AAPL Practice Guideline for the Forensic Psychiatric Evaluation of Competence to Stand Trial: an English legal perspective.

This brief commentary compares the law relating unfitness to plead in England and Wales with that of competency to stand trial, as reflected in the AAPL Practice Guideline. In so doing, it presents the argument that English law, with its adherence to a test of unfitness that goes back to the first half of the 19th century, may no longer be fit for the purpose. Unlike the test for incompetency to stand trial adopted by most of the United States, English law fails to incorporate decisional competence and consequently may be failing to protect vulnerable defendants. The commentary concludes that, despite the differences in law and practice between our respective countries, the AAPL Guideline contains much of value for psychiatrists and lawyers who have to deal with unfitness to plead, an area of the law that surely ought to be the subject of consideration for reform.