Madness, badness, and evil

Abstract

The mad vs bad debate raises fundamental difficulties for the interaction of psychiatry and the law. In one sense the separation of these two states is quite clear. Those who are mad are not responsible for their actions committed as a consequence of their mental state and should be located within treatment parameters on the grounds that their behavior is unlikely to have been conscious, intentional, and voluntary. On the other hand, those who are bad are handled within the confines of the criminal justice system with the prime object being punishment for their transgressions. These boundaries are not as discrete as they might at first appear. Should behavior be excessively depraved and grossly cruel then there is a temptation to add evil to the mix, as if this is the unifying link between the two. Although this term is readily invoked in the public domain, both lawyers and psychiatrists cannot escape the influence of ordinary fears and perceptions, especially when behavior is intransigent and resistant to management strategies. It is this mad/bad/evil trajectory that is reviewed in this chapter. © 2006 Humana Press Inc.