Journal of Psychiatric Intensive Care


The concept of judgment in the medico-legal context: A view from Israel

Sergey Raskina1, Natasha Fastovskya1, M Dominic Beera2 and Rimona Dursta1 c1

a1 The Jerusalem Mental Health Center (Locked Ward), Kfar Shaul Hospital, Affiliated with the Hebrew University – Hadassah Medical School, Jerusalem, Israel

a2 Oxleas NHS Foundation Trust & Division of Psychological Medicine (Institute of Psychiatry), London, England


The assessment of judgment has a central role in court-appointed evaluation, especially when criminal responsibility is in debate. Psychiatry and the law view the concept of judgment differently. The legal system aims for clear determinations of right or wrong, guilty versus not guilty. In psychiatry, judgment is a more complex concept; it involves analytical thinking, socio-ethical behaviors and insight. In clinical practice, these are inter-related and affect each other. The two viewpoints meet in court where they sometimes clash. Judgment is considered preserved when all three components are intact, or when only one is impaired. Impairment of two components inevitably leads to compromise of the third and to judgment impairment as a whole, resulting in criminal non-responsibility.

Clinical vignettes, mainly from acute secured wards, will illustrate the dynamic inter-relation among the different components of judgment and show the influence of judgment evaluation as a whole in criminal law.


c1 Correspondence to: Rimona Durst, Kfar Shaul Mental Health Center, Jerusalem, Israel. Tel. 972–2-6551559/550; Fax. 972–2-6541281; Email: