An analysis of the costs and benefits of the current doctrine on incompetency to stand trial proposes a radical restructuring of the incompetency process to minimize costs and free scarce clinical resources for reallocation to treatment. A discussion of the insanity defense reviews empirical research on three of the most popular reform proposals and concludes that legislators, scholars, and practitioners should make greater use of empiricism and social science research to guide their reform efforts. A critical evaluation of research regarding mentally disabled criminal defenders proposes future research initiatives in six areas: (1) impact assessment of legal decisions and revised laws, (2) prediction of dangerousness, (3) policing and the mental health system, (4) jails, (5) outcome studies, and (6) research on special groups like women and youth. An analysis of the evolving law of refusal of treatment emphasizes the impact on law on the quality of treatment and patients' participation in their own treatment. An analysis of the medical model examines the meaning of the concept 'mental illness' and its uses in the legal system. A discussion of informed consent in psychiatric research presents an overview of case law and regulation and an agenda for future research. A paper on advocacy for persons with mental disabilities argues that rights for the mentally disabled are meaningless without an effective advocacy system and proposes an integrated and comprehensive advocacy network. Chapter footnotes. For individual papers, see NCJ 110226-30.