Clark v. Arizona ( 2006 )


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  • (Slip Opinion)              OCTOBER TERM, 2005                                       1
    Syllabus
    NOTE: Where it is feasible, a syllabus (headnote) will be released, as is
    being done in connection with this case, at the time the opinion is issued.
    The syllabus constitutes no part of the opinion of the Court but has been
    prepared by the Reporter of Decisions for the convenience of the reader.
    See United States v. Detroit Timber & Lumber Co., 
    200 U. S. 321
    , 337.
    SUPREME COURT OF THE UNITED STATES
    Syllabus
    CLARK v. ARIZONA
    CERTIORARI TO THE COURT OF APPEALS OF ARIZONA
    No. 05–5966. Argued April 19, 2006—Decided June 29, 2006
    Petitioner Clark was charged with first-degree murder under an Ari
    zona statute prohibiting “[i]nten[tionally] or knowing[ly]” killing a
    police officer in the line of duty. At his bench trial, Clark did not con
    test that he shot the officer or that the officer died, but relied on his
    own undisputed paranoid schizophrenia at the time of the incident to
    deny that he had the specific intent to shoot an officer or knowledge
    that he was doing so. Accordingly, the prosecutor offered circumstan
    tial evidence that Clark knew the victim was a police officer and tes
    timony indicating that Clark had previously stated he wanted to
    shoot police and had lured the victim to the scene to kill him. In pre
    senting the defense case, Clark claimed mental illness, which he
    sought to introduce for two purposes. First, he raised the affirmative
    defense of insanity, putting the burden on himself to prove by clear
    and convincing evidence that, in the words of another state statute,
    “at the time of the [crime, he] was afflicted with a mental disease or
    defect of such severity that [he] did not know the criminal act was
    wrong.” Second, he aimed to rebut the prosecution’s evidence of the
    requisite mens rea, that he had acted intentionally or knowingly to
    kill an officer.
    Ruling that Clark could not rely on evidence bearing on insanity to
    dispute the mens rea, the trial court cited the Arizona Supreme
    Court’s decision in State v. Mott, 
    187 Ariz. 536
    , 
    931 P. 2d 1046
    , which
    refused to allow psychiatric testimony to negate specific intent and
    held that Arizona does not allow evidence of a mental disorder short
    of insanity to negate the mens rea element of a crime. As to his in
    sanity, then, Clark presented lay testimony describing his increas
    ingly bizarre behavior over the year before the shooting. Other lay
    and expert testimony indicated, among other things, that Clark
    thought that “aliens” (some impersonating government agents) were
    2                           CLARK v. ARIZONA
    Syllabus
    trying to kill him and that bullets were the only way to stop them. A
    psychiatrist testified that Clark was suffering from paranoid schizo
    phrenia with delusions about “aliens” when he killed the officer, and
    concluded that Clark was incapable of luring the officer or under
    standing right from wrong and was thus insane at the time of the
    killing. In rebuttal, the State’s psychiatrist gave his opinion that
    Clark’s paranoid schizophrenia did not keep him from appreciating
    the wrongfulness of his conduct before and after the shooting. The
    judge then issued a first-degree murder verdict, finding that in light
    of that the facts of the crime, the expert evaluations, Clark’s actions
    and behavior both before and after the shooting, and the observations
    of those who knew him, Clark had not established that his schizo
    phrenia distorted his perception of reality so severely that he did not
    know his actions were wrong.
    Clark moved to vacate the judgment and life sentence, arguing,
    among other things, that Arizona’s insanity test and its Mott rule
    each violate due process. He claimed that the Arizona Legislature
    had impermissibly narrowed its insanity standard in 1993 when it
    eliminated the first of the two parts of the traditional M’Naghten in
    sanity test. The trial court denied the motion. Affirming, the Ari
    zona Court of Appeals held, among other things, that the State’s in
    sanity scheme was consistent with due process. The court read Mott
    as barring the trial court’s consideration of evidence of Clark’s mental
    illness and capacity directly on the element of mens rea.
    Held:
    1. Due process does not prohibit Arizona’s use of an insanity test
    stated solely in terms of the capacity to tell whether an act charged
    as a crime was right or wrong. Pp. 6–15.
    (a) The first part of the landmark English rule in M’Naghten’s
    Case asks about cognitive capacity: whether a mental defect leaves a
    defendant unable to understand what he was doing. The second part
    presents an ostensibly alternative basis for recognizing a defense of
    insanity understood as a lack of moral capacity: whether a mental
    disease or defect leaves a defendant unable to understand that his
    action was wrong. Although the Arizona Legislature at first adopted
    the full M’Naghten statement, it later dropped the cognitive incapac
    ity part. Under current Arizona law, a defendant will not be ad
    judged insane unless he demonstrates that at the time of the crime,
    he was afflicted with a mental disease or defect of such severity that
    he did not know the criminal act was wrong. Pp. 6–7.
    (b) Clark insists that the side-by-side M’Naghten test represents
    the minimum that a government must provide, and he argues that
    eliminating the first part “ ‘offends [a] principle of justice so rooted in
    the traditions and conscience of our people as to be ranked as funda
    Cite as: 548 U. S. ____ (2006)                    3
    Syllabus
    mental,’ ” Patterson v. New York, 
    432 U. S. 197
    , 202. The claim entails
    no light burden, and Clark does not carry it. History shows no defer
    ence to M’Naghten that could elevate its formula to the level of fun
    damental principle, so as to limit the traditional recognition of a
    State’s capacity to define crimes and defenses. See, e.g., Patterson,
    
    supra, at 210
    . Even a cursory examination of the traditional Anglo-
    American approaches to insanity reveals significant differences a
    mong them, with four traditional strains variously combined to yield
    a diversity of American standards. Although 17 States and the Fed
    eral Government have adopted recognizable versions of the
    M’Naghten test with both its components, other States have adopted
    a variety of standards based on all or part of one or more of four vari
    ants. The alternatives are multiplied further by variations in the
    prescribed insanity verdict. This varied background makes clear that
    no particular formulation has evolved into a baseline for due process,
    and that the insanity rule, like the conceptualization of criminal of
    fenses, is substantially open to state choice. Pp. 7–12.
    (c) Nor does Arizona’s abbreviation of the M’Naghten statement
    raise a proper claim that some constitutional minimum has been
    shortchanged. Although Arizona’s former statement of the full
    M’Naghten rule was constitutionally adequate, the abbreviated rule
    is no less so, for cognitive incapacity is relevant under that state
    ment, just as it was under the more extended formulation, and evi
    dence going to cognitive incapacity has the same significance under
    the short form as it had under the long. Though Clark is correct that
    applying the moral incapacity test (telling right from wrong) does not
    necessarily require evaluation of a defendant’s cognitive capacity to
    appreciate the nature and quality of the acts charged against him,
    his argument fails to recognize that cognitive incapacity is itself
    enough to demonstrate moral incapacity, so that evidence bearing on
    whether the defendant knew the nature and quality of his actions is
    both relevant and admissible. In practical terms, if a defendant did
    not know what he was doing when he acted, he could not have known
    that he was performing the wrongful act charged as a crime. The
    Arizona appeals court acknowledged as much in this case. Clark
    adopted this very analysis in the trial court, which apparently agreed
    when it admitted his cognitive incapacity evidence for consideration
    under the State’s moral incapacity formulation. Clark can point to no
    evidence bearing on insanity that was excluded. Pp. 12–15.
    2. The Arizona Supreme Court’s Mott rule does not violate due
    process. Pp. 15–38.
    (a) Mott held that testimony of a professional psychologist or psy
    chiatrist about a defendant’s mental incapacity owing to mental dis
    ease or defect was admissible, and could be considered, only for its
    4                           CLARK v. ARIZONA
    Syllabus
    bearing on an insanity defense, but could not be considered on the
    element of mens rea. Of the three categories of evidence that poten
    tially bear on mens rea—(1) everyday “observation evidence” either
    by lay or expert witnesses of what Clark did or said, which may sup
    port the professional diagnoses of disease and in any event is the
    kind of evidence that can be relevant to show what was on Clark’s
    mind when he fired his gun; (2) “mental-disease evidence,” typically
    from professional psychologists or psychiatrists based on factual re
    ports, professional observations, and tests about Clark’s mental dis
    ease, with features described by the witness; and (3) “capacity evi
    dence,” typically by the same experts, about Clark’s capacity for
    cognition and moral judgment (and ultimately also his capacity to
    form mens rea)—Mott imposed no restriction on considering evidence
    of the first sort, but applies to the latter two. Although the trial court
    seems to have applied the Mott restriction to all three categories of
    evidence Clark offered for the purpose of showing what he called his
    inability to form the required mens rea, his objection to Mott’s appli
    cation does not turn on the distinction between lay and expert wit
    nesses or the kinds of testimony they were competent to present.
    Rather, the issue here is Clark’s claim that the Mott rule violates due
    process. Pp. 15–25.
    (b) Clark’s Mott challenge turns on the application of the pre
    sumption of innocence in criminal cases, the presumption of sanity,
    and the principle that a criminal defendant is entitled to present
    relevant and favorable evidence on an element of the offense charged
    against him. Pp. 25–30.
