Ultimately, legislators who must consider any reforms are swayed more by the political implications than the medical ones, Resnick said. Legislators perceive their chances of election are greater if they present a tough stand on law and order, and efforts to broaden the insanity defense are most often viewed as soft on crime.
"When a high profile insanity defense is successfulåthere tends to be a backlash against the insanity defense and a political demand to either narrow or abolish the defense," Resnick told PT. "When a high profile insanity case like Yates' is unsuccessful there will be a few voices saying that the insanity defense is too narrow, but rarely will it be of sufficient political clout to make a difference."
With two nationally recognized forensic psychiatrists pitted against one another in the Yates case, it was not surprising that questions would again arise as to whether the expert testimony is really something jurors listen to anyway. Legal commentators and others have criticized the prosecutor from Harris County, Texas, who brought Yates to trial, claiming his decision to seek the death penalty was merely a ruse to seat a more conservative jury who would more likely convict rather than exonerate based on an insanity plea.
"It's not really a battle of the experts," said prosecutor Joseph S. Owmby, during a post-trial press conference. "The question of sanity is a question of common senseåand the experts are there to help them frame, help present the evidence from the medical side. The jurors can't say that this is a severe mental disease or defect, but lay people can tell you whether they believe a person knew right from wrong at the time."
But it's not that simple, said Saul J. Faerstein, M.D., clinical professor of psychiatry at University of California, Los Angeles, School of Medicine and forensic expert who has consulted in high profile cases, including working for the defense in the O.J. Simpson case. He told PT that he is not convinced that any reform in the procedures by which insanity defenses are governed will ever actually bring any consistency to these emotionally laden cases.
"What's interesting is that the two experts involved [in the Yates case] are two very well-respected, highly credentialed, effective witnesses. I mean Phillip Resnick and Park Dietz are the cream of the crop, so you're not dealing with people who don't know what they're talking about," Faerstein said. "One would have to raise the question, if two people are so smart, and know the history of the insanity defense and know the standards of the insanity defense so well, how could they interpret it in polar opposite ways if they're both using the same data, the same facts, the same reasoning, the same history and the same legal basis for interpreting what the insanity defense was? How could one say black and the other one say white? That's a very troubling concept for me."
The problem with psychiatric defense is who should try them, Faerstein continued. Everyone -- including judges, lawyers, juries and even psychiatrists -- brings their own biases to the process, and nothing will eliminate them. Reflecting on the Yates case, he added, "I don't think that it's ever possible to have totally objective trier of fact on a case of that nature. People will listen to the facts and listen to the law, but their own prejudices will be superimposed on that substrate, and they'll decide whether a person is sane or insane based on their attitudes toward this woman, their attitudes toward fundamental Christianity, their attitudes toward Rusty Yates and how he treated his wife, their attitudes about lots of things that have nothing to do with what [Texas's insanity defense] test says."
Larry H. Strasburger, M.D., assistant clinical professor of psychiatry at Harvard Medical School and AAPL's president, agreed that cases like Yates' do not make understanding the issue easier.