you must find the
defendant not guilty by reason of insanity. If, however, you should find that
the Government has proven either first or second-degree [*856] murder, and has
also proved beyond a reasonable doubt either that the defendant was of sound
mind at the time of the offense, or that the act was not caused by any mental
disease or defect from which the defendant may have been suffering on that date,
that is, April 5th, 1957, * * * you may find the defendant guilty of such
offense. Now, ladies and gentlemen, it should be crystal clear to you that when
some evidence is introduced to you the presumption of sanity disappears and the
responsibility from that point on is on the Government. It is not a
responsibility which is on the defendant to prove any mental illness or that
the mental illness was the causal effect (effective cause?) or was the
motivating force behind the act in question. Those are responsibilities for the
Government.'
We have considered the erroneous instruction, which we have numbered (2), in
its context. We have placed it where the District Judge placed it, between
[**10] the two correct instructions which we have numbered (1) and (3). We
have endeavored to omit nothing that might be thought to have any tendency to
reduce the effect of the erroneous instruction. Perhaps the jurors were more
likely to act on the correct instructions than on the incorrect one. But we
cannot be certain that any juror did so. We think it unlikely that every juror
did so. We think it not unlikely that some jurors voted to convict Blocker
because (a) they could not decide whether his act was or was not the product of
mental illness and (b) the judge had told them they 'must find' the act was
produced by mental illness if they were to acquit him on the ground of insanity.
We see no reason to assume the jury found that Blocker had no mental disease or
defect, or found that no such abnormality produced the act.
As we said on January 21, 1960, regarding the charge to the jury in the Isaac
case, supra: 'The statements to the effect that in order to render a verdict of
not guilty by reason of insanity the jury * * * must find that the accused
suffered from a mental disease and that his acts were the product of the
PAGE 5
110 U.S. App. D.C. 41; 288 F.2d 853, *856;
1961 U.S. App. LEXIS 5164, **11
disease, were erroneous. Those statements ignored the burden [**11] which was
on the prosecution under the Davis case. It is true that the court correctly
stated to the jury several times that the burden of proof was on the Government
to establish beyond a reasonable doubt that the accused was not suffering from
a mental disease or that the acts were not the product of a mental disease. The
two conflicting views of the law, the erroneous and the correct, as to the
burden of proof were repeated several times in this charge. We cannot speculate
that the correct statements obliterated in the minds of the jurors the repeated
erroneous statements. We recognize that the problems posed by the
burden-of-proof rule in respect to the defense of insanity are somewhat
difficult, but the rule of law is plain and absolutely certain. It should be
made plain and certain to juries in such cases.' 109 U.S.App.D.C. at page 37,
284 F.2d at page 171.
Wright v. United States, 102 U.S.App.D.C. 36, 43, 250 F.2d 4, 11, and Carter
v. United States, 102 U.S.App.D.C. 227, 233, 252 F.2d 608, 614, are to similar
effect.
Because this is a capital case, it is especially important to avoid the
confusion which the court's self-contradictory [**12] instructions may have
created in the minds of at least some of the members of the jury.
We think the authorities we have cited make it clear that the conviction must
be reversed and the case remanded to the District Court for further proceedings
consistent with this opinion.
Appellant's court-appointed counsel has expressed deep concern that certain
practices in the administration of the rule of criminal responsibility which
this court adopted in 1954 endanger its broadened purposes. In dealing with
these matters in a number of previous cases, we have expressed similar concern.
We think the present case does not present a useful context for further
discussion of these matters.
CONCURBY:
CONCUR:
PRETTYMAN, BAZELON, FAHY, WASHINGTON, and DANAHER, Circuit Judges, concur in
this opinion.
[*857]
Reversed and remanded.
BURGER, Circuit Judge (concurring in the result only).
