The Homicidal Patient

  • Stanley I. Kruger


My original charge for this paper was to describe how the potentially homicidal patient can be recognized. My response to that task is that it cannot be done. Perhaps we can talk about people who might kill someone or could kill someone, but we cannot predict this behavior in an individual case. Moreover, we have great difficulty assessing “dangerousness,” the necessity for “involuntary commitment,” “mental illness diagnoses,” and “being in need of care and treatment” with any degree of reliability. In fact, in reviewing the psychiatric literature, two lawyers (Ennis and Litwack, 1974) concluded that little evidence exists that psychiatrists are any more expert than lay persons in making these predictions. Yet the courts and the law assume that psychiatrists can reach reliable and valid conclusions concerning these questions, which have awesome implications for the lives of the patients being evaluated, such as: Should they be free persons? Should they be involuntarily held? Should they be tried for offenses and perhaps sent to prison?


Civil Hospital Business Trip Drinking Beer Massachusetts Department Prior Arrest 
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  2. Ennis, B., and Litwack, R. 1974. Psychiatry and the presumption of expertise: Flipping coins in the courtroom. Calif. Law Rev., 62, 693–752.CrossRefGoogle Scholar
  3. Kozol, H., Boucher, R., and Garofalo, R. 1972. The diagnosis and treatment of dangerousness. Crime and Delinquency, 18, 371–392.CrossRefGoogle Scholar
  4. Steadman, H., and Keveles, G. 1972. The community adjustment and criminal activity of the Boxstrom patients: 1966–70. Am. J. Psychiat., 129, 304–310.PubMedGoogle Scholar

Copyright information

© Plenum Press, New York 1979

Authors and Affiliations

  • Stanley I. Kruger
    • 1
  1. 1.Massachusetts Department of CorrectionUSA

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