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Fitness to plead and competence to stand trial: a systematic review of theconstructs and their applicationT. P. Rogers a; N. J. Blackwood ab; F. Farnham b; G. J. Pickup c; M. J. Watts bc

a Department of Forensic Mental Health Science, Kings College London, Institute of Psychiatry, UK b NorthLondon Forensic Service, Barnet, Enfield, and Haringey Mental Health Trust, London, UK c Sub-Departmentof Clinical Health Psychology, University College London, UK

Online Publication Date: 01 December 2008

To cite this Article Rogers, T. P., Blackwood, N. J., Farnham, F., Pickup, G. J. and Watts, M. J.(2008)'Fitness to plead and competenceto stand trial: a systematic review of the constructs and their application',Journal of Forensic Psychiatry & Psychology,19:4,576 — 596

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RESEARCH ARTICLE

Fitness to plead and competence to stand trial: a systematic

review of the constructs and their application

T.P. Rogersa*, N.J. Blackwooda,b, F. Farnhamb, G.J. Pickupc andM.J. Wattsb,c

aDepartment of Forensic Mental Health Science, Kings College London, Institute ofPsychiatry, UK; bNorth London Forensic Service, Barnet, Enfield, and HaringeyMental Health Trust, London, UK; cSub-Department of Clinical Health Psychology,University College London, UK

(Received 1 May 2007; final version received 14 January 2008)

Fitness to plead is a fundamental legal concept. Its determination inEngland and Wales rests on professional interpretation of the‘Pritchard’ criteria (1836). In the United States, the determination ofthe analogous concept of competence to stand trial rests on professionalinterpretation of the ‘Dusky’ criteria (1960). Numerous assessmentinstruments have been developed in North America to help guideprofessional determinations of competence to stand trial, but suchassessments are not routinely employed in British settings. The evidencereviewed calls into question the utility of the fitness to plead construct ascurrently formulated and highlights the inadequacy of the proceduresemployed in its determination. We argue that both conceptual andprocedural changes are required.

Keywords: fitness to plead and stand trial; adjudicative competence;competence to stand trial; instrument; tool; mental health legislation

Introduction

Fitness to plead is a fundamental concept in British law. Its essence is that‘no man may be brought to trial upon any criminal charge unless and untilhe is mentally capable of fairly standing his trial’ (Lord Edmund-Davies inR v Podola, 1960). The entitlement of every person to ‘a fair and publichearing by an independent and impartial tribunal’ is further enshrined inArticle 6 of the European Convention on Human Rights (ECHR; Councilof Europe, 1950). Fitness is related to other principles which include: adesire for the mentally disordered to receive treatment not punishment;the presumption of innocence until proven guilty; and (to a lesser extent) theright to represent oneself in court. This systematic review examines the

*Corresponding author. Email: [email protected]

The Journal of Forensic Psychiatry & PsychologyVol. 19, No. 4, December 2008, 576–596

ISSN 1478-9949 print/ISSN 1478-9957 online

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DOI: 10.1080/14789940801947909

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development and use of the construct of ‘fitness to plead’ in England andWales and the analogous American construct of ‘competence to stand trial’.The many instruments that exist to assist in its assessment (largelyoriginating in North America) are reviewed. Finally, we highlight theconceptual problems identified as regards these constructs and theprocedural difficulties in their determination.

Method

A systematic search strategy was implemented. This involved searching theelectronic databases Medline, Embase, PsycINFO, and Pubmed from 1966up to the end of May 2006. The review used a subject and textword searchstrategy with ‘fitness to plead’, ‘competency to stand trial’, and ‘adjudicativecompetence’ as the main search terms. These were combined with‘instruments’ and ‘assessment’. Reference searching and hand-searches ofrelevant journals were also carried out.

Development of the fitness to plead concept in England and Wales

The mentally disordered were recognised as requiring special considerationin law as early as the seventh century (Walker, 1968). Although crimes hadto be paid for by way of material compensation, it was recognised that, ‘If aman fall out of his senses or wits, and it come to pass that he kill someone,let his kinsmen pay for the victim’ (Walker, 1968, p. 15). The origins of thefitness to plead concept can be traced to the 14th century, when the courtsneeded a formal method of dealing with the mentally disordered who camebefore them (Grubin, 1996). The issue arose from reverence for the ritual ofthe law: it was unthinkable that a trial could proceed and a conviction beprocured without a plea. Techniques like ‘peine forte et dure’ were born,whereby a mute prisoner was gradually crushed under increasing weightsuntil he either entered a plea or died. The court then made a decision as towhether a defendant was ‘mute of malice, or by visitation of God’ (Grubin,1996, pp. 11–12): it was not until 1772 that ‘peine’ was officially abolished.Being ‘mute by visitation’ was often a bar to trial, but this was not absolute(e.g., R v Steel, 1787). A two-step process was required: a decision about thecause of muteness, followed by a decision about whether the defendant wasof sufficient intelligence to undergo trial. It was not until the 18th centurythat the insane defendant stood any real chance of being found unfit for trial(Walker, 1968). For example, in the case of R v Dyle (1756) the defendantwas indicted for murder but found ‘not of sound mind and memory’ andthere is no record of a subsequent trial (Chiswick, 1990).

From 1800, the Criminal Lunatics Act was used to keep in custody allthose who were found unfit for trial regardless of the underlying reason, butthe actual criteria for a finding of unfitness were not formulated until the

The Journal of Forensic Psychiatry & Psychology 577


case of R v Dyson (1831). Esther Dyson was indicted for the murder of her‘bastard child’ and the jury heard evidence that she was deaf and dumb,finding that this was ‘by visitation’. Although she pleaded not guilty(through an interpreter, via hand gestures), her learning disability meantthat she was found to be insane and detained indefinitely. The key case of Rv Pritchard (1836) also involved a deaf and dumb defendant, who had beenindicted for bestiality. His abilities were more extensive and he was foundable to plead as he could read, write, and gesture that he was not guilty.Although finding him able, his jury found him unfit to plead as he did notmeet all of the criteria Judge Baron Alderson had given them, namely:

whether he is of sufficient intellect to comprehend the course of proceedings onthe trial, so as to make a proper defence – to know that he might challenge anyof you to whom he might object – and to comprehend the details of theevidence. It is not enough that he may have a general capacity ofcommunicating on ordinary matters.

