FM11.3-4 | Criminal & Civil Responsibility; Feigned Illness — Summary & Reflection

KEY TAKEAWAYS

Criminal responsibility of a mentally ill person in India is governed by BNS Section 22 (replacing IPC Section 84 from 01 July 2024), which codifies the McNaughten Rules (1843): a complete defence exists if, at the time of the act, the accused was incapable of knowing the nature of the act OR incapable of knowing the act was wrong. The test is cognitive and retrospective — it does not cover volitional impairment (irresistible impulse) and does not apply to voluntary intoxication.

Civil responsibility is capacity-specific and moment-specific: contracts and wills made during a lucid interval are valid; testamentary capacity requires knowing the nature of making a will, the extent of property, the claims of beneficiaries, and freedom from influencing delusions; evidence-giving capacity and marital capacity have their own statutory thresholds.

Feigned mental illness (malingering) is a conscious, deliberate simulation or exaggeration of symptoms for external gain. It is detected through history inconsistencies, ward behaviour inconsistent with claimed severity, willingness to endorse suggested symptoms, and absence of prior psychiatric contact. Ganser syndrome is a genuine ICD-11 dissociative disorder — not malingering — characterised by approximate answers (Vorbeireden), altered consciousness, conversion symptoms, and hallucinations. The medicolegal trap is the superficial resemblance to malingering.

Every forensic psychiatric court report must address: mental state at the time of the act (for criminal responsibility), current mental state (for fitness to plead), diagnosis under ICD-11, and explicit reliability assessment of the findings.

REFLECT

Suppose you are a junior forensic physician on a three-member medical board evaluating a prisoner who was allegedly psychotic at the time of a robbery and stabbing. During the examination, the prisoner scores 30/30 on the MMSE, gives detailed, coherent accounts of his life history, but then claims to hear voices continuously and to believe he is the reincarnation of Akbar. When you probe the voices, he describes them as giving him commentary on everything that happens — including the examination itself — but he cannot give any specific content. The senior board member quietly says, "I think this is malingering." The lawyer present objects that the prisoner has been on antipsychotic medication since arrest and the symptoms may be partially controlled. How would you structure the board's further assessment, what additional information would you seek, and how would you structure the opinion letter to address both possibilities without foreclosing either the prosecution's argument or the defence's claim?