    (i) The presumption of innocence is that a defendant is inno
    cent unless and until the government proves beyond a reasonable
    doubt each element of the offense changed, including the mental ele
    ment or mens rea. The modern tendency is to describe the mens rea
    required to prove particular offenses in specific terms, as shown in
    the Arizona statute requiring the State to prove that in acting to kill
    the victim, Clark intended to kill a law enforcement officer on duty or
    knew that the victim was such an officer on duty. As applied to mens
    rea (and every other element), the force of the presumption of inno
    cence is measured by the force of the showing needed to overcome it,
    which is proof beyond a reasonable doubt that a defendant’s state of
    mind was in fact what the charge states. See In re Winship, 
    397 U. S. 358
    , 361–363. Pp. 25–26.
    (ii) The presumption of sanity dispenses with a requirement
    that the government include as an element of every criminal charge
    an allegation that the defendant had the capacity to form the mens
    rea necessary for conviction and criminal responsibility. Unlike the
    presumption of innocence, the presumption of sanity’s force varies
    Cite as: 548 U. S. ____ (2006)                      5
    Syllabus
    across the many state and federal jurisdictions, and prior law has
    recognized considerable leeway on the part of the legislative branch
    in defining the presumption’s strength through the kind of evidence
    and degree of persuasiveness necessary to overcome it, see Fisher v.
    United States, 
    328 U. S. 463
    , 466–476. There are two points where the
    sanity or capacity presumption may be placed in issue. First, a State
    may allow a defendant to introduce (and a factfinder to consider) evi
    dence of mental disease or incapacity for the bearing it can have on
    the government’s burden to show mens rea. Second, the sanity pre
    sumption’s force may be tested in the consideration of an insanity de
    fense raised by a defendant. Insanity rules like M’Naghten and the
    variants noted above are attempts to define or indicate the kinds of
    mental differences that overcome the presumption of sanity or capac
    ity and therefore excuse a defendant from customary criminal re
    sponsibility, see, e.g., Jones v. United States, 
    463 U. S. 354
    , 373, n. 4,
    even if the prosecution has otherwise overcome the presumption of
    innocence by convincing the factfinder of all the elements charged be
    yond a reasonable doubt. The burden a defendant raising the insan
    ity issue must carry defines the strength of the sanity presumption.
    A State may, for example, place the burden of persuasion on a defen
    dant to prove insanity as the applicable law defines it, whether by a
    preponderance of the evidence or to some more convincing degree.
    See, e.g., Leland v. Oregon, 
    343 U. S. 790
    , 798. Pp. 26–29.
    (iii) A defendant has a due process right to present evidence
    favorable to himself on an element that must be proven to convict
    him. Evidence tending to show that a defendant suffers from mental
    disease and lacks capacity to form mens rea is relevant to rebut evi
    dence that he did in fact form the required mens rea at the time in
    question. Thus, Clark claims a right to require the factfinder in this
    case to consider testimony about his mental illness and his incapacity
    directly, when weighing the persuasiveness of other evidence tending
    to show mens rea, which the prosecution has the burden to prove.
    However, the right to introduce relevant evidence can be curtailed if
    there is a good reason for doing so. For example, trial judges may
    “exclude evidence if its probative value is outweighed by certain other
    factors such as unfair prejudice, confusion of the issues, or potential
    to mislead the jury.” Holmes v. South Carolina, 547 U. S. ___, ___.
    And if evidence may be kept out entirely, its consideration may be
    subject to limitation, which Arizona claims the power to impose here.
    Under state law, mental-disease and capacity evidence may be con
    sidered only for its bearing on the insanity defense, and it will avail a
    defendant only if it is persuasive enough to satisfy the defendant’s
    burden as defined by the terms of that defense. Such evidence is thus
    being channeled or restricted to one issue; it is not being excluded en
    6                            CLARK v. ARIZONA
    Syllabus
    tirely, and the question is whether reasons for requiring it to be
    channeled and restricted satisfy due process’s fundamental fairness
    standard. Pp. 29–30.
    (c) The reasons supporting the Arizona rule satisfy due process.
    Pp. 30–38.
    (i) The first such reason is Arizona’s authority to define its pre
    sumption of sanity (or capacity or responsibility) by choosing an in
    sanity definition and placing the burden of persuasion on criminal
    defendants claiming incapacity as an excuse. Consistent with due
    process, a State can require defendants to bear that burden, see
    Leland, 
    supra,
     at 797–799, and Clark does not object to Arizona’s deci
    sion to require persuasion to a clear and convincing degree before the
    presumption of sanity and normal responsibility is overcome. If a
    State is to have this authority in practice as well as in theory, it must
    be able to deny a defendant the opportunity to displace the sanity
    presumption more easily when addressing a different issue during
    the criminal trial. Yet just such an opportunity would be available if
    expert testimony of mental disease and incapacity could be consid
    ered for whatever a factfinder might think it was worth on the mens
    rea issue. The sanity presumption would then be only as strong as
    the evidence a factfinder would accept as enough to raise a reason
    able doubt about mens rea; once reasonable doubt was found, acquit
    tal would be required, and the standards established for the insanity
    defense would go by the boards. What counts for due process is sim
    ply that a State wishing to avoid a second avenue for exploring capac
    ity, less stringent for a defendant, has a good reason for confining the
    consideration of mental disease and incapacity evidence to the insan
    ity defense. Pp. 30–32.
    (ii) Arizona’s rule also serves to avoid confusion and misunder
    standing on the part of jurors. The controversial character of some
    categories of mental disease, the potential of mental-disease evidence
    to mislead, and the danger of according greater certainty to capacity
    evidence than experts claim for it give rise to risks that may rea
    sonably be hedged by channeling the consideration of such evidence
    to the insanity issue on which, in States like Arizona, a defendant
    has the burden of persuasion. First, the diagnosis may mask vigor
    ous debate within the psychiatric profession about the very contours
    of the mental disease itself. See, e.g., Jones, 
    supra,
     at 364–365, n. 13.
    Though mental-disease evidence is certainly not condemned wholesale,
    the consequence of this professional ferment is a general caution in
    treating psychological classifications as predicates for excusing other
    wise criminal conduct. Next, there is the potential of mental-disease
    evidence to mislead jurors (when they are the factfinders) through
    the power of this kind of evidence to suggest that a defendant suffer
    Cite as: 548 U. S. ____ (2006)                      7
    Syllabus
    ing from a recognized mental disease lacks cognitive, moral, voli
    tional, or other capacity, when that may not be a sound conclusion at
    all. Even when a category of mental disease is broadly accepted and
    the assignment of a defendant’s behavior to that category is uncon
    troversial, the classification may suggest something very significant
    about a defendant’s capacity, when in fact the classification tells little
    or nothing about the defendant’s ability to form mens rea or to exer
    cise the cognitive, moral, or volitional capacities that define legal san
    ity. The limits of the utility of a professional disease diagnosis are
    evident in the dispute between the two testifying experts in this case;
    they agree that Clark was schizophrenic, but they reach opposite con
    clusions on whether his mental disease left him bereft of cognitive or
    moral capacity. Finally, there are particular risks inherent in the
    opinions of the experts who supplement the mental-disease classifica
    tions with opinions on incapacity: on whether the mental disease
    rendered a particular defendant incapable of the cognition necessary
    for moral judgment or mens rea or otherwise incapable of under
    standing the wrongfulness of the conduct charged. Unlike observa
    tional evidence bearing on mens rea, capacity evidence consists of
    judgment, and judgment is fraught with multiple perils. Although
    such capacity judgments may be given in the utmost good faith, their
    potentially tenuous character is indicated by the candor of the de
    fense expert in this very case. He testified that Clark lacked the ca
    pacity to appreciate the circumstances realistically and to under
    stand the wrongfulness of what he was doing, but he admitted that
    no one knew exactly what was on Clark’s mind at the time of the
    shooting. Even when an expert is confident that his understanding of
    the mind is reliable, judgment addressing the basic categories of ca
    pacity requires a leap from the concepts of psychology, which are de
    vised for thinking about treatment, to the concepts of legal sanity,
    which are devised for thinking about criminal responsibility. Pp. 33–
    38.
    (d) For these reasons, there is also no cause to claim that chan
    neling evidence on mental disease and capacity offends any “ ‘princi
    ple of justice so rooted in the traditions and conscience of our people
    as to be ranked as fundamental,’ ” Patterson, supra, at 202. P. 38.
    Affirmed.
    SOUTER, J., delivered the opinion of the Court, in which ROBERTS,
    C. J., and SCALIA, THOMAS, and ALITO, JJ., joined, and in which BREYER,
    J., joined except as to Parts III–B and III–C and the ultimate disposi
    tion. BREYER, J., filed an opinion concurring in part and dissenting in
    part. KENNEDY, J., filed a dissenting opinion, in which STEVENS and
    GINSBURG, JJ., joined.
    Cite as: 548 U. S. ____ (2006)                              1
    Opinion of the Court
    NOTICE: This opinion is subject to formal revision before publication in the
    preliminary print of the United States Reports. Readers are requested to
    notify the Reporter of Decisions, Supreme Court of the United States, Wash
    ington, D. C. 20543, of any typographical or other formal errors, in order
    that corrections may be made before the preliminary print goes to press.