This basis for legal decisions about fitness, remaining in force to this day,has therefore been largely developed in relation to individuals with sensoryimpairment and learning disability. It was not until the case of R v Davies(1853) that the impairments arising from psychotic illnesses were firstrecognised in case law. Davies was an elderly man charged with murder whowas thought by his jury to be ‘mad’. The additional criterion that adefendant must be ‘capable of properly instructing his counsel for hisdefence’ was therefore appended to the Pritchard criteria. In current practicethese cases are interpreted together, such that contemporary psychiatricdiagnoses are not separated in terms of their impact in court. The fivecriteria currently used in court in England and Wales to determine fitness toplead (Grubin, 1991a; Mackay & Kearns, 2000) have thus remainunchanged for over 150 years. They are:

(1) ability to plead(2) ability to understand evidence(3) ability to understand the court proceedings(4) ability to instruct a lawyer(5) knowing that a juror can be challenged

It is clear that this formulation conflates the issues of ‘fitness to plead’ and‘fitness to stand trial’ in the unitary construct of being ‘under disability’. It isaccepted that fitness to plead incorporates aspects of standing trial but anarrow interpretation of the former relates more specifically to the processof entering a plea.

The law has been slow to develop since the case of Davies. Defendantsfound unfit under the Criminal Procedure (Insanity) Act (1964) weredetained in hospital in order to recover their fitness, without a trial of the

578 T.P. Rogers et al.


facts taking place. Many of these unwell defendants were subsequentlydetained for long periods without recovering fitness or standing trial(Murphy & Clare, 2003). The Criminal Procedure (Insanity and Unfitness toPlead) Act (1991) introduced a two-stage procedure relating to fitness.Under this procedure, two Crown Court juries were convened, one to makea decision on fitness, and (if they found the defendant unfit) another todecide in a ‘trial of the facts’ whether the defendant committed the act(s)alleged. For the first time, the possible range of disposals was widened toinclude an option for community placement. The procedure was simplifiedin the Domestic Violence, Crime and Victims Act (2004), which establishedthat a judge alone (and not a jury) could decide upon the issue of fitness,although the jury were still to decide the trial of the facts. Options fordisposal currently include: hospital order (with or without restrictions);supervision order; and an order for absolute discharge.

For a hospital order to be made, the court must also be satisfied that thedefendant meets criteria for detention under Section 37 of the Mental HealthAct (1983) in addition to having fulfilled the criteria for being unfit to plead– the two issues not being mutually exclusive (Morris, Elcock, Hardie, &Mackay, 2006). This change resulted from concerns that aspects of the 1991Act contravened Article 5(1) of the Human Rights Act (ECHR; Council ofEurope, 1950) which relates to ‘the right to liberty and security’. Previouslya defendant could potentially have been detained (having been found unfitto plead) without either a conviction or a mental disorder.

The above procedures for determining fitness to plead relate only to theCrown Courts, where indictable offences are dealt with. This is somewhatparadoxical, as the overwhelming majority of mentally ill defendants passthrough the (lower) magistrates courts (see Exworthy, 2006). A person’sfitness to plead may not be determined at this level, although variousmechanisms are available to resolve such a situation. The CrownProsecution Service may discontinue legal proceedings when considerationof the person’s mental health outweighs the interests of justice. Such anoutcome can be combined with the admission of a person to hospital undercivil law through the use of the Mental Health Act (1983). There are courtdiversion schemes that have been developed in order to attempt to identifysuch individuals (Birmingham, 2001). In other circumstances, when satisfiedthat the accused ‘did the act or made the omission charged’, a magistrate hasthe power to make a hospital order (without recording a conviction) underSection 37(3) of the Mental Health Act (1983). There is no possibility of areturn to court should the person subsequently become fit to plead again.

Development of the competence to stand trial concept in the United States

When considering the utility of the Pritchard approach, it is useful toconsider the law elsewhere in the world. In North America, the analogous



concept is of competence to stand trial (also known as adjudicativecompetence). Here, the foundational case is that of Dusky v U.S. (1960). Itis notable for its sparse language and for the fact that it provides noexplanation or reasoning for its ruling. Subsequent Supreme Court decisions(e.g., Cooper v Oklahoma, 1996; Jackson v Indiana, 1972; Riggens vNevada, 1992) have consistently upheld Dusky’s central tenets.

Dusky was a young man who was charged with kidnapping after heassisted two teenagers in raping a 16-year-old. He had schizophrenia, butwas found competent to stand trial and given a 45-year sentence aspunishment. The U.S. Supreme Court ruled on appeal that competent tostand trial meant having ‘sufficient present ability to consult with [his]lawyer with a reasonable degree of rational and factual understanding of[the] proceedings against him. It is not sufficient to find him oriented to time,place, and some events’. He was re-tried and his sentence was reduced to 20years. The test of competence established in Dusky has subsequently beenadopted in most U.S. states, and careful reading of the language of the testreveals three separate factors. Defendants must be able to:

(1) consult with defence counsel(2) ‘otherwise assist with [their] defence’(3) have both a rational and factual understanding of the proceedings.

Underlying the Dusky standard is the idea that the ability to understand theproceedings is related to the sixth amendment (the right to be informed ofthe nature and cause of the accusation) and also the idea that a defendantmust be able to enjoy his right to the assistance of counsel. As withPritchard, the Dusky test is a unitary one, where an all-or-nothing (i.e.,competent or not) finding is made. This has been the subject of both detailedresearch, discussed below, and legal challenge. The case of Godinez v Moran(1993) was primarily concerned with whether or not there were distinctionsbetween competence to stand trial, competence to waive counsel, andcompetence to plead guilty. However, the U.S. Supreme Court ruled that allcompetencies are the same (and involve the same standards), despite thearguments to the contrary. Other court rulings have also insisted thatcompetence to stand trial and to plead guilty is a single construct (e.g.,Allard v Helgemoe, 1978).

Is Pritchard ‘fit for purpose’ as a theoretical construct?

Anachronistic aspects of the criteria

In England and Wales, the Butler Committee investigating mentallyabnormal offenders reported, ‘[M]ost observers thought the currentPritchard criteria largely worked well’ (1975). However, even at this earlystage, it was recommended that the reference to challenging jurors be



dropped, as it was no longer relevant. It was later proposed that the abilityto give evidence on one’s own behalf could be usefully introduced in its place(Gray et al., 2001). Section 35 of the Criminal Justice and Public Order Act(1994) offers some protection to the accused in those cases when it ‘appearsto the court that the physical or mental condition of the accused makes itundesirable for him to give evidence’. Here the court must not draw adverseinferences from failure or refusal to answer a question. As we have seen, thisseemingly crucial aspect of a fair trial does not form part of the Pritchardtest, and psychiatrists may not always be aware that there is relevantlegislation elsewhere. However, what of the remaining four standards: dothey amount to a comprehensive construct?

