Suggestions for reform seem invariably to fall on one side or the other of the standard philosophical, legal, and psychiatric arguments. Current reform proposals, like prior ones, often discuss possible limitations on the operation of the insanity defense. These proposed limitations typically relate to the nature of qualifying mental disease and to the nature of the impact of the impairment of cognitive or volitional functions. Limitations of a very different sort may address more directly the areas of public and professional dissatisfaction with the insanity defense. The offense-victim perspective offers a fresh framework, as a means of reorienting the debate, and as a device for provoking the development of different approaches to this area of the law. A total of 55 notes are included. (Author abstract modified)