VII. THE MATRIX OF THEORY AND PRACTICE: READINGS FROM THE LEGAL-MEDICAL LITERATURE

The Dangerousness Criterion

Under international legal and medical standards, a number of key principles are held to be paramount in the field of psychiatry. First, compulsory hospitalization is, in most cases, only justified where the patient's mental state poses a direct danger, usually physical, either to his or her own health and safety, or to that of others; alternative considerations, such as concern by the authorities that a person's mental state or behavior may prove injurious to "social stability," do not meet the requirements of this key "dangerousness" criterion.¹⁹⁴ As a U.N. Special Rapporteur noted in 1983, "It is not satisfactory to generalize about `dangerousness' in the abstract. One must distinguish between `danger to self', danger to others', and `danger to the public'... The argument of `overprediction of dangerousness' poses a grave threat to the human rights and fundamental freedoms of the patient."¹⁹⁵ Second, it is a commonplace of international law, starting with the Universal Declaration of Human Rights, that no person may be subjected to detention, arrest, trial or any other form of persecution on account of their peacefully held political or religious views and activities.¹⁹⁶ And third, as a logical extension of these two principles, it is flatly impermissible for government authorities to subject any person, whether mentally ill or otherwise, to involuntary psychiatric treatment or hospitalization on criminal charges relating to the person's political or religious views and beliefs - or indeed, to do so for any other reasons of governmental convenience.

The following questions should be borne in mind, therefore, in seeking to evaluate the cases of those described as "mentally ill political offenders" in China. Were the individuals concerned in fact mentally ill? If so, did they pose a genuine and direct danger to themselves or to others? And did their activities, as officially described, in any way justify their being placed under arrest and subjected to the authority of the State's criminal-psychiatric assessors? The first question is, in most cases, difficult if not impossible to answer on the basis of the fragmentary case material available, although certain useful insights can often be gleaned. The remaining two issues boil down, in essence, to the dangerousness criterion and how it is defined and interpreted by the authorities. The understanding of dangerousness as a medico-legal category varies considerably in legal systems around the world,¹⁹⁷ but the question of a mentally ill person's potential for doing physical harm to himself or others is of central and primary concern in most jurisdictions; secondary considerations may include psychological harm, danger to property, or damage to the environment.¹⁹⁸ China, however, is today the only country known specifically to include "political harm to society" within the scope of what the medico-legal authorities officially regard as being dangerous mentally ill behavior.¹⁹⁹

How high or prominently, then, do so-called political cases figure in the Chinese psychiatric establishment's general hierarchy or ranking of "serious crimes committed by the mentally ill"? This important issue has a close bearing upon the further question of whether the offenders concerned, once evaluated as being "not legally responsible" for their actions, will end up, variously: a) being set free and placed under a "family surveillance and control" order, or instructed to undergo either outpatient or inpatient psychiatric treatment at a normal hospital; b) being placed under involuntary committal in the secure ward of a regular mental hospital or, for those with no means of financial support, in a similar closed section of one of the numerous Ministry of Civil Affairs-run "social welfare institutes"²⁰⁰ found throughout the country; or c), being forcibly confined without limitation of time in an Ankang institute for the criminally insane. As the following passage from 1988 makes clear, "cases of a political nature" are deemed by the Chinese medico-legal establishment to rank among the most serious and dangerous of all possible forensic-psychiatric offenses:

Of the 222 cases in the present group where diagnoses of schizophrenia were made, sixty-six cases (or 29.7 percent) involved murder or serious injury (a figure closely approximating the findings of Li Congpei et al in their study); there were fifty-five cases of a political nature; and forty-eight cases involved disturbances of social order. The combined total for these three categories came to 169 cases, accounting for 76.1 percent of all cases committed by schizophrenics. From this, we can ascertain the major gravity of the threat posed to social order and personal safety by schizophrenia sufferers who commit crimes, and also the severity of the consequences thereof.²⁰¹

Thus, so-called political cases and also those involving disturbance of public order²⁰² are evidently seen by China's legal-medical authorities as representing no less serious and dangerous a threat to society than cases of murder and injury committed by genuinely psychotic criminal offenders. In other words, psychiatric detainees of both these political categories are prime candidates for long-term admission into Ankang. But the official view goes still further than this, for it sometimes seeks actually to equate violence and dissidence, by depicting the latter as being a form of "violence" in itself. A prime example of this mode of thinking can be seen in the following passage written by Li Congpei, probably the most eminent forensic psychiatrist working in China today, and several others, on the question of crimes committed by schizophrenics:

Among the cases under discussion, outbursts of violent behavior²⁰³ were characterized by several unusual features: for example, the person's "criminal" motive would frequently be vague and unclear or the reverse of what it originally seemed to be, and was thus difficult to fathom; or the person would often display absolutely no sense or instinct of self-preservation, for example by openly mailing out reactionary letters or pasting up reactionary slogan-banners in public places - and even, in some cases, signing his or her real name to the documents; and in cases where the "criminal" behavior had been relatively savage,²⁰⁴ the person would later maintain an air of cool indifference.²⁰⁵

At the outset of this analysis of 386 cases of criminal behavior by schizophrenics, Li and his colleagues stated that the diagnostic criteria applied in the study were based, among other things, upon the psychiatric classification models laid down in the World Health Organization's International Classification of Diseases (ICD-9) and the American medical profession's Diagnostic and Statistical Manual of Mental Disorders (DSM-III). The authors' explicit characterization, however, of the relatively mild acts of public political protest referred to above as representing typical examples of violent psychotic behavior will no doubt dismay psychiatric professionals around the world who actually do base their work on these standard reference texts.

Official Statistics on Political Psychiatry

The frequency with which "cases of a political nature" are referred to in the official forensic psychiatric literature has been noted several times in this article, and we shall now examine these statistics in greater detail. According to these sources, the incidence of forensic psychiatric "political cases" has declined steadily over the past two decades, falling from a level of around fifteen percent in the 1980s to as low as one or a few percent in the late 1990s; the general trend thus appears to parallel the sharp decline seen in the numbers of "genuine" counterrevolutionary cases dealt with by the authorities over the same period.

At the outset, it should be noted that not all of the "political cases" cited in these official publications necessarily involved persons who were of entirely sound mind when detained by the security authorities for exercising their right to free expression. Many of them may indeed have been suffering from various mental quirks, disorders or abnormalities at the time in question, and a certain proportion may even have been in urgent need of psychiatric attention. Two key questions arise in all such cases, however. First, why were the numerous individuals who actually make up these statistics arrested by the police in the first place, since their only real offense seems to have been voicing opinions and viewpoints which, for a wide range of questionable reasons, the Chinese authorities viewed as politically unacceptable? The fact that these dissident, or pseudo-dissident, viewpoints were apparently directed, in a high number of reported cases, against the Communist Party of China neither represents a legally acceptable grounds for arrest, nor - still less - can it be regarded as a medically sound or valid reason for questioning the basic sanity of those involved. And second, why were so many of these individuals, sane or otherwise, seen by the authorities as posing such a serious "danger" or "threat" to society that, upon being arrested, they had to be labeled by forensic psychiatrists as "not legally responsible" for their dissident or pseudo-dissident activities, and then promptly divested, as a result, of most of their civil and litigious rights - notably the right to be tried in court - and finally, sent for indeterminate periods of time to police-run institutes for the criminally insane?

