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To the Editor:—
Dr. Scrignar's article (201:343, 1967) accurately highlights the existing confusion between competency determinations and the issue of insanity at the time of commission of a crime.Pretrial competency hearings certainly should not admit into evidence data concerning insanity at time of the commission of the crime. However, this does not preclude the physician from evaluating and expressing an opinion in his report concerning both issues, since frequently the court has requested an opinion regarding both issues. Furthermore, if the physician's reasoning in arriving at his conclusions is spelled out, the court is better able to evaluate whether the physician had had a clear understanding of the distinction between "present competency" and "insanity" at the time of commission of the alleged crime. A single examination regarding both of the above issues precludes unnecessary duplication of examinations.
Marcus EH. Sanity or Insanity and The Criminal Act. JAMA. 1967;202(6):551. doi:10.1001/jama.1967.03130190157037