In a murder trial, the defence pleads that the accused was of unsound mind at the time of the act and calls a psychiatrist to testify. The prosecution says the defence must prove the plea. Under Indian evidence law, who must prove unsoundness of mind, and to what standard?

The accused, on a preponderance of probability

The accused, beyond reasonable doubt

The court, through its own medical board

The prosecution, beyond reasonable doubt

A man with schizophrenia stops his medication. Over the next week he hears voices saying that his neighbour is a demon who will kill his children, and one night he attacks the neighbour with a sickle, killing him. He had been admitted twice before with similar relapses. He makes no attempt to hide or run, and tells the police calmly that he has saved his family from a demon. The psychiatrist who examines him the next day finds active psychosis with persecutory delusions and command hallucinations. What is the likely legal outcome at trial?

Not an offence, as he could not know the act was wrong

Murder, with mental illness reducing only the sentence

Culpable homicide, as he was provoked

A retired headmaster with early Alzheimer disease (MMSE 24/30) asks his family doctor to witness his will at home, in which he divides two houses between his son and daughter. The doctor knows the family is in dispute. What should the doctor do before signing as a witness?

Examine his mental state then and record the findings

Ask the son and daughter to agree to the will first

Refuse, as dementia rules out a valid will

Sign without examination, as he is only a witness

After his death, a landowner's will is challenged by a nephew. In his last years the testator believed that the panchayat was poisoning his well water and refused to drink it, but he ran his farm well, sold his crops at good prices and kept his accounts himself until his death. His family doctor noted no memory loss. The will leaves his property equally to his three children, whom he loved, and nothing to the nephew, with whom he had quarrelled for years. How is the will likely to be judged?