The following passages provide a typical cross-section of the numerous statistical references to such cases that have appeared in China's professional literature during the post-Mao era. During the 1980s, the overall statistical profile for political-style forensic psychiatric appraisals was broadly as follows. According to Shen Zheng, a leading authority in the field,

In a research study of 1986 on eighty-three criminal cases where diagnoses of schizophrenia were made, Zhang Junxian and others found that cases of murder and injury accounted for 55.4 percent, political cases accounted for 13.3 percent, and hooliganism and sexual crime accounted for 10.8 percent.²⁰⁶

More specifically,

Of the eleven cases of antisocial acts or statements carried out by schizophrenics, six involved the writing of slogan-banners in public places, three involved the shouting of slogans amidst crowds of people, and two involved the sending of openly-signed letters by post.²⁰⁷

According to Zhang Xinzhi, an elderly forensic medical expert who had worked in the Chinese police force since 1954 (most recently as deputy-head of the Wuhan Municipal Public Security Bureau's department of forensic medicine),

In criminal cases, mentally ill people, as a result of their pathological thoughts and hallucinatory delusions, may exhibit abnormal behavior in the form of anti-social acts and statements; for example: murder, arson, rape, theft, injury, disrupting traffic, and writing reactionary letters and posters or shouting reactionary slogans.

Out of a sample group of fifty criminal cases studied by Zhang in which the defendants were examined by police-appointed psychiatrists,

Altogether six cases, or twelve percent of the total, involved the writing of reactionary letters; and another two cases, or four percent of the total, involved the shouting of reactionary slogans."²⁰⁸

The combined incidence of sixteen percent in this sample is broadly consistent with the 13.3 percent figure given for "political cases" by Shen Zheng. Moreover, out of an expanded group of 111 cases examined by Zhang from the period 1982-89 in which criminal defendants underwent forensic psychiatric evaluation,

There were forty cases of murder, accounting for thirty-nine percent of the total; fifteen cases of rape, or thirteen percent of the total; fourteen cases of theft, also thirteen percent; six arson cases, or six percent; sixteen cases of injury, or fourteen percent; twelve cases of writing reactionary letters, or eight percent; four cases involving the shouting of reactionary slogans, or four percent; and four suicide cases, another four percent.²⁰⁹

The combined incidence for the two types of "political case" noted by Zhang in his expanded study was thus twelve percent, again broadly consistent with the figure of 13.3 percent officially recorded elsewhere in China during the mid- to late-1980s.

Similarly, a study by Shen Muci, Jin Wei and other psychiatrists from the Hangzhou No.7 People's Hospital published in the Chinese Journal of Nervous and Mental Diseases in 1988, found that out of 654 people subjected to forensic-psychiatric evaluation at the hospital between 1973 and 1986 in connection with alleged criminal acts,

Altogether 103 cases were of a political nature; of these, forty cases involved the making of political statements, twenty-five involved [the display or distribution of] political slogan-banners or leaflets, twenty-one cases involved acts of political propaganda; and seventeen cases involved [the writing and sending of] letters.²¹⁰

Once again, the aggregate figure for "political-style" criminal-psychiatric cases in this particular sample group comes, coincidentally or otherwise, to almost sixteen percent - a figure surpassed only, moreover, by the 21.9 percent of those in the same forensic sample group who had allegedly committed murder or serious injury.²¹¹

In addition, the same study noted that a further one hundred of the 654 cases concerned acts that allegedly "disturbed social order," including twenty-nine cases of "unreasonably making trouble" (wuli qunao) - a code-phrase generally reserved by the authorities to denote the legions of "petitioners" (shangfangzhe) who regularly besiege the government offices around the country responsible for dealing with citizens' complaints about official malfeasance or corruption, and which are also supposed to handle citizens' applications for official redress of the countless past acts of political persecution and injustice committed by Chinese government agencies.²¹² As mentioned above, many of those falling in this general category should also properly be seen as "political cases."²¹³ Out of the one hundred persons accused of "disturbing social order," forty-eight were diagnosed as suffering from schizophrenia, eight were said to have various personality disorders, thirteen were found to be not mentally ill (and so were "legally responsible" for their actions), while an additional five were diagnosed as being "paranoid psychotics." If cases of this secondary category are added into the various statistics for those primarily defined by the authorities as being "political" in nature, then the overall incidence rates for political psychiatry in China in the 1980s rises to somewhere in the region of 20 percent of the criminal psychiatric caseload.

Finally, it should be noted that of the 103 "political cases" in the group, only sixteen, or approximately 15 percent, were determined to be "not suffering from mental illness" and so were liable to criminal prosecution; the majority of the group was found to be mentally ill and thus liable for psychiatric custody. Similarly, of the 100 cases of "disturbing social order," only thirteen were determined to be not mentally ill, while all the rest were found to be not legally responsible and were also therefore candidates for involuntary psychiatric committal.²¹⁴

Turning now to the present era, two recently published studies from China have provided a detailed statistical breakdown of the relative incidence of "political cases" in forensic psychiatric appraisals work during successive decades from 1960 to as recently as the late 1990s. The first of these, published in January 2000, examines the situation in one particular institution in the southwestern city of Kunming, the Yunnan Provincial Mental Hospital.²¹⁵ The authors of the study offer few specific observations on their various findings, but they provide a very useful set of data, contained in Table 1.

Table 1: Forensic Psychiatric Appraisals at the Yunnan Provincial Mental Hospital, 1960-97

Period		1960-1979	1980-1989	1990-1997
Total cases		575	1274	936
Violent cases	#	236	734	437
	%	41.04	57.61	46.69
Economic cases	#	13	92	131
	%	2.26	7.22	14.00
Sexual assault cases	#	23	79	60
	%	4.00	6.20	6.41
Political cases	#	288	54	9
	%	50.09	4.24	0.96
Divorce cases	#	0	40	52
	%	0	3.14	5.56
Sexual victim cases	#	1	87	98
	%	0.17	6.83	10.47
Mental injury cases	#	1	28	61
	%	0.17	2.20	6.52
Appraisals of sentenced prisoners	#	13	160	88
	%	2.26	12.56	9.40

According to the data, the reported incidence of political cases at this one hospital fell from a high point of around 50 percent in the 1960s and 1970s,²¹⁶ to just over four percent during the 1980s, and ended at an average level of just under one percent in the 1990s. It should be noted, however, that this hospital appears to have dealt with a comparatively low number of political cases during the 1980s; as we have seen, the reported level for that period elsewhere in China was around fifteen percent. Moreover, while the actual number of cases reported for the 1990s was only nine, this was merely the figure for one hospital. If typical for the rest of the country, this low figure would translate into a total for the country as a whole during the 1990s of several hundred "political cases," and possibly thousands.

The second recent study, published in January 1999, surveyed a total of 9,925 cases of forensic psychiatric appraisal that had been reported in 231 separate articles published in ten psychiatric legal-medical journals in China between 1976 and 1995. During the period in question, the authors found a total of 375 "political cases," representing an average incidence rate of 3.78 percent. The overall data from this considerably more representative survey was tabulated in the article as shown in Table 2.²¹⁷

Table 2: Forensic Psychiatric Appraisals Listed in Ten Chinese Journals, 1976-95

Period	1976-1990		1991-1995		Total (1976-95)
Cases	#	%	#	%	#	%
Murder and injury	2,016	40.90	1,841	36.85	3,857	38.86
Theft	617	12.52	605	12.11	1,222	12.31
Arson	129	2.62	172	3.44	301	3.03
Sexual crime	465	9.43	612	12.25	1,077	10.85
Sexual victims	373	7.57	1,178	23.58	1,551	15.63
Obstructing social order	591	11.99	331	6.63	922	9.29
Politics (zhengzhi)	272	5.52	103	2.06	375	3.78
Hooliganism	81	1.64	88	1.76	169	1.70
Other	385	7.81	66	1.32	451	4.54
Total	4,929	100.00	4,996	100.00	9,925	100.00

