On August 10, 1999, a self proclaimed agent of the white supremacist underground revealed himself amidst a hail of bullets. Buford O. Furrow, Jr., was charged by the State of California with first degree murder in the killing of a mail carrier and five counts of attempted murder for a shooting spree that took place in the lobby of a Jewish community center One adult, a teenage camp counselor and two six-year-old children were wounded.

The defense has suggested it will ultimately enter a "not guilty by reason of insanity" plea and that should there be a conviction, his mental condition will be a primary issue at sentencing. Since the prosecution and defense will have a very strong interest in how his state of mind is represented, The Forensic Panel was queried as to the pertinent issues that should be considered in the insanity phase, as well as for mitigation if Furrow faces the death penalty.

Michael First, M.D., New York, NY

William Foote, Ph.D., Albuquerque, NM

Rayna Rogers, D.O., San Francisco, CA

James Seward, Ph.D., Paoli, PA

Cornelius Stockman, Ph.D., New York, NY

Michael Welner, M.D., New York, NY

TFPL: What do you make, psychiatrically, of a history of racism?

RR: First, I would want to know if Furrow is mentally ill or just socially taught a lot of plain old hatred.

MF: One psychiatrist recently published an article in which he claims that racism itself should be considered a mental disorder. That assertion has not met with acceptance, however. But, a racial hatred could still comprise an element in an overall record of hallucinatory experiences, assuming those were also present.

CS: A delusion of a religious or racial nature is unlikely to be accepted by the Court as incorporated into a NGRI defense. Whether or not the defendant is legally able to appreciate right from wrong will be looked at from the standpoint of widely held beliefs and values. The values of a cult, an individual or some other cultural value, will not work to help an insanity defense.

WF: Others may also have a personality disorder diagnosis or a drug/alcohol problem. The racial antipathy, inability to get along and highly uncontrolled hostility may just be personality disorder stuff. Absent a delusional disorder or delusional system and command hallucinations you don't have insanity.

MF: The statements made by Furrow about "sending a message" could be used by the defense if it is part of a delusional system which includes the belief in outside agencies commanding the acts (The devil told me to do it). Otherwise, what this would signify is a person with some history of violence combined with a racial hatred and poor impulse control.

CS: There could be a chance for defense success with a well orchestrated argument to a jury that some delusional beliefs are so severe that the killer might not know right from wrong.

MW: The same kind of philosophy seems to apply in intrafamilial homicides. Namely, the crime is so against the values of the trier of fact that the killer "had to be crazy." It's an unscientific argument, but one an attorney can fashion without reliance upon expertise. The prosecution must then counter with the expertise to show recognition of wrong in deeds and words.

TFPL: What history is unusual to this case?

JS: This was not a career crime or a crime for profit. If he were just a pure antisocial personality, he wouldn't have turned himself in. This is not Ted Bundy. He is not a smart man. What he did was horrible, but it is not rocket science. Nor is it the classic exploitation of an antisocial personality.

MW: We need to determine why he chose to go on a crime spree now. If there was any recent blow to his self-esteem, loss, rejection or escalation of a stress or impending deadline, this might increase his desperation and would impact on his regard for consequences. In that situation he might know right from wrong, and the quality of his actions, but just not care.

WF: Clearly he had a plan and a bunch of weapons. He was ready to go. Then again, having a plan doesn't preclude a plan from being an insane plan or one motivated by delusions.

TFPL: Are there diagnoses that come to mind?

WF: Is this a person so confused from Schizophrenia that he doesn't know what he is doing? On the other hand, if he is schizophrenic, that doesn't necessarily translate into violence. Violence among schizophrenics is almost entirely tied in with paranoid schizophrenia and those who hear voices.

MF: I would obviously want to see any history of prior mental illness and would also want to know what, if any, anti-psychotic medication he was taking.

WF: In most cases of actual insanity, where there has been a judicial finding, most of the defendants have delusions and command hallucinations. You just have to have that for a jury to find that the guy did not know right from wrong.

MF: A rule of thumb is that people who are mentally ill but only intermittently "crazy" will generally run the same theme repeatedly. A person who hallucinates that the FBI is monitoring his activities, for example, will generally have the same theme running through all episodes even though there are lucid intervals between them. It would be important to know more specifically about the content of any hallucinations.

RR: He may choose to raise some traumatic event that caused him to snap. But Post Traumatic Stress Disorder doesn't succeed very often, even though some people who have it experience situations in which they briefly lose the ability to appreciate right from wrong. Juries just don't buy it even though it is very hard to fake well. In that case the educating jury is very important.

WF: Most states exclude personality disorders from the definition of legal insanity. These are people who have not accomplished much in life like maintaining jobs and have been losers in almost every respect in life.

MW: A defense attorney would probably want to establish a Manic Depressive Disorder, because it would more cleanly explain the traveling, spending a large amount of money on a cab and showing up in front of the press while in custody, smiling. Still, without more disorganization, it's a stretch to term behavior part of a manic episode alone if the bizarre history was only the shooting itself.

TFPL: What factors should emerge as important as potential mitigators or aggravators?

MW: Other signs, beyond criminal activity, of his simply behaving as someone out of control would be meaningful to help establish that he could not conform his conduct. Such behavior as intruding on others' boundaries, making a spectacle of himself through his utter lack of awareness or regard for how others might view the things he was saying or doing are examples.

RR: There are circumstances where some people become so angry that they have lost control.

WF: The personality disordered offender has not been able to get recognition from other people because he hasn't done anything that counts. Then he sees another loser who is on the screen. Everybody in the country now knows his name and within a week or so everybody knows his life story. That kind of elevation and reward is mother's milk for these guys because they achieve respect and recognition in no other way.

JS: The Brothers Karamazov is a story of brothers, one of whom is dull-witted. These brothers used to get together and bitch about their father saying that they wished he were dead. The dullard took them literally. Consider the possibility of Furrow as kind of flaky, mentally ill, unbalanced. This person craves attention and tends to get involved with any group with a strong dogma. Pretty soon he starts listening to the stuff and then acts out on it.

MW: There is also the possibility of brain injury. A frontal lobe injury, particularly to the orbitofrontal region would leave a person with a decreased ability to control impulses.

RRR: Whatever brain damage condition he might have had would be more meaningful if it affected his communicating, decision making, or physical function in some way.

WF: The influence of the media can't be overlooked. Looking at Furrow in particular, if you saw his picture, he had a big grin on his face. He was as happy as could be. Here is a guy who is a classic Grade A loser who now gets recognition from other right wing colleagues.

JS: The people in the hate group, I suspect, probably would not have done what this guy did. The unbalanced person takes the talk seriously. This may be an individual with no friends, who needs a little attention, wants to belong and is kind of pathetic. So he does this act and then its not satisfying unless you turn yourself in and have someone interview you.

MW: The prosecution can always benefit from an established past history of sadism, and that history just might turn up when hate is such an important part of the case.