In my view we should reverse on the grounds urged by appellant's very able
brief with respect to the mechanical and restrictive aspects of the
'disease-defect-product' n1 test for determining criminal responsibility. This
would require that we modify the standard of criminal responsibility adopted
[**13] by us in 1954 n2 from the New Hampshire rule of 1869. n3
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110 U.S. App. D.C. 41; 288 F.2d 853, *857;
1961 U.S. App. LEXIS 5164, **13
n1. 'Disease' as hereafter used is intended to include 'defect.'
n2. Durham v. United States, 1954, 94 U.S.App.D.C. 228, 214 F.2d 862, 874.
n3. The rule we adopted in 1954 was 'that an accused is not criminally
responsible if his unlawful act was the product of mental disease or mental
defect.' Compare State v. Pike, 1870, 49 N.H. 399, 402, where the rule is 'the
verdict should be 'not guilty by reason of insanity' if the (unlawful act) was
the off-spring or product of mental disease * * *.' Some commentators emphasize
that while the 1869 rule and our 1954 rule are virtually identical in language,
they differ in that New Hampshire cast its rule as one of evidence governing the
scope of evidence to be received while Durham lays down a rule of law. Reid,
Understanding The New Hampshire Doctrine of Criminal Insanity, 69 Yale L.J. 367,
371, 389-91 (1960). Similarly the so called 'right and wrong' test is not the
same as the M'Naghten test.
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[**14]
Since its adoption in 1954, the 'disease-product' test has been both
acclaimed n4 and criticized; it has been called 'vague,' 'confusing,'
'ambiguous,' 'misleading,' and it has been condemned as taking the fact
determination away from jurors and transferring it to experts. n5 Curiously it
has even been attacked [*858] as 'novel' by critics who overlooked its 1869
origins, and as 'radical' by some who seemingly are unwilling to allow the same
scope to medical testimony in a criminal case as we have allowed historically in
civil cases, such as will contests where mental capacity is at issue.
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n4. E.g. Zilboorg, A Step Towards Enlightened Justice, 22 U.Chi.L.Rev. 331
(1955).
n5. Professor Mueller states: 'The first part of M'Naughten is designed to
determine (defendant's capacity for understanding the nature and consequences of
the act charged). The vague Durham test does not, and is, therefore, rightly
rejected by most of our courts. * * * let us not be hasty about changing our law
on capacity. Although psychiatry and neurology continue to make enormous
advances, psychiatrists are likely to reverse themselves completely between fall
and spring.' 1959 Ann.Survey Am.L. 112-114.
Professor Wechsler in The Criteria of Criminal Responsibility, 22
U.Chi.L.Rev. 367, 373 (1955) observed 'Durham then puts forth, in my opinion, a
legal principle beclouded by a central ambiguity, both unexplained and
unsupported by its basic rationale.'
Judge L. Hand said: 'I have read the (Durham) opinion * * * but, frankly, it
did not seem to me to give us any guidance that perceptibly would help.
'The truth appears to me to be that the question goes to the heart of
whatever we choose to make our purpose in criminal punishment. It is only
indirectly, or at second hand, a psychiatric question.' (Emphasis added.) Letter
from Judge L. Hand, 22 U.Chi.L.Rev. 319 (1955).
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110 U.S. App. D.C. 41; 288 F.2d 853, *858;
1961 U.S. App. LEXIS 5164, **14
Professor Guttmacher viewed Durham hopefully but with reservations saying
that while it 'will be a vast improvement over the criteria of responsibility in
common use, difficulties will still exist. * * * There will be uncertainty and
differences of opinion as to what constitutes a 'diseased or defective mental
condition.' And there will at times be doubt as to whether or not the act was
the product of the existing mental abnormality.' Guttmacher, The Psychiatrist As
An Expert Witness, 22 U.Chi.L.Rev. 325, 327 (1955).