Although the time periods used in this survey are not strictly comparable with those in Table 1, what is clear is that among the sample data used, the total number of "political cases" for the five-year period 1991-95 was more than one third of that reported for the entire 15-year preceding period. In other words, viewed chronologically, rather than as a percentage of the total cases for each individual period, the absolute per-year numbers of political cases had hardly changed at all between 1976 and 1995. Moreover, even when viewed as a percentage of the total cases for each period, the incidence rate for "political cases" was still, apparently, proceeding along at the quite considerable level of 2.06 percent during the first half of the 1990s, or more than half the average rate for the entire period since 1976. Also important to note is the fact that the figure of 103 such cases for this period was by no means the total number that actually arose around the country. Rather, it was simply the number that happened to emerge in a rather large group of separately published local studies. The true figure for China as a whole at that time was undoubtedly far higher than this.²¹⁸ Finally, many of those included under the heading of "obstructing social order" in the above table were probably also "political cases" in the wider Chinese forensic-psychiatric sense of the term, since this is often the police's criminal charge of choice in cases of "litigation mania," whistleblowing, persistent complaint against authority, and "false accusation" (wugao.)²¹⁹

Armed with the above statistical data, we can now attempt to make a rough "ballpark" estimation of altogether how many political dissidents and people in other similar categories may have been branded as criminally insane and confined to forensic custodial facilities in China over the past two decades. It should be stressed that, given the fragmentary nature of the currently available statistical evidence, this is an inherently hazardous undertaking and one that can yield, at best, only a very approximate indication of the actual extent of the problem. As we have seen, "political cases" accounted, according to the official statistics, for around 15 percent of all forensic psychiatric appraisals carried out during the 1980s, and, during the 1990s, for somewhere in the region of several percent. The largest statistical indicator on this general topic thus far found in China's legal-medical literature appeared in a volume published in 1988 and was as follows:

According to statistical materials presented at the First National Conference on Forensic Psychiatry, held at Hangzhou in June 1987, the total number of forensic psychiatric appraisals cases (most of which dated from 1980 and later) handled by a certain number of mental hospitals in China had already reached more than 10,000.²²⁰

According to the same source (at p.28), altogether twelve mental hospitals accounted for no fewer than 7,862 of the above-mentioned cases; findings of mental illness were made in 87.51 percent of these cases. In addition, the same source notes (at p.31) that three mental hospitals in Shanghai conducted a total of almost 1,000 cases of forensic psychiatric appraisal over the five-year period between August 1982 and August 1987; again, findings of mental illness were made in approximately 80 percent of these cases. However, another source states that between 1982 and 1989, a single hospital in the Shanghai area - the Shanghai Municipal Center for Mental Health - carried out as many as 1,034 forensic psychiatric appraisals.²²¹ Similarly, between 1983 and 1987, as noted earlier, a total of 931 cases of forensic psychiatric appraisal were conducted at the Beijing Anding Hospital alone. While figures for the total numbers of such appraisals carried out during the 1990s in China are as yet relatively scarce, it is clear from numerous officially published sources that the recent general trend here has been rapidly upwards.

To summarize briefly the above data, during the period 1980-97, twelve hospitals in China performed almost 8,000 forensic psychiatric appraisals, or an average number of 670 per hospital. Applying the average "political case" rate of 15 percent for this general period to the latter figure, one obtains a total figure of 1,200 "political cases," of whom approximately 90 percent (or 1,080) would have been found legally non-imputable by reason of insanity for their alleged crimes and hence (in most or all cases) sent to forensic custody (the remainder would almost certainly have been sent to prison as "counterrevolutionaries"). In addition, we see that the total numbers of forensic psychiatric appraisals that were conducted by individual mental hospitals in China reached, during the same general period, high triple figures. And finally, we know that the total number of such evaluations being conducted across China nowadays is rapidly rising each year.

In order to estimate, on the basis of these partial figures, the approximate sum total of forensic psychiatric "cases of a political nature" in China, we also need to know how many mental hospitals there are throughout the country and how many of those are engaged in forensic appraisals work. The former figure, at least, is known; according to a recently published article in the Chinese press, "575 hospitals and 77,000 doctors and nurses are dealing with mental diseases in China."²²² It is not known how many of these hospitals are qualified or officially authorized to perform forensic psychiatric evaluations.

Let us assume, however, that only one in twenty of the hospitals (that is, around thirty institutions) is so authorized; this is likely to be a considerable underestimate of the actual situation. If so, one could reasonably estimate, on the basis of the average number of cases examined by each of the twelve hospitals referred to above, that these institutions performed somewhere in the region of 20,000 forensic psychiatric appraisals during the first seven years of the 1980s alone, and that approximately 3,000 of these were probably "political cases." (It should also be remembered that many other cases - notably those involving "crimes of disturbing public order" - were appraised during the same period that did not fall within the scope of the authorities' own definition of "political cases," but which would nonetheless qualify as such from the international standards point of view.)

Even allowing for the officially reported decrease in cases of this general nature from the early 1990s onwards, therefore, it is reasonable to estimate that somewhere in excess of 3,000 "political cases" (broadly defined) have been dealt with by Chinese forensic psychiatric examiners countrywide over the past two decades, and moreover that the great majority of these were subjected, as a result, to some form and duration of forced psychiatric custody and treatment. This conjectural "ballpark" figure is almost certainly inaccurate, but it probably errs on the conservative side; and it provides, at least, a reasonable indication of the general order of magnitude involved. By comparison, in the case of the Soviet Union, existing studies indicate that the total confirmed number of political dissidents and others in similar categories who were wrongfully branded as mentally ill and sent to forensic custodial facilities during the 1970s and 1980s was somewhere (depending upon the study in question) in the region of two to three hundred, with unconfirmed estimates also extending into the several thousands.²²³

Diagnostic Concerns

A useful and pithy working definition of the abnormal mental condition allegedly responsible for the various civic-minded activities mentioned above was provided as recently as 1994 in a textbook on forensic psychiatry written by a leading official at the Beijing Ankang institute:

Paranoid psychosis manifests itself, in clinical practice, in two different ways: one form is "litigious mania," in which delusions of persecution tend to predominate; the other form is "political mania," where the dominant role is played by "political delusions." The content of the delusions in "political mania" concern the line and policies of the State; those afflicted do avid research into politics and put forward a whole set of original theories of their own, which they then try to peddle by every means possible, thereby leading to court action.²²⁴ For this reason, such people are sometimes viewed as being political dissidents.

For example, one middle-aged person who was suffering from "political mania" wanted to do research into "modern humanism" and spontaneously resigned from his job. He spent all his time shut up at home, writing manuscripts tens of thousands of characters in length, which he then sent to the Academy of Social Sciences and the editorial departments of various newspapers and journals, hoping they would accept them. When all his efforts failed, he got in touch with some foreigners and asked them to publish his articles abroad, thereby causing a great deal of trouble.²²⁵

With this definition in mind, we shall now consider a number of important medical diagnosis-related issues that commonly arise in the context of the forensic-psychiatric evaluation of "political cases" in China. The first concerns the high rate at which findings of legal non-imputability on grounds of mental illness are made. In reviewing a total of 931 cases of forensic-psychiatric evaluation performed at Beijing's Anding hospital during the period 1983-87, Tian Zu'en and other senior physicians at the hospital established, among other things, that altogether 301, or 32.3 percent, of the criminal defendants concerned were found to have "impaired ability to recognize" their actions; another 307, or 33 percent, had "impaired ability to control" their actions; and 323 others, or 34.7 percent, had "no impairment of legal capacity."²²⁶ This finding is significant because, like numerous other officially published statistics on the same point, it indicates that a far higher proportion of criminal defendants brought before psychiatric evaluation panels in China, altogether 65.3 percent in Tian's case study, are found to be legally incapable by reason of insanity than is the case in most other countries.²²⁷ An even more striking finding of the same study was that out of the nineteen political psychiatric cases specifically defined as being "counterrevolutionary" in nature, fourteen defendants, or 73.7 percent, were determined to have "impaired recognition" of their allegedly criminal acts, while the remaining five, or 26.3 percent, were found to have "impaired control" over their actions.²²⁸ None of these nineteen pseudo-counterrevolutionaries was determined to be mentally normal.²²⁹