    SUPREME COURT OF THE UNITED STATES
    _________________
    No. 05–5966
    _________________
    ERIC MICHAEL CLARK, PETITIONER v. ARIZONA
    ON WRIT OF CERTIORARI TO THE COURT OF APPEALS OF
    ARIZONA, DIVISION ONE
    [June 29, 2006]
    JUSTICE SOUTER delivered the opinion of the Court.
    The case presents two questions: whether due process
    prohibits Arizona’s use of an insanity test stated solely in
    terms of the capacity to tell whether an act charged as a
    crime was right or wrong; and whether Arizona violates
    due process in restricting consideration of defense evi
    dence of mental illness and incapacity to its bearing on a
    claim of insanity, thus eliminating its significance directly
    on the issue of the mental element of the crime charged
    (known in legal shorthand as the mens rea, or guilty
    mind). We hold that there is no violation of due process in
    either instance.
    I
    In the early hours of June 21, 2000, Officer Jeffrey
    Moritz of the Flagstaff Police responded in uniform to
    complaints that a pickup truck with loud music blaring
    was circling a residential block. When he located the
    truck, the officer turned on the emergency lights and siren
    of his marked patrol car, which prompted petitioner Eric
    Clark, the truck’s driver (then 17), to pull over. Officer
    Moritz got out of the patrol car and told Clark to stay
    where he was. Less than a minute later, Clark shot the
    2                        CLARK v. ARIZONA
    Opinion of the Court
    officer, who died soon after but not before calling the police
    dispatcher for help. Clark ran away on foot but was ar
    rested later that day with gunpowder residue on his
    hands; the gun that killed the officer was found nearby,
    stuffed into a knit cap.
    Clark was charged with first-degree murder under 
    Ariz. Rev. Stat. Ann. §13
    –1105(A)(3) (West Supp. 2005) for
    intentionally or knowingly killing a law enforcement
    officer in the line of duty.1 In March 2001, Clark was
    found incompetent to stand trial and was committed to a
    state hospital for treatment, but two years later the same
    trial court found his competence restored and ordered him
    to be tried. Clark waived his right to a jury, and the case
    was heard by the court.
    At trial, Clark did not contest the shooting and death,
    but relied on his undisputed paranoid schizophrenia at the
    time of the incident in denying that he had the specific
    intent to shoot a law enforcement officer or knowledge
    that he was doing so, as required by the statute. Accord
    ingly, the prosecutor offered circumstantial evidence that
    Clark knew Officer Moritz was a law enforcement officer.
    The evidence showed that the officer was in uniform at the
    time, that he caught up with Clark in a marked police car
    with emergency lights and siren going, and that Clark
    acknowledged the symbols of police authority and stopped.
    The testimony for the prosecution indicated that Clark
    had intentionally lured an officer to the scene to kill him,
    having told some people a few weeks before the incident
    that he wanted to shoot police officers. At the close of the
    State’s evidence, the trial court denied Clark’s motion for
    judgment of acquittal for failure to prove intent to kill a
    ——————
    1 Section
    13–1105(A)(3) provides that “[a] person commits first degree
    murder if . . . [i]ntending or knowing that the person’s conduct will
    cause death to a law enforcement officer, the person causes the death of
    a law enforcement officer who is in the line of duty.”
    Cite as: 548 U. S. ____ (2006)                   3
    Opinion of the Court
    law enforcement officer or knowledge that Officer Moritz
    was a law enforcement officer.
    In presenting the defense case, Clark claimed mental
    illness, which he sought to introduce for two purposes.
    First, he raised the affirmative defense of insanity, putting
    the burden on himself to prove by clear and convincing
    evidence, §13–502(C) (West 2001), that “at the time of the
    commission of the criminal act [he] was afflicted with a
    mental disease or defect of such severity that [he] did not
    know the criminal act was wrong,” §13–502(A).2 Second,
    he aimed to rebut the prosecution’s evidence of the requi
    site mens rea, that he had acted intentionally or know
    ingly to kill a law enforcement officer. See, e.g., Record in
    No. CR 2000–538 (Ariz. Super. Ct.), Doc. 374 (hereinafter
    Record).
    The trial court ruled that Clark could not rely on evi
    dence bearing on insanity to dispute the mens rea. The
    court cited State v. Mott, 
    187 Ariz. 536
    , 
    931 P. 2d 1046
     (en
    banc), cert. denied, 
    520 U. S. 1234
     (1997), which “refused
    to allow psychiatric testimony to negate specific intent,”
    
    187 Ariz., at 541
    , 
    931 P. 2d, at 1051
    , and held that “Ari
    ——————
    2 Section 13–502(A) provides in full that
    “A person may be found guilty except insane if at the time of the
    commission of the criminal act the person was afflicted with a mental
    disease or defect of such severity that the person did not know the
    criminal act was wrong. A mental disease or defect constituting legal
    insanity is an affirmative defense. Mental disease or defect does not
    include disorders that result from acute voluntary intoxication or
    withdrawal from alcohol or drugs, character defects, psychosexual
    disorders or impulse control disorders. Conditions that do not consti
    tute legal insanity include but are not limited to momentary, temporary
    conditions arising from the pressure of the circumstances, moral
    decadence, depravity or passion growing out of anger, jealousy, revenge,
    hatred or other motives in a person who does not suffer from a mental
    disease or defect or an abnormality that is manifested only by criminal
    conduct.”
    A defendant found “guilty except insane” is committed to a state
    mental health facility for treatment. See §13–502(D).
    4                        CLARK v. ARIZONA
    Opinion of the Court
    zona does not allow evidence of a defendant’s mental
    disorder short of insanity . . . to negate the mens rea ele
    ment of a crime,” ibid.3
    As to his insanity, then, Clark presented testimony from
    classmates, school officials, and his family describing his
    increasingly bizarre behavior over the year before the
    shooting. Witnesses testified, for example, that paranoid
    delusions led Clark to rig a fishing line with beads and
    wind chimes at home to alert him to intrusion by invaders,
    and to keep a bird in his automobile to warn of airborne
    poison. There was lay and expert testimony that Clark
    thought Flagstaff was populated with “aliens” (some im
    personating government agents), the “aliens” were trying
    to kill him, and bullets were the only way to stop them. A
    psychiatrist testified that Clark was suffering from para
    noid schizophrenia with delusions about “aliens” when he
    killed Officer Moritz, and he concluded that Clark was
    incapable of luring the officer or understanding right from
    wrong and that he was thus insane at the time of the
    killing. In rebuttal, a psychiatrist for the State gave his
    opinion that Clark’s paranoid schizophrenia did not keep
    him from appreciating the wrongfulness of his conduct, as
    shown by his actions before and after the shooting (such as
    circling the residential block with music blaring as if to
    lure the police to intervene, evading the police after the
    shooting, and hiding the gun).
    At the close of the defense case consisting of this evi
    dence bearing on mental illness, the trial court denied
    Clark’s renewed motion for a directed verdict grounded on
    failure of the prosecution to show that Clark knew the
    ——————
    3 The trial court permitted Clark to introduce this evidence, whether
    primarily going to insanity or lack of intent, “because it goes to the
    insanity issue and because we’re not in front of a jury.” App. 9. It also
    allowed him to make an offer of proof as to intent to preserve the issue
    on appeal. Ibid.
    Cite as: 548 U. S. ____ (2006)                   5
    Opinion of the Court
    victim was a police officer.4 The judge then issued a spe
    cial verdict of first-degree murder, expressly finding that
    Clark shot and caused the death of Officer Moritz beyond
    a reasonable doubt and that Clark had not shown that he
    was insane at the time. The judge noted that though
    Clark was indisputably afflicted with paranoid schizo
    phrenia at the time of the shooting, the mental illness “did
    not . . . distort his perception of reality so severely that he
    did not know his actions were wrong.” App. 334. For this
    conclusion, the judge expressly relied on “the facts of the
    crime, the evaluations of the experts, [Clark’s] actions and
    behavior both before and after the shooting, and the ob
    servations of those that knew [Clark].” Id., at 333. The
    sentence was life imprisonment without the possibility of
    release for 25 years.
    Clark moved to vacate the judgment and sentence,
    arguing, among other things, that Arizona’s insanity test
    and its Mott rule each violate due process. As to the in
    sanity standard, Clark claimed (as he had argued earlier)
    that the Arizona Legislature had impermissibly narrowed
    its standard in 1993 when it eliminated the first part of
    the two-part insanity test announced in M’Naghten’s Case,
    10 Cl. & Fin. 200, 8 Eng. Rep. 718 (1843). The court de
    nied the motion.
    The Court of Appeals of Arizona affirmed Clark’s convic
    tion, treating the conclusion on sanity as supported by
    enough evidence to withstand review for abuse of discre
    tion, and holding the State’s insanity scheme consistent
    with due process. App. 336. As to the latter, the Court of
    Appeals reasoned that there is no constitutional require
    ment to recognize an insanity defense at all, the bounds of
    ——————
    4 Clark did not at this time make an additional offer of proof, as con
    templated by the trial court when it ruled that it would consider
    evidence bearing on insanity as to insanity but not as to mens rea. See
    n. 3, supra.
