For reversal and remandment -- Justices Jacobs, Hall, Sullivan, Pashman and Clifford. For affirmance -- None. The opinion of the Court was delivered by Pashman, J. Clifford, J. (concurring and dissenting in part). Clifford, J., concurs in result.
This appeal calls upon us to consider the propriety of conditional release for those adjudicated insane both at the time of the commission of an offense and at trial, necessitating commitment to the state hospital and dismissal of the indictment pursuant to N.J.S.A. 2A:163-2.
On January 10, 1969, Milton Carter walked into police headquarters in Plainfield, New Jersey and shot and wounded a police officer. Prior to this incident, Carter was withdrawn and had a history of psychiatric care. On June 5, 1970, the Union County Court found Carter both legally insane under the M'Naghten test at the time of the offense and incapable of standing trial. He was committed to the state hospital in Trenton "until such time as he may be restored to reason." N.J.S.A. 2A:163-2. The criminal indictment was dismissed. In April 1971, Carter filed a writ of habeas corpus in the Superior Court, Mercer County seeking discharge from the hospital. After hearing the testimony of a staff psychiatrist at the state hospital, the court ordered Carter's release and transfer to the Union County Jail to await trial. This order was apparently entered without knowledge or reference to the June 5, 1970 commitment order. Carter's parents began a separate action in Union County Court, Probate Division to have appellant declared mentally incompetent. On September 7, 1971, they were appointed as Carter's guardians. The court approved his voluntary commitment to a school for retarded persons; however, adjustment problems resulted in his being returned to the state hospital. On the basis of further examinations and being of the opinion that Carter's problem was one of mental deficiency rather than mental illness, the hospital director, without court approval, ordered Carter's release in his parents' custody. Finally in March 1972, the Union County prosecutor requested the judge who had entered both the June 5, 1970 and September 7, 1971 orders to review the matter. This resulted in a hearing on the issue of appellant's sanity pursuant to the requirements of N.J.S.A. 2A:163-2 as interpreted by State
v. Maik, 60 N.J. 203 (1972). Appellant was not deemed to have been "restored to reason" and was again ordered returned to the state hospital in July 1972, never having been tried for the crime for which he was indicted.
The Appellate Division affirmed this judgment on March 2, 1973 in a per curiam opinion, Judge Halpern dissenting. This appeal follows as a matter of right pursuant to R. 2:2-1(a). Appellant's recommitment was stayed by this Court on March 13, 1973 pending disposition of the appeal.
At the hearings prior to the entry of the July 1972 order, there was medical testimony indicating that Carter spoke repeatedly about killing himself or others. It was suggested that while he may improve, his condition would not stabilize to such a degree as to warrant his return to the community. Carter's condition was diagnosed as both mental defective with incipient schizophrenia and a catatonic type of schizophrenia. While supervision and medication may reduce the frequency of attacks, there was evidence to indicate that the accurate prediction of future occurrences would be impossible. There was also some indication that the psychotic episodes could be related to appellant's use of alcohol, which is dangerous to those with his condition. In addition, it was stated that with proper supervision, Carter could continue to function without the likelihood of his condition disintegrating.
The trial judge found that Carter's condition had not been cured or neutralized and that defendant was still suffering from schizophrenia and mental retardation. The possibility of release accompanied by supervision was considered indefinite and uncertain; in any event, the court regarded any form of release under supervision as inadequate to protect the public. The court held that there existed the danger of recurring psychotic episodes at any time. The testimony failed to satisfy the trial judge that such episodes would be predictable. In view of the court's findings, Carter was ordered to be returned to the state hospital.
The Appellate Division held that the lower court's findings were more than adequately supported by credible evidence
and that a conditional release would not be utilized unless authorized by this Court or the Legislature. The court noted that even if conditional release was available, the trial court's findings did not justify its use.
The dissent assumed that Carter had been restored to that degree of reason which he is capable of reaching. The issue then became whether this level of reason could be expected to prevail over his underlying illness so that he would not be a threat to his own or society's safety. In this sense, Judge Halpern argues that Maik places a responsibility upon the courts to "make considered judgments and take calculated risks in releasing defendants." The alternative is to "condemn this 25 year old defendant to a State mental institution for life because his underlying illness (schizophrenia) is incurable." Judge Halpern would remand the case for a full hearing to determine whether conditional release is warranted in that the court has inherent power "to do justice when the circumstances require it."