These various figures suggest either that the standard of proof and evidence for determining criminal insanity is considerably less rigorous in China than elsewhere, or that far fewer cases of a frivolous, implausible or opportunist nature are presented for expert medical evaluation. The latter possibility can effectively be ruled out since virtually all such cases in China are put forward by the police or the state prosecutor, rather than, as generally occurs in the West, the counsel for the defense. Either way, it is clear that criminal defendants' chances of being "acquitted" of the suspicion of mental illness is in practice extremely low - a situation broadly similar to that found in the criminal trials system, where less than one percent of defendants are eventually found to be innocent. A volume published in 1999 by three experts from the Institute of Forensic Medicine at the West China Medical University in Chengdu, including Liu Xiehe, one of China's top forensic psychiatrists, sheds important light on this issue. Liu and his colleagues began by calling for his Chinese colleagues to adopt, along the lines of certain stipulations found in the Criminal Code of Canada, a "presumption of sanity" when conducting forensic psychiatric appraisals. As they explained,

At present in China there are two main modes of thought. First, the "clinical mode of thought," which is mainly found among appraisals experts who have worked for many years as clinical psychiatrists and also, part time, as judicial psychiatric appraisers. When psychiatric experts of this kind have to perform judicial appraisals, they make a presumption that the person being examined is either mentally abnormal or afflicted by some form of mental illness. The reason for this is that they assume that the examinee would not have been sent for appraisal in the first place unless he or she was in fact mentally abnormal or suffering from mental illness; or else, they feel that the person must indeed have been behaving in some unusual kind of way, otherwise the judicial officers, lawyer or family members concerned would not have raised the request for an appraisal to be carried out. As a result of this general presumption, or feeling of probability, the appraiser will then go to great pains to avoid "being negligent," either by searching through the case files for any possible evidence of mental abnormality or mental disease, or by urging the judicial officers, lawyer or family members to provide as much evidence of this nature as they can.²³⁰

The second main mindset, which the three writers call "the judicial appraisal mode of thought," was one generally found among full-time police forensic psychiatrists, who tended to take the opposite approach and presume that all criminal suspects sent for psychiatric appraisal were mentally normal. The reason they did so was in order to ensure that as many offenders as possible would receive due punishment for their actions. In the view of the book's authors, both of these tendencies were biased and unscientific, and they concluded by calling for China to adopt a similar "presumption of sanity" rule as that found in the Canadian legislation.

The situation described here clearly gives much cause for general concern. Where "cases of a political nature" are involved, however, the implications become more complex and troubling still. Basically, these have to do with the same general problem identified elsewhere in this discussion, namely the essentially specious nature of the Chinese judicial authorities' distinction between "genuine" and "mentally ill" counterrevolutionary offenders. At least where internationally recognized criminal offenses are concerned, the two "modes of thought" identified above might result, at worst, in either a mentally ill offender being sent to a regular prison and not receiving any medical treatment, or in a sane offender being wrongly diagnosed as mentally ill and sent to a forensic psychiatric asylum.²³¹ In China's "political cases," however, no internationally recognized offense has been committed, but simply an act of free expression protected by international law, so the general picture assumes a significantly different quality and character than this. Presumably, the former type of Chinese psychiatrist will tend to rush to assume that a person detained for political offenses is indeed mentally ill and needs to be forcibly committed, whereas those of the second mindset will insist that "due punishment" be meted out and that the person be sent immediately to jail. In short, political detainees are presumed to be either guilty, or insane. Given this essentially punitive medico-legal climate, whichever variety of expert appraiser the hapless Chinese dissident, or "pseudo-dissident," happens to encounter, it is evident that his or her chances of being allowed to walk free at the end of the day are effectively nil.

As if this were not unjust enough, there is sometimes a further subtle twist to the situation. One of the tasks of forensic psychiatrists everywhere is to ascertain whether or not the examinee is feigning symptoms of mental illness as a way of avoiding trial or punishment. This phenomenon, generally referred to as "malingering," was discussed in the context of the psychiatric examination of political offenders by one Chinese source as follows:

Counterrevolutionary behavior by the mentally ill: In most cases, the mental illness takes the form of either delusions of grandeur or delusions of persecution. When the mentally ill person exhibits behavior that endangers the People's Republic of China, it is usually in the form of speech or writing, such as writing reactionary posters or banners, shouting reactionary slogans, or drafting reactionary manifestos. The hallmark of such counterrevolutionary behavior by the mentally ill is that one can generally find no immediate or proximate cause for it. The thoughts and actions appear illogical. The counterrevolutionary behavior is carried out in public, with no apparent fear of the consequences, in broad daylight and in a brazen and flagrant manner. However, one must be on the alert in such situations: the person concerned may simply be feigning mental illness as a cover for their actions, while all the time engaging in genuinely counterrevolutionary plots.²³²

The above passage also raises another diagnostic emphasis, or clinical predisposition, that appears to be central to the official forensic psychiatric mindset in cases of this type. In essence, this can be colloquially summed up as the belief: "You'd have to be crazy to do things like that in China." Underlying this assumption, which itself is a reflection or facet of the "presumption of insanity" issue, is the common understanding that any Chinese citizen in his or her right mind would surely be aware that to publicly challenge the government on questions of political ideology is an extremely high risk activity that most likely will lead to one's arrest by the police. One writer succinctly conveyed the official psychiatric viewpoint on this question in a book published in 1989:

Political offenses of this kind are usually perpetrated in public places. The person concerned will write out reactionary documents, sign them in full, and then sometimes - as if afraid that people won't know his or her real identity - even add their full addresses and give details of their work unit. In other cases, the person involved will write out slogan-banners and then go walking down the street, in broad daylight and into crowded areas, with a whole pile of the things draped over his or her arm and begin pasting them up all over the place. When other people start noticing this performance and come over to see what's happening, the person often tries to "act casual" and pretend that he or she is some kind of a "big hero."²³³

With unintended irony, other Chinese forensic psychiatrists frequently note that the mental instability of people of this type is further apparent because, in "openly signing their real names" to such documents and then "failing to run away" afterwards, they have clearly demonstrated a "lack of any instinct for self-preservation."²³⁴ The above passage, however, could easily have been referring to the kinds of peaceful protest actions that took place on a daily and hourly basis in Tiananmen Square, and most other parts of China, during the May 1989 pro-democracy movement. While such activities are understandably irksome to authoritarian governments who insist upon a high degree of public conformity to official standards of thought and behavior, and while it is possible that some, or perhaps even many, of the "political offenders" concerned may have been mentally or emotionally disturbed in some way, the fact remains that none of these people, according to the official account, committed murders, raped or molested anyone, set fire to public buildings, attacked important government leaders, or even exposed themselves naked in the street. Those who were indeed mentally ill should have been provided with prompt and appropriate medical care, while the rest should have been allowed, in conformity with internationally recognized standards, to go about their public business in an unrestricted fashion.

An Illustrative Case

The following case study appeared in a 1994 textbook on criminal psychiatric work edited by a leading official at the Beijing Ankang facility:

A retired worker threw himself wholeheartedly into the study of political economy, tirelessly and laboriously writing "A Manifesto of a Scientific Communist." Why was this mental illness?²³⁵

Subject of [forensic-psychiatric] evaluation: Zhu, male, 57 years old, married. Ethnically Han, lower middle school educational level, worker in a coalmine. No unusual aspects in his development since childhood. Upper-primary school [sic] educational level, entered the army in 1956, joined the Party in 1961, and enthusiastically studied the works of Chairman Mao. Was demobilized in 1963 and began work at the coalmine. During the "Cultural Revolution," served as vice-chairman of the mine's Revolutionary Committee and was quite an activist. His achievements in "grasping revolution and promoting production" were, moreover, publicized in the People's Daily, and because of this Zhu regarded the Cultural Revolution as the sole path to the realization of Communism.

