Delusions and Violence

When dangerous deeds such as those of the violent maniac and the religious or ideological zealot result from delusional states, how are they to be evaluated? Delusional agency, when a person acts out of, or upon, delusional ideas, has often been judged to be broadly exculpating, and exculpating simpliciter. Yet the range and variety found among clinical delusions suggest a more nuanced picture. Delusional agency often exculpates. It admits of assessment as culpable when a range of conditions apply, however, conditions involving belief states, reasoning capabilities, degree of insight, and measure of self-control. Two implications of this complexity are stressed here: that such assessment will remain unchanged whether we adopt a continuum or categorical view of delusions, and that the same considerations affecting how we hold and act on ordinary beliefs guide assessments about how we hold and act on delusional states.