Pretrial Dispositions Case Vignette

A young man arrested and jailed in connection with an apparent homicide was referred for a forensic consultation to address competency to stand trial and the need for psychiatric hospitalization. Anamnesis revealed that he did not have a significant history of assaulting people. However, he had tortured and killed cats and dogs over the years for sadistic pleasure. Close relatives confirmed cruelty to animals. He explained the homicide as an extension of his acts of cruelty to animals, motivated by pleasure, not by passion or personal gain. Diagnoses included antisocial personality disorder and malingering. On the basis of these diagnoses, hospitalization was not recommended.

During the course of the evaluation, the defendant threatened to kill the evaluator, the evaluator's secretary, and several principals in the upcoming trial once he had an opportunity to do so. He was detained in jail and could be convicted and transferred to prison. Nonetheless, the risk of violence was substantial and, if the defendant were to be released, was within his means. Moreover, he had already demonstrated the capacity for such violence. Hos-pitalization was not an option. Therefore, careful documentation and warnings to the identifiable victims were made. The court and the head of the jail were also notified, as was the defendant's attorney, to ensure that his legal rights were protected. All of these measures were explained to the defendant to further enhance protection for potential victims and to benefit the defendant himself. After a short time in prison, the man was released. No one was notified, but he was reportedly soon rearrested, this time for robbery.

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