In 1979 he began to get ideas about writing books on political theory, and after he retired in 1986 he often used to seek out members of the leadership and expound his thoughts and ideas to them. In his view, [the policy of] taking economic construction as the focus [of national work] was entirely mistaken, and he completely negated the principles and policies laid down [by Deng Xiaoping in December 1978] at the Third Plenum of the Party's 11^th Central Committee. He maintained that the international communist movement had already entered a third high tide, that China had produced its leader, and that this leader was none other than himself.²³⁶ Furthermore, he wrote a 100,000-character-long document entitled "A Manifesto of a Scientific Communist" and mailed it out to all the leading organs at central, provincial and municipal levels. Zhu had discussed all these views with the leadership of his work unit. He was normally a fairly quiet man, and he never used to discuss politics with ordinary members of the masses.

Most leaders of Zhu's work unit felt that while his political viewpoints were wrong, they were not reactionary in content; moreover, he had relayed them all to the leadership and the organization, he had not disseminated them among the masses, and when mailing them out he had signed his real name to them. Also, Zhu had spent several thousand yuan of his own money to buy a printing machine, which his wife used to print out his various writings, and so his behavior had seemed orderly and logical and he didn't appear to be mentally ill.

According to the masses, Zhu's everyday speech was quite logical; he behaved in a respectable manner, was always polite in his dealings with people, and had an orderly and regular lifestyle. In their view he wasn't mentally ill, just highly eccentric, and so they regarded him as being a political dissident.

In March 1987, Zhu was expertly evaluated and found to be suffering from paranoid psychosis, on the following main grounds:

The content of Zhu's "theories" was conceptually chaotic: for example, he maintained that "during the period of scientific socialism, it is the State that engenders [social] classes, the superstructure that determines the economic base, and the mode of rule that determines the mode of production," etc. He maintained that all the principles and policies laid down since the Third Plenum of the 11^th Central Committee were wrong. He was the leader who would guide the international communist movement during its third high tide. All this was a form of "political delusion," a pathological mental disorder, and Zhu's behavior was thus obstinate, impervious to reason, and insoluble through criticism or discussion.

Under the influence of his "political delusions," Zhu's pathological willpower grew ever stronger. Upon his retirement, he declared that he would "keep on writing until his very last breath." He saved more than 4,000 yuan to buy a printing machine. Even after these materials had been sent back,²³⁷ he continued writing and mailing out his articles just as before, thereby manifesting utter political lunacy.²³⁸

Zhu's views and utterances were incompatible with his status, position, qualifications and learning; the great disparities here clearly demonstrated his divorcement from reality.

Paranoid psychosis differs from schizophrenia in that, in the former, mental activity remains well balanced, the delusions are relatively systematic and not entirely absurd in content, and the integrity of the personality remains relatively intact. Aside from his "political delusions," therefore, Zhu's overall mental activity remained normal, he was able to lead a quite normal life, and even his own family had difficulty believing that he was mentally ill.

Crucially, this account contains no indication that Zhu had engaged, by international standards, in anything of a remotely criminal nature. From the case details provided, it seems clear that he was simply a committed leftwing thinker, of the kind to be found everywhere in China during the Cultural Revolution decade, but one who - inexplicably and inexcusably from the government's point of view - had failed to perform the requisite ideological volte face after the 1978 return to power of Deng Xiaoping and the Party's repudiation of Cultural Revolution-era political theory. It should also be noted that over the several years following Mao's death and the ascendancy of the new political line, thousands of Zhu's fellow "die-hard ultra-leftists" across China were arrested and sentenced to long terms of imprisonment on various counts of counterrevolution.²³⁹ So why was Zhu, presumably following his initial detention or arrest on such charges, not dealt with in similar fashion, but rather referred by the police for forensic-psychiatric assessment and then found to be mad? Zhu's case affords several vital clues that help elucidate the curious dividing line drawn by China's medico-legal authorities between "political crime" and "political insanity."

The first aspect of Zhu's case that seems to have raised forensic psychiatric eyebrows was the fact that Zhu had in no sense acted covertly or "conspiratorially" in the way he developed and publicized his contrarian political theories: as was noted earlier, this is widely taken in China to be a prima facie indication of mental instability, on the implicit assumption that "proper" political dissidents have "sufficient sense of self-preservation" to assiduously conceal their activities from the authorities, through fear of the stern judicial punishment they would otherwise encounter.

Second, the authorities evidently saw Zhu's endeavors in the realm of political theory as somehow "incompatible" with his status as a mere worker. This condescending attitude may seem surprising in view of the strong emphasis placed by Mao on the importance of China rearing a new generation of "worker intellectuals" after 1949. But Zhu was a longtime Party member who had at one time risen to the relatively important position of vice-chair of his local Revolutionary Committee, so he was surely entitled to have more than a passing interest in political theory. What the authorities appear to have taken primary exception to, however, is Zhu's original authorial efforts in this field, and in particular their detailed and extensive nature. In the official medico-legal view, only academic scholars or Party theorists are supposed to engage in this type of activity; for ordinary members of the public to do so is apparently seen as being not just eccentric, but also - and especially where dissident-type theories are being advanced - indicative of an underlying mental abnormality.

Third, there was the alleged "conceptual chaos" of Zhu's theoretical writings: this represents perhaps the most sinister aspect of the authorities' forensic psychiatric "case" against his sanity. What is significant, however, is that no substantive evidence was raised to suggest that Zhu was in any way cognitively impaired, or that his thoughts were indeed "chaotic" or disconnected. To the contrary, he was officially said to be "logical...respectable...polite" and to have "an orderly and regular lifestyle." The evidence that was officially given pertained solely to his ideas and theories themselves: these were "wrong," "obstinate" and "politically deluded," and the fact that Zhu persisted in holding them, even after receiving an official warning, was identified as a sign of "utter political lunacy."²⁴⁰ The authorities' stated belief that Zhu's "overall mental activity remained normal" and their observation that even his own family viewed him as sane, was seen, not as undermining the final diagnosis of "paranoid psychosis," but rather as in effect confirming it. As noted earlier, this particular diagnostic contradiction was the very hallmark of the Soviet-era political diagnosis of "sluggish schizophrenia."

The above case is not one drawn from the obscure archives of China's revolutionary past. It was published in Beijing in 1994 in an official training manual for Chinese forensic psychiatrists. It was thus presumably seen as a typical illustrative case, the concluding diagnosis being one fully appropriate for study and emulation by others in the legal-psychiatric profession today.

¹⁹⁴ The U.N. Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care (discussed above: see Section II) contain broader criteria for involuntary hospitalization than just that of dangerousness; for example, they also permit involuntary commitment in the case of a person suffering from mental illness whose judgment is impaired and who is likely to suffer further psychiatric deterioration if not hospitalized. This aspect of the Principles clearly goes well beyond the question of dangerousness to self or others, and as such is viewed as controversial by many experts in the field. For a detailed critique of this and other aspects of the December 1991, U.N. document, see Eric Rosenthal and Leonard S. Rubenstein, "International Human Rights Advocacy under the `Principles for the Protection of Persons with Mental Illness,'" International Journal of Law and Psychiatry, vol.16 (1993), p. 257. However, while the Principles may create a certain potential for abusive practices by allowing involuntary commitment on the grounds of possible further deterioration in the patient's subjective mental condition, they nonetheless still define the objective "dangerousness" criterion quite narrowly. Since the Chinese authorities invariably cite this particular criterion (and in the much wider form, moreover, of a putatively "social" or "political" type of dangerousness) when explaining why certain types of political nonconformists require to be psychiatrically detained, it is important to emphasize that China is in violation of international standards in this specific and key respect. Certainly, official concern that the mental state of those involved might "further deteriorate" unless they are forcibly committed never appears, in the Chinese legal-medical literature, as being either the whole or partial grounds for such action having been taken by the authorities. Finally, it is again vital to stress here that one is talking, in the Chinese case, about people being criminally detained and then subjected to forensic psychiatric appraisal - a very different matter from the kinds of involuntary civil commitment cases to which the psychiatric "deterioration" provisions in the U.N. Principles might well give rise.

