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Subhead	
  here	
  
•  Body	
  copy	
  here	
  
Religious Delusion, Decision-
Making Capacity, and Culpability:
Understand...
Aasif	
  Mandvi	
  
2015	
  Radio	
  and	
  Television	
  Correspondents’	
  Dinner	
  
C-­‐SPAN	
  
March	
  26,	
  2015	...
A	
  false	
  belief	
  based	
  on	
  incorrect	
  inference	
  about	
  external	
  
reality	
  that	
  is	
  firmly	
  h...
The	
  Scope	
  
Religious	
  fundamentalists	
  who	
  exhibit	
  
parMcular	
  vulnerabiliMes	
  and	
  propensiMes	
  
...
•  Acts	
  of	
  violence	
  that	
  are	
  influenced	
  by	
  
delusional	
  beliefs	
  or	
  predisposing	
  
vulnerabil...
Religious	
  Fundamentalism:	
  
•  Literalist-­‐exclusivist	
  interpreta7ons	
  of	
  religious	
  doctrine	
  
•  Condu...
The	
  Scope	
  
Religious	
  fundamentalists	
  who	
  exhibit	
  
parMcular	
  vulnerabili7es	
  and	
  propensi7es	
  
...
Religious	
  Fundamentalism	
  &	
  
Mental	
  Health	
  
Religious	
  Fundamentalism	
  &	
  
Mental	
  Health	
  
The	
  Scope	
  
Religious	
  fundamentalists	
  who	
  exhibit	
  
parMcular	
  vulnerabiliMes	
  and	
  propensiMes	
  
...
Religious	
  Fundamentalism	
  &	
  
Mental	
  Health	
  
Vulnerabili7es,	
  Propensi7es,	
  and	
  Collec7ve	
  Iden7ty:	...
Issues	
  of	
  Moral/Legal	
  Culpability	
  	
  
•  The	
  Insanity	
  Defense	
  
•  Subjec've	
  v.	
  Objec've	
  Und...
(a)  Affirmative Defense— It is an affirmative defense to
a prosecution under any Federal statute that, at the
time of the c...
Issues	
  of	
  Moral/Legal	
  Culpability	
  	
  
•  The	
  Insanity	
  Defense	
  
•  Subjec5ve	
  v.	
  Objec5ve	
  Und...
Issues	
  of	
  Moral/Legal	
  Culpability	
  	
  
Subjec5ve	
  v.	
  Objec5ve	
  Understanding	
  of	
  
Wrongfulness	
  ...
Issues	
  of	
  Moral/Legal	
  Culpability	
  	
  
•  The	
  Insanity	
  Defense	
  
•  Subjec've	
  v.	
  Objec've	
  Und...
Issues	
  of	
  Moral/Legal	
  Culpability	
  	
  
First	
  Amendment	
  
•  United	
  States	
  v.	
  Ballard:	
  "The	
 ...
Issues	
  of	
  Moral/Legal	
  Culpability	
  	
  
•  The	
  Insanity	
  Defense	
  
•  Subjec've	
  v.	
  Objec've	
  Und...
Issues	
  of	
  Moral/Legal	
  Culpability	
  	
  
Defendant's	
  View	
  of	
  Self-­‐Psychology	
  
	
  Despite	
  signs...
Issues	
  of	
  Moral/Legal	
  Culpability	
  	
  
•  The	
  Insanity	
  Defense	
  
•  Subjec've	
  v.	
  Objec've	
  Und...
“Significantly reduced mental capacity" means the
defendant, although convicted, has a significantly
impaired ability to (A)...
Future	
  ConsideraMons	
  
Authors	
  &	
  Acknowledgments	
  
Co-­‐Author	
  
Jemel	
  A	
  Derbali,	
  JD	
  
Massachuse2s	
  InsMtute	
  of	
  Tec...
Abbas Rattani, "Religious Delusion, Decision-Making Capacity, and Culpability: Understanding Subjective Mental Illness Dia...
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Abbas Rattani, "Religious Delusion, Decision-Making Capacity, and Culpability: Understanding Subjective Mental Illness Diagnoses in the Context of the Insanity Defense and Religious Freedom"

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Religion and medicine have historically gone hand in hand, but increasingly have come into conflict in the U.S. as health care has become both more secular and more heavily regulated. Law has a dual role here, simultaneously generating conflict between religion and health care, for example through new coverage mandates or legally permissible medical interventions that violate religious norms, while also acting as a tool for religious accommodation and protection of conscience.

