'Reliable Witness': 'Doctors', dementia, and confessions
Watching in passing an episode of the BBC daytime serial drama Doctors entitled 'Reliable Witness', one of the storylines was about a man with dementia who confesses to the murder of his wife. The very vexing issues of the punishment of people with dementia could not be explored in depth in one episode, but there was some coverage of the neuroethical problem of holding someone to account whose mental capacity is severely reduced.
There are a number of reasons related to mental conditions for not holding someone to account. In the case of sufficiently advanced dementia, the basic problem is that it may be impossible to hold the person to account in the truest sense. The person with advanced dementia cannot own their actions nor answer for them. If they cannot understand the reasons why they were being punished, and therefore to punish them would be truly Kafka-esque. Instead of reflecting on their crimes, they would be constantly perplexed by their predicament.
If dementia was apparent at the time of the proceedings, the defendant might be found unfit to plead, and so be spared a trial. However, they would still be liable for the disposal options available under the Criminal Procedure (Insanity and Unfitness to Plead) Act 1991 - either an absolute discharge, outpatient supervision, or a hospital order. In the case of homicide, a hospital order would be mandatory for a mental disorder.
There are a number of reasons related to mental conditions for not holding someone to account. In the case of sufficiently advanced dementia, the basic problem is that it may be impossible to hold the person to account in the truest sense. The person with advanced dementia cannot own their actions nor answer for them. If they cannot understand the reasons why they were being punished, and therefore to punish them would be truly Kafka-esque. Instead of reflecting on their crimes, they would be constantly perplexed by their predicament.
If dementia was apparent at the time of the proceedings, the defendant might be found unfit to plead, and so be spared a trial. However, they would still be liable for the disposal options available under the Criminal Procedure (Insanity and Unfitness to Plead) Act 1991 - either an absolute discharge, outpatient supervision, or a hospital order. In the case of homicide, a hospital order would be mandatory for a mental disorder.
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