¹⁹⁵ Erica-Irene A. Daes, Principles, Guidelines and Guarantees, p.20.

¹⁹⁶ See for example, Articles 9, 18 and 19 of the Universal Declaration of Human Rights.

¹⁹⁷ For an informative account of this topic, see Timothy Harding and Cleopatre Montandon, "Does Dangerousness Travel Well? A Cross-National Perspective on Medico-Legal Applications," in John R. Hamilton and Hugh Freeman, eds., Dangerousness: Psychiatric Assessment and Management (Gaskell, 1982), pp.46-52. A fuller and more in-depth discussion of the various issues involved can be found in John Gunn, "Dangerousness," in John Gunn and Pamela J. Taylor, eds., Forensic Psychiatry: Clinical, Legal and Ethical Issues (Butterworth & Heinemann, 1993), pp.624-645.

¹⁹⁸ The dangerousness criterion is a contentious issue among psychiatrists at the best of times, even when it is narrowly restricted to the potential for committing physical violence. According to one writer,

Furthermore, the evidence is pretty overwhelming that psychiatrists are not very good at predicting dangerousness; their success rate in correctly identifying future violence varies from a high of 40 percent...to a low of something like 0.3 percent... The role of psychiatrists in sentencing and detaining procedures is also challenged, on the grounds that they cannot even agree amongst themselves on a definition of dangerousness. I myself like the simple one of it being the potential to cause serious physical harm to others, although there is a case for psychological harm to be included also. (Hamilton and Freeman, Dangerousness, pp.1-3.)

¹⁹⁹ This is not to say that no other countries still practice political psychiatry; a handful do, notably Cuba. For the background history, see Charles J. Brown and Armando M. Lago, The Politics of Psychiatry in Revolutionary Cuba (Freedom House, 1992). For a more recent case report, see "Dissidents Stage Fast to Protest Reincarceration," Agence France Presse, February 27, 1998; in FBIS same day. But so far as is known in these other cases, the notion of political harm is not actually written into the formal definition of psychiatric dangerousness. It is also worth noting that even where the dangerousness criterion is validly and legitimately applied, "The level of security applied to a patient should always be the minimum level which is compatible with safety and good management" (John Gunn and Pamela J. Taylor, Forensic Psychiatry, p.635). In practice this means that unless a crime has already been committed, a violent mentally ill person may be detained in, for example, the secure ward of a normal mental hospital; those who commit serious crimes of violence may, by contrast, end up in a secure prison mental hospital. In China, as the Ankang admissions criteria listed earlier clearly indicate, non-violent and alleged mentally ill "political offenders" are among those most likely to receive the latter kind of treatment.

²⁰⁰ These institutes serve, simultaneously, as warehouses or dumping grounds for indigent elderly people, abandoned or orphaned infants and small children and also the destitute mentally ill. For further information, see Human Rights Watch/Asia, Death By Default: A Policy of Fatal Neglect in China's State Orphanages (New York: Human Rights Watch, 1996), Chapter 2 and passim.

²⁰¹ Shen Muci, Jin Wei, Cai Jianhua, and Han Baojin, "Sifa Jingshen Yixue Jianding 654 Li Fenxi (An Analysis of 654 Cases of Forensic-Psychiatric Medical Evaluation)," Chinese Journal of Nervous and Mental Diseases, vol. 21, no.3 (1988), p.166-168. As can be seen, "cases of a political nature" accounted for as much as 25 percent of all the schizophrenia cases forensically examined in this study.

²⁰² Many cases of "disturbing public order" in China also merit inclusion under the general heading of "cases of a political nature," since state-appointed forensic examiners frequently diagnose such persons as suffering from "litigious mania" (susong kuang) also known as "processomania." The latter diagnostic category was reportedly first posited by a French psychiatrist in the 19^th century, and was widely applied by Soviet forensic psychiatrists (who generally regarded it - as do their Chinese counterparts today - as being a subspecies of "paranoid psychosis") in the cases of politically dissident detainees up until the late 1980s. Western systems of law acknowledge a category of persons known as "vexatious litigators"; but this term is applied only in civil cases (most commonly, in judicial denial of the right to bring suit on the grounds that the plaintiff's allegations are frivolous or unwarranted), and certainly not as a psychiatric label leading to incarceration on the grounds of criminal insanity. The various different types of "disturbing social order" in China that also properly qualify as "political cases" are further discussed below.

²⁰³ "shixing baoli xingwei"

²⁰⁴ "jiaowei xiongcan"

²⁰⁵ Li Congpei, Li Yongzhi, Liu Jinsheng and Fang Mingzhao, "Jingshen Fenliezheng Sifa Jingshenbing Jianding An Li Fenxi (An Analysis of Cases Involving the Forensic-Psychiatric Evaluation of Schizophrenia)," Chinese Journal of Nervous and Mental Diseases, vol. 20, no.3 (1987), pp.135-138. It is worth noting also that the works of Georgi Morozov were cited as an authority in the footnotes to this article.

²⁰⁶ Shen Zheng, Falü Jingshenbingxue, p.302. For the study referred to by Shen, see Zhang Junxian, "An Analysis of the Forensic Evaluation of 83 Cases of Schizophrenia," Fayixue Zazhi (Journal of Forensic Medicine), vol. 1, no. 2 (1986), pp.33-36.

²⁰⁷ Ibid., p. 305. (NB: In the Columbia Journal of Asian Law version of this article, the passage in question was wrongly attributed to Zhou Yingde, another Chinese forensic medical expert; see next Note.)

²⁰⁸ Zhang Xinzhi, "A Preliminary Analysis of 50 Cases of Crime by the Mentally Ill," in Zhou Yingde, ed., Fanzui Zhenchaxue Gailun: Cankao Ziliao (General Theory of Criminal Investigation: Reference Materials), (Beijing 1987), pp.417-422 (volume marked: "Internal teaching materials: keep confidential").

²⁰⁹ Zhang Xinzhi, "A Preliminary Analysis of 111 Cases of Crimes by the Mentally Ill," in Zhai Jian'an, ed., Zhongguo Fayi Shijian (Forensic Medical Practice in China), (Beijing: Police Officers' Educational Publishing House, August 1993), pp.556-561. No fewer than 85 percent of the 111 criminal cases reportedly involved schizophrenics. (NB: This sample group of 111 cases appears to have included the fifty cases cited in the 1987 study by Zhang - see preceding Note.)

²¹⁰ Shen Muci et al., "Sifa Jingshen Yixue Jianding 654 Li Fenxi," pp.166-168.

²¹¹ According to the article, 80 percent of the political cases in this particular study were ones dating back from before 1980, a situation about which the authors comment: "This shows that [the incidence of forensic-psychiatric] cases of a political nature is closely related to [the question of] political movements and social stability" (Ibid., p.168).