Public safety is the primary concern in shielding the public from both criminals and those adjudicated insane. "[T]he aim of the law is to protect the innocent from injury by the sick as well as the bad." State v. Maik, supra at 213. The criminal is punished by a prison term and hopefully deterred from further unlawful acts. Another object of confining the insane is treatment and rehabilitation. They are an "exceptional class of people" who have demonstrated their threat to society by committing an act harmful to others. Overholser v. Leach, 103 U.S. App. D.C. 289, 257 F.2d 667, 669 (D.C. Cir. 1958).
Since Maik, release is based on a test more demanding than the M'Naghten standard required for initial commitment. Confinement to a state institution is to continue not only until manifestations of the illness have abated and the offender once again can distinguish right from wrong, but until the underlying illness from which psychotic episodes emerge is cured. Given an individual's demonstrated capacity to violate the law, coupled with his susceptibility to psychotic
episodes depriving him of reason, anything short of confinement "would fail to protect the citizens from further acute episodes." State v. Maik, supra at 217. The underlying illness is the defect of reason which must be restored prior to release.
While the Court recognizes the overriding concern for public safety involved in commitments subsequent to an adjudication of insanity, we do not believe that the commission of an offense against the laws of this State by one subsequently adjudicated insane and committed to a state hospital is a carte blanche justification for lifetime commitment where the underlying mental condition is incurable. We recognize that some patients will be faced with lifetime commitment; however, we can discern no legislative intent to confine others for those periods during which they may be capable of functioning in society so long as reasonable assurances are provided that no harm will come to the public. We therefore reverse the judgment of the Appellate Division and remand to the trial court for a hearing on the propriety of conditional release.
The question as to conditional release now before this Court arises under commitment pursuant to N.J.S.A. 2A:163-2. The statute provides in part:
If any person in confinement under commitment, indictment or under any process, shall appear to be insane, the assignment judge, or judge of the county court of the county in which such person is confined, may, upon presentation to him of the application and certificates as provided in Title 30, chapter 4 of the Revised Statutes, institute an inquiry and take proofs as to the mental condition of such person. The proofs herein referred to may include testimony of qualified psychiatrists to be taken in open court by the judge, either in the presence of a jury specially impanelled to try the issue of insanity alone, or without a jury, as the judge in his discretion may determine. It shall be competent for the judge if sitting without a jury, or the jury, if one is impanelled, to determine not only the sanity of the accused at the time of the hearing, but as well the sanity of the accused at the time the offense charged against him is alleged to have been committed.
If it shall be determined after hearing as aforesaid, that the accused was insane at the time the offense charged against him is alleged to have been committed, the charge against him shall be dismissed on this ground and the records of the proceedings so noted. In this event, the judge or jury, as the case may be, shall also find separately whether his insanity in any degree continues, and, if it does, shall order him into safe custody and direct him to be sent to the New Jersey state hospital at Trenton, to be confined as otherwise provided by law, and maintained as to expense as is otherwise provided for the maintenance of the criminal insane, until such time as he may be restored to reason, and no person so confined shall be released from such confinement except upon the order of the court by which he was committed. This section shall not be construed to prevent the use of the writ of habeas corpus.
Determination can be made as to the prisoner's sanity both at the time of the hearing and as it existed at the time of the offense charged. Where the accused is adjudicated insane in both instances, the charges are to be dismissed and, if insanity continues in any degree, the court is to order the accused committed to the New Jersey state hospital at Trenton. He is to be maintained as to expense in the manner provided for the "criminal insane, until such time as he may be restored to reason . . . ."*fn1 Release is possible only upon court order.