'The Durham court rejected the New Hampshire approach of refusing to rule
that any particular overt condition or action was a manifestation of mental
disease, and instead has ruled, as a matter of law, that knowledge of right and
wrong, while no longer the test for mental disease, was a symptom of it. Thus
the Durham judges refused to heed Doe's dictum that the law is not concerned
with the correctness of any medical theory, and did the very thing for which
they condemned the M'Naghten judges, transforming contemporary medical theory
into judicial fact. As a result, the Durham court has not only offered
definitions on questions which New Hampshire would leave to the jury, but,
despite clearly stated intentions to the contrary, may also be said to have set
itself up as the ultimate trier of facts, reversing convictions when it has
disagreed with the jury's conclusions as to the value of specific expert
psychiatric testimony.' Reid, Understanding The New Hampshire Doctrine of
Criminal Insanity, 69 Yale L.J. 367, 390-91 (1960).
'To believe that one's own theories are facts is considered by many
contemporary psychiatrists as a 'symptom' of schizophrenia. Yet this is what the
language of the Durham decision does. It reifies some of the shakiest and most
controversial aspects of contemporary psychiatry (i.e., those pertaining to what
is 'mental disease' and the classification of such alleged diseases) and by
legal fiat seeks to transform inadequate theory into 'judicial fact." Dr. T. S.
Szasz, Psychiatry, Ethics, and the Criminal Law, 58 Colum.L.Rev. 183, 190
(1958).
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[**15]
As I see it, our Durham opinion was a wrong step but in the right direction;
its direction was correct because, like Smith v. United States, 1929, 59
App.D.C. 144, 36 F.2d 548, 70 A.L.R. 654, it sought to open the jury's inquiry
to include the expanding knowledge of the human mind and personality. The
precise step -- the 'disease-product' test -- is, however, subject to many
valid criticisms which we must face. Among other things it tends to treat
unsupported and dubious psychiatric theory as scientific knowledge. It is an
example of exercising judicial power beyond judicial comprehension in an area
where not even relative certainties are established. From ancient times the
development of the law was always on the basic idea that man should be held
criminal responsible for his voluntary acts resulting from the exercise of his
will. While we have said this was our 'basic postulate,' n6 our '
disease-product' instruction to the jury totally ignores will or choice. It is
obvious, of course, that under a jury system the standard or 'test' or 'rule'
of criminal responsibility is only what is given to the jury as an instruction.
What we say in our opinions but withhold [**16] from the jury is meaningless
except as it discloses the gap between the law as stated by this court and the
law as applied by the jury.
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110 U.S. App. D.C. 41; 288 F.2d 853, *858;
1961 U.S. App. LEXIS 5164, **16
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n6. Carter v. United States, 1957, 102 U.S.App.D.C. 227, 235, 252 F.2d 608,
616.
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I
Fallacies of Our Present
Criminal Responsibility Standard
I agree with appellant's attack on the mechanical and restrictive 'labelling'
aspect of the 'disease-product' test and I believe that we cannot escape from
the dilemma created by that rule except by adopting some other alternative. Of
necessity the whole of my reasons must be set forth at some length, since what I
propose is that the entire background of this problem be reexamined and that the
'disease-product' jury instruction be abandoned. We have devoted literally
hundreds of pages in numerous opinions in our effort to explain and interpret
what that rule means; not surprisingly it will require some space to review this
history, to demonstrate the defects of the rule and to set forth possible
alternatives.
Appellant's [**17] counsel has not made a direct attack on Durham, but
rather conches his attack in terms of the manner in which the prosecution 'used'
and the court applied it. Without reaching the alleged errors in the charge on
burden of proof, which were persuasive to the majority, I am satisfied that the
District Judge applied our rule literally and scrupulously in allowing experts
to express conclusory opinions in the same terms as the ultimate jury question.
Our rule permits, and indeed rests upon the premise that psychiatrists may do
precisely that.
Appellant's cogent attack on the 'disease-product' concept is best stated in
the terms of his own very able brief. First he attacks the 'disease' aspect of
[*859] the rule and argues that in Blocker's trial
'the issue of insanity was for all purposes tried and decided solely on the
catch-phrase 'mental disease,' with the result that appellant was effectively
denied a jury trial on that vital issue.'