²¹² Usefully, Shen and his colleagues also provide a break-down of the specific medical diagnoses made by state forensic psychiatrists in respect of the various criminal categories included within this large sample group. Notably, of the 103 "political cases," fifty-five (or more than half) were attributed to schizophrenia; mental retardation was said to account for five of the cases; eight were attributed to mania; seven were described as being due to anti-social or sociopathic personality disorders; nine were said to be due to reactive psychosis; three more were attributed, respectively, to prison psychosis, "other mental illness" and organic brain disease sequella; and in only sixteen (or 15 percent) of the numerous "political cases" were the defendants found to be "not mentally ill" - and therefore liable to criminal prosecution for their "anti-social" or "counterrevolutionary" acts. (It should be stressed, of course, that the majority of those in the "political" subcategory were not set free by the authorities after being found "not legally responsible" by reason of mental illness; rather, the legal issue then became: in what particular form of "non-penal" state custody would it be most appropriate to place such people in order that society could be afforded maximum protection from their "pathologically dangerous" political behavior.)

²¹³ For further information on the authorities' application of abusive detention policies to mentally ill persons alleged to have "disturbed social order," see Human Rights in China, Not Welcome at the Party: Behind the "Clean-Up" of China's Cities - A Report on Administrative Detention under "Custody and Repatriation" (New York: Human Rights in China [HRIC], September 1999). In the late 1980s, even orphans and abandoned children, residents of the Shanghai Children's Welfare Institute, were sometimes forcibly sent to psychiatric institutions by the orphanage authorities; this was done to them as a punishment for daring to cooperate with an independent investigation then being carried out by the Shanghai municipal legislature into phenomenally high death rates among infants and young children at the orphanage. For details of two of these cases, see Human Rights Watch/Asia, Death By Default, pp.272-275.

²¹⁴ The authors of the study also offered a statistical break-down of the subjective "motives" (zuo'an dongji) underlying the "criminal acts" carried out by the individuals in question. Of the 103 "political cases," thirty-one were attributed (oddly enough, given the ostensible topic of discussion) to "pathological behavior" on the defendant's part, thirteen were attributed to "delusions of persecution," fifteen were attributed to "impairments of mental logic," nine were attributed to "auditory delusions," eight to "personality disorders," while a total of twenty were attributed to "non-pathological" motives (note that this figure exceeds by four, for some reason, the overall number who were determined to be "not suffering from mental illness"); the remaining seven cases were attributed, variously, to "delusions of jealousy" (one case), "relational delusions" (five cases), and "impairment of consciousness" (one case). Of the one hundred cases of "disturbing social order," altogether twenty-eight were attributed to "pathological behavior" on the defendant's part, sixteen to "delusions of persecution," and twelve to "personality disorders"; eighteen cases were deemed to be "non-pathological" in motive; and the remaining twenty-six to various other motivating factors.

²¹⁵ See Yao Zuhua et al., "Jin 40 Nian Sifa Jingshenbingxue Jianding Anli de Bijiao (A Comparative Study on the Case Expertise of Forensic Psychiatrics Over the Past 40 Years)," Chinese Journal of Psychiatry, vol. 33, no. 1 (2000), pp.47-49.

²¹⁶ Interestingly, regarding the figure of 50.09 percent for the 1960s and 1970s, the authors comment: "At that time, when applying for appraisals to be carried out, the judicial organs almost never requested that an appropriate determination of legal responsibility be rendered in respect of the person being examined; in the overwhelming majority of cases, therefore, only a medical diagnosis was made in the appraisal conclusion." This was probably because the police and procuratorial system was in tatters for much of this period: especially during the Cultural Revolution, all such work was subsumed under the activities of ad hoc "security committees" (baowei weiyuanhui) set up in all the localities of China.

²¹⁷ See Zhao Jiancong et al., "Woguo Sifa Jingshenbingxue Xianzhuang de Yanjiu (A Study on the Current Data of Judicial Psychiatry in China)," Chinese Journal of Psychiatry, no. 1 (1999), pp.53-54.

²¹⁸ Another study published in April 2000, for example, noted that at a single psychiatric hospital, the Zigong Mental Health Center, altogether 956 cases of forensic psychiatric evaluation were performed over the period 1981-88. If this was roughly typical for the rest of the country, the total number of such evaluations conducted across China as a whole during the same period would certainly have run into the tens of thousands, and possibly even the hundreds of thousands (Wei Qingping et al., "An Analysis of Expert Psychiatric Testimony on Epileptic Patients' Illegal Actions").

²¹⁹ For a detailed account of the forensic-psychiatric handling of cases of "false accusation" in China, see Zhongguo Gong'an Baike Quanshu (China Encyclopedia of Public Security), p.1965. As the article explains, those found guilty of false accusation are subject to the disturbing judicial principle of "reverse criminal culpability" (shixing fan zuo zui), whereby the offender is sentenced to whatever term of imprisonment would have been applied to the person accused in the event that the accusation had proved to be well founded. Whilst mentally ill offenders of this type are supposed be exempted from criminal judgment, they may nonetheless still be subject to the "commensurability principle" (see above, "Judicial Psychiatry in China and its Political Abuses," Section V.A) and so have to spend similarly long periods in psychiatric custody.

²²⁰ Jia Yicheng, Shiyong Sifa Jingshenbingxue, pp.1-2.

²²¹ See Lin Huai, Jingshen Jibing Huanzhe Xingshi Zeren Nengli He Yiliao Jianhu Cuoshi, p.133. (No rate for findings of mental illness in this group was given.)

²²² See "Nation's Mentally Ill Need More Care," China Daily, November 27, 2000.

²²³ See, e.g., the various estimates on this topic presented in Bloch and Reddaway, Russia's Political Hospitals, and Smith and Olesczuk, No Asylum: State Psychiatric Repression.

²²⁴ "...cong'er yinqi susong" literally means "thereby leading to litigation." The text is ambiguous as to whether it is the dissident or the government who initiates the "litigation" in question. Since there is no known case of any Chinese political dissident having ever launched court action against the government for pursuing "erroneous politics" (i.e., an "incorrect" form of Marxist socialism), the above reference to "litigation" or "court action" can only be understood as a somewhat euphemistic indication by the author that the dissident in question was criminally prosecuted for his contrarian political views and writings. This would also explain why he was being subjected to forensic psychiatric examination: he had already been detained or arrested for alleged political crimes.

²²⁵ Long Qingchun, ed., Sifa Jingshen Yixue Jianding Zixun Jieda, pp.83-84. Interestingly, the author adds: "The incidence of unlawful and calamitous behavior, however, is markedly less common in the case of paranoid psychotics than in the case of schizophrenics. The vast majority of such behavior is caused by the sufferers' paranoid delusions... And in cases where, under the dominant influence of delusions of grandeur or persecution, `reactionary speech or action' ensues, then it will usually do so in public places, for example with the person concerned handing out leaflets or sticking up big-character posters, signed with his or her real name, in crowded public places."

²²⁶ The Chinese terms for these categories, in order of above listing, are: "bianren zhang'ai," "kongzhi zhang'ai" and "falü nengli wu zhang'ai." See Tian Zu'en, Yu Qingbo, Qi Wei, Wang Ping, Chen Lifeng and Yu Tian, "Jingshenbingren de Xingshi Falü Nengli (Criminal Legal Capacity of the Mentally Ill)," Chinese Journal of Nervous and Mental Diseases, vol. 21, no.3 (1988) pp.169-171. Under Chinese law the presence of either "impaired recognition" or "impaired control" constitutes, by itself, sufficient grounds for a finding of "lack of legal responsibility."