This conference identified the various ways in which law intersects with religion and health care in the United States, examined the role of law in creating or mediating conflict between religion and health care, and explored potential legal solutions to allow religion and health care to simultaneously flourish in a culturally diverse nation.

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Abbas Rattani, "Religious Delusion, Decision-Making Capacity, and Culpability: Understanding Subjective Mental Illness Diagnoses in the Context of the Insanity Defense and Religious Freedom"

  1. 1. Subhead  here   •  Body  copy  here   Religious Delusion, Decision- Making Capacity, and Culpability: Understanding Subjective Mental Illness Diagnoses in the Context of the Insanity Defense and Religious Freedom Abbas  Ra2ani  MBe,  MD  (c)   MS-­‐1,  School  of  Medicine  
  2. 2. Aasif  Mandvi   2015  Radio  and  Television  Correspondents’  Dinner   C-­‐SPAN   March  26,  2015    
  3. 3. A  false  belief  based  on  incorrect  inference  about  external   reality  that  is  firmly  held  despite  what  almost  everyone  else   believes  and  despite  what  cons5tutes  incontrover5ble  and   obvious  proof  or  evidence  to  the  contrary.  The  belief  is  not   ordinarily  accepted  by  other  members  of  the  person's   culture  or  subculture  (i.e.,  it  is  not  an  arMcle  of  religious   faith).       American  Psychiatric  AssociaMon.  DiagnosMc  and  staMsMcal  manual  of  mental   disorders  (5th  ed).  Washington,  DC:  American  Psychiatric  AssociaMon,  2013.     Delusion:  
  4. 4. The  Scope   Religious  fundamentalists  who  exhibit   parMcular  vulnerabiliMes  and  propensiMes   which  may  lead  to  criminal  behavior,  and  the   influence  of  group  dynamics  in  exacerbaMng  or   normalizing  suspicious  ideaMon.        
  5. 5. •  Acts  of  violence  that  are  influenced  by   delusional  beliefs  or  predisposing   vulnerabili7es       •  Does  the  law  fairly  account  for  mental  illness?       •  Mental  vulnerabili7es  and  wrongdoing   commi=ed  in  the  name  of  religious  beliefs   Points  of  ConsideraMon  
  6. 6. Religious  Fundamentalism:   •  Literalist-­‐exclusivist  interpreta7ons  of  religious  doctrine   •  Conduits  of  a  supernatural  deity   •  Ac7ons  as  part  of  furthering  a  divine  agenda,  command,   or  injunc7on   •  Dualis7c  language:  “us”  versus  “them”     •  “Wrongdoing”  is  normalized  
  7. 7. The  Scope   Religious  fundamentalists  who  exhibit   parMcular  vulnerabili7es  and  propensi7es   which  may  lead  to  criminal  behavior,  and  the   influence  of  group  dynamics  in  exacerbaMng  or   normalizing  suspicious  ideaMon.        
  8. 8. Religious  Fundamentalism  &   Mental  Health  
  9. 9. Religious  Fundamentalism  &   Mental  Health  
  10. 10. The  Scope   Religious  fundamentalists  who  exhibit   parMcular  vulnerabiliMes  and  propensiMes   which  may  lead  to  criminal  behavior,  and  the   influence  of  group  dynamics  in  exacerba7ng   or  normalizing  suspicious  idea7on.        
  11. 11. Religious  Fundamentalism  &   Mental  Health   Vulnerabili7es,  Propensi7es,  and  Collec7ve  Iden7ty:     •  Rogers  et  al:  “extrinsic  religiosity  has  been  shown  to  correlate  with   several  indices  of  poor  mental  health  and  minor  psychopathology”       •  Rogers  et  al:  “self  or  narcissisMc  pathology”  /  “narcissisMcally   vulnerable  personaliMes”     •  CollecMve  idenMty  offers  to  meet  those  need     •  InterpretaMon  of  counter  logic  as  inherently  immoral  if  it   challenges  their  worldview      
  12. 12. Issues  of  Moral/Legal  Culpability     •  The  Insanity  Defense   •  Subjec've  v.  Objec've  Understanding  of   Wrongfulness   •  First  Amendment   •  Defendant's  View  of  Self-­‐Psychology     •  Diminished  Capacity    