Theoretically important abilities which underpin ‘fitness’

If fitness to plead were to be reformulated de novo, a wide range ofabilities could be considered of importance. Melton, Petrila, Poythress, andSlobogin (1997) have attempted a comprehensive theoretical list of relatedabilities (Table 1). British Psychological Society guidelines (Dooley et al.,2006) also cite 12 potentially relevant areas of psychological assessment:comprehension; reasoning ability; consistency; memory; concentration andattention; suggestibility; inappropriateness; impulsivity; insight; affect;passivity; and the dangers of ‘faking bad’. It is immediately clear that theexisting Pritchard criteria are by no means comprehensive. It seems likelythat many defendants both with and without a mental disorder will performpoorly in a number of these areas without concerns ever being raised abouttheir fitness.

Theoretical reformulations of competence

In North America, the validity of the Dusky approach has been similarlycriticised (e.g., Grisso, 1992). Bonnie (1992) wrote that the legal formula-tions were ‘not anchored in a shared understanding of why (in)competencematters’ (p. 295). His subsequent theoretical reformulation of competence(Bonnie, 1992, 1993) delineated two separable factors: first, the foundationalconcept of competence to assist counsel; second, the contextualised conceptof decisional ability. Bonnie proposed that American case law bereconsidered in terms of these two broad dimensions. The foundationalconcept of competence to assist counsel included several elements of Dusky:understanding the charges and the criminal process; awareness of one’s roleas a defendant; and ability to disclose relevant information to counsel. Thesewere proposed to be the minimum conditions required to participate in one’sown defence. The contextualised concept of decisional ability reflects thesub-processes involved in rational decision-making: cognitive skills;conceptual abilities; and rationality of thought.



Table

1.

Abilitiesrelatedto

thenotionofcompetence

(Melton,Petrila,Poythress,&

Slobogin,1997).

Tounderstandthearrestprocess

Tomakedecisionsafter

receivingadvice

Tounderstandthecurrentlegalsituation

Tomaintain

acollaborativerelationship

withcounseland

Tounderstandthecharges,both

innature

andseverity

helpplanlegalstrategy

Tounderstandrelevantfacts

Tofollow

testim

onyforcontradictionsorerrors

Tounderstandthelegalissues

andprocedures

Totestifyrelevantlyandbecross-examined

ifnecessary

Tounderstandpotentiallegaldefences

Tochallengeprosecutionwitnesses

Tounderstandthepossible

dispositions,pleas,andpenalties

Totolerate

stress

atthetrialandwhileawaitingtrial

Toappraisethelikelyoutcome

Torefrain

from

irrationalandunmanageable

behaviourduringtrial

Toappraisetherolesofthedefence

counsel,prosecutor,

judge,

jury,witnesses,anddefendant

Todisclose

pertinentfactssurroundingthealleged

offence

Toprotect

oneselfandutilise

legalsafeguardsavailable

Toidentify

witnesses

Toappraisethelikelyoutcomeofthecase

Torelate

tocounselin

atrustingandcommunicativefashion

Tocomprehendinstructionsandadvice



In support of these ideas, Whittemore, Ogloff, and Roesch (1997) used astandardised fitness assessment instrument (the Fitness Interview Test–Revised; see below) to compare competence to understand initial cautions,competence to plead guilty, and fitness to stand trial among a group ofremand prisoners in Canada. They found that competence at one juncture incriminal proceedings did not correspond with fitness at all other stages ofthe proceedings, and they suggested the need for a stage-specific approach toassessment. While the wording of case law may differ by legal jurisdiction,the principles unearthed in these investigations apply to the mentally ill incourt regardless of location, and should prompt a re-examination of the lawin England and Wales.

Fitness in the young

An increasing body of research highlights the way in which the construct offitness may differ in younger people (e.g., Cowden and McKee, 1995; Grisso,2005a). It is argued that the degree of maturity of cognitive abilities, and thedegree of development of social-emotional capacities, are relevant toassessments of fitness in younger people. Indeed, it is cautioned that age isnot synonymous with developmental level. In younger people, the ability touse information to make sound judgments and decisions (as a result ofcognitive maturity) might be of greater concern than factual understanding(Baird & Fugelsang, 2004).

The potential impact of the MCA Act (2005)

The Mental Capacity Act (MCA, 2005) was implemented in England andWales in 2007. It applies to a number of different areas of decision-making(including the management of financial affairs and social care) and providesa clear framework and guidance for determining capacity. It defines capacityas follows:

[A] person lacks capacity in relation to a matter if at the material time he isunable to make a decision for himself in relation to the matter because of animpairment of, or a disturbance in the functioning of, the mind or brain(whether permanent or temporary).

The Act makes no direct reference to fitness to plead. However, its adoptionin civil law from 2007 may influence decision-making in this area. Vassall-Adams and Scott-Moncrieff (2006) argue that the new Act highlightssignificant inadequacies in the existing law on fitness to plead, and that thereis clearly a considerable difference between the strict ‘Pritchard’ criteria andthe much less stringent test that would apply were fitness to plead to bedecided in the way enshrined in the Mental Capacity Act (2005). Theauthors propose that the Pritchard test discriminates against significant



numbers of defendants who would be better served by a civil test that wouldmore fairly find them lacking in capacity.

A central part of the assessment of capacity under the MCA (2005) is the‘functional approach’. This focuses on the interaction between a person’sabilities and the demands of the particular situation/task, in contrast to adiagnostic approach, which considers a person’s capacity to make decisionsbased upon membership of a specific group (e.g., a diagnostic category).This latter approach has been criticised, particularly because a clinicaldiagnosis provides limited information about the person’s decision-makingability within a specific situation at a particular time. Indeed, although it isrecognised that a diagnosis will often trigger concerns over incapacity, thefunctional approach should be adopted when it comes to assessment(Dooley et al., 2006). The functional approach to assessment requires thatthe task is operationalised in terms of its specific demands and that thecognitive and/or psychological capacities required to fulfil those demandsare clearly outlined. It is also likely that these will vary according to thecomplexities of the legal case. Although the Pritchard test takes a functionalapproach, it appears from the research discussed above that thisoperationalisation needs revision.