Second, he attacks the 'product' aspect in these terms:
'What happened in appellant's trial was a classic case of usurpation of the
jury function by expert witnesses, and it should be promptly corrected.
Permitting the sort of questioning [**18] and testimony that was indulged in
below undermines the whole purpose behind the promulgation of the Durham rule,
for it tends to narrow the scope of psychiatric testimony on the accused
person's mental condition. Furthermore, it is especially dangerous to permit
psychiatric testimony in terms that the jury is likely to regard as conclusive
on the question of criminal responsibility, for psychiatrists have no competence
whatsoever to offer opinions on that ultimate question.' (Emphasis added.)
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110 U.S. App. D.C. 41; 288 F.2d 853, *859;
1961 U.S. App. LEXIS 5164, **18
(1)
The Term 'Disease' Is Inadequate
The rule we adopted in 1954 is based on the premise that the critical
threshold issue is whether the defendant has a 'mental disease or defect.' Our
opinion did not define these terms except to say that the former is a 'condition
which is considered capable of either improving or deteriorating' while the
latter was fixed and subject neither to improvement nor deterioration. This
merely distinguishes 'disease' from 'defect' without defining either term. Not
being judicially defined, these terms mean in any given case whatever the expert
witnesses say they mean. We know also that psychiatrists are in disagreement on
what is a 'mental disease,' and even [**19] whether there exists such a
definable and classifiable condition. So distinguished an authority as Dr.
Philip Q. Roche, author of The Criminal Mind, which received the Isaac Ray Award
from the American Psychiatric Association, said as recently as 1958:
'I will say there is neither such a thing as 'insanity' nor such a thing as '
mental disease.' These terms do not identify entities having separate existence
in themselves. * * * 'Mental illness,' a medical term, borrowed from the
mechanistic concepts of classical physical disease, refers to an altered
internal status of the individual vis-a-vis his external world as interpreted by
others. In a way the term is a misnomer, since the mental illness n7 is not
actually something limited to a place called the 'mind,' but rather it is a
changed interrelationship of the individual with his fellow creatures. * * * To
the psychiatrist the mental illness can have a meaning only in the sense of what
in the future will be done to or with the patient to relieve him and those
around him.' (Emphasis added.) Symposium on Criminal Responsibility and Mental
Disease, 19th Annual Law Institute, Univ. of Tenn. 1958, in 26 Tenn.L.Rev. 221,
240-41 (1959). [**20]
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n7. The Durham opinion treated the terms 'mental disease' and 'mental
illness' as interchangeable.
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Dr. Charles Savage, writing in The American Journal of Psychiatry tells us:
'Though widely heralded as bringing legal psychiatry more in line with modern
psychology, it (the Durham rule) actually does not such thing. It is a peculiar
mixture of Aristotelean faculty psychology, metaphysics, mysticism, and
mediaeval theology. * * * It is indeed vague particularly in the matter of the
first test of responsibility: that of mental illness. There are very few people
who could not qualify under this test * * *.' Dr. C. savage, Discussion, 11l Am.
J. of Psychiatry 295, 296 (1959).
[*860] Dr. John R. Cavanagh has said:
'The term disease is also misleading because it leads to the misconception
that each psychic disorder must have some specific cause, e.g., as the specific
cause of tuberculosis is the tubercle bacillus. This is not true. In reference
to this term, Hinsie and Shatsky make this comment: 'It is not [**21]
PAGE 10
110 U.S. App. D.C. 41; 288 F.2d 853, *860;
1961 U.S. App. LEXIS 5164, **21
considered in keeping with the available facts to refer to a psychosis as a
disease * * *.'
'In view of this evidence (various cited authorities omitted), the term
disease as applied to mental conditions should be dropped because it is
misleading.' Cavanagh, A Psychiatrist Looks At The Durham Decision, 5 Catholic
U.L.Rev. 25, 28, 30 (1955).