    6                    CLARK v. ARIZONA
    Opinion of the Court
    which are left to the State’s discretion. Beyond that, the
    appellate court followed Mott, reading it as barring the
    trial court’s consideration of evidence of Clark’s mental
    illness and capacity directly on the element of mens rea.
    The Supreme Court of Arizona denied further review.
    We granted certiorari to decide whether due process
    prohibits Arizona from thus narrowing its insanity test or
    from excluding evidence of mental illness and incapacity
    due to mental illness to rebut evidence of the requisite
    criminal intent. 546 U. S. ___ (2005). We now affirm.
    II
    Clark first says that Arizona’s definition of insanity,
    being only a fragment of the Victorian standard from
    which it derives, violates due process. The landmark
    English rule in M’Naghten’s Case, 10 Cl. & Fin. 200, 8
    Eng. Rep. 718 (1843), states that
    “the jurors ought to be told . . . that to establish a de
    fence on the ground of insanity, it must be clearly
    proved that, at the time of the committing of the act,
    the party accused was laboring under such a defect of
    reason, from disease of the mind, as not to know the
    nature and quality of the act he was doing; or, if he
    did know it, that he did not know he was doing what
    was wrong.” 10 Cl. & Fin., at 210, 8 Eng. Rep., at 722.
    The first part asks about cognitive capacity: whether a
    mental defect leaves a defendant unable to understand
    what he is doing. The second part presents an ostensibly
    alternative basis for recognizing a defense of insanity
    understood as a lack of moral capacity: whether a mental
    disease or defect leaves a defendant unable to understand
    that his action is wrong.
    When the Arizona Legislature first codified an insanity
    rule, it adopted the full M’Naghten statement (subject to
    modifications in details that do not matter here):
    Cite as: 548 U. S. ____ (2006)                  7
    Opinion of the Court
    “A person is not responsible for criminal conduct if at
    the time of such conduct the person was suffering
    from such a mental disease or defect as not to know
    the nature and quality of the act or, if such person did
    know, that such person did not know that what he
    was doing was wrong.” 
    Ariz. Rev. Stat. Ann. §13
    –502
    (West 1978).5
    In 1993, the legislature dropped the cognitive incapacity
    part, leaving only moral incapacity as the nub of the
    stated definition. See 1993 Ariz. Sess. Laws ch. 256, §§2–
    3.6 Under current Arizona law, a defendant will not be
    adjudged insane unless he demonstrates that “at the time
    of the commission of the criminal act [he] was afflicted
    with a mental disease or defect of such severity that [he]
    did not know the criminal act was wrong,” 
    Ariz. Rev. Stat. Ann. §13
    –502(A) (West 2001).
    A
    Clark challenges the 1993 amendment excising the
    express reference to the cognitive incapacity element. He
    insists that the side-by-side M’Naghten test represents the
    minimum that a government must provide in recognizing
    an alternative to criminal responsibility on grounds of
    mental illness or defect, and he argues that elimination of
    ——————
    5 This statutory standard followed the Arizona Supreme Court’s dec
    laration that Arizona has “uniformly adhered” to the two-part
    M’Naghten standard. State v. Schantz, 
    98 Ariz. 200
    , 206, 
    403 P. 2d 521
    , 525 (1965) (citing cases), cert. denied, 
    382 U. S. 1015
     (1966).
    6 This change was accompanied by others, principally an enumeration
    of mental states excluded from the category of “mental disease or
    defect,” such as voluntary intoxication and other conditions, and a
    change of the insanity verdict from “not responsible for criminal con
    duct” by reason of insanity to “guilty except insane.” See 1993 Ariz.
    Sess. Laws ch. 256, §§2–3. The 1993 amendments were prompted, at
    least in part, by an acquittal by reason of insanity in a murder case.
    See Note, Arizona’s Insane Response to Insanity, 
    40 Ariz. L. Rev. 287
    ,
    290 (1998).
    8                        CLARK v. ARIZONA
    Opinion of the Court
    the M’Naghten reference to nature and quality “ ‘offends
    [a] principle of justice so rooted in the traditions and
    conscience of our people as to be ranked as fundamental,’ ”
    Patterson v. New York, 
    432 U. S. 197
    , 202 (1977) (quoting
    Speiser v. Randall, 
    357 U. S. 513
    , 523 (1958)); see also
    Leland v. Oregon, 
    343 U. S. 790
    , 798 (1952).
    The claim entails no light burden, see Montana v. Egel
    hoff, 
    518 U. S. 37
    , 43 (1996) (plurality opinion), and Clark
    does not carry it.        History shows no deference to
    M’Naghten that could elevate its formula to the level of
    fundamental principle, so as to limit the traditional recog
    nition of a State’s capacity to define crimes and defenses,
    see Patterson, 
    supra, at 210
    ; see also Foucha v. Louisiana,
    
    504 U. S. 71
    , 96 (1992) (KENNEDY, J., dissenting).
    Even a cursory examination of the traditional Anglo-
    American approaches to insanity reveals significant dif
    ferences among them, with four traditional strains vari
    ously combined to yield a diversity of American standards.
    The main variants are the cognitive incapacity, the moral
    incapacity, the volitional incapacity, and the product-of
    mental-illness tests.7 The first two emanate from the
    alternatives stated in the M’Naghten rule. The volitional
    incapacity or irresistible-impulse test, which surfaced over
    two centuries ago (first in England,8 then in this country9),
    asks whether a person was so lacking in volition due to a
    ——————
    7 “Capacity” is understood to mean the ability to form a certain state
    of mind or motive, understand or evaluate one’s actions, or control
    them.
    8 See Queen v. Oxford, 9 Car. & P. 525, 546, 173 Eng. Rep. 941, 950
    (1840) (“If some controlling disease was, in truth, the acting power
    within [the defendant] which he could not resist, then he will not be
    responsible”); Hadfield’s Case, 27 How. St. Tr. 1281, 1314–1315, 1354–
    1355 (K. B. 1800). But cf. Queen v. Burton, 3 F. & F. 772, 780, 176 Eng.
    Rep. 354, 357 (1863) (rejecting the irresistible-impulse test as “a most
    dangerous doctrine”).
    9 E.g., Parsons v. State, 
    81 Ala. 577
    , 
    2 So. 854
     (1887); State v. Thomp
    son, Wright’s Ohio Rep. 617 (1834).
    Cite as: 548 U. S. ____ (2006)                    9
    Opinion of the Court
    mental defect or illness that he could not have controlled
    his actions. And the product-of-mental-illness test was
    used as early as 1870,10 and simply asks whether a per
    son’s action was a product of a mental disease or defect.11
    Seventeen States and the Federal Government have
    adopted a recognizable version of the M’Naghten test with
    both its cognitive incapacity and moral incapacity compo
    nents.12 One State has adopted only M’Naghten’s cogni
    ——————
    10 State v. Jones, 50 N. H. 369 (1871); State v. Pike, 49 N. H. 399
    (1870).
    11 This distillation of the Anglo-American insanity standards into
    combinations of four building blocks should not be read to signify that
    no other components contribute to these insanity standards or that
    there are no material distinctions between jurisdictions testing insanity
    with the same building blocks. For example, the jurisdictions limit, in
    varying degrees, which sorts of mental illness or defect can give rise to
    a successful insanity defense. Compare, e.g., 
    Ariz. Rev. Stat. Ann. §13
    –
    502(A) (West 2001) (excluding from definition of “mental disease or
    defect” acute voluntary intoxication, withdrawal from alcohol or drugs,
    character defects, psychosexual disorders, and impulse control disor
    ders) with, e.g., 
    Ind. Code §35
    –41–3–6(b) (West 2004) (excluding from
    definition of “mental disease or defect” “abnormality manifested only by
    repeated unlawful or antisocial conduct”). We need not compare the
    standards under a finer lens because our coarser analysis shows that
    the standards vary significantly.
    12 See 
    18 U. S. C. §17
    ; Ala. Code §13A–3–1 (1994); Cal. Penal Code
    Ann. §25 (West 1999); 
    Colo. Rev. Stat. §16
    –8–101.5 (2005); 
    Fla. Stat. §775.027
     (2003); 
    Iowa Code §701.4
     (2005); 
    Minn. Stat. §611.026
     (2004);
    Stevens v. State, 
    806 So. 2d 1031
    , 1050–1051 (Miss. 2001); 
    Mo. Rev. Stat. §562.086
     (2000); State v. Harms, 
    263 Neb. 814
    , 836–837, 
    643 N. W. 2d 359
    , 378–379 (2002); 
    Nev. Rev. Stat. §194.010
     (2003); Finger
    v. State, 
    117 Nev. 548
    , 553–577, 
    27 P. 3d 66
    , 70–85 (2001); N. J. Stat.
    Ann. §2C:4–1 (West 2005); N. Y. Penal Law Ann. §40.15 (West 2004);
    State v. Thompson, 328 N. C. 477, 485–486, 
    402 S. E. 2d 386
    , 390
    (1991); Burrows v. State, 
    640 P. 2d 533
    , 540–541 (Okla. Crim. App.
