The Role Of Forensic Psychiatry In Criminal Justice System Of Pakistan - A Question To Be Answered. But #SaveGhulamAbbas

The Role Of Forensic Psychiatry In Criminal Justice System Of Pakistan - A Question To Be Answered. But #SaveGhulamAbbas
Editor's Note: At the time of writing of these lines, the decision to stay the execution of Ghulam Abbas, a mentally ill prisoner who was scheduled to be hanged on June 18, had not yet been made. Sadiq Naveed’s article however lays out why the execution of mentally ill serves no purpose as it ‘provides no example to others and thus contributes nothing to whatever deterrence value is intended to be served by capital punishment’.

Psychiatry and criminal law frequently complement each other on the questions of Competence to Stand Trial and Competence to be executed. This concept is rather alien to Pakistani judicial system and has been frequently ignored in judicial proceedings. Today, I came across a Twitter trend #SaveGhulamAbass. A tweet by Barrister Ambreen Qureshi, a lawyer and activist, stated that the “Supreme Court has overturned the death sentence in 97% of cases in 2018 alone” and that she was hopeful that Ghulam Abbas’s execution will also be stopped.

My question is, why do we have this conflicting attitude towards patients with mental health illnesses? While looking for the answer to this question, we need to keep in mind that Pakistan is a signatory of international conventions prohibiting the execution of mentally ill people.

Ghulam Abbas, a 36-year-old young man, has spent 13 years on death row and is scheduled for execution on June 18, 2019. According to a story on Dawn News, Ghulam Abbas was visited by psychiatrists multiple times in the last six months (five times in the month of April alone). He was previously diagnosed with learning disability and seizures with a family history of mental illnesses.

Family history of schizophrenia and mental illness increases the likelihood of these illnesses in other family members. Ghulam Abbas was diagnosed and treated for psychosis with Risperidone by a renowned psychiatrist, Dr Malik Hussain Mubbashar.

Unfortunately, this is not the first time an individual with an illness like schizophrenia is being executed in Pakistan. I still have memories of Imdad Ali (late) who was executed despite his history of schizophrenia, and there are many more on the death row.

I had the opportunity to review the judgment of Supreme Court in the case of Imdad Ali. This decision reflects on the need for engagement of mental health experts in cases involving patients with psychiatric illnesses. With due respect for honourable Supreme Court judges, I will like to comment on the few points raised in this judgment.

  1. The judgment acknowledged the fact that Imdad Ali has raised the plea of insanity at different stages of this case. Mr Imdad Ali was diagnosed with Schizophrenia but this claim was not taken into consideration by the competent court. The competent court cited that it was a reason to delay the execution. However, it is unclear if an expert witness (usually a mental health provider) was called for expert opinion regarding this particular concern.

  2. The most troublesome thing for me is that this judgment used Webster’s Dictionary to define Schizophrenia without using any credible references from the recent literature on psychiatry and mental health. The judgment cites a controversial reference of Communication and Mental Health, 1962 by Karl Menninger. The field of science especially psychiatry is dynamic and has grown significantly during the last few decades. I may sound like a broken record but this again stresses the need for integration of mental health and law.

  3. Schizophrenia was cited as “not a mental illness” since it is a recoverable illness and this notion was questioned in several newspaper articles and peer-review publications. This is contrary to the knowledge of psychiatry that describes schizophrenia as a remitting and relapsing illness with a profound impact on the functioning of an individual’s brain.

Let's take a look at what other countries do and what does field of psychiatry say.

On the question of Competence to Stand Trial, the US courts have decided in a landmark case of Dusky Vs United States. This judgment mandates that a test of competence should be applied to determine the ability of the defendant to consult with a lawyer with a reasonable understanding about the rational, factual understanding of the case, and court proceedings.

On the specific question of the Competence to Be Executed, which applies very well on Mr Ghulam Abbas’s case, the US Supreme Court has required to ensure competence in the case of Ford Vs Wainwright. Mark A Small of University of Nebraska College of Law summarised the Ford Vs Wainwright decision in these points in his review article titled “Performing "Competency to Be Executed" Evaluations: A Psycholegal Analysis for Preventing the Execution of the Insane”.

  1. The execution simply offends humanity.

  2. The execution provides no example to others and thus contributes nothing to whatever deterrence value is intended to be served by capital punishment.

  3. It is uncharitable to dispatch an offender into another world when he is incapable of preparing for it.

  4. Execution serves no purpose because madness is its own punishment.

  5. Retribution is not served, as the life taken has a "lesser value" than that of the crime for which the offender is to be punished.

I will urge the President of Pakistan to grant mercy to Ghulam Abbas considering the severity of his illness. In long-term, we need to integrate mental health and law with an increased involvement of mental health professionals.

Acknowledgements: I will like to acknowledge Barrister Ambreen Qureshi, Justice Project Pakistan, and Dawn News whose work inspired me to write this blog.