The failure of N.J.S.A. 2A:163-2 to expressly provide for conditional release is not dispositive of the question of legislative intent or policy The spirit of legislative direction prevails over its general terms. Dvorkin v. Dover Twp., 29 N.J. 303, 315 (1959). The fundamental purpose for which the legislation was enacted controls. New Jersey Builders, Owners and Managers Ass'n v. Blair, 60 N.J. 330, 338 (1972). See also Jersey City Chapter Prop. Owners, etc. Ass'n v. City Council, 55 N.J. 86, 100 (1969); Caputo v. Best Foods, 17 N.J. 259, 264 (1955); Alexander v. New Jersey Power & Light Co., 21 N.J. 373, 378 (1956); Wright v. Vogt, 7 N.J. 1, 6 (1951). It is not the words but the "internal
sense of the act that controls." San-Lan Builders, Inc. v. Bexendale, 28 N.J. 148, 155 (1958). See also Board of Education, Asbury Park v. Hoek, 38 N.J. 213, 231 (1962).
[The] will of the law-giver is to be gathered from the object and nature of the subject matter, the contextual setting, and the mischief felt and the remedy in view . . . [and the] particular terms are to be made responsive to the essential principle of the law. San-Lan Builders, Inc. v. Baxendale, supra 28 N.J. at 155.
"Where a literal rendering will lead to a result not in accord with the essential purpose and design of the Act, the spirit of the law will control the letter." New Jersey Builders, Owners and Managers Ass'n v. Blair, supra, 60 N.J. at 338. Reason is the soul of law. Wright v. Vogt, 7 N.J. 1 (1951).
The legislative intent underlying sections 2A:163-2 and 2A:163-3 is protection of the innocent from injury. To this end, those not "restored to reason" are to be confined in the state hospital. Where there is no danger or threat of harm to the public, commitment assumes a different light. The amicus brief contends that assurance that psychotic episodes will not recur coupled with supervisory controls to detect deterioration of the patient's condition would satisfy the "restored to reason" test. While we clearly do not accept that position, the fact that some possibility of harm to society is eliminated or so reduced as to render prediction of episodes possible under proper supervision weakens the continued justification for commitment.
It has been argued that since N.J.S.A. 30:4-107 provides for the conditional release by hospital authorities of those civilly committed, the absence of such a provision in N.J.S.A. 2A:163-2 precludes it. This interpretation assumes that the Legislature intended to permit hospital administrators to conditionally release patients civilly committed while denying similar powers to the judiciary as to the "criminally" insane. It is more likely that the Legislature, in omitting a specific authorization for court sanctioned
conditional release, was merely recognizing the court's inherent power to fashion appropriate remedies.
The fact that the Legislature has acted to provide a remedy does not mean that the judicial branch is limited to the boundary lines of strict legislative expression in fashioning or denying remedies in a particular case. Shell Oil Co. v. Marinello, 120 N.J. Super. 357, 375 (Law Div. 1972), mod. and aff'd 63 N.J. 402 (1973). "[W]ithin the bounds of their respective duties and powers, both the executive and judicial branches must 'adjudicate' and 'legislate'." David v. Vesta Co., 45 N.J. 301, 324 (1965). It is now well recognized that "judicial decision making is often creative and requires that judges, although in a strictly limited sense, 'legislate.'" State v. Johnson, 43 N.J. 572, 583 (1965), aff'd 384 U.S. 719, 86 S. Ct. 1772, 16 L. Ed. 2d 882, rehearing denied 385 U.S. 890, 87 S. Ct. 12, 17 L. Ed. 2d 121 (1966). Contemporary judicial decisions announcing a new rule of law "are the product, not only of re-evaluation of abstract principles of justice but also of practical considerations. . . ." State v. Johnson, supra at 583.
The court's power to fashion remedies in the realm of criminal justice is unquestioned. At common law, courts of criminal jurisdiction had the power to suspend sentences. In re Baer, 140 N.J. Eq. 571, 573 (E. & A. 1947). Probation has a deep-rooted common law basis. The enactment of a statute relating to a particular aspect of probation does not preempt the entire field. Lathrop v. Lathrop, 57 N.J. Super. 532, 538-539 (App. Div. 1959). It follows that a statute neglecting to mention probation would certainly not preempt the court's ability to provide for it. Just as the primary concern of release under N.J.S.A. 2A:163-2 is that of public safety, probation has long been applied upon the condition that "the court considers that [the offender] may be reformed and is persuaded that probation in the particular case is not inimical to the well being of society generally." State v. Pascal, 133 N.J.L. 528, 531 (Sup. Ct. 1946), aff'd 1 N.J. 261 (1949). See Ex Parte Samber, 13 N.J. Super. 410, 412-413
(Law Div. 1950). The same analysis is applicable to the court's use of "probation" in the commitment context. If there is a distinction between the court's authority to provide for probation in the criminal context and an analogous release system as to those adjudicated insane, this Court fails to discern it. The courts have power to fashion psychiatric out-patient probation in the form of conditional releases.*fn2
The Legislature's contemplation of additional remedies under N.J.S.A. 2A:163-2 is further compelled by the existence of a legislative provision for the humane care and treatment of the mentally ill.