    1982) (interpreting statutory language excusing from criminal respon
    sibility mentally ill defendants when “at the time of committing the act
    charged against them they were incapable of knowing its wrongful
    ness,” Okla. Stat., Tit. 21, §152(4) (West 2001), to mean the two-part
    M’Naghten test); 
    18 Pa. Cons. Stat. §315
     (2002); 
    Tenn. Code Ann. §39
    –
    11–501 (2002); Wash. Rev. Code §9A.12.010 (2004). North Dakota has
    10                        CLARK v. ARIZONA
    Opinion of the Court
    tive incapacity test,13 and 10 (including Arizona) have
    adopted the moral incapacity test alone.14 Fourteen juris
    dictions, inspired by the Model Penal Code,15 have in place
    an amalgam of the volitional incapacity test and some
    variant of the moral incapacity test, satisfaction of either
    (generally by showing a defendant’s substantial lack of
    capacity) being enough to excuse.16 Three States combine
    a full M’Naghten test with a volitional incapacity for
    mula.17 And New Hampshire alone stands by the product
    ——————
    a unique test, which appears to be a modified version of M’Naghten,
    asking whether a defendant “lacks substantial capacity to comprehend
    the harmful nature or consequences of the conduct, or the conduct is
    the result of a loss or serious distortion of the individual’s capacity to
    recognize reality,” N. D. Cent. Code Ann. §12.1–04.1–01(1)(a) (Lexis
    1997), when “[i]t is an essential element of the crime charged that the
    individual act willfully,” §12.1–04.1–01(1)(b).
    13 
    Alaska Stat. §12.47.010
     (2004).
    14 
    Ariz. Rev. Stat. Ann. §13
    –502 (West 2001); Del. Code Ann., Tit. 11,
    §401 (1995); 
    Ind. Code §35
    –41–3–6 (West 2004); Ill. Comp. Stat., ch.
    720, §5/6-2 (West 2004); 
    La. Stat. Ann. §14:14
     (West 1997); Me. Rev.
    Stat. Ann., Tit. 17–A, §39 (2006); 
    Ohio Rev. Code Ann. §2901.01
    (A)(14)
    (Lexis 2006); S. C. Code Ann. §17–24–10 (2003); S. D. Codified Laws
    §22–1–2(20) (2005 Supp. Pamphlet); 
    Tex. Penal Code Ann. §8.01
     (West
    2003).
    15 ALI, Model Penal Code §4.01(1) (Proposed Official Draft 1962) (“A
    person is not responsible for criminal conduct if at the time of such
    conduct as a result of mental disease or defect he lacks substantial
    capacity either to appreciate the criminality [wrongfulness] of his
    conduct or to conform his conduct to the requirements of the law”).
    16 
    Ark. Code Ann. §5
    –2–312 (2006); Conn. Gen. Stat. §53a–13 (2005);
    Malede v. United States, 
    767 A. 2d 267
    , 269 (D. C. 2001); 
    Ga. Code Ann. §§16
    –3–2, 16–3–3 (2003); 
    Haw. Rev. Stat. §704
    –400 (1993); 
    Ky. Rev. Stat. Ann. §504.020
     (West 2003); Md. Crim. Proc. Code Ann. §3–109
    (Lexis 2001); Commonwealth v. McLaughlin, 
    431 Mass. 506
    , 508, 
    729 N. E. 2d 252
    , 255 (2000); Ore. Rev. Stat. §161.295 (2005); State v.
    Martinez, 
    651 A. 2d 1189
    , 1193 (R. I. 1994); Vt. Stat. Ann., Tit. 13,
    §4801 (1998); State v. Lockhart, 
    208 W. Va. 622
    , 630, 
    542 S. E. 2d 443
    ,
    451 (2000); 
    Wis. Stat. §971.15
     (2003–2004); 
    Wyo. Stat. Ann. §7
    –11–304
    (2005).
    17 
    Mich. Comp. Laws Ann. §768
    .21a (West 2000); State v. Hartley, 90
    N. M. 488, 490–491, 
    565 P. 2d 658
    , 660–661 (1977); Bennett v. Com
    Cite as: 548 U. S. ____ (2006)                  11
    Opinion of the Court
    of-mental-illness test.18 The alternatives are multiplied
    further by variations in the prescribed insanity verdict: a
    significant number of these jurisdictions supplement the
    traditional “not guilty by reason of insanity” verdict with
    an alternative of “guilty but mentally ill.”19 Finally, four
    States have no affirmative insanity defense,20 though one
    provides for a “guilty and mentally ill” verdict.21 These
    four, like a number of others that recognize an affirmative
    insanity defense, allow consideration of evidence of mental
    illness directly on the element of mens rea defining the
    offense.22
    With this varied background, it is clear that no particu
    lar formulation has evolved into a baseline for due process,
    and that the insanity rule, like the conceptualization of
    criminal offenses, is substantially open to state choice.
    Indeed, the legitimacy of such choice is the more obvious
    when one considers the interplay of legal concepts of men
    tal illness or deficiency required for an insanity defense,
    ——————
    monwealth, 
    29 Va. App. 261
    , 277, 
    511 S. E. 2d 439
    , 446–447 (1999).
    18 State v. Plante, 134 N. H. 456, 461, 
    594 A. 2d 1279
    , 1283 (1991).
    19 See, e.g., 
    Alaska Stat. §§12.47.020
    (c), 12.47.030 (2004); Del. Code
    Ann., Tit. 11, §401 (1995); 
    Ga. Code Ann. §17
    –7–131 (2004); Ill. Comp.
    Stat., ch. 720, §5/6–2 (West 2004); 
    Ind. Code §§35
    –35–2–1, 35–36–1–1,
    35–36–2–3 (West 2004); 
    Ky. Rev. Stat. Ann. §504.130
     (West 2003);
    
    Mich. Comp. Laws Ann. §768.36
     (West Supp. 2006); N. M. Stat. Ann.
    §31–9–3 (2000); 
    18 Pa. Cons. Stat. §314
     (2002); S. C. Code Ann. §17–
    24–20 (2003); S. D. Codified Laws §23A–26–14 (2004). Usually, a
    defendant found “guilty but mentally ill” will receive mental-health
    treatment until his mental health has rebounded, at which point he
    must serve the remainder of his imposed sentence. See, e.g., 
    Alaska Stat. §12.47.050
     (2004).
    20 
    Idaho Code §18
    –207 (Lexis 2004); 
    Kan. Stat. Ann. §22
    –3220 (1995);
    
    Mont. Code Ann. §§46
    –14–102, 46–14–311 (2005); 
    Utah Code Ann. §76
    –
    2–305 (Lexis 2003). We have never held that the Constitution man
    dates an insanity defense, nor have we held that the Constitution does
    not so require. This case does not call upon us to decide the matter.
    21 §§77–16a–101, 77–16a–103, 77–16a–104 (Lexis 2003).
    22 See statutes cited in n. 20, supra.
    12                   CLARK v. ARIZONA
    Opinion of the Court
    with the medical concepts of mental abnormality that
    influence the expert opinion testimony by psychologists
    and psychiatrists commonly introduced to support or
    contest insanity claims. For medical definitions devised to
    justify treatment, like legal ones devised to excuse from
    conventional criminal responsibility, are subject to flux
    and disagreement. See infra, at 31–33; cf. Leland, 
    343 U. S., at
    800–801 (no due process violation for adopting the
    M’Naghten standard rather than the irresistible-impulse
    test because scientific knowledge does not require other
    wise and choice of test is a matter of policy). There being
    such fodder for reasonable debate about what the cognate
    legal and medical tests should be, due process imposes no
    single canonical formulation of legal insanity.
    B
    Nor does Arizona’s abbreviation of the M’Naghten
    statement raise a proper claim that some constitutional
    minimum has been shortchanged. Clark’s argument of
    course assumes that Arizona’s former statement of the
    M’Naghten rule, with its express alternative of cognitive
    incapacity, was constitutionally adequate (as we agree).
    That being so, the abbreviated rule is no less so, for cogni
    tive incapacity is relevant under that statement, just as it
    was under the more extended formulation, and evidence
    going to cognitive incapacity has the same significance
    under the short form as it had under the long.
    Though Clark is correct that the application of the
    moral incapacity test (telling right from wrong) does not
    necessarily require evaluation of a defendant’s cognitive
    capacity to appreciate the nature and quality of the acts
    charged against him, see Brief for Petitioner 46–47, his
    argument fails to recognize that cognitive incapacity is
    itself enough to demonstrate moral incapacity. Cognitive
    incapacity, in other words, is a sufficient condition for
    establishing a defense of insanity, albeit not a necessary
    Cite as: 548 U. S. ____ (2006)                  13
    Opinion of the Court
    one. As a defendant can therefore make out moral inca
    pacity by demonstrating cognitive incapacity, evidence
    bearing on whether the defendant knew the nature and
    quality of his actions is both relevant and admissible. In
    practical terms, if a defendant did not know what he was
    doing when he acted, he could not have known that he was
    performing the wrongful act charged as a crime.23 Indeed,
    when the two-part rule was still in effect, the Supreme
    Court of Arizona held that a jury instruction on insanity
    containing the moral incapacity part but not a full recita
    tion of the cognitive incapacity part was fine, as the cogni
    tive incapacity part might be “ ‘treated as adding nothing
    to the requirement that the accused know his act was
    wrong.’ ” State v. Chavez, 
    143 Ariz. 238
    , 239, 
    693 P. 2d 893
    , 894 (1984) (quoting A. Goldstein, The Insanity De
    fense 50 (1967)).
