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Login to JCSM. Recently, several authors have published discussions on forensic sleep disorders and relevant aspects of criminal law. We are concerned that legal discussion contained therein is inaccurate. While some of these errors may be of little importance, others may directly impact the presentation of expert evidence in court and trial direction.


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We would like to clarify several important points. Mahowald, Schenck, and Cramer Bornemann state: Anglo-American law has traditionally defined criminal offenses as requiring both an actus reus and a mens rea in order to secure a conviction. Essentially, actus reus is the physical component of the alleged offense while mens rea attempts to define the required state of mind. There is a similar statement by Siclari et al. A criminal conviction in many western countries is secured upon proving two essential elements: mens rea guilty mind and actus reus the accomplished act.

In alleged violent behaviour arising from sleep, actus reus is usually never in doubt, whereas the medical expert will need to provide compelling arguments related to mens rea , or the claimant's degree of consciousness. Applying this concept to a particular act can be problematic for a variety of reasons.

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They also correctly identify that sleepwalking can be the basis of a defence of lack of mens rea. Doghramji, Bertoglia, and Watson have commented on the basis of the convictions and acquittals in the cases of Parks , 5 Falater , and Reitz 6 but paradoxically fail to include the reasoning of a jury in Tirrell where it was available the jury stated sleepwalking did not enter into their considerations 7. In our opinion, no inferences should be made if the deliberations of the respective juries are not known.

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Mahowald, Schenck, and Cramer Bornemann state: The strength and merit of any argument does not reside in supporting or refuting the defendant's clinical diagnosis. Instead, the argument maintains focus on the component necessary for conviction or acquittal— mens rea …a forensic analysis of the accused degree of consciousness. The definition of automatism given by Lord Denning in the case of Bratty states that automatism is: An act which is done by the muscles without any control by the mind such as a spasm, a reflex action or a convulsion; or an act done by a person who is not conscious of what he is doing such as an act done whilst suffering from concussion or whilst sleepwalking.

The following are not voluntary acts within the meaning of this Section: a reflex or convulsion;. Section 2. We accept that many of these points are about technical, legal definitions, but we are equally aware that medical publications are regularly used by lawyers in preparing their cases and quoted in court. Clearly, every aspect of these articles will be scrutinised and challenged to confirm their accuracy.

For these reasons, we believe it is important to have a correct understanding of the legal theory in order to frame expert testimony optimally. Morrison has received research support from UCB and is on the advisory board for Eisai. The authors have indicated no financial conflicts of interest. Criminal law and parasomnias: some legal clarifications.

J Clin Sleep Med ;12 8 — State dissociation, human behavior, and consciousness. Curr Top Med Chem. The Law Commission.

Criminal Liability: Reforming Insanity and Automatism. Discussion Paper. London: Law Commission. Section 5.

Parasomnias

Nightmare disorders in children. Recurrent isolated sleep paralysis RISP. Sleep-related hallucinations. REM behavior disorder in adults. REM behavior disorder in children.


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Part V. Other parasomnias. Nocturnal paroxysmal dystonia. Sleep related dissociative disorders.

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Sleep bruxism. Nocturnal enuresis. Sleep-related eating disorders: a separate entity or part of the NES clinical spectrum?. Parasomnia overlap disorder. Part VI. Neurological, psychiatric and medical disorders presenting as parasomnias. Neurological conditions associated with parasomnias. Psychiatric disorders presenting with parasomnias. Medical disorders presenting with parasomnias.

The parasomnias: epidemiology, clinical features, and diagnostic approach.

Parasomnias caused by other conditions. Part VIII. Interventions for parasomnias. Treatment of parasomnias.