The literature on the subject since 1954 abounds with similar comments. This
is not to suggest we cannot rely on so uncertain an 'infant science' as
psychiatry but rather to suggest that no rule of law can possibly be sound or
workable which is dependent upon the terms of another discipline whose members
are in profound disagreement about what those terms mean. How can lay jurors
possibly understand and apply terms whose meaning is unclear to acknowledged
experts? This is not simply a matter of experts disagreeing on opinions or on
diagnosis, which often occurs, but disagreement at the threshold on what their
own critical terms mean.
The fallacy of judicial reliance on terms such as 'disease' or 'disorder' is
further illustrated by a series of cases in this court, including the first
trial and appeal of this appellant. We reversed [**22] Blocker's first
conviction because after his trial and while his appeal was pending in this
court, another case, In re Rosenfield, D.C.D.C.1957, 157 F.Supp. 18 n8 was being
heard on petition for release on a writ of habeas corpus. In that case a
psychiatrist made it known to the District Court that between the court session
on Friday and Monday morning, St. Elizabeths Hospital, by some process not then
disclosed, altered its 'official' view that sociopathic or psychopathic
personality disorder was not a mental disease. It had been decided that
commencing Monday, St. Elizabeths Hospital and its staff would thereafter call
and classify the condition known to them as 'psychopathic personality' as a '
mental disease' or 'mental disorder.' n9
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n8. See also testimony in United States v. Leach, Crim. No. 450-57 D.D.C.;
and discussion in Blocker v. United States, 1959, 107 U.S.App.D.C. 63, at pages
65-71, 274 F.2d 572, at pages 574-580 (dissent).
n9. This is reminiscent of Lewis Carroll's classic utterance: 'When I use a
word,' Humpty Dumpty said, in rather a scornful tone, 'it means just what I
choose it to mean -- neither more nor less.'
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[**23]
The courts, of course, have neither concern nor control over the nomenclature
or diagnostic terms of the medical discipline. To the extent that such
nomenclature constitutes a form of 'shorthand' language to facilitate
communication within the profession it is of no concern to anyone outside. But
the impact of this 'week-end change' was shown when Blocker then came to this
court and claimed (1) that he was a sociopathic or psychopathic personality, (2)
that he was entitled to a new trial under circumstances where his condition
could be described as a 'mental disease' under the revised definition. In
Blocker's first trial three psychiatrists who testified said he had no 'mental
PAGE 11
110 U.S. App. D.C. 41; 288 F.2d 853, *860;
1961 U.S. App. LEXIS 5164, **23
disease.' I am now satisfied that our reversal of Blocker's first conviction on
the stated grounds n10 without more, was an error (and one in which I
participated at the time.) In holding as we did, we tacitly conceded the power
of St. Elizabeths Hospital Staff to alter drastically the scope of a rule of law
by a 'week-end' change in nomenclature which was without any scientific basis,
so far as we have any record or information. [*861] n11 If the impact of the
'week-end' change was confined to the hospital [**24] for clinical and
professional purposes of psychiatrists and their aides, we would have no cause
to concern ourselves. n12 But this change altered the scope of the '
disease-product' test to embrace a vast number of people and problems not
contemplated by this court when the rule was adopted. Of course legal rules
should be flexible enough to embrace the bona fide, and scientifically
recognized developments and discoveries of medicine. n13
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n10. Other substantial asserted grounds for reversal of Blocker's first
conviction were not reached in our opinion and may well have warranted such
action.
n11. We can take judicial notice that the American Psychiatric Association
altered its nomenclature in 1952 to change psychopathic personality disturbance
or sociopathic personality disturbance from a non-disease category into a mental
disease. Whether this was by 'voice vote' at a convention or some other
parliamentary process we are not informed. The medical literature suggests that
a large number, perhaps even a majority of psychiatrists do not consider
'psychopathic personality disturbance' a mental disease.