Problems with the Pritchard approach in practice

The threshold for ‘caseness’

Singleton et al. (1998) found that 10% of men on remand have shown signs ofa psychotic illness in the previous year. Non-psychotic psychiatric morbidityis also prominent in the prison population (Fazel and Danesh, 2002). In thecontext of such numbers, formal findings of unfitness are extremely rare inEngland and Wales. A survey of Home Office files on all those found unfit toplead between 1976 and 1988 (Grubin, 1991a) found an average of only 25per year. Mackay and Kearns (2000) reported about 30 cases found unfit toplead per year. The most recent research (Mackay, Mitchell, & Howe, 2007)found that there were still only 66 per year between 1997 and 2001, despitethe new more flexible powers of disposal that have existed since 1991.

In considering whether or not this might be problematic, it is instructiveto make a comparison with North America. Here, equivalent findings ofabsent competence are vastly more common. Around one fifth of anestimated 60 000 evaluations each year find competence to stand trial to belacking (Bonnie and Grisso, 2000) – that is, many hundreds of times morefrequent. As such, if there exists a spectrum of impaired fitness, a very highthreshold has clearly been set for ‘caseness’ in England and Wales (Vassall-Adams and Scott-Moncrieff, 2006).

Only a brief examination of case law is needed to illustrate how such asituation may have arisen. The case of R v Robertson (1968) involved theprosecution of a delusional seaman for murder. He believed that members of



his crew were trying to poison him and was found unfit, a finding againstwhich he appealed. His appeal was allowed and with this came the assertionthat the ‘mere fact of being incapable of doing things in one’s own bestinterests is not sufficient for a finding of disability’. Furthermore, it wassubsequently clarified that an accused can suffer a high degree of mentalabnormality (R v Berry, 1977) without being found unfit to plead.

Taken together, these cases suggest that English law has tended to view afinding of disability as such an infringement of one’s fundamental right to afair trial that it is reserved only for the most severely disturbed ofdefendants. An illustration of this is the trial in an adult court of the two 10-year-olds Thompson and Venables (R v T and V, 1993) for the murder ofJames Bulger. The European Court of Human Rights held that there hadbeen a breach of Article 6 (discussed above) in this case, as the youngdefendants had been denied a fair trial in light of their youth and their lackof understanding of the legal process. The European Court ruled that,although special arrangements had been made in the Crown Court, the twoyouths were highly unlikely to have been able to follow the proceedingsproperly or to pass information to their lawyers.

Subsequently a practice direction was introduced with the stated intentof reducing the scope for avoidable intimidation, humiliation, or distress toyoung defendants on trial in the Crown Court. It required courts to takesteps to ensure that a juvenile defendant understands court procedurethrough, for example, the provision of regular breaks and placing thedefendant beside counsel. Perhaps because the situation of standing trialwith a mental disorder is not dissimilar, many of these ‘sympathetic trialmanagement’ measures have been introduced as a way of helping ‘border-line’ unfit cases to cope with the court process. However, this should notdiminish the importance of re-evaluating our approach to to the mentally illin court.

The causes of unfitness

As above, the Pritchard judgement refers to sufficient intellect. However,fewer than one-third of those found unfit to plead actually have intellectualimpairment (Mackay et al., 2007). The majority of those who are found unfitto plead suffer from schizophrenia or another enduring mental illness. Afinding of unfitness in schizophrenic patients is significantly associated withthe presence of positive psychotic symptomatology, in particular conceptualdisorganisation and delusional thinking (James, Duffield, Blizard, &Hamilton, 2001). The most important legal criteria in determining clinicaldecisions about unfitness are, first, whether the person can follow theproceedings of the trial and, second, whether they can give adequateinstructions to their solicitor. The legal criteria concerning trial are morepredictive than those concerning plea in determining the overall clinical



judgement. Having studied a large number of cases, James et al. (2001)concluded that the fitness criteria could be simplified without loss ofpredictive power.

Factor analysis has emphasised the importance of psychoticism, with-drawal, and mania symptom clusters (in the Brief Psychiatric Rating Scale(BPRS); Lukoff, Nuechterlein, & Ventura, 1986) over depressive symptomsin impairing competence to stand trial (Jacobs, Ryba, & Zapf, 2007).Viljoen, Roesch, and Zapf (2002) found that this link between competenceand psychosis was independent of IQ but, interestingly, that as many as 40%of defendants with no diagnosis were also found to be impaired on one ormore (but not always all) aspects of legal ability as measured by the FitnessInterview Test instrument (discussed below). It is thus clear that the natureof a trial is challenging to many who are not mentally disordered. However,there are currently no community norms to inform this issue.

Inconsistent application of the criteria

There is evidence to suggest that the Pritchard criteria are applied byclinicians in a highly inconsistent way. Grubin (1991a) reviewed 295 reportsto the court on fitness to plead; only 195 referred to the ability to instructlawyers, only 144 discussed ability to comprehend court proceedings, andonly 98 commented on the ability to challenge a juror. Moreover, Mackayand Kearns (2000) reviewed 197 psychiatric reports and found that only 21took into account all of the above criteria, with about a third referring to theability to understand the court proceedings and another third consideringthe ability to instruct counsel. Of note, 28 simply mentioned diagnosticcriteria for the underlying mental illness.

It may be that these findings mask the fact that there are in fact otherfactors (not mentioned in any legal criteria) that are at play when cliniciansmake judgements about fitness. For example, Rosenfeld and Ritchie (1998)found that clinicians required a higher degree of competence for defendantscharged with more serious offences, and that the process of assessment didnot apply equally to competent and incompetent defendants. It seems thatwhat constitutes competence for one person may differ for the next. Insupport of this, Buchanan (2006) argued that it is right for the degree ofcompetence to differ in relation to the seriousness of the charge. Heproposed a ‘principle of proportionality’, whereby the level of capacityrequired relates to the consequences of being found competent. At the centreof these debates is the approach taken to assessment, including both thefunctional and diagnostic (status) approaches described above.

