The psychiatric role in the criminal justice process creates tensions because it sometimes appears to conflict with public perceptions of justice. The public will tolerate psychiatric interventions in the justice system as long as they do not result in significant departures from the public conception of justice. The Durham rule and other modern formulations, including the Model Penal Code of the American Law Institute, have enlarged the narrow, cognitive exceptions from criminal liability set out in the classic McNaughtan rules. Under these modern formulations, psychiatric witnesses have a larger and perhaps more realistic role in informing the court about the defendant's mental and emotional state. In many jurisdictions, the courts and legislatures seem to be recognizing the right or responsibility of the psychiatrist to take part more broadly in such proceedings. At the same time they are also recognizing the due process rights of prisoners and patients. These trends are not in conflict with one another. Greater public acceptance of the role of psychiatrists in courts would result from a reform that would retain the McNaughtan rule, with irresistible impulse added, in the most serious criminal matters and that would apply somewhat different rules to lesser cases. Seven footnotes are provided.