title: Incapacity of the Mind Secondary to Medication Misuse as a Not Criminally Responsible Defense.
abstract: The manifestations of disorders of the mind may play a role in the occurrence of criminal behavior. In the majority of the cases, the presence of a psychiatric disorder is cited as the reason that an individual was not fully aware of his behavior. However, other conditions, such as seizure disorders or hypoglycemia, have also been linked to an inability to understand the nature and consequences of one's actions. On occasion, these situations can be explained by a state of automatism that may be described as insane or noninsane. In this article, we describe the case of a 77-year-old man, suffering from Parkinson's disease, where the issue of criminal responsibility associated with incapacity of the mind secondary to medication misuse was raised. We elaborate on the thinking behind this opinion and the implications according to Canadian law. Although the legal outcome of this case is specific to our jurisdiction, the clinical implication may be common to any patient suffering from a similar condition and may inform physicians, families, and lawyers.
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.|Forensic Psychiatry Program, St Joseph's Healthcare, Hamilton, ON, Canada.|EA 2114 Psychologie des âges de la vie, Université François Rabelais, Tours, France.
authors.forename: Sebastien S
authors.initials: SS
authors.lastname: Prat
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.|Forensic Psychiatry Program, St Joseph's Healthcare, Hamilton, ON, Canada.
authors.forename: Bruno J
authors.initials: BJ
authors.lastname: Losier
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.|Forensic Psychiatry Program, St Joseph's Healthcare, Hamilton, ON, Canada.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Moulden
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.|Forensic Psychiatry Program, St Joseph's Healthcare, Hamilton, ON, Canada.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Chaimowitz
mesh_terms: D000368:Aged; D018491:Dopamine Agonists / Q000008:administration & dosage / Q000009:adverse effects*; D000076064:Drug Misuse / Q000331:legislation & jurisprudence*; D006801:Humans; D000066511:Intimate Partner Violence / Q000331:legislation & jurisprudence*; D008297:Male; D016743:Mental Competency / Q000331:legislation & jurisprudence*; D009483:Neuropsychological Tests; D009864:Ontario; D010300:Parkinson Disease / Q000188:drug therapy* / Q000523:psychology; D014951:Wounds, Stab
chemical_list: D018491:Dopamine Agonists
keywords: Parkinson; dopamine agonist; forensic psychiatry; forensic science; medication misuse; non criminally responsible; offense