I. Historical Development of Anglo-American Insanity Perspectives.- 1. An Historical Look at Insanity Defenses: From King Aethelred to Queen Victoria.- Secular Shortcomings and Ecclesiastical Entwinings.- Partial Insanity—The Emerging Gray Area.- Beyond the Beast.- Hadfield Fires, but Erskine Hits the Mark.- M’Naghten.- 2. From M’Naghten to Hinckley: Yesterday’s Answers Breed Today’s Questions.- The Rules Run Afoul.- The Dust Settles, but Does Not Clear.- To Know the Nature and Quality of the Act.- Wrong.- Disease of Mind.- Irresistible Impulses.- Isaac Ray and the Durham Rule.- The ALI Fallback.- Diminished Responsibility.- Abolishing the Insanity Defense.- 3. The Courtship of Law and Psychology.- The First Profession.- Medicine and Morality.- Punishment, Treatment, and the Presumption of Expertise.- Medicine’s Insecurities and Inroads.- Divestment.- Blind Justice Sees a Wolf in Sheep’s Clothing.- The Psychological Age.- A Medico-Psychological Retreat.- Healer Heal Thyself, or Else.- II. Background Issues—Basic Concepts, False Hopes, and Erroneous Beliefs.- 4. The Concept of Mental Illness (Disease).- The Problem of Defining Mental Disorder.- Mental Illness: A Medical or Cross-Dimensional Concept?.- Schizophrenia.- Demedicalizing Mental Illness.- The Hypothesized Relationship Between Mental Illness and Insanity.- A Mental Illness Threshold for Legal Insanity.- A Judgment-Capacity Connection?.- A Consciousness -Mens Rea Connection?.- A Rent in the Self.- Some Conclusions about the Mental Illness-Insanity Relationship.- 5. Therapeutics for the Insane, Dilemmas for Therapists.- The Reach of the Therapeutic Hand…and the Surety of Its Grasp.- Therapy at Its Best.- Therapeutic Dilemmas.- Therapy as an Ethical-Moral Undertaking.- In Search of Ethical Precepts…and Effective Therapy.- Contracts.- Confidentiality.- Consent.- Therapeutic Limits.- 6. Punishment and the Insane.- Popular, but Erroneous, Assumptions.- When May We Punish?.- Harm.- A Moral Wrong.- A Criminal Act.- Mens rea—Intent.- A Capacity.- Why Punish?.- Retribution.- Deterrence.- Rehabilitation.- The Problem of Having Only Two Choices.- Revenge and “Wild Justice”.- Future Directions and Dead Ends.- III. Prevailing Currents, Unsettling Consequences.- 7. The Layman’s (Juror’s) Perspective on Insanity.- The Jurors Stand Accused.- Empirical Evidence.- Insanity Test Instructions.- Case-by-Case Discriminations.- Subject Variables.- A Swayed or Independent Jury?.- Construing.- Framing the Case.- Juror’s Sentiments.- The Law’s vs. the Jurors’ Constructs.- Suggested Directions for an Insanity Test.- 8. Neuropsychological Perspectives on Insanity.- Split-Brain Background Facts.- Split-Brain Madness.- The Issue of Responsibility.- Where Personal Responsibility Ends and Brain Processes Begin.- “What Sort of Persons Are Hemispheres?”.- Split Psyches.- Closing Summary, Deliberations, and a Verdict.- A Disquieting Epilogue.- 9. The Patient’s Perspective: Involuntary Treatment.- A Preliminary Issue—Competence to Stand Trial.- Pragmatic and Political Concerns.- Lang, Jackson, and Most Grievous Abuses.- Confusions over Competency.- Assessing Competency.- Unequal Protection.- NGRI Consequences.- Retribution.- Deterrence.- Rehabilitation.- Release.- The APA Position.- IV. Future Directions and Recommendations.- 10. The Essence of Insanity.- A Dogged Dilemma.- In Defense of an Insanity Defense.- Justifications for Excusing.- No mens.- The Need for a Unifying Doctrine.- Strict Liability.- Abolishing the Insanity Defense.- Mens Rea Proposals.- Lady Wootton’s Proposal.- H. L. A. Hart’s Proposal.- Fine-Tuning the NGRI.- Partial Insanity.- Diminished Responsibility and Diminished Capacity.- GBMI.- An Unasked Question and Conclusion.- 11. Toward a New Test for Insanity.- Culpability Reconsidered.- The DOM Doctrine.- An Expanding Contextual Universe.- Closing an Escape Hatch.- A New Schema for Insanity.- DOM as an Affirmative Defense.- Redefining Actus Reus Behaviorally.- The Mens Phase.- Culpability for the DOM.- Sentences and Consequences.- Instructions to the Jury.- General Remarks.- Instructions.- The Behavioral Decision.- The Mens Decision.- Culpability Decision.- Mens Rea Decision.- A Concluding Comment to the Jury.- 12. Law and Psychology—the Courtship Reconsidered.- Remaining Matters.- A Passionate Ambivalence.- A Withering and Widening Courtship.- Unveiling Values.- Science (and Facts) vs. Morality (and Values).- Free Will vs. Determinism.- Paternalism vs. Autonomy.- Unveiling the Law.- Final Recommendations.- A Concluding Moral.- References.