In his recent Isaac Ray Award book The Criminal Mind (1958), Dr. Roche tells
us:
'Psychiatric nomenclature is undergoing revision and there is considered the
possibility of discarding the terms 'psychosis' and 'neurosis' altogether in
favor of a more flexible framework in keeping with our present knowledge and
operational methods. * * * It would be of interest to the legal profession that
the term 'psychopathic personality' is no longer regarded by psychiatry as
meaningful, yet it will probably remain embalmed for some time to come in the
statutes of several States. * * *' Id. at 25.
On the preceding page of the same work the author has already told the reader
that
'Two of the most frequently encountered terms in psychiatry are 'psychosis'
and 'psychoneurosis' ('neurosis') and it might appear that in such currency
their meaning should be settled in universal agreement. This is not the case.
Not only is there confusion, theoretically and practically, as to the precise
meaning of each term, but also is there often as much confusion as to the
existence of a pathological process to which either or both terms can be
applied.' Id. at 24-25. [**25]
n12. As to the substance of the change in classification or nomenclature
there is good reason to reject it categorically so far as the courts are
concerned. Many psychiatrists do not accept the view that 'psychopathy' is or
should be classified as a 'disease.' Responsible experts have testified in cases
PAGE 12
110 U.S. App. D.C. 41; 288 F.2d 853, *861;
1961 U.S. App. LEXIS 5164, **25
in this jurisdiction that to cure a psychopath the treatment must change his
entire personality -- something few psychiatrists think possible. The Isaac
Ray Award book, The Criminal Mind states:
'Psychiatry is yet divided in its concept of psychopathy. Some subscribe to
the view that the psychopath in our society imposes a greater threat than the
conventially insane * * *. Few psychopaths have been changed.' Roche, The
Criminal Mind 257-58 (1958). (Emphasis added.)
See testimony of Dr. Cushard, Ragsdale v. Overholser, 1960, 108 U.S.App.D.C.
308, 281 F.2d 943, 945 note 5: 'I don't think a (psychopath) improves or
recovers from his personality. * * * In other words, I think these people are
able to control their acts if they make the necessary effort.'
n13. As recently as 1957 the most that the court claimed for these
'diagnostic terms' was that they are 'abbreviations for sets of symptoms which
are relatively standardized in medical literature and increasingly relied upon
in practice.' Lyles v. United States, 1957, 130 U.S.App.D.C. 22, 37, 254 F.2d
725, 740, certiorari denied 1958, 356 U.S. 961, 78 S.Ct. 997, 2 L.Ed.2d 1067.
(Emphasis added.) Yet it is to such 'diagnostic terms' that we had already
firmly tied a rule of law.
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[**26]
Standards which are to be relied on by judges and juries, by their very
function should not be subject to such wide variation from case to case or
witness to witness or month to month. Evenhanded justice cannot be measured out
with a 'rubber' yardstick.
These factors, I think, demonstrate that a term such as 'disease' which has
no fixed, agreed or accepted definition in the discipline which is called upon
to supply expert testimony and which, as we have seen, is literally 'subject to
change without notice' is a tenuous and indeed dangerously vague term to be a
critical part of a rule of law on criminal responsibility. [*862] n14 Later I
shall try to demonstrate that the law need not concern itself with whether the
accused has a 'mental disease' or illness by any particular name or label and
hence testimony about 'disease' as such is not relevant. Our 1954 opinion
purported to free the problem from labels, but we are now more prisoners of
labels than before. Lest these observations be taken as a criticism of the
medical profession, I emphasize that this court, not the psychiatrists, made the
rule.
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n14. A distinction must be made between permitting experts to describe the
diagnosis, as we should, and making a particular diagnosis, i.e., 'mental
disease', the threshold fact question for the jury.
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[**27]
(2)
Before WILBUR K. MILLER, Chief Judge, and EDGERTON, PRETTYMAN, BAZELON, FAHY,
WASHINGTON, DANAHER, BASTIAN, and BURGER, Circuit Judges, sitting in banc.
EDGERTON
BURGER; FAHY