Competence may also differ by context. Buchanan (2006) furtherproposed that issues worthy of consideration include: the complexity ofthe case; the permanence of a defendant’s condition; whether counsel agreesor disagrees with a defendant’s decisions; the nature of the defence offered;



and whether a defendant is intending to represent him- or herself. However,the fairness of such a graded test may be called into question: for examplethe benefits of a finding of unfitness might more readily apply to a white-collar worker charged with complex fraud than a similarly able violentoffender.

Difficulties in detecting unfitness

The current system may struggle to detect those who are potentially unfit toplead. For example, in one study of those found unfit to plead (Grubin,1991b), two-thirds had been dealt with by the courts in a normal manner onprevious occasions, while some defendants went on to be convicted offurther offences while still technically unfit to plead on a previous charge.There is currently no method or procedure for the screening of defendantsappearing in court, other than they happen to be known to be unwell ortheir pattern of interaction happens to arouse suspicion among legalprofessionals who are unlikely to have any training in mental health issues.Failure to consider fitness issues is further compounded by the apparentshortcomings of the test.

Instruments assessing fitness to plead and stand trial

In England and Wales the gold standard test is currently a consensus ofpsychiatric opinion. When there is a concern over intellectual and/or othercognitive impairment, clinical psychologists may also provide expertevidence. In North America, a great many measures have been developedto assist in the assessment of competence. In total, this review found 19instruments of interest, which variously overlap or are successive versions ofeach other. Table 2 summarises each of these instruments in approximatechronological order. At present, only one of these has been adapted for usein England and Wales (Akinkunmi, 2002).

As Table 2 illustrates, the first instruments to be published were simplechecklists (Robey, 1965). To these were next added a series of scriptedquestions (Bukatman, Foy, & DeGrazia, 1971), before the development ofsentence completion tasks (Lipsitt, Lelos, & McGarry, 1971) preceded thefirst structured interviews. These early structured tools (e.g., Wildman et al.,1979) were impaired by poorly defined and subjective scoring criteria. Thisled to the development of interviews with strict standardised protocols foradministration and scoring (e.g., Hoge et al., 1997). A lengthy computerisedself-report measure has also been developed, the Computer-AssistedCompetence Assessment Tool (CADCOMP; Barnard et al., 1991).

Wildman’s early structured tool, the Georgia Court Competency Test(or GCCT) is a set of guidelines for questions that tap three dimensions:general legal knowledge; the job of the judge; and the job of lawyers.



Table

2.

Instruments

developed

inNorthAmericato

operationalise

theassessm

entoffitness/competence.

Author(s)

Date

Form

at

Item

s/duration

Strengths

Lim

itations

Achecklist

for

psychiatrists

Ames

Robey

1965

Checklist

Oneofthefirststandard

methods

Few

ifanyscoring

guidelines

Screeninginterview

for

competency

evaluation

Bukatm

an,Foy,and

deGrazia

1971

Checklist

andsetof

interview

questions

Competency

Screening

Test(C

ST)

Lipsitt,Lelos,and

McG

arry

1971

Sentence

completiontask

22item

s,25minutes

Lesssubjectivitythanan

unstructuredinterview

Highfalsepositive

rates,inconsistent

factorstructure

Competency

Screening

Test,brief

version

(CST)

Shatin

1979

Sentence

completiontask

5item

sQuick,correlateswell

withthefulltest

Competency

tostandtrial

assessm

entinstrument

(CAI)

McG

arryandCurran

1973

Interview

without

criterion-basedscoring

13item

sCanstructure

clinical

evaluations

Lim

ited

range;

lack

offocusonlink

symptoms/legal

impairment

Georgia

Court

Competency

Test

(GCCT)

Wildmanet

al.

1979

Interview

without


17item

s,10minutes

Only

test

touse

avisual

technique,

possibly

betteriflow

IQ

Focustoogreaton

foundational

competencies

(cf.IF

I,FIT

)

Georgia

Court

Competency

Test,

revised

(GCCT-M

SH)

Wildman,White,

and

Brandenburg

1990

Interview

without


21item

s,15–20minutes

Addsascreen

for

potentialfeigning

Interdisciplinary

Fitness

Interview

(IFI)

Golding,Roesch,and

Schreiber

1984

Interview

without


5item

sforlegal,11for

psychopathology,4for

overall

Foundationaland

decisionalcompetencies

covered

Designed

foruse

bytw

oraters,legaland

medicaltogether

Interdisciplinary

Fitness

Interview,revised

(IFI-R)

Golding

1993

Interview

without


11globaldomains

Wideranging,reflects

recentchanges

inU.S.

constitutionallaw

(U.S.versionofFIT

)

(continued)



Table

2.

(Continued). A

uthor(s)

Date

Form

at

Item

s/duration

Strengths

Lim

itations

FitnessInterview

Test

(FIT

)Roesch,Webster,and

Eaves

1984

Interview

without


Adaptable

toother

jurisdictions(created

foruse

inCanada),

canbeusedto

screen

or

tostructure

FitnessInterview

Test,

revised

(FIT

-R)

Roesch,Zapf,Eaves,

andWebster

1998

Interview

without


70item

sin

threesections,

takes

30minutes

Assessesfoundational

anddecisional

competences(likeIF

I)

Computer-Assisted

Competence

Assessm

entTool

(CADCOMP)

Barnard

etal.

1991

Computerisedself-report

questionnaire

272item

s,60–90minutes,

plusafollow-up

interview.

Broadcoverage,

designed

alsoto

monitorpro-

gress

inrestorationof

competence

Tim

eneeded,reduced

patientinteraction,

subjectivitydueto

self-

reporting

Competence

Assessm

ent

forStanding

Trial-Mental

Retardation

(CAST-M

R)

EveringtonandDunn

1995

Structuredapproach

usingamultiple-choice

form

at

34–40minutes

Specialisedformildto

moderate

learning

disability,helps

compensate

for

receptiveand

expressivelanguage

deficits

Cancreate

problemssince

legalstandardsare

not

lower

ordifferentfor

mentallyretarded

de-

fendants,mayalsolack

ecologicalvalidity

Evaluationof

Competency

toStandTrial–Revised

(ECST-R

)

RogersandTillbrook

1998

Sem

i-structuredinterview

Focusoncase-specific

inform

ation,includes

screen

forfeigned

incompetence

Metfors

Fitness

Questionnaire(M

FQ)

Nussbaum,Mamak,

Tremblay,Wright

andCallaghan

1998

Self-report

questionnaire

19item

s,5minutes

Developed

foruse

inCanada

MacA

rthurStructured

Assessm

entofthe

Competencies

of

CriminalDefendants

(MacSAC-C

D)

Hogeet

al.