Valid, as the delusion did not affect his bequests

Invalid, as the nephew was a natural heir

Valid only if a doctor certified him sane when he made it

Invalid, as any delusion destroys testamentary capacity

Forensic psychiatry, insanity and criminal responsibility

18 NEET-PG practice questions on Forensic psychiatry, insanity and criminal responsibility, part of Forensic Medicine. The first 18 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
Concerning criminal responsibility in India: 1. Irresistible impulse is a complete defence. 2. The mental state at the time of the act decides responsibility. 3. A person who knew the act was wrong is responsible even if he is mentally ill. 4. Medical insanity and legal insanity are not the same. Which statements are correct?
1. A1, 2 and 3 only
2. B1, 2, 3 and 4
3. C1 and 4 only
4. D2, 3 and 4 only
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Answer: D · 2, 3 and 4 only
Indian law follows the McNaghten test, which looks at whether the accused could know the nature of the act or that it was wrong at the time of the act. Irresistible impulse, an inability to control conduct despite knowing it is wrong, is not accepted as a defence in India. Many mentally ill people know right from wrong, so medical insanity does not equal legal insanity. Key point: In India, irresistible impulse is no defence; only incapacity to know the act or its wrongness at the time counts.
- A: Statement 1 is wrong: irresistible impulse is not a defence in India.
- B: Statement 1 is wrong, so all four cannot be correct.
- C: Statement 1 is wrong, and statements 2 and 3 are correct.
Question 2 · Medium
In a murder trial, the defence pleads that the accused was of unsound mind at the time of the act and calls a psychiatrist to testify. The prosecution says the defence must prove the plea. Under Indian evidence law, who must prove unsoundness of mind, and to what standard?
1. AThe accused, beyond reasonable doubt
2. BThe court, through its own medical board
3. CThe accused, on a preponderance of probability
4. DThe prosecution, beyond reasonable doubt
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Answer: C · The accused, on a preponderance of probability
The prosecution must prove the offence beyond reasonable doubt, but the burden of proving that a case falls within a general exception, such as unsoundness of mind, lies on the accused under the Bharatiya Sakshya Adhiniyam (carrying over IEA 105). The courts accept proof on a preponderance of probabilities, a lower standard. Evidence of conduct before, during and after the act is weighed with the medical evidence. Key point: The accused proves unsoundness of mind, but only on a preponderance of probability.
- A: The accused needs only a preponderance of probability, not proof beyond doubt.
- B: The court does not take the burden of proof; it decides on evidence.
- D: The prosecution proves the offence; the accused proves the exception.
Question 3 · Medium
A man with schizophrenia stops his medication. Over the next week he hears voices saying that his neighbour is a demon who will kill his children, and one night he attacks the neighbour with a sickle, killing him. He had been admitted twice before with similar relapses. He makes no attempt to hide or run, and tells the police calmly that he has saved his family from a demon. The psychiatrist who examines him the next day finds active psychosis with persecutory delusions and command hallucinations. What is the likely legal outcome at trial?
1. AMurder, with mental illness reducing only the sentence
2. BMurder, as he intended to kill
3. CCulpable homicide, as he was provoked
4. DNot an offence, as he could not know the act was wrong
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Answer: D · Not an offence, as he could not know the act was wrong
Under the BNS (carrying over IPC 84), nothing is an offence if done by a person who, at the time, because of unsoundness of mind, was incapable of knowing the nature of the act or that it was wrong or contrary to law. A delusion that the victim is a demon threatening his children meant he did not know the act was wrong. He is acquitted, and the court orders his safe custody and treatment. Key point: An act done under psychosis, without knowing it was wrong, is no offence; the court orders custody and treatment.
- A: If the defence of unsound mind succeeds, he is acquitted, not given a reduced sentence.
- B: Intention does not make it murder when he could not know the act was wrong.
- C: A delusional belief is not legal provocation.
Question 4 · Medium
A retired headmaster with early Alzheimer disease (MMSE 24/30) asks his family doctor to witness his will at home, in which he divides two houses between his son and daughter. The doctor knows the family is in dispute. What should the doctor do before signing as a witness?
1. AExamine his mental state then and record the findings
2. BAsk the son and daughter to agree to the will first
3. CRefuse, as dementia rules out a valid will
4. DSign without examination, as he is only a witness
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Answer: A · Examine his mental state then and record the findings
Dementia does not by itself remove testamentary capacity; the question is his capacity at the time he makes the will. A doctor asked to witness should examine him then, testing whether he knows he is making a will, the extent of his property and the claims of his children, and record the findings, as they may be needed if the will is contested. The family's agreement is not required. Key point: A doctor witnessing a will should assess and record the testator's mental state at that time.
- B: The heirs' approval has no legal role in making a will.
- C: Early dementia does not by itself make a will invalid.
- D: With a likely dispute, a written record of capacity is essential.
Question 5 · Hard
After his death, a landowner's will is challenged by a nephew. In his last years the testator believed that the panchayat was poisoning his well water and refused to drink it, but he ran his farm well, sold his crops at good prices and kept his accounts himself until his death. His family doctor noted no memory loss. The will leaves his property equally to his three children, whom he loved, and nothing to the nephew, with whom he had quarrelled for years. How is the will likely to be judged?
1. AInvalid, as the nephew was a natural heir
2. BValid, as the delusion did not affect his bequests
3. CValid only if a doctor certified him sane when he made it
4. DInvalid, as any delusion destroys testamentary capacity
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Answer: B · Valid, as the delusion did not affect his bequests
A delusion invalidates a will only if it influences the disposition of property, for example a delusion that a child is not his. Here the delusion about the panchayat has no bearing on his decisions, and leaving his property to his children rather than an estranged nephew is rational. He understood his property and those with claims on him. A medical certificate is useful evidence but not a legal requirement. Key point: A delusion invalidates a will only if it affects how the property is left.
- A: A nephew has no natural claim over children, and leaving him out is rational.
- C: A doctor's certificate is helpful evidence, not a condition of validity.
- D: A delusion unrelated to the bequests does not remove testamentary capacity.
Question 6 · Easy
After a minor road accident, a lorry driver claims compensation for complete hearing loss in both ears. Pure-tone audiometry gives inconsistent thresholds on repeat testing, and his examiner suspects he is feigning. Which finding most strongly supports malingering?
1. AHe reports tinnitus since the accident
2. BHe hears a soft question when unaware he is tested
3. CHe appears anxious and depressed during examination
4. DHe has a history of chronic suppurative otitis media
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Question 7 · Easy
A will is valid only if, when signing it, the testator had testamentary capacity. Which understanding is essential to this capacity?
1. AThe medical diagnosis and prognosis of his illness
2. BThe tax effects of each bequest
3. CHis act, his property and his heirs' claims
4. DThe legal section under which the will is made
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Question 8 · Medium
Blood alcohol of 260 mg/100 mL is reported in a man arrested after he stabbed a fellow guest at a wedding party in Jalandhar. He had been drinking whisky by choice for several hours, and says he does not remember the act. His lawyer pleads intoxication. How does the law treat his drunkenness?
1. AHe is not responsible, as he lacked knowledge
2. BHe is treated like a person of unsound mind
3. CHe is judged as if he had the knowledge of a sober man
4. DDrunkenness converts murder to death by negligence
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Question 9 · Medium
In the psychiatry OPD, a man with a manic relapse has not slept for four days, threatened his wife with a knife yesterday and refuses admission, as he lacks capacity to decide. A psychiatrist and a medical officer have examined him on the same day. Which admission under the Mental Healthcare Act is appropriate?
1. ASupported admission for up to 30 days
2. BIndependent admission
3. CEmergency treatment for up to 72 hours only
4. DAdmission by a magistrate's order
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Question 10 · Easy
The legal test of insanity used for criminal responsibility in India is based on which rule?
1. AAmerican Law Institute test
2. BDurham rule
3. CCurrens rule
4. DMcNaghten rule
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Question 11 · Medium
In a district jail, an undertrial prisoner awaiting a murder trial is seen by the psychiatrist. Asked how many legs a cow has, he says 'five'; asked the colour of the sky, he says 'green'. He seems dazed, with patchy amnesia, and the symptoms began after his arrest. Which condition does this most likely represent?
1. ADelirium
2. BGanser syndrome
3. CKorsakoff syndrome
4. DSchizophrenia
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Question 12 · Medium
Two hours after midnight, a man with psychosis is brought to the casualty by the police, violently agitated and attacking staff. He has no relatives with him, and no psychiatrist is available until morning. The casualty medical officer gives intramuscular haloperidol and lorazepam. What does the Mental Healthcare Act allow?
1. AEmergency treatment for up to 72 hours, excluding ECT
2. BAny treatment including ECT, for up to 7 days
3. CNo treatment without the patient's consent
4. DTreatment only after the Review Board approves it
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Question 13 · Hard
A man stabs his wife to death at night, washes the knife, burns his blood-stained shirt and takes a bus to another state, where he is arrested a week later. At trial he pleads unsoundness of mind; a psychiatrist had diagnosed paranoid schizophrenia two years earlier, he had stopped his tablets, and he says he had long suspected his wife's fidelity. Neighbours describe him as quiet and withdrawn, and his employer says he worked normally until the week of the crime. Which point most strongly defeats the plea?
1. AHis concealment and flight after the act
2. BHe gave a motive for the killing
3. CHis diagnosis was made two years before the act
4. DThe killing took place at night
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Question 14 · Hard
1. Every person with mental illness has a right to confidentiality. 2. ECT may be given only with anaesthesia and a muscle relaxant. 3. Chaining is allowed for violent patients in a mental health establishment. 4. Sterilisation of men or women as a treatment for mental illness is prohibited. Which statements match the Mental Healthcare Act 2017?
1. A1, 2, 3 and 4
2. B2, 3 and 4 only
3. C1 and 3 only
4. D1, 2 and 4 only
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Question 15 · Hard
Two years after a man stabbed a stranger in a market, his sessions trial for attempt to murder is due to begin. The jail psychiatrist reports active psychosis: he cannot follow the proceedings, understand the charge or instruct his lawyer. He has been on antipsychotics in the jail hospital for three months with little response. The evidence suggests he was well and planned the act at the time, buying the knife two days earlier and waiting for the victim, with whom he had a land dispute. What should the court do?
1. AProceed, as he was sane at the time of the act
2. BPostpone the trial and treat him
3. CAcquit him because he is now of unsound mind
4. DClose the case and send him home with his family
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Question 16 · Easy
A man with recurrent episodes of mania makes a will between episodes, when he is calm, oriented and reasoning normally. What is the legal status of a will made in such a lucid interval?
1. AInvalid, as he is a person of unsound mind
2. BValid, if capacity is shown at that time
3. CValid only if a court approves it beforehand
4. DValid only if a psychiatrist signs it
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Question 17 · Medium
Admitted as an independent patient for depression with suicidal ideas, a woman asks on the third day to leave. The psychiatrist finds that she now lacks capacity to make treatment decisions and has made a fresh suicide plan. Under the Mental Healthcare Act, what may the psychiatrist do?
1. ADischarge her, as independent patients may always leave
2. BGive ECT at once under the independent admission
3. CHold her briefly to assess for supported admission
4. DKeep her indefinitely as an independent patient
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Question 18 · Medium
At an office party, a teetotal clerk is given a soft drink secretly mixed with a large amount of alcohol by colleagues as a prank. Within an hour he becomes confused and pushes a man down a staircase, causing a head injury. He had never consumed alcohol before; his blood alcohol two hours later was 210 mg/100 mL, and witnesses describe him as staggering, slurring and laughing without reason. Medical evidence shows he could not then understand what he was doing. The injured man has a skull fracture and recovers after surgery. Which defence is available to him?
1. AGrave and sudden provocation
2. BInvoluntary intoxication
3. CIrresistible impulse
4. DVoluntary intoxication
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Forensic psychiatry, insanity and criminal responsibility