    The Court of Appeals of Arizona acknowledged as much
    in this case, too, see App. 350 (“It is difficult to imagine
    that a defendant who did not appreciate the ‘nature and
    quality’ of the act he committed would reasonably be able
    to perceive that the act was ‘wrong’ ”), and thus aligned
    itself with the long-accepted understanding that the cogni
    tively incapacitated are a subset of the morally incapaci
    tated within the meaning of the standard M’Naghten rule,
    see, e.g., Goldstein, supra, at 51 (“In those situations
    where the accused does not know the nature and quality of
    his act, in the broad sense, he will not know that it was
    wrong, no matter what construction ‘wrong’ is given”); 1
    ——————
    23He  might, of course, have thought delusively he was doing some
    thing just as wrongful as the act charged against him, but this is not
    the test: he must have understood that he was committing the act
    charged and that it was wrongful, see 
    Ariz. Rev. Stat. Ann. §13
    –502(A)
    (West 2001) (“A person may be found guilty except insane if at the time
    of the commission of the criminal act the person was afflicted with a
    mental disease or defect of such severity that the person did not know
    the criminal act was wrong”).
    14                         CLARK v. ARIZONA
    Opinion of the Court
    W. LaFave, Substantive Criminal Law §7.2(b)(3), p. 536
    (2d ed. 2003) (“Many courts feel that knowledge of ‘the
    nature and quality of the act’ is the mere equivalent of the
    ability to know that the act was wrong” (citing cases)); id.,
    §7.2(b)(4), at 537 (“If the defendant does not know the
    nature and quality of his act, then quite obviously he does
    not know that his act is ‘wrong,’ and this is true without
    regard to the interpretation given to the word ‘wrong’ ”); cf.
    1 R. Gerber, Criminal Law of Arizona 502–7, n. 1 (2d ed.
    1993).24
    Clark, indeed, adopted this very analysis himself in the
    ——————
    24 We think this logic holds true in the face of the usual rule of statu
    tory construction of “ ‘ “giv[ing] effect, if possible, to every clause and
    word of a statute,” ’ ” Duncan v. Walker, 
    533 U. S. 167
    , 174 (2001) (quot
    ing United States v. Menasche, 
    348 U. S. 528
    , 538–539 (1955)); see also 2
    J. Sutherland, Statutes and Statutory Construction §4705 (3d ed. 1943).
    Insanity standards are formulated to guide the factfinder to determine the
    blameworthiness of a mentally ill defendant. See, e.g., Jones v. United
    States, 
    463 U. S. 354
    , 373, n. 4 (1983) (Brennan, J., dissenting). The
    M’Naghten test is a sequential test, first asking the factfinder to conduct
    the easier enquiry whether a defendant knew the nature and quality of
    his actions. If not, the defendant is to be considered insane and there is no
    need to pass to the harder and broader enquiry whether the defendant
    knew his actions were wrong. And, because, owing to this sequence, the
    factfinder is to ask whether a defendant lacks moral capacity only when
    he possesses cognitive capacity, the only defendants who will be found to
    lack moral capacity are those possessing cognitive capacity. Cf. 2 C.
    Torcia, Wharton’s Criminal Law §101 (15th ed. 1994). Though, before
    1993, Arizona had in place the full M’Naghten test with this sequential
    enquiry, see, e.g., Schantz, 
    98 Ariz., at 207
    , 
    403 P. 2d, at 525
    , it would
    appear that the legislature eliminated the cognitive capacity part not to
    change the meaning of the insanity standard but to implement its judg
    ment that a streamlined standard with only the moral capacity part
    would be easier for the jury to apply, see Arizona House of Representative
    Judiciary Committee Notes 3 (Mar. 18, 1993); 1 R. Gerber, Criminal Law
    of Arizona 502–6, 502–11 (2d ed. 1993 and Supp. 2000). This is corrobo
    rated by the State’s choice for many years against revising the applicable
    recommended jury instruction (enumerating the complete M’Naghten test)
    in order to match the amended statutory standard. See 1 Gerber, supra,
    at 502–6.
    Cite as: 548 U. S. ____ (2006)           15
    Opinion of the Court
    trial court: “[I]f [Clark] did not know he was shooting at a
    police officer, or believed he had to shoot or be shot, even
    though his belief was not based in reality, this would
    establish that he did not know what he was doing was
    wrong.” Record, Doc. 374, at 1. The trial court apparently
    agreed, for the judge admitted Clark’s evidence of cogni
    tive incapacity for consideration under the State’s moral
    incapacity formulation. And Clark can point to no evi
    dence bearing on insanity that was excluded. His psychi
    atric expert and a number of lay witnesses testified to his
    delusions, and this evidence tended to support a descrip
    tion of Clark as lacking the capacity to understand that
    the police officer was a human being. There is no doubt
    that the trial judge considered the evidence as going to an
    issue of cognitive capacity, for in finding insanity not
    proven he said that Clark’s mental illness “did not . . .
    distort his perception of reality so severely that he did not
    know his actions were wrong,” App. 334.
    We are satisfied that neither in theory nor in practice
    did Arizona’s 1993 abridgment of the insanity formulation
    deprive Clark of due process.
    III
    Clark’s second claim of a due process violation chal
    lenges the rule adopted by the Supreme Court of Arizona
    in State v. Mott, 
    187 Ariz. 536
    , 
    931 P. 2d 1046
     (en banc),
    cert. denied, 
    520 U. S. 1234
     (1997). This case ruled on the
    admissibility of testimony from a psychologist offered to
    show that the defendant suffered from battered women’s
    syndrome and therefore lacked the capacity to form the
    mens rea of the crime charged against her. The opinion
    variously referred to the testimony in issue as “psychologi
    cal testimony,” 
    187 Ariz., at 541
    , 
    931 P. 2d, at 1051
    , and
    “expert testimony,” ibid., and implicitly equated it with
    “expert psychiatric evidence,” 
    id., at 540
    , 
    931 P. 2d, at 1050
     (internal quotation marks omitted), and “psychiatric
    16                       CLARK v. ARIZONA
    Opinion of the Court
    testimony,” 
    id., at 541
    , 
    931 P. 2d, at 1051
    .25 The state
    court held that testimony of a professional psychologist or
    psychiatrist about a defendant’s mental incapacity owing
    to mental disease or defect was admissible, and could be
    considered, only for its bearing on an insanity defense;
    such evidence could not be considered on the element of
    mens rea, that is, what the State must show about a de
    fendant’s mental state (such as intent or understanding)
    when he performed the act charged against him. See 
    id., at 541, 544
    , 
    931 P. 2d, at 1051, 1054
    .26
    A
    Understanding Clark’s claim requires attention to the
    categories of evidence with a potential bearing on mens
    rea. First, there is “observation evidence” in the everyday
    sense, testimony from those who observed what Clark did
    and heard what he said; this category would also include
    testimony that an expert witness might give about Clark’s
    tendency to think in a certain way and his behavioral
    characteristics. This evidence may support a professional
    diagnosis of mental disease and in any event is the kind of
    evidence that can be relevant to show what in fact was on
    Clark’s mind when he fired the gun. Observation evidence
    in the record covers Clark’s behavior at home and with
    friends, his expressions of belief around the time of the
    killing that “aliens” were inhabiting the bodies of local
    people (including government agents),27 his driving around
    ——————
    25 We thus think the dissent reads Mott too broadly. See post, at 6–7
    (opinion of KENNEDY, J.) (no distinction between observation and
    mental-disease testimony, see infra, at 16–17, or lay and expert).
    26 The more natural reading of Mott suggests to us that this evidence
    cannot be considered as to mens rea even if the defendant establishes
    his insanity, though one might read Mott otherwise.
    27 Clark’s parents testified that, in the months before the shooting
    and even days beforehand, Clark called them “aliens” and thought that
    “aliens” were out to get him. See, e.g., Tr. of Bench Trial in No. CR
    2000–538, pp. 110–112, 136, 226–228 (Aug. 20, 2003). One night before
    Cite as: 548 U. S. ____ (2006)                    17
    Opinion of the Court
    the neighborhood before the police arrived, and so on.
    Contrary to the dissent’s characterization, see post, at 2
    (opinion of KENNEDY, J.), observation evidence can be
    presented by either lay or expert witnesses.
    Second, there is “mental-disease evidence” in the form of
    opinion testimony that Clark suffered from a mental
    disease with features described by the witness. As was
    true here, this evidence characteristically but not always28
    comes from professional psychologists or psychiatrists who
    testify as expert witnesses and base their opinions in part
    on examination of a defendant, usually conducted after the
    events in question. The thrust of this evidence was that,
    based on factual reports, professional observations, and
    tests, Clark was psychotic at the time in question, with a
    condition that fell within the category of schizophrenia.