1997

Interview

withcriterion-

basedscoring

47

Cumbersomeresearch

instrument (continued)



Table

2.

(Continued). A

uthor(s)

Date

Form

at

Item

s/duration

Strengths

Lim

itations

MacA

rthurCompetency

Assessm

entTool–

CriminalAdjudication

(MacC

AT-C

A)

Hogeet

al.

1999

Interview

with


22item

s,30minutes

Standardised

administrationand

scoring,delineates

knowledgeand

understanding,

strongesttheoretical

foundations

Vignette

form

atlimits

utility

–canappear

irrelevantto

subject’s

owncase,basedon

U.S.Dusky

framew

ork

MacA

rthurCompetency

Assessm

entTool–

Fitnessto

Plead

(MacC

AT-FP)

Akinkunmi

2002

Interview

with


22item

s,30minutes

Modified

accordingto

legalcriteria

inEngland

andWales

JuvenileAdjudicative

Competence

Interview

(JACI)

Grisso

2005a

Structuredinterview

Focusesonjuveniles,has

acompanionguidefor

lawyers(2005b)

Notastandardised

assessm

enttoolwith

norm

sorpsychometric

properties



The instrument focuses on behavioural aspects of competence, rather thanthe possible presence of mental illness. It has undergone several revisions,including the addition of a feigning screen (Gothard, Rogers, & Sewell,1995). Uniquely, it also uses a visual methodology that can be useful forintellectually or verbally impaired defendants. Drawbacks include an over-emphasis on Bonnie’s foundational competences (i.e., the capacity tounderstand the charges and the nature and purpose of the criminal process,and the capacity to communicate rationally the facts of the case to counsel).

More modern tools include the Fitness Interview Tests – the FIT andFIT-R developed in Canada (Roesch, Webster, & Eaves, 1984; Roesch,Zapf, Eaves, & Webster, 1998), the Evaluation of Competency to StandTrial–Revised (Rogers & Tillbrook, 1998; Rogers, Jackson, Sewell, &Tillbrook, 2003), and the various versions of the MacArthur StructuredAssessment of Competence-Criminal Defendants (MacSAC-CD; Hogeet al., 1997). We will consider these in turn.

The FIT-R uses a semi-structured interview approach, involving 70questions which take approximately 30 minutes to administer. It has agreater focus on mental illness than legal areas, and is divided into threemain sections: ability to understand the nature or object of the proceedings(factual knowledge of criminal procedure); ability to understand the possibleconsequences of the proceedings (appreciation of personal involvement inand importance of the proceedings); and ability to communicate withcounsel (to participate in the defence). It can be used as a screening device oras a means of structuring a more comprehensive evaluation.

The Evaluation of Competency to Stand Trial–Revised (Rogers et al.,1998) also uses a semi-structured interview assessing competence based onDusky criteria. It contains systematic screening for feigning, with questionsprobing impairment and symptomatology relevant to fitness. It focuses oncase-specific information, in contrast to the MacArthur instruments that usea standardised scripted vignette.

The MacArthur Structured Assessments (Poythress et al., 2002) usestandardised administration and criterion-based scoring, and make asystematic distinction between defendants’ existing legal knowledge andthe capacity to attain such knowledge. It contains a short vignette about analleged assault involving two male acquaintances who get into a fight in apool hall. Defendants are presented with approximately 15 details about thishypothetical case, which are embedded in the first 16 inquiries. As with theFIT-R, this assessment is broken down into sections: the first, under-standing, is intended to correspond with Dusky’s factual understanding; thesecond section, reasoning, is intended to assess Dusky’s ability to consultwith counsel criterion; the final section, appreciation, is intended to measureDusky’s rational understanding. In all, 22 items are scored (0, 1, or 2)according to manualised criteria. All the MacArthur instruments havestrong conceptual underpinnings, being based on Bonnie’s (1992, 1993)



theoretical reformulation. Their weakness may be the limitation in clinicalutility that results when the vignette is too far removed from the case inhand. Its internal factorial structure has also been criticised (Cruise &Rogers, 1998).

A specific tool has been developed to assist in the assessment ofcompetence in childhood and adolescence, the Juvenile AdjudicativeCompetence Interview (JACI; Grisso, 2005a, 2005b). Community normshave not been established for performance on this instrument.

Despite the specific adaptation of the MacCAT to England and Wales(Akinkumi, 2002), no structured instruments are used routinely in Englandand Wales. The finding that the Pritchard criteria are applied inconsistently(Mackay & Kearns, 2000), with the result that experts frequently disagree intheir subjective assessments of fitness, suggests that such standardisedinstruments might offer specific benefits.

Summary

Fitness to plead and competence to stand trial are fundamental legalconcepts that draw together a number of related principles and ideas. Intheory these are simple and intuitive, but in practice their determination iscomplicated. In England and Wales, the case law that informs the concept offitness to plead originates from the 19th century, involving cases of learningdisability and sensory impairment. In contrast, the corresponding AmericanDusky model of competence is more concise and was developed around anestablished case of schizophrenia.

Attempts at theoretical definitions of fitness produce long lists ofconsiderations that are not fully accounted for in either of the aboveconceptualisations. Separate factors have been described in studies ofcompetence that do not support a unitary fit-or-unfit system and,furthermore, it is likely that discrete aspects of competence correspond todifferent aspects of the trial process.

In England and Wales, the all-or-nothing finding of unfitness is rare. Itrequires a very high level of disability, at the extreme end of a spectrum of‘psycho-legal’ ability. Many defendants who undergo trial suffer significantlevels of impairment without ever reaching this threshold. There is alsoevidence to suggest that among those who do reach the threshold for‘caseness’ under Pritchard, unfitness is frequently missed and trials may goahead as normal. Clinicians are inconsistent in their application of thePritchard criteria, and may assess fitness differently according to theseriousness of the alleged offence. Only certain aspects of the psychoticindividual (conceptual disorganisation and delusions) appear to correlatewell with final subjective judgements. British clinicians have been reluctantto embrace the structured assessments of fitness pioneered in NorthAmerica. Finally, the outdated Pritchard criteria do not reflect the wealth



of current knowledge and are significantly at odds with the principles of thenew Mental Capacity Act (2005).