In a murder trial, the defence pleads that the accused was of unsound mind at the time of the act and calls a psychiatrist to testify. The prosecution says the defence must prove the plea. Under Indian evidence law, who must prove unsoundness of mind, and to what standard?

A retired headmaster with early Alzheimer disease (MMSE 24/30) asks his family doctor to witness his will at home, in which he divides two houses between his son and daughter. The doctor knows the family is in dispute. What should the doctor do before signing as a witness?

After a minor road accident, a lorry driver claims compensation for complete hearing loss in both ears. Pure-tone audiometry gives inconsistent thresholds on repeat testing, and his examiner suspects he is feigning. Which finding most strongly supports malingering?

A will is valid only if, when signing it, the testator had testamentary capacity. Which understanding is essential to this capacity?

Blood alcohol of 260 mg/100 mL is reported in a man arrested after he stabbed a fellow guest at a wedding party in Jalandhar. He had been drinking whisky by choice for several hours, and says he does not remember the act. His lawyer pleads intoxication. How does the law treat his drunkenness?

The legal test of insanity used for criminal responsibility in India is based on which rule?

A man with recurrent episodes of mania makes a will between episodes, when he is calm, oriented and reasoning normally. What is the legal status of a will made in such a lucid interval?

Admitted as an independent patient for depression with suicidal ideas, a woman asks on the third day to leave. The psychiatrist finds that she now lacks capacity to make treatment decisions and has made a fresh suicide plan. Under the Mental Healthcare Act, what may the psychiatrist do?