U.S. v. Edward Carter, Jr.
Criminal No. 69
Report on 507 Notes
November 18, 1975 sb: Joseph T. Smith, M.D., - Medical Officer (Psychiatry)
MEDICAL STAFF CONFERENCE.
Edward Carter was presented at a Medical Diagnostic Staff Conference which was attended by psychiatrists, psychologists, social workers, nurses and forensic technicians. The diagnoses which have been maintained in his chart up to the present time are (1) Sexual Sadism, (2) Non-Psychotic Organic Brain Syndrome with Circulatory Disturbance. The conference listed the symptoms associated with organic brain syndrome as follows: (1) impairment of orientation, (2) impairment of memory, (3) impairment of all intellectual functions such as comprehension, calculation, knowledge learning, etc. (4) impairment of judgment, and (5) lability and shallowness of affect. Mr. Carter was examined by the whole group and found to have no impairment of orientation, no impairment of memory, no impairment of judgment, no lability or shallowness of affect. His intellectual functioning was within normal range for his I.Q. which is low normal. Brain scan, EEG and neurological examinations are essentially negative. The group agreed that since these symptoms of an organic brain syndrome were all lacking, there is no reason to continue this diagnosis so it is deleted. When the diagnosis of sexual sadism was given to the patient in 1970 at a Diagnostic Staff Conference, it was stated that this diagnosis of sexual sadism may be open to some question because of (1) lack of ability to confirm the extensive history that he gave of rapes. He originally reported something like 300 rapes and today he says that he was lying at that time to create an impressive background of sexual problems for his own insanity defense. (2) It was also pointed out there that he had given a different sexual history to Dr. Clark when he came to the Hospital in December 1964. At that time, he did not mention the rapes or any sexual deviation. (3) It was also pointed out that psychological studies show very little to suggest any sexual psychopathology. The conference then listed various aspects of sexual sadism. The criteria that were listed for sexual sadism included (1) inflicting pain to obtain sexual gratification. It was obvious from the history that he has inflicted pain on people. Also that he has obtained sexual gratification. But it was never shown that he inflicted pain specifically for the purpose of sexual gratification. Another criteria might be a history of torturing animals in childhood or enuresis. There was no history of such cruelty to animals or of enuresis. (2) another criterion could be the evidence from psychological reports. Although the psychological reports showed that he was immature emotionally and that he was immature sexually, and that he had underlying hostility and aggression, it did not shown psychosexual pathology. (3) Another criteria would be poor impulse control. Although the history indicates poor impulse control, he has shown no poor impulse control in John Howard for the last 40 months. As the group confronted these and decided that there is nothing presently to indicate that he either is or is not a sexual sadist, and so the group ended up by saying that they don't know whether he is or not. Psychological testing shows a fairly consistent pattern throughout the period of time that he has been in the Hospital, but attention should be drawn to the final paragraph in the psychological test done by Ms. Judith Rumreich on November 1, 1974, where she states "it is likely that in a similarly highly structured setting, Mr. Carter would be able to function effectively, but his capacity for assaultive outburst under conditions of stress should not be ignored in less structured settings." This statement does not really mean very much when taken generally because the same is true of almost anybody. Most people placed under sufficient stress in an unstructured situation are capable of assaultive outbursts. The significant thing is that under the same circumstances, Mr. Carter would not fail to act the same as anybody else as far as outbursts go. The only present evidence to support a diagnosis of Sexual Sadism come from the patient himself. The patient is obviously an unreliable witness - He claims now that he fabricated the 300 rape story to get an insanity defense in 1969. Today he says it was only 12 rapes. Without more objective evidence the diagnosis of Sexual Sadism is meaningless. Available police reports show a history of general criminal activity such as burglary, auto theft, homicide, assault with intent to commit rape etc. rather than a distinct pattern of torturing women for sexual gratification. Without more to go on the diagnosis of Sexual Sadism is dropped and the patient is without mental disorder.
[ILLEGIBLE WORD], / Medical Officer (Psychiatry)
[ILLEGIBLE WORD], / Chief, Post-trial Branch
REGISTER NO: WARD NO. FORENSIC-12
SAINT ELIZABETHS HOSPITAL
REPORT ON or CONTINUATION OF 507 Notes-2
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