The challenge lies in determining whether limiting or abolishing the insanity defense would better serve and protect society. A review of the history and purpose of the insanity defense from M'Naghten in 1843 to the present focuses on the merits of various reform proposals in the wake of Hinckley's acquittal. As a symbol of the rise in violent crime, the insanity defense has influence far beyond its restricted use. Citizens can be persuaded to give up legal safeguards on the grounds that the new order will increase protection for society. In crime bills passed by the U.S. Senate in 1984, this trade-off was implicit in provisions denying bail to dangerous but unconvicted defendants who are locked up before trial, as well as in limits on the exclusionary rule permitting the government to present illegally obtained evidence at trial. To put the Hinckley case in perspective, the story of another insanity defense trial in Washington at the same time as Hinckley's, in which a poor black man was charged with murdering a prostitute, is presented. Contrasts are outlined between the law's interest in the terms of judgment and medicine's concern for a defendant's mental health as well as contrasts between calls for mental health as well as contrasts between calls for punishment of a would-be assassin and pleas for the maintenance of the integrity of American justice. An index and a table of contents are provided.