This review highlights key questions that need careful considerationand further research, in order to inform procedural and legislative change.If the fitness to plead criteria in England and Wales are to be reframed,should this be in terms of the ability to assist legal counsel and decisionalcompetence, or in terms of capacity? Can community norms for theseaspects of fitness be developed? Finally, the issue of consistence andobjectivity in clinicians’ assessments of fitness needs to be addressed. Theneed for a well-researched, standardised, criterion-based approach inEngland and Wales is apparent.

References

Akinkunmi, A.A. (2002). The MacArthur Competence Assessment Tool—Fitness toPlead: A preliminary evaluation of a research instrument for assessing fitness toplead in England and Wales. Journal of the American Academy of Psychiatry andthe Law, 30, 476–482.

Baird, A.A., & Fugelsang, J.A. (2004). The emergence of consequential thought:Evidence from neuroscience. Philosophical Transactions of the Royal Society ofLondon, 359, 1797–1804.

Barnard, G.W., Thompson, J.W. Jr., Freeman, W.C., Robbins, L., Gies, D., &Hankins, G.C. (1991). Competency to stand trial: Description and initialevaluation of a new computer-assisted assessment tool (CADCOMP). Bulletin ofthe American Academy of Psychiatry and Law, 19, 367–381.

Birmingham, L. (2001). Diversion from custody. Advances in Psychiatric Treatment,7, 198–207.

Bonnie, R.J. (1992). The competence of criminal defendants: A theoreticalreformulation. Behavioral Sciences and the Law, 10, 291–316.

Bonnie, R.J. (1993). The competence of criminal defendants: Beyond Dusky andDrope. University of Miami Law Review, 47, 539–601.

Bonnie, R.J., & Grisso, T. (2000). Adjudicative competence and youthful offenders.In T. Grisso & R.G. Schwartz (Eds.), Youth on trial: A developmental perspectiveon juvenile justice (pp. 73–103). Chicago: University of Chicago Press.

Buchanan, A. (2006). Competency to stand trial and the seriousness of the charge.Journal of the American Academy of Psychiatry and the Law, 34, 458–465.

Bukatman, B.A., Foy, J.L., & DeGrazia, E. (1971). What is competency to standtrial? American Journal of Psychiatry, 127, 1225–1229.

Butler Report. (1975). Report of the Committee on Mentally Abnormal Offenders(Cmnd. 6244). London: HMSO.

Chiswick, D. (1990). Fitness to stand trial and plead: Mutism and deafness. In R.Bluglass & P. Bowden (Eds.), Principles and practice of forensic psychiatry (pp.171–177). Edinburgh: Churchill Livingstone.

Council of Europe. (1950). Convention for the protection of human rights andfundamental freedoms. Rome: Registry of the European Court of Human Rights.

Cowden, V.L., & McKee, G.R. (1995). Competency to stand trial in juveniledelinquency proceedings: Cognitive maturity and the attorney–client relation-ship. University of Louisville Journal of Family Law, 33, 629–660.

Cruise, K.R., & Rogers, R. (1998). An analysis of competency to stand trial: An inte-grationof case law and clinical knowledge.Behaviour Science and theLaw, 16, 35–50.



Dooley, C., Baker, P., Devonshire, P., Evers, C., Herbert, C., Husband, H., et al.(2006). Professional practice board assessment of capacity guidelines groupassessment of capacity in adults: Interim guidance for psychologists. RetrievedJuly 20, 2007, from http://www.bps.org.uk/document-download-area/document-download$.cfm?File_uuid¼8B5AO5CE-1143-DFDO-7E4E-65C98DAFOCA1&ext¼pdf

Everington, C., & Dunn, C. (1995). A second validation study of the CompetenceAssessment for Standing Trial for Defendants with Mental Retardation (CAST-MR). Criminal Justice and Behavior, 22, 44–59.

Exworthy, T. (2006). Commentary: UK perspective on competency to stand trial.Journal of the American Academy of Psychiatry and the Law, 34, 466–471.

Fazel, S., & Danesh, J. (2002). Serious mental disorders in 23 000 prisoners: Asystematic review of 62 surveys. Lancet, 359, 545–550.

Golding, S.L. (1993). Interdisciplinary Fitness Interview–Revised (Training Manualand Interview Procedure). Unpublished monograph, State of Utah Division ofMental Health.

Golding, S.L., Roesch, R., & Schreiber, J. (1984). Assessment and conceptualizationof competency to stand trial: Preliminary data on the Interdisciplinary FitnessInterview. Law and Human Behavior, 8, 321–334.

Gothard, S., Rogers, R., & Sewell, K. (1995). Feigning incompetency to stand trial:An investigation of the Georgia Court Competency Test. Law and HumanBehavior, 19, 363–373.

Gray, N.S., O’Connor, C., Williams, T., Short, J., & MacCulloch, M. (2001). Fitnessto plead: Implications from case law arising from the Criminal Justice and PublicOrder Act 1994. Journal of Forensic Psychiatry, 12, 52–62.

Grisso, T. (1992). Five-year research update (1986–1990): Evaluations forcompetence to stand trial. Behavioral Sciences and the Law, 10, 353–369.

Grisso, T. (2005a). Evaluating juveniles’ adjudicative competence: A guide for clinicalpractice. Sarasota, FL: Professional Resource Press.

Grisso, T. (2005b). Clinical evaluations of juveniles’competence to stand trial: A guidefor legal professionals. Sarasota, FL: Professional Resource Press.

Grubin, D.H. (1991a). Unfit to plead in England and Wales, 1976–1988: A survey.British Journal of Psychiatry, 158, 540–548.

Grubin, D.H. (1991b). Unfit to plead, unfit for discharge: Patients who are foundunfit to plead who are still in hospital. Criminal Behaviour and Mental Health, 1,282–294.

Grubin, D.H. (1996). Fitness to plead in England and Wales (Maudsley Monographs38). Hove, UK: Psychology Press.

Hoge, S.K., Bonnie, R.J., Poythress, N., Monahan, J., Eisenberg, M., &Feucht-Haviar, T. (1999). The MacArthur Competence Assessment Tool-Criminal Adjudication. Odessa, FL: Psychological Assessment Resources.

Jacobs, M.S., Ryba, N.L., & Zapf, P.A. (2007). Competence-related abilities andpsychiatric symptoms: An analysis of the underlying structure and correlates ofthe MacCAT-CA and the BPRS [Electronic version]. http://www.springerlink.com/content/783748107m2pOv43/. Law and Human Behavior.