²²⁷ According to Richard J. Bonnie, Professor of Law at the University of Virginia School of Law and Director of the University's Institute of Law, Psychiatry and Public Policy:

In the United States, where most psychiatric evaluations of criminal responsibility are initiated by defense attorneys, forensic examiners find a clinical basis for an insanity defense in approximately 10-20 percent of cases, depending on the state. See, e.g., Warren, J.W., Rosenfeld, B., Fitch, W.L., and Hawk, G., "Forensic Mental Health Clinical Evaluation: An Analysis of Interstate and Intersystemic Differences," Law and Human Behavior, Vol. 21, 1997, pp.377-390. (In 1987-88, opinions favoring insanity were rendered by forensic examiners in 7 percent of evaluations in Michigan, 9 percent of evaluations in Virginia, and 13 percent of evaluations in Ohio.) Interestingly, forensic examiners in the former USSR tended to render opinions of non-imputability in a substantial majority of cases in which the defendant was found to have a mental disorder. (See Bonnie, R.J., "Coercive Psychiatry and Human Rights: An Assessment of Recent Changes in the Soviet Union," Criminal Law Forum, 1990, No.1, pp.319-346, at page 334: `[N]onimputability determinations ... occur in a much larger proportion of criminal cases than appears to be the norm in the united States and other Western countries.') That practice appears to have continued in Russia (Richard J. Bonnie, personal communication to author, December 7, 2000).

See also "Statistics of Mentally Disordered Offenders 1999 - England and Wales," U.K Government, available at http://www.homeoffice.gov.uk/rds/pdfs/hosb2100.pdf; see in particular Table 6, p.12.

²²⁸ Curiously enough, however, where the question of "criminal motive" (fanzui dongji) was concerned, Tian and his coauthors found that while the illegal political behavior of eleven of the nineteen "counterrevolutionary" forensic examinees had been inspired by "pathological motives" (bingli dongji), and that of three others by "unclear motives" (buming dongji), the remaining five examinees were said to have been prompted by "real" or "authentic" motives (xianshi dongji) - meaning (in the authors' own words): "motives arising from the conflicts and requirements of reality and having no direct or evident relationship to the mental illness from which the person is suffering." In other words, the five "mentally ill" individuals in question appear, by the authorities' own admission, to have been entirely sane and rational at the time of staging their banned political manifestations (Tian Zu'en et al., "Criminal Legal Capacity of the Mentally Ill," pp.175-177). The same article also discussed the correlation between motive and legal responsibility: out of the total group of 931 forensic-psychiatric examinees, all the 323 persons who were determined to bear "full legal responsibility" for their criminal acts were also said to have been inspired by "authentic" motivating factors, suggesting an officially perceived one-to-one correlation between these elements under normal circumstances; a roughly similar number of persons (352) were found to bear "limited responsibility" for their actions despite also having been prompted by real or authentic motives; and only twenty-three persons found to be similarly motivated were determined to bear "no legal responsibility" for their acts. Of 163 persons whose crimes were officially attributed to "pathological motives," all were declared to be not legally responsible, as were eighteen others who were said to have acted from "mixed motives." The remaining 52 persons from the group were said to have had "unclear" motives, and all were similarly held not legally responsible (Ibid., p.176).

²²⁹ But again, they were caught on the horns of what might be called "psychiatric justice with Chinese characteristics." For had they been found to be sane, they would have proceeded to trial and almost certain conviction on charges of counterrevolution, the most serious offence in the Criminal Law. Since, however, the ostensibly political activities that brought them into the orbit of the criminal justice system in the first place are viewed by the government as being so "socially dangerous" that such persons must on no account be allowed to continue manifesting their "pathological symptoms" within society at large, the fact that they were determined to be mentally ill meant that they would instead, in all probability, be placed in closed psychiatric prison wards where they would be forced to undergo indefinite medical treatment for their exotic psycho-political disorders. For China's hapless "political lunatics," in short, freedom is seldom a viable outcome.

²³⁰ Zhang Wei, Huo Kediao and Liu Xiehe, "Fayi Jingshenbingxue Jianding de Siwei Fangshi (Modes of Thought in Forensic Psychiatric Appraisals)," in Fayixue Jinzhan yu Shijian (Advances and Practices in Forensic Medicine) (Chengdu Science and Technology University Press, 1999). The passage quoted above can be found at http://www.legalmed.org/ref/99z1.html.

²³¹ There is, of course, a third possibility, namely that the person sent either to prison or a mental asylum will eventually turn out to have been innocent; such miscarriages of justice occur, from time to time, in all legal systems around the world.

²³² "...jiu keneng shi yi weizhuang jingshenbing shouduan wei yanhu, jinxing zhenzhengde fan'geming goudang." See China Encyclopedia of Public Security, p.1967. The implied scenario - of a dissident being caught in the street red-handed by the police while pasting up banned political material, and then being forensically examined to see if he or she was only "pretending to be mad" - surely takes some beating, even by official Chinese standards of political diligence and correctness. The most suitable diagnostic label for such crafty and devious political offenders would perhaps be "pseudo-pseudo-counterrevolutionaries."

²³³ See Shen Zheng, ed., Falü Jingshenbingxue, p.305; the quoted passage was written by Zheng Zhanpei.

²³⁴ See, for example: Mao Shulin et al., "Chapter Seven: Psychopathology and Crime," Fanzui Xinlixue (Psychology of Crime), (Beijing: Qunzhong Chubanshe, 1985), p.222; see also Jia Yicheng, Shiyong Sifa Jingshenbingxue, p.38. Similar references to the "lack of instinct for self-preservation" shown in cases of this type can be found throughout the Chinese legal-medical literature.

²³⁵ See Long Qingchun, Sifa Jingshen Yixue Jianding Zixun Jieda, pp.174-175 (italics indicate subtitle of passage, in original).

²³⁶ Many Western-trained psychiatrists might also identify this particular aspect of Zhu's behavior as a possible sign of mental instability - as being, say, indicative of "delusions of grandeur" or other forms of "overvalued ideation." Both these diagnostic concepts appear with particular frequency, however, in Chinese forensic psychiatric discussions of "political cases" (the Chinese terms used are, respectively, "kuada wangxiang" and "chaojia guannian"), where those being psychiatrically assessed at the same time face serious criminal charges for activities that a Western-trained examiner would be viewing, at worst, as a potential medical problem. Moreover, it should be noted that much of China's political culture during the first three decades after 1949, especially the "individual heroic" mode of leadership embodied in the exemplary person and history of Chairman Mao, served to instill in many Chinese people a strong and no doubt exaggerated sense of personal responsibility for the entire "fate of China." A good example is that of Chen Erjin, a young dissident who in 1974 wrote a book entitled Lun Wuchanjieji Minzhu Geming (On the Proletarian Democratic Revolution), in which he called for national democratic change in the direction of a socialist two-party system. In 1982, he was arrested and sentenced to ten years of imprisonment as a counterrevolutionary for attempting to set up a "second Communist Party" in China. According to several reliable informants who knew Chen well, however, he was in no way mentally impaired or unstable (Chen Erjin, Crossroads Socialism: A Manifesto for Proletarian Democracy, trans. Robin Munro [London: NLB/Verso Editions, 1984]; Chen's book was first published in the June 1979 issue of the Beijing dissident journal Si-Wu Luntan [April Fifth Forum]).

²³⁷ Presumably, after confiscation by the authorities.

²³⁸ "biaoxianchu zhengzhi-shang de fengkuangxing"

²³⁹ The official sobriquet generally applied to such people at the time was "residual poisonous dregs of the Gang of Four."

²⁴⁰ In point of fact, all the various theoretical viewpoints attributed to Zhu by the authorities (for example, that "the superstructure determines the economic base") are typical of mainstream Maoist thought from the late 1950s until Mao's death in 1976, and moreover are held in common by numerous 20^th century Western schools of Marxism, in a tradition extending from Trotsky through to the various "New Left" European schools of thought of the 1960s and 70s. Zhu may well have been slightly "megalomaniac" by disposition, but then so, by some accounts, were many European New Left theorists.