Every individual who is mentally ill or mentally retarded shall be entitled to humane care and treatment and, to the extent that facilities, equipment and personnel are available, to medical care and other professional services in accordance with the highest accepted standards. N.J.S.A. 30:4-24.1.
While the Court is not now directly faced with delineating the scope of the right to treatment in New Jersey, the existence of such a right bears on the availability of conditional release, at least to the extent that such release is a therapeutic measure. The right to treatment is an affirmative obligation on behalf of the State.
It is beyond question that a person committed to a state hospital for the mentally afflicted has a right to receive treatment in an effort to cure or improve his or her condition. It is a notorious fact that over-crowding and under-staffing in our public mental institutions result in inadequate treatment for the average patient. But recognition must be given to a patient's right to treatment. It is not enough to confine the patient, to afford only minimal custodial care, to institutionalize him or her in a mental prison. * * *
We recognize that the Legislature is better equipped to create specific procedures and establish the necessary institutions to insure a mental patient's right to treatment than are the courts. However, in the absence of any legislative implementation, the court must function
to protect the rights of persons committed to our public mental institutions. The court may insure that the administrators have performed their task with care and reached a reasonable result. In re D.D., 118 N.J. Super. 1, 6 (App. Div. 1971).
In recognizing the right to treatment, the Court of Appeals for the District of Columbia went so far as to indicate that where a statute required a bona fide effort to "cure or improve" the patient (D.C. Code § 21-562) "conditional release may be in order if it appears that the opportunity for treatment has been exhausted or treatment is otherwise inappropriate." Rouse v. Cameron, 125 U.S. App. D.C. 366, 373 F.2d 451, 458-459 (D.C. Cir. 1966).
Viewed solely in terms of the goal of protection, continued institutionalization offers many obvious benefits. When an ill person poses a physical danger to himself or others, institutionalization offers more effective protection than any other form of disposition. Removed to a place distant from their families and from population centers, the mentally ill can find total shelter from the relationships they had found impossible to manage. They can live in a locked ward with the staff alerted to the control problems they may pose and empowered to administer whatever tranquilizing medications seem necessary.
As noted, the problem becomes most acute, when, as here, the patient's underlying or latent personality disorder is incurable but in a state of remission. Confinement until "restored to reason," under these circumstances, is tantamount to a commitment for the offender's natural life. Clearly, a person with such a mental state should be subject to supervisory and clinical control for the protection of society. Yet, treatment is inherent in the rationale, not merely confinement.
When a patient is in a state of remission and there are sufficient medical assurances that he will not pose a threat to the public safety if at large, prolonged confinement can serve no therapeutic purpose. Retribution is inapposite, since the mentally ill, by definition, are not criminally responsible for their
behavior. So too, the concept of deterrence has no applicability. Prolonged detention under "a total recovery" standard, in these circumstances, equates institutionalization with a prison sentence and thereby defeats the very purpose for which N.J.S.A. 2A:163-2 was enacted.
The value of conditional release as a therapeutic measure is to be considered against the background of the Legislature's intent to provide "humane care and treatment." Surely there is a point reached where a patient can no longer benefit from confinement in the artificial and protected environment afforded by a mental institution.*fn3 Perhaps even more compelling is the harm which could occur to patients confined in institutions when contact with the outside world would stimulate them to recovery or prevent deterioration into more harmful states.*fn4 It has even been suggested that "psychiatrists might be forced into certifying evasive reports in order to prevent continued detention and to avoid the possible harm to a rehabilitated patient which the denial of a discharge might cause. . . ." Note, "Releasing Criminal Defendants Acquitted and Committed Because of Insanity: The Need for Balanced Administration," 68 Yale L.J. 293, 299 ...