Rep. Gifford shooting: The Shooter

Nurses Disabilities

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Specializes in Alzheimer's, Geriatrics, Chem. Dep..

I thought about putting this on Allnurses Central and maybe a mod will end up moving it - but I am really bothered, and it has a lot to do with my disability (bipolar). Has to do with my functioning as a nurse. Also has to do with our patients, what if we have to take care of someone who has shot and killed other people? (I'm sure many of you have had to deal w/ it).

Funny, just last nite saw Grey's Anatomy in which they had to operate on a shooter in a mass casualty situation.

ANYway - here is my rant, do with it as you will, I just cut-and-pasted it from my almost-post on Central:

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Here is a rant, skip it if you are sick of hearing about other people's problems (lol)

REALLY upset about this shooting, but not for the reasons you might think. A friend mentioned we need to pray for the shooter's family as well as for those in the crossfire. Didn't occur to me, and she was right.

Later, I realized we ought to pray for the shooter himself.

GAH -= I hate that people are going to pick apart his "being disturbed" as they call it. It's obvious apparently, from his FB and myspace accounts, that it has been festering for a long time...

So, of COURSE mental illness a major cause. I can't imagine a scenario where anyone who shoots a human being (other than self-defense) could possibly be sane.

But I can't help but think about a few members of my family, and I myself, who suffer from mental illness, and but for the grace of God it could have been one of us with that gun - (shaking my head). And now sitting in a jail cell wondering what on earth happened ... or even - feeling justified? He might be...

I imagine his family is wondering "what if" and "what could they have done to help him before he got to this point..."

I don't know why I "went there" but I don't like it. Just feeling really sad and disgusted.

It really makes me mad the cost of mental illness on the fabric of our society, emotionally, financially, etc.

And, selfishly I know, hating that I have to deal with my own. Like, dealing with meds and dr's appts, plus all the worry about 2 siblings and my own son - who don't really take care of their illness. And, if you recall, I went a couple years thinking it was wise not to be on meds myself. Found out I was risking myself and my patients' safety, because I did relapse with my hypomania. That ALSO makes me mad, in hindsight. I could have hurt someone, or myself, on the job, driving, who knows?

Which goes to show you, the person with mental illness doesn't always judge their problem correctly!!! Feeling a little guilt there. At times have felt VERY guilty.

Of course, the meds aren't always right, so it isn't always the patient. And, sometimes side effects can make a person screwy.

So, forgive me for ranting a little bit - I am just really sad for the whole situation. Of course I am upset for the people who were shot and their loved ones.

There is also the obvious thought, that life is short and we never know when someone we love can be taken away from us - reminds us to make peace with each other and with God.

Sighhhh-

Specializes in Family Nurse Practitioner.

This is a good topic and might get more replies and insight in the psych nurse section. Unfortuately there are no easy answers. I get a sinking feeling in my stomach when I hear media stories of someone who committed a horrific crime that imo could have only been done by someone with mental illness learn they are not considered insane largely because of the contempt an insanity plea seems to generate. I'm not condoning the behavior for one second and absolutely do believe they should be incarcerated even without chance for parole depending on the crime but denying the psychiatric component is also criminal. A recent example is the kidnapper of Elizabeth Smart. Not insane? Are you kidding me? Look at the man for crap sake! It doesn't take a professional to see that he is bat **** crazy and again I'd advocate him never being let out to offend again however that doesn't negate the fact that he is mentally ill and should receive treatment. Sadly our society has a long way to go when it comes to understanding and dealing with mental illness. :(

"Sane" and "insane" are legal concepts, not medical/psychiatric concepts, and I don't think the issue has anything to do with "contempt." The standard for being found "sane" and competent to stand trial is quite low. "Just" being seriously mentally ill is not, by itself, sufficient (and, indeed, the vast majority of the mentally ill, even the seriously mentally ill, never intentionally hurt anyone else or break the law in any significant, dramatic way). Lots of people are "bat **** crazy" without meeting the legal standard for being "insane." This is why defense attorneys never use an insanity defense unless they truly have absolutely no other option; and, even then, it's successful in only a small minority of cases.

"Consider the Jeffrey Dahmer case. Dahmer was arrested in Milwaukee in 1991 after he had killed at least 13 victims. His apartment contained the remains of many young men who he had brutally murdered and dissected. He poured acid on his victims, cut them into pieces and preserved their heads and genitals. He treated, preserved and decorated the skulls of his victims. His crimes are a litany of perversion and torture that is rare even for sexually motivated serial killers. In court, his attorneys attempted to plead Dahmer not guilty by reason of insanity. But prosecutors were able to prove that Dahmer knew full well that killing was against the law and what he was doing was wrong. The insanity plea was not accepted in his case. If someone like Dahmer could not be categorized as legally insane, then it stands up to reason that the criteria for insanity must surely be a difficult standard to meet.

This is the reality of the insanity defense in America: difficult to plead, seldom used and almost never successful. But in that small number of cases where it is successful, it is sometimes manipulated or abused in a way that often grabs headlines and captures the imagination of the public. Ultimately, only a jury can decide the issue of insanity, which in itself may be the most controversial aspect about the insanity defense. In other words, people who have no training in the field, rarely come into contact with the mentally ill and have a minimal understanding of the issues involved, make legal, long-lasting judgments that are frequently based on shifting criteria."

All about the insanity defense by Mark Gado Crime Library on truTV.com

I, personally, am glad that it's not easier than it is to be successful with an NGRI defense in court. This is one of those "slippery slope" kind of things, IMO.

Specializes in Alzheimer's, Geriatrics, Chem. Dep..

Thanks guys. I really appreciate your responding!

