a1 The Jerusalem Mental Health Center (Locked Ward), Kfar Shaul Hospital, Affiliated with the Hebrew University – Hadassah Medical School, Jerusalem, Israel
a2 Oxleas NHS Foundation Trust & Division of Psychological Medicine (Institute of Psychiatry), London, England
The assessment of judgment has a central role in court-appointed evaluation, especially when criminal responsibility is in debate. Psychiatry and the law view the concept of judgment differently. The legal system aims for clear determinations of right or wrong, guilty versus not guilty. In psychiatry, judgment is a more complex concept; it involves analytical thinking, socio-ethical behaviors and insight. In clinical practice, these are inter-related and affect each other. The two viewpoints meet in court where they sometimes clash. Judgment is considered preserved when all three components are intact, or when only one is impaired. Impairment of two components inevitably leads to compromise of the third and to judgment impairment as a whole, resulting in criminal non-responsibility.
Clinical vignettes, mainly from acute secured wards, will illustrate the dynamic inter-relation among the different components of judgment and show the influence of judgment evaluation as a whole in criminal law.