Medico-Legal Conßict.
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THE MEDICO-LEGAL CONFLICT OVER MENTAL RESPONSIBILITY. Bv GINO C. SPERANZA. T AW and medicine are known to be L/ "learned professions," and membership in either of them establishes a prima facie case of intelligence and culture. It is natural to expect among men of culture and intelli gence that there should be, if not a consen sus of opinion upon questions whose solu tion depends on scientific or philosophic examination and study, at least a certain agreement on substantial points. At all events, we would not expect a persistent antagonism and wide divergence between them. The most casual observation, however, suffices to show that there is at least one of such questions vhich has been and is the cause of an apparently irreconcilable con flict between doctors and lawyers—the ques tion of mental responsibility in regard to criminal acts. This persistent and aggressive disagree ment between two learned professions upon such a question cannot be ascribed to a puer ile reason, as that of professional jealousy, but must have some rational cause. The question is one of great importance and it will be one step towards its solution if we can ascertain the causes of disagree ment, even though a basis for conciliation is not found. To this end it will be necessary to examine the respective scopes or objects of medicine and lav, not purely as an aca demic question, but in the light of history and common usage. The traditional aims and principles of the professions of law and medicine are very dissimilar. The doctor looks to the preserva tion of the individual patient and is bound and trained to use every effort towards this end. The lawyer's first duty, on the other hand, is to the public, for he "occupies a po sition of public trust" whose primary object
is "the furtherance of justice." He is not so much a defender of individual liberties as of the laws which guarantee them. Thus, for ex ample, when a lawyer applies for a writ of habeas corpus he does so for the purpose of asserting and maintaining a fundamental law of the State, which he deems to have been violated, even though in effect he brings a benefit to his client. Again, the sick man appeals to the medical practitioner as one who suffers and who must be helped and relieved, even though his dis ease is the result of immoral, illicit and illegal conduct. The criminal, instead, appeals to the legal practitioner (I omit those who pros titute law by conspiring with their clients for the miscarriage of justice) as one who in flicts suffering and menaces the order and stability of the State. The physician bends his energy to save his patient; the lawyer, as prosecutor, uses all his powers to destroy the malefactor. Such being the respective aims of the two professions, it will be readily seen that if the question of mental responsibility for crimes were to pass from the juriclic to the medical field, the tendency would be to change the point of view from that which sees in the criminal a law-breaker to that which recog nizes him as a diseased unfortunate. Or, in other words, the power of abridging the right of liberty would in effect pass from the judicial tribunal to the bench of mental ex perts. I do not say that this would not be a distinct gain to the administration of justice, but I dwell upon it for the purpose of show ing how strong arguments are possible on either side. The doctors say (and no thought ful observer can deny it) "the courts are sending many men to prison and to death who ought to be confined in asylums." Or, in the words of Dr. Richardson before the
