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April 18, 2013


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Thanks for the thoughtful post, Michelle. I just listened to this podcast last night and it reminded me of a wonderfully humanizing documentary made about families with a history of Huntington's Disease and the traumatic decision to get tested. It's called, "Do You Really Want to Know". Website here: I'd highly recommend it to anyone interested in learning more about the disease.


Kurt Vonnegut used Huntington's Disease prominently in one of his novels, and I've heard of it outside of literature, but I've never heard of it being used as a defense in a court case.

Michelle Meyer

@Anna: Thanks. I also highly recommend Mapping Fate: A Memoir of Family, Risk, and Genetic Research (1996), by Alice Wexler, whose mother died of HD and whose sister, Nancy Wexler, and their father, Milton, discovered the HD gene. HD was the first genetic disease whose gene was discovered. Alas, 10 years last week after the completion of the Human Genome Project, and still no cure or treatment. It's great personal memoir combined with an inspiring scientific story. Of more recent vintage is Robert Klitzman's Am I My Genes?: Confronting Fate and Family Secrets in the Age of Genetic Testing (2012), which reports the results of the author's interviews with 64 people who have or are at-risk for Huntington's Disease, breast/ovarian cancer, or Alpha-1 antitrypsin deficiency.

@Tate: Well, HD is a rare disease, and people with HD who commit violent crimes are rarer still, in part because soon enough, they are too physically and cognitively disabled to get around to whatever crime their behavioral disturbance might lead them to commit. So that may be the biggest reason why you've never seen the "HD defense."

It's not clear what Benjamin Gilmer and/or the TAL producer believe should have happened, had the HD diagnosis been clear at the time of the trial. Minimally, they seem (rightly, I'd think) to believe that he shouldn't have been found competent to represent himself. Beyond that, they both remark that "he shouldn't be [in prison]." Neither one is a lawyer, so who knows, but perhaps they meant not that HD should have been an affirmative defense to the crime of murder, but only that his HD should have been a very significant mitigating factor in his sentencing after conviction (which seems right), and/or that he should be involuntarily committed to a psychiatric facility rather than to prison. Of course, he'd apparently already been moved to in the psych ward of the VA prison system, so maybe they want him entirely released (until he requires private care). It's possible that Gilmer/TAL would have Vince's HD operate as an NGRI defense. And under Virginia law, I suppose he could possibly meet the "irresistible impulse" prong of that defense. That was, after all, his lay testimony at trial (it's not entirely clear from the episode what his legal theory was), though he coupled that testimony with only his "serotonin-starved brain" theory, which, unlike HD (one presumes), may not have qualified as a bona fide "mental disease or defect." But of course then we run into the classic case of the double-edged sword of genetic/neuro evidence as simultaneously suggesting both reduced culpability and increased future dangerousness. HD isn't curable or treatable, though maybe anti-psychotics would have some effect on his irresistible impulses, and as he deteriorates, he'll sadly reach a point where he won't be capable of physically endangering others.

Anyway, leaving aside the stigmatizing omission about how rarely people with HD harm others, it was surprising to me that TAL didn't bring in anyone to discuss the legal implications of the HD diagnosis, especially since they ended with Benjamin dedicated to the idea of "becoming Vince's lawyer" in order to free/clear him.

Brad Areheart

Hi Michelle. Thanks for your post. I too listened to this episode (prior to seeing your entry here) and found it engrossing. It was a fascinating "investigation"/re-telling of a horrible set of criminal acts, humanized and made even more interesting by the Gilmer who was doing the investigating and seemed both incredibly honest and noble.

But to be candid, I really didn't take away from listening to this that Huntington's commonly causes people to be violent or lash out in unpredictable ways. The emphasis derived from the diagnosis seemed to be on those things you noted: that he wasn't competent to defend himself, that perhaps the remainder of his sentence should be changed in some way, etc. Nor did I catch the implication that HD may have caused Gilmer's father to abuse - but I may just have missed it.

I also didn't find it too surprising that they didn't spend more time on the legal implications of the HD diagnosis (though I would have been interested). I think the point of the show was something much more aesthetically limited and intriguing (spell-binding even?) ... to explore the mystery of this set of circumstances and potentially help solve the mystery of how a seemingly kind and generous doctor could have committed the acts he did under the circumstances that he did. (Though of course I don't think they ever spent time re-examining all of the things he did along the way that suggest it was premeditated, which the whole case seemed to hinge on when the trial took place.) All that to say, I don't share your worry at all, but I understand where you are coming from. I suppose they could have taken 5 mins toward the end to discuss how unusual such behavior is for someone with Huntington's but then again, I assume the average viewer would think the type of behavior at the core of this show - no matter the condition with which it is associated - is quite, quite unusual.


Thanks for this post. I am also a huge TAL enthusiast and I was really upset about this episode. I am a prosecutor and they totally missed / misled regarding whether Dr. Gilmer's mental issues could (1) bar him from representing himself and / or (2) mitigate or obliviate his criminal responsibility. Usually they have such great journalism, but I felt that this particular episode bordered on irresponsible, given the lame-o legal discussion at the end (they couldn't even interview a defense attorney? Review the jury instructions for mental defenses? Consult with a lawyer to find out why Dr. Gilmer was able to represent himself) and I, too, was concerned that they painted folks with Huntington's disease as dangerous. (Never mind the fact that they did not and could not prove whether the onset occurred prior to the murder.) Mental illness is not always a legal defense - lots of people have mental illness but still have control over their actions and know the difference between right and wrong. There is no indication that Dr. Gilmer lacked an appreciation of the difference between right and wrong or somehow lacked control. I expect better reporting.

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