  13. 13. (a)  Affirmative Defense— It is an affirmative defense to a prosecution under any Federal statute that, at the time of the commission of the acts constituting the offense, the defendant, as a result of a severe mental disease or defect, was unable to appreciate the nature and quality or the wrongfulness of his acts. Mental disease or defect does not otherwise constitute a defense. (b)  Burden of Proof— The defendant has the burden of proving the defense of insanity by clear and convincing evidence. 18  U.S.  Code  §  17  –  Insanity  Defense  
  14. 14. Issues  of  Moral/Legal  Culpability     •  The  Insanity  Defense   •  Subjec5ve  v.  Objec5ve  Understanding  of   Wrongfulness   •  First  Amendment   •  Defendant's  View  of  Self-­‐Psychology     •  Diminished  Capacity    
  15. 15. Issues  of  Moral/Legal  Culpability     Subjec5ve  v.  Objec5ve  Understanding  of   Wrongfulness   Deific  Decrees:   Ø  Lundgren  v.  Mitchell:  "A  common  instance  is   where   he   fully   believes   that   the   act   he   is   doing   is   done   by   the   immediate   command   of  God,  and  he  acts  under  the  delusive  but   sincere   belief   that   what   he   is   doing   is   by   the   command   of   a   superior   power,   which   supersedes  all  human  laws,  and  the  laws  of   nature.”    
  16. 16. Issues  of  Moral/Legal  Culpability     •  The  Insanity  Defense   •  Subjec've  v.  Objec've  Understanding  of   Wrongfulness   •  First  Amendment   •  Defendant's  View  of  Self-­‐Psychology     •  Diminished  Capacity    
  17. 17. Issues  of  Moral/Legal  Culpability     First  Amendment   •  United  States  v.  Ballard:  "The  religious  views  espoused  by   respondents  might  seem  incredible,  if  not  preposterous,  to   most   people.   But   if   those   doctrines   are   subject   to   trial   before   a   jury   charged   with   finding   their   truth   or   falsity,   then  the  same  can  be  done  with  the  religious  beliefs  of  any   sect.  When  the  triers  of  fact  undertake  that  task,  they  enter   a  forbidden  domain.  The  First  Amendment  does  not  select   any   one   group   or   any   one   type   of   religion   for   preferred   treatment.  It  puts  them  all  in  that  posiMon.”  
  18. 18. Issues  of  Moral/Legal  Culpability     •  The  Insanity  Defense   •  Subjec've  v.  Objec've  Understanding  of   Wrongfulness   •  First  Amendment   •  Defendant's  View  of  Self-­‐Psychology     •  Diminished  Capacity    
  19. 19. Issues  of  Moral/Legal  Culpability     Defendant's  View  of  Self-­‐Psychology    Despite  signs  of  mental  illness,  an  insanity    defense  was  refused:     Nidal  Malik  Hasan   Carlos  Bledsoe  
  20. 20. Issues  of  Moral/Legal  Culpability     •  The  Insanity  Defense   •  Subjec've  v.  Objec've  Understanding  of   Wrongfulness   •  First  Amendment   •  Defendant's  View  of  Self-­‐Psychology     •  Diminished  Capacity    
  21. 21. “Significantly reduced mental capacity" means the defendant, although convicted, has a significantly impaired ability to (A) understand the wrongfulness of the behavior comprising the offense or to exercise the power of reason; or (B) control behavior that the defendant knows is wrongful. Federal  Sentencing  Guidelines:     §5K2.13—Diminished  Capacity    
  22. 22. Future  ConsideraMons  
  23. 23. Authors  &  Acknowledgments   Co-­‐Author   Jemel  A  Derbali,  JD   Massachuse2s  InsMtute  of  Technology,  MIT  ConnecMon  Science   Cambridge,  MA     Acknowledgements   Stephen  McLeod-­‐Bryant,  MD   Chair  &  Professor  of  Psychiatry   Meharry  Medical  College   Nashville,  TN   Kimberly  Brown,  PhD   Assistant  Professor     Department  of  Psychiatry   Vanderbilt  University   Nashville,  TN   Keith  G.  Meador,  MD,  MPH,  ThM   Professor  of  Psychiatry     Vanderbilt  University   Nashville,  TN   John  L  Miller,  JD   VisiMng  Lecturer  in  American  Criminal  Law   InsMtute  of  Criminology   Eberhard  Karls  University,  Tübingen   Germany  

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