    Third, there is evidence we will refer to as “capacity
    evidence” about a defendant’s capacity for cognition and
    moral judgment (and ultimately also his capacity to form
    mens rea). This, too, is opinion evidence. Here, as it
    usually does,29 this testimony came from the same experts
    and concentrated on those specific details of the mental
    condition that make the difference between sanity and
    insanity under the Arizona definition.30 In their respec
    ——————
    the shooting, according to Clark’s mother, Clark repeatedly viewed a
    popular film characterized by her as telling a story about “aliens”
    masquerading as government agents, a story Clark insisted was real
    despite his mother’s protestations to the contrary. See 
    id.,
     at 59–60
    (Aug. 21, 2003). And two months after the shooting, Clark purportedly
    told his parents that his hometown, Flagstaff, was inhabited principally
    by “aliens,” who had to be stopped, and that the only way to stop them
    was with bullets. See, e.g., 
    id.,
     at 131–132 (Aug. 20, 2003); 
    id.,
     at 24–25
    (Aug. 21, 2003).
    28 This is contrary to the dissent’s understanding. See post, at 2–3
    (opinion of KENNEDY, J.).
    29 In conflict with the dissent’s characterization, see post, at 2 (opin
    ion of KENNEDY, J.), it does not always, however, come from experts.
    30Arizona permits capacity evidence, see, e.g., State v. Sanchez, 117
    18                        CLARK v. ARIZONA
    Opinion of the Court
    tive testimony on these details the experts disagreed: the
    defense expert gave his opinion that the symptoms or
    effects of the disease in Clark’s case included inability to
    appreciate the nature of his action and to tell that it was
    wrong, whereas the State’s psychiatrist was of the view
    that Clark was a schizophrenic who was still sufficiently
    able to appreciate the reality of shooting the officer and to
    know that it was wrong to do that.31
    A caveat about these categories is in order. They at
    tempt to identify different kinds of testimony offered in
    this case in terms of explicit and implicit distinctions
    made in Mott. What we can say about these categories
    goes to their cores, however, not their margins. Exact
    ——————
    Ariz. 369, 373, 
    573 P. 2d 60
    , 64 (1977); see also Ariz. Rule Evid. 704
    (2006) (allowing otherwise admissible evidence on testimony “em
    brac[ing] an ultimate issue to be decided by the trier of fact”), though
    not every jurisdiction permits such evidence on the ultimate issue of
    insanity. See, e.g., Fed. Rule Evid. 704(b) (“No expert witness testifying
    with respect to the mental state or condition of a defendant in a crimi
    nal case may state an opinion or inference as to whether the defendant
    did or did not have the mental state or condition constituting an ele
    ment of the crime charged or a defense thereto. Such ultimate issues
    are matters for the trier of fact alone”); United States v. Dixon, 
    185 F. 3d 393
    , 400 (CA5 1999) (in the face of mental-disease evidence, Rule
    704(b) prohibits an expert “from testifying that [the mental-disease
    evidence] does or does not prevent the defendant from appreciating the
    wrongfulness of his actions”).
    31 Arizona permits evidence bearing on insanity to be presented by
    either lay or expert witnesses. See State v. Bay, 
    150 Ariz. 112
    , 116, 
    722 P. 2d 280
    , 284 (1986). According to Bay, “[f]oundationally, a lay wit
    ness must have had an opportunity to observe the past conduct and
    history of a defendant; the fact that he is a lay witness goes not to the
    admissibility of the testimony but rather to its weight.” 
    Ibid.
     (citation
    omitted); see also State v. Hughes, 
    193 Ariz. 72
    , 83, 
    969 P. 2d 1184
    ,
    1195 (1998). In fact, a defendant can theoretically establish insanity
    solely via lay testimony. See Bay, 
    150 Ariz., at 116
    , 
    722 P. 2d, at 284
    .
    But cf. State v. McMurtrey, 
    136 Ariz. 93
    , 100, 
    664 P. 2d 637
    , 644 (1983)
    (“[I]t is difficult to imagine how a defendant could place his or her
    sanity in issue . . . without expert testimony as to the defendant’s state
    of mind at the time of the crime”).
    Cite as: 548 U. S. ____ (2006)          19
    Opinion of the Court
    limits have thus not been worked out in any Arizona law
    that has come to our attention, and in this case, neither
    the courts in their rulings nor counsel in objections in
    voked or required precision in applying the Mott rule’s
    evidentiary treatment, as we explain below. Necessarily,
    then, our own decision can address only core issues, leav
    ing for other cases any due process claims that may be
    raised about the treatment of evidence whose categoriza
    tion is subject to dispute.
    B
    It is clear that Mott itself imposed no restriction on
    considering evidence of the first sort, the observation
    evidence. We read the Mott restriction to apply, rather, to
    evidence addressing the two issues in testimony that
    characteristically comes only from psychologists or psy
    chiatrists qualified to give opinions as expert witnesses:
    mental-disease evidence (whether at the time of the crime
    a defendant suffered from a mental disease or defect, such
    as schizophrenia) and capacity evidence (whether the
    disease or defect left him incapable of performing or ex
    periencing a mental process defined as necessary for san
    ity such as appreciating the nature and quality of his act
    and knowing that it was wrong).
    Mott was careful to distinguish this kind of opinion
    evidence from observation evidence generally and even
    from observation evidence that an expert witness might
    offer, such as descriptions of a defendant’s tendency to
    think in a certain way or his behavioral characteristics;
    the Arizona court made it clear that this sort of testimony
    was perfectly admissible to rebut the prosecution’s evi
    dence of mens rea, 
    187 Ariz., at 544
    , 
    931 P. 2d, at 1054
    .
    Thus, only opinion testimony going to mental defect or
    disease, and its effect on the cognitive or moral capaci
    ties on which sanity depends under the Arizona rule, is
    restricted.
    20                       CLARK v. ARIZONA
    Opinion of the Court
    In this case, the trial court seems to have applied the
    Mott restriction to all evidence offered by Clark for the
    purpose of showing what he called his inability to form the
    required mens rea, see, e.g., Record, Doc. 406, pp. 7–10,
    (that is, an intent to kill a police officer on duty, or an
    understanding that he was engaging in the act of killing
    such an officer, see 
    Ariz. Rev. Stat. Ann. §13
    –1105(A)(3)
    (West Supp. 2005)). Thus, the trial court’s restriction may
    have covered not only mental-disease and capacity evi
    dence as just defined, but also observation evidence of
    fered by lay (and expert) witnesses who described Clark’s
    unusual behavior. Clark’s objection to the application of
    the Mott rule does not, however, turn on the distinction
    between lay and expert witnesses or the kinds of testi
    mony they were competent to present.32
    C
    There is some, albeit limited, disagreement between the
    dissent and ourselves about the scope of the claim of error
    properly before us. To start with matters of agreement, all
    Members of the Court agree that Clark’s general attack on
    the Mott rule covers its application in confining considera
    tion of capacity evidence to the insanity defense.
    In practical terms, our agreement on issues presented
    extends to a second point. JUSTICE KENNEDY understands
    that Clark raised an objection to confining mental-disease
    evidence to the insanity issue. As he sees it, Clark in
    effect claimed that in dealing with the issue of mens rea
    the trial judge should have considered expert testimony on
    what may characteristically go through the mind of a
    ——————
    32 With respect to “the limited factual issues the trial court held it
    could consider under [Ariz. Rev. Stat. Ann. §]13–502 and Mott, defense
    counsel made no additional ‘offer of proof’ at the conclusion of the case
    but preserved [Clark’s] legal contentions by asking the court to consider
    all of the evidence presented in determining whether the state had
    proved its case.” Brief for Petitioner 10, n. 20 (citations omitted).
    Cite as: 548 U. S. ____ (2006)           21
    Opinion of the Court
    schizophrenic, when the judge considered what in fact was
    in Clark’s mind at the time of the shooting. See post, at 3
    (dissenting opinion) (“[T]he opinion that Clark had para
    noid schizophrenia—an opinion shared by experts for both
    the prosecution and defense—bears on efforts to deter
    mine, as a factual matter, whether he knew he was killing
    a police officer”). He thus understands that defense coun
    sel claimed a right to rebut the State’s mens rea demon
    stration with testimony about how schizophrenics may
    hallucinate voices and other sounds, about their character
    istic failure to distinguish the content of their imagination
    from what most people perceive as exterior reality, and so
    on. It is important to be clear that this supposed objection
    was not about dealing with testimony based on observa
    tion of Clark showing that he had auditory hallucinations
    when he was driving around, or failed in fact to appreciate
    objective reality when he shot; this objection went to use of
    testimony about schizophrenics, not about Clark in par
    ticular. While we might dispute how clearly Clark raised
    this objection, we have no doubt that the objection falls
    within a general challenge to the Mott rule; we understand
    that Mott is meant to confine to the insanity defense any
    consideration of characteristic behavior associated with
    mental disease, see 
    187 Ariz., at 544
    , 
    931 P. 2d, at 1054
    (contrasting State v. Christensen, 
    129 Ariz. 32
    , 
    628 P. 2d 580
     (1991), and State v. Gonzales, 
    140 Ariz. 349
    , 
    681 P. 2d 1368
     (1984)). We will therefore assume for argument that
    Clark raised this claim, as we consider the due process
    challenge to the Mott rule.
