One of the hazards of being a forensic psychiatrist is that in the wake of certain high-profile events you get nudged, privately and publicly, to speculate on what you “really think was going on” in the mind of the perpetrator.
Unfortunately, in the last few years, there have been several opportunities for this to happen: following the Amish murders in Lancaster County, the Virginia Tech and Fort Hood incidents, and after six people died in the Arizona shooting. Thanks to social media, you can also now follow the media coverage in real time through Twitter feeds and live-blogging journalists. Social media enabled me to follow public comments made by various mental health professionals immediately following the offense.
Just out of curiosity, I did a little preliminary survey to see what these professionals had to say about the incident. I searched the Internet using the term “Colorado shooter motivation” along with either the term “psychologist” or “psychiatrist.” While the following results are neither complete nor scientific, I think they are symptomatic of a problem in both professions.
What I discovered was that psychiatrists and psychologists from California, Texas, Illinois, Oregon, Pennsylvania, and South Carolina all proffered observations about the alleged shooter’s possible motivation as well as his mental state during a court appearance. Some went so far as to make specific diagnoses such as schizophrenia, an unspecified psychotic disorder, or psychopathy. All based their opinions solely upon information presented in the media, and only one – a psychologist – made a point of couching the opinion with the disclaimer that their information could be incomplete or simply wrong.
The most striking example I found was posted by a guest columnist for an online newspaper. This psychiatrist stated, “This man is mentally ill. I do not have information enough to be diagnosing, but clearly he has a psychotic disorder. No sane person behaves this way.”
While it may be tempting or flattering to be given the opportunity to be a media commentator, psychiatrists do have an ethical duty to restrict our public comments. According to Section 7.3 of the American Psychiatric Association's Principles of Medical Ethics:
“On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself or herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general.
However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement.”
The requirement for a personal examination is particularly important when an opinion is derived solely from media sources whose information may be unreliable. In a recent court filing, the district attorney in the Colorado shooting case reportedly stated that the media was obtaining information from “hoaxers, fraudsters, or maybe from nobody at all.” Some of the early information that these professionals relied upon has now been found to be wrong, such as the suspect’s lack of previous contact with mental health care.
Ethical guidelines also require physicians to practice within their area of competence. Mental health professionals without experience or training specific to criminal behavior, violence and mental illness, and the legal assessment of competence or sanity may be practicing outside the scope of their training by offering opinions on these issues.
Not to be completely negative, there were good examples of psychiatric commentary. Dr. Keith Ablow, a member of the Fox News medical team, presented a detailed and careful overview of the sanity evaluation process and addressed a number of public misconceptions about the insanity defense.
The Goldwater rule was intended to protect celebrities, politicians and other high-profile figures from unwarranted invasion of privacy and damage to their reputations. I’m sure the authors of this clause didn’t anticipate the unintended effects such speculation could have on a criminal defendant, the alleged suspect’s family, or the victims of the offense. Public speculation about a criminal defendant has much more serious repercussions than a tarnished reputation.
Eventually, a jury will be empaneled to hear the case. Finding an unbiased juror will be difficult enough for a notorious offense, but may be impossible once the general public has been exposed to repeated statements by psychiatrists and psychologists about a defendant’s aberrant mental state. Even when couched in a disclaimer, jurors will remember the opinion rather than the disclaimer. If a death penalty is requested in this case, implications that a defendant has a serious mental illness could prejudice a sentencing hearing, since research has shown that a capital sentence is more likely to be given to mentally ill defendants.