I did end up posting something similar in the nursing central section and got more responses:

The Az. shootings - a psychiatric perspective - Family, Politics, and Entertainment

I didn't post it in the psych nursing section cuz it seemed more about "me," public awareness, etc. Not a whole lot about providing care. But that's just what I was thinking at the time.

I was also expressing sadness that with my own disability I'm not able to do more about mental health awareness/education.

I'm feeling better, having vented a bit. thanks!

"Sane" and "insane" are legal concepts, not medical/psychiatric concepts, and I don't think the issue has anything to do with "contempt." The standard for being found "sane" and competent to stand trial is quite low. "Just" being seriously mentally ill is not, by itself, sufficient (and, indeed, the vast majority of the mentally ill, even the seriously mentally ill, never intentionally hurt anyone else or break the law in any significant, dramatic way). Lots of people are "bat **** crazy" without meeting the legal standard for being "insane." This is why defense attorneys never use an insanity defense unless they truly have absolutely no other option; and, even then, it's successful in only a small minority of cases.

"Consider the Jeffrey Dahmer case. Dahmer was arrested in Milwaukee in 1991 after he had killed at least 13 victims. His apartment contained the remains of many young men who he had brutally murdered and dissected. He poured acid on his victims, cut them into pieces and preserved their heads and genitals. He treated, preserved and decorated the skulls of his victims. His crimes are a litany of perversion and torture that is rare even for sexually motivated serial killers. In court, his attorneys attempted to plead Dahmer not guilty by reason of insanity. But prosecutors were able to prove that Dahmer knew full well that killing was against the law and what he was doing was wrong. The insanity plea was not accepted in his case. If someone like Dahmer could not be categorized as legally insane, then it stands up to reason that the criteria for insanity must surely be a difficult standard to meet.

This is the reality of the insanity defense in America: difficult to plead, seldom used and almost never successful. But in that small number of cases where it is successful, it is sometimes manipulated or abused in a way that often grabs headlines and captures the imagination of the public. Ultimately, only a jury can decide the issue of insanity, which in itself may be the most controversial aspect about the insanity defense. In other words, people who have no training in the field, rarely come into contact with the mentally ill and have a minimal understanding of the issues involved, make legal, long-lasting judgments that are frequently based on shifting criteria."

All about the insanity defense by Mark Gado Crime Library on truTV.com

I, personally, am glad that it's not easier than it is to be successful with an NGRI defense in court. This is one of those "slippery slope" kind of things, IMO.

what we need is a guilty, though insane....rather than not guilty by reason of insanity....

what we need is a guilty, though insane....rather than not guilty by reason of insanity....

But the whole point of there being a legal standard for "insane," and one of the key, foundational principles of modern jurisprudence (here and in many other countries), is that, if one is "insane" by the standards of the legal system (and, again, it's a legal term, not a medical term, and with a specific definition -- not just a synonym for "mentally ill" -- although the general public uses the term v. casually), one is not responsible or accountable for one's actions -- this concept goes back to the mid-19th century. The idea is that, if an individual is truly that incapacitated, it would be cruel and unreasonable to hold her/him to the same standards of behavior and accountability and punish them the same as everyone else -- the same as we have a different standard of accountability and punishment for children within the legal system than we do adults.

Again, as the legal system in the US currently operates, hardly anyone qualifies as insane and escapes responsibility for her/his actions. The "insanity" defense is v. rarely used, and, in the cases where it is used, v. rarely successful. It's been a long time since I've looked seriously into any of this, but I believe (if I'm recalling correctly) that some states do have a "guilty but mentally ill" verdict option, but, again, that would apply to individuals whose mental illness played a role in their crime but they do not meet the legal standard of "insane."

prolly not insane, just had a really nasty personailty.

Specializes in Alzheimer's, Geriatrics, Chem. Dep..
prolly not insane, just had a really nasty personailty.

Your user name gives me pause given the name of the thread, lol!!

Yeah, who knows what was going on with this guy!

Interesting discussion.

I think that the guy was pushed into a corner by constant rejection which was partially his own fault.

His behavior got him kicked out of college, he lost several jobs and the army rejected him. That's a lot to deal with and no doubt left him out there hopeless and he probably developed feelings of hate and anger towards society.

The current economic environment will push some people over the edge and as a society, we have to be aware and not single out those who need our help.

Specializes in Alzheimer's, Geriatrics, Chem. Dep..
Interesting discussion.

I think that the guy was pushed into a corner by constant rejection which was partially his own fault.

His behavior got him kicked out of college, he lost several jobs and the army rejected him. That's a lot to deal with and no doubt left him out there hopeless and he probably developed feelings of hate and anger towards society.

The current economic environment will push some people over the edge and as a society, we have to be aware and not single out those who need our help.

Thanks Barbara! All good points. And the longer someone is sick, the worse their work history, the fewer the friends and family, etc., etc., it just compounds itself.

One key, when losing friends and family members due to the illness, is to find a support network of friends also in recovery, a "chosen family" if you will, to help you through the bumps, and help you understand when you need more INTENSIVE help. The person who goes it alone entirely is the person whose prognosis is really poor :( One common symptom of many of these illnesses is a tendency to isolate, it is REALLY hard to fight that but so important :(

Here's a link I got from another thread about this:

http://www.cnn.com/2011/HEALTH/01/14/mental.health.loughner/index.html

Specializes in Family Nurse Practitioner.
prolly not insane, just had a really nasty personailty.

Although I personally think it is inappropriate I really hope you are joking. :confused:

Although I personally think it is inappropriate I really hope you are joking. :confused:

nope. dead serious. seen a few similar cases from close up, and discussed the clinical opinion of the defendendants with the court appointed psychiatrist. this guy was way too organised to be mentally incapacitated. he is classic anti-social personality from what i have read of his profile. he just has a really nasty personality, and needs to be put away for multiple life terms.

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