    The point on which we disagree with the dissent, how
    ever, is this: did Clark apprise the Arizona courts that he
    believed the trial judge had erroneously limited the con
    sideration of observation evidence, whether from lay wit
    nesses like Clark’s mother or (possibly) the expert wit
    nesses who observed him? This sort of evidence was not
    covered by the Mott restriction, and confining it to the
    22                        CLARK v. ARIZONA
    Opinion of the Court
    insanity issue would have been an erroneous application
    of Mott as a matter of Arizona law. For the following
    reasons we think no such objection was made in a way the
    Arizona courts could have understood it, and that no such
    issue is before us now. We think the only issue properly
    before us is the challenge to Mott on due process grounds,
    comprising objections to limits on the use of mental-
    disease and capacity evidence.
    It is clear that the trial judge intended to apply Mott:
    “[R]ecognizing that much of the evidence that [the de
    fense is] going to be submitting, in fact all of it, as far
    as I know . . . that has to do with the insanity could
    also arguably be made along the lines of the Mott is
    sue as to form and intent and his capacity for the in
    tent. I’m going to let you go ahead and get all that
    stuff in because it goes to the insanity issue and be
    cause we’re not in front of a jury. At the end, I’ll let
    you make an offer of proof as to the intent, the Mott
    issues, but I still think the supreme court decision is
    the law of the land in this state.” App. 9.
    At no point did the trial judge specify any particular
    evidence that he refused to consider on the mens rea issue.
    Nor did defense counsel specify any observation or other
    particular evidence that he claimed was admissible but
    wrongly excluded on the issue of mens rea, so as to pro
    duce a clearer ruling on what evidence was being re
    stricted on the authority of Mott and what was not. He
    made no “offer of proof” in the trial court;33 and although
    ——————
    33 We do not agree with the State’s argument that the failure to make
    an offer of proof, see n. 4, supra, is a bar to pressing Clark’s claim about
    the admissibility of mental-illness or capacity evidence as to mens rea,
    see Brief for Respondent 27–29, especially when the Arizona Court of
    Appeals rejected Clark’s argument on the merits rather than clearly on
    this ground, see App. 351–353; see also Michigan v. Long, 
    463 U. S. 1032
    , 1042 (1983) (“[I]t is not clear from the opinion itself that the state
    Cite as: 548 U. S. ____ (2006)                  23
    Opinion of the Court
    his brief in the Arizona Court of Appeals stated at one
    point that it was not inconsistent with Mott to consider
    nonexpert evidence indicating mental illness on the issue
    of mens rea, and argued that the trial judge had failed to
    do so, Appellant’s Opening Brief in No. 1CA–CR–03–0851
    etc. (Ariz. Ct. App.), pp. 48–49 (hereinafter Appellant’s
    Opening Brief), he was no more specific than that, see,
    e.g., id., at 52 (“The Court’s ruling in Mott and the trial
    court’s refusal to consider whether as a result of suffering
    from paranoid schizophrenia [Clark] could not formulate
    the mens rea necessary for first degree murder violated his
    right to due process”). Similarly, we read the Arizona
    Court of Appeals to have done nothing more than rely on
    Mott to reject the claim that due process forbids restricting
    evidence bearing on “[a]bility to [f]orm [m]ens [r]ea,” App.
    351 (emphasis in original), (i.e., mental-disease and capac
    ity evidence) to the insanity determination. See id., at
    351–353.
    This failure in the state courts to raise any clear claim
    about observation evidence, see Appellant’s Opening Brief
    46–52, is reflected in the material addressed to us, see
    Brief for Petitioner 13–32. In this Court both the question
    presented and the following statement of his position were
    couched in similarly worded general terms:
    “I. ERIC WAS DENIED DUE PROCESS WHEN THE
    TRIAL    COURT    REFUSED  TO   CONSIDER
    EVIDENCE OF HIS SEVERE MENTAL ILLNESS IN
    DETERMINING FACTUALLY WHETHER THE
    PROSECUTION      PROVED    THE   MENTAL
    ELEMENTS OF THE CRIME CHARGED.” Id., at 13.
    But as his counsel made certain beyond doubt in his reply
    brief,
    ——————
    court relied upon an adequate and independent state ground and . . . it
    fairly appears that the state court rested its decision primarily on
    federal law”).
    24                        CLARK v. ARIZONA
    Opinion of the Court
    “Eric’s Point I is and always has been an attack on the
    rule of State v. Mott, which both courts below held ap
    plicable and binding. Mott announced a categorical
    ‘rejection of the use of psychological testimony to chal
    lenge the mens rea element of a crime,’ and upheld
    this rule against federal due process challenge.” Re
    ply Brief for Petitioner 2 (citations omitted).
    This explanation is supported by other statements in
    Clark’s briefs in both the State Court of Appeals and this
    Court, replete with the consistently maintained claim that
    it was error to limit evidence of mental illness and inca
    pacity to its bearing on the insanity defense, excluding it
    from consideration on the element of mens rea. See, e.g.,
    Appellant’s Opening Brief 46, 47, 51; Brief for Petitioner
    11, 13, 16, 20–23.
    In sum, the trial court’s ruling, with its uncertain edges,
    may have restricted observation evidence admissible on
    mens rea to the insanity defense alone, but we cannot be
    sure.34 But because a due process challenge to such a
    restriction of observation evidence was, by our measure,
    neither pressed nor passed upon in the Arizona Court of
    Appeals, we do not consider it. See, e.g., Kentucky v. Stin
    cer, 
    482 U. S. 730
    , 747, n. 22 (1987); Illinois v. Gates, 
    462 U. S. 213
    , 217–224 (1983). What we do know, and now
    ——————
    34We therefore have no reason to believe that the courts of Arizona
    would have failed to restrict their application of Mott to the professional
    testimony the Mott opinion was stated to cover, if Clark’s counsel had
    specified any observation evidence he claimed to be generally admissi
    ble and relevant to mens rea. Nothing that we hold here is authority
    for restricting a factfinder’s consideration of observation evidence
    indicating state of mind at the time of a criminal offense (conventional
    mens rea evidence) as distinct from professional mental-disease or
    capacity evidence going to ability to form a certain state of mind during
    a period that includes the time of the offense charged. And, of course,
    nothing held here prevents Clark from raising this discrete claim when
    the case returns to the courts of Arizona, if consistent with the State’s
    procedural rules.
    Cite as: 548 U. S. ____ (2006)           25
    Opinion of the Court
    consider, is Clark’s claim that Mott denied due process
    because it “preclude[d] Eric from contending that . . .
    factual inferences” of the “mental states which were neces
    sary elements of the crime charged” “should not be drawn
    because the behavior was explainable, instead, as a mani
    festation of his chronic paranoid schizophrenia.” Brief for
    Petitioner 13 (emphasis in original). We consider the
    claim, as Clark otherwise puts it, that “Arizona’s prohibi
    tion of ‘diminished capacity’ evidence by criminal defen
    dants violates” due process, 
    ibid.
    D
    Clark’s argument that the Mott rule violates the Four
    teenth Amendment guarantee of due process turns on the
    application of the presumption of innocence in criminal
    cases, the presumption of sanity, and the principle that a
    criminal defendant is entitled to present relevant and
    favorable evidence on an element of the offense charged
    against him.
    1
    The first presumption is that a defendant is innocent
    unless and until the government proves beyond a reason
    able doubt each element of the offense charged, see Patter
    son, 
    432 U. S., at
    210–211; In re Winship, 
    397 U. S. 358
    ,
    361–364 (1970), including the mental element or mens rea.
    Before the last century, the mens rea required to be proven
    for particular offenses was often described in general
    terms like “malice,” see, e.g., In re Eckart, 
    166 U. S. 481
    (1897); 4 W. Blackstone, Commentaries *21 (“[A]n unwar
    rantable act without a vicious will is no crime at all”), but
    the modern tendency has been toward more specific de
    scriptions, as shown in the Arizona statute defining the
    murder charged against Clark: the State had to prove that
    in acting to kill the victim, Clark intended to kill a law
    enforcement officer on duty or knew that the victim was
    26                        CLARK v. ARIZONA
    Opinion of the Court
    such an officer on duty. See generally Gardner, The Mens
    Rea Enigma: Observations on the Role of Motive in the
    Criminal Law Past and Present, 
    1993 Utah L. Rev. 635
    .
    As applied to mens rea (and every other element), the force
    of the presumption of innocence is measured by the force
    of the showing needed to overcome it, which is proof be
    yond a reasonable doubt that a defendant’s state of mind
    was in fact what the charge states. See Winship, supra, at
    361–363.
    2
    The presumption of sanity is equally universal in some
    variety or other, being (at least) a presumption that a
    defendant has the capacity to form the mens rea necessary
    for a verdict of guilt and the consequent criminal respon
    sibility. See Leland, 
    