How James Holmes will be evaluated by psychiatrists (
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By Dr. Keith Ablow
July 24, 2012, FoxNews.com
First, given the extraordinary change in Holmes' mental status--from brilliant neuroscience Ph.D candidate to a mass killer--all organic (i.e. physical) causes for psychiatric symptoms must be excluded via an extensive medical work-up, including an MRI (to rule out a brain tumor or slow bleed), an EEG (to rule out seizures), a lumbar puncture (to obtain cerebrospinal fluid to rule out a central nervous system infection) and blood work (to rule out toxicity from heavy metals, other physiological abnormalities and any use by Holmes of illicit drugs). Any medication with which Holmes has recently been treated will be considered for its possible psychiatric side effects.
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The medical and psychiatric evaluation(s) will also form the basis of any "insanity" plea Holmes may put forward. The questions at the heart of that matter will be whether a major mental illness so impaired Mr. Holmes as to render him unable to tell right from wrong, or if he still knew right from wrong, and whether an illness so impaired him as to render him unable to conform his behavior to the requirements of the law.
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Holmes' journey through the system is just beginning. Insanity pleas are notoriously unsuccessful. The vast, vast majority fail, probably because juries simply don't want to worry over whether a person capable of horrific acts will ever hit the streets. So, if Holmes should offer such a plea and prevail, it will be because he isn't even close to sane and because the culprit who stole 12 lives and shattered dozens more was mental illness, camouflaged by those accomplices who saw it hobbling a man and did nothing--or too little.