James, D.V., Duffield, G., Blizard, R., & Hamilton, L.W. (2001). Fitness to plead: Aprospective study of the inter-relationships between expert opinion, legal criteriaand specific symptomatology. Psychological Medicine, 31, 139–150.

Lipsitt, P.D., Lelos, D., & McGarry, A.L. (1971). Competency for trial: A screeninginstrument. American Journal of Psychiatry, 128, 105–109.

Lukoff, D., Nuechterlein, K.H., & Ventura, J. (1986). Appendix A: Manual for ex-panded Brief Psychiatric Rating Scale (BPRS). Schizophrenia Bulletin, 12, 594–602.



http://www.bps.org.uk/document-download-area/document-download$.cfm?File_uuid=8B5AO5CE-1143-DFDO-7E4E-65C98DAFOCA1&ext=pdf





http://www.springerlink.com/content/783748107m2pOv43/

http://www.springerlink.com/content/783748107m2pOv43/

Mackay, R.D., & Kearns, G. (2000). An upturn in fitness to plead? Dis-ability in relation to the trial under the 1991 Act. Criminal Law Review, 532–546.

Mackay, R.D., Mitchell, B.J., & Howe, L. (2007). A continued upturn in unfitness toplead: More disability in relation to trial under the 1991 Act. Criminal LawReview, 530–545.

McGarry, A.L., & Curran, W.J. (1973). Competency to stand trial and mental illness.Rockville, MD: National Institute of Mental Health.

Melton, G.B., Petrila, J., Poythress, N.G., & Slobogin, C. (1997). Psychologicalevaluations for the courts: A handbook for mental health professionals and lawyers(2nd ed.). New York: Guilford.

Morris, A.J., Elcock, S., Hardie, D., & Mackay, R.D. (2006). Changes to (un)fitnessto plead and insanity proceedings. The Journal of Forensic Psychiatry andPsychology, 17, 603–610.

Murphy, G.H., & Clare, I.C.H. (2003). Adults’ capacity to make legal decisions. InHandbook of psychology in legal contexts (2nd ed., pp. 31–66). Chichester, UK:John Wiley and Sons.

Nussbaum, D., Mamak, M., Tremblay, H., Wright, P., & Callaghan, J. (1998). TheMetfors Fitness Questionnaire (MFQ). American Journal of Forensic Psychology,16, 41–45.

Otto, R.K., Poythress, N.G., Nicholson, R.A., Edens, J.F., Monahan, J., Bonnie,R.J., et al. (1998). Psychometric properties of the MacArthur CompetenceAssessment Tool–Criminal Adjudication (MacCAT-CA). Psychological Assess-ment, 10, 435–443.

Poythress, N., Monahan, J., Bonnie, R., Otto, R.K., & Hoge, S.K. (2002).Adjudicative competence: The MacArthur studies. New York: Kluwer/Plenum.

Robey, A. (1965). Criteria for competency to stand trial: A checklist for psychiatrists.American Journal of Psychiatry, 122, 616–623.

Roesch, R., Webster, C.D., & Eaves, D. (1984). The Fitness Interview Test: A methodfor examining fitness to stand trial. Toronto: Center of Criminology, Universityof Toronto.

Roesch, R., Zapf, P.A., Eaves, D., & Webster, C.D. (1998). The Fitness InterviewTest (Rev. ed.). Burnaby, BC: Mental Health, Law, and Policy Institute.

Rogers, R., Jackson, R.L., Sewell, K.W., & Tillbrook, C.E. (2003). Assessingdimensions of competency to stand trial: Construct validation of the ECST-R.Assessment, 10, 344–351.

Rogers, R., & Tillbrook, C.E. (1998). Evaluation of Competency to Stand Trial–Revised (ECST-R). Unpublished test, University of North Texas, Denton.

Rosenfeld, B., & Ritchie, K. (1998). Competence to stand trial: Clinician relia-bility and the role of offense severity. Journal of Forensic Science, 43, 151–157.

Shatin, L. (1979). Brief form of the Competency Screening Test for mentalcompetence to stand trial. Journal of Clinical Psychology, 35, 464–467.

Singleton, N., Meltzer, H., & Gatward, R. (1998). Psychiatric morbidity amongprisoners in England and Wales. London: Stationery Office.

Vassall-Adams, G., & Scott-Moncrieff, L. (2006). Capacity and fitness to plead: Theyawning gap. Counsel, 14–16.

Viljoen, J.L., Roesch, R., & Zapf, P.A. (2002). An examination of the relationshipbetween competency to stand trial, competency to waive interrogation rights,and psychopathology. Law and Human Behavior, 26, 481–506.

Walker, N. (1968). Crime and insanity in England, Vol. 1: The historical perspective.Edinburgh, UK: Edinburgh University Press.



Whittemore, K.E., Ogloff, J.R., & Roesch, R. (1997). An investigation ofcompetency to participate in legal proceedings in Canada. Canadian Journal ofPsychiatry, 42, 869–875.

Wildman, R., Batchelor, E., Thompson, L., Nelson, F., Moore, J., Patterson, M., &de Laosa, M. (1979). The Georgia Court Competency Test. Newsletter of theAmerican Association of Correctional Psychologists, 2, 4.

Wildman, R.W., White, P.A., & Brandenburg, C.A. (1990). The Georgia CourtCompetency Test: The baserate problem. Perceptual and Motor Skills, 70, 1055–1058.

England and Wales case law

R v Berry (1977) 66 Cr App R 156.R v Davies (1853) CLC 326.R v Dyson (1831) 7 C. & P. 305, n.R v Dyle (1756) see Walker (1968).R v Podola [1960] 1 QB 325.R v Pritchard (1836) 7 C. & P. 303.R v Robertson (1968) 52 Cr App R 690.R v Steel (1787) see Grubin (1996).

United States case law

Allard v Helgemoe, 572 F.2d 1,3 (1st Cir 1978).Cooper v Oklahoma, 116 S.Ct. 1373 (1996).Drope v Missouri, 420 U.S. 162 (1974).Dusky v United States, 362 U.S. 402 (1960).Godinez v Moran, 509 U.S. 389 (1993).Jackson v Indiana, 406 U.S. 715 (1972).Riggens v Nevada, 504 U.S. 127 (1992).

Cases in the European Court of Human Rights

V v UK Application No. 24888/94. (1999).T v UK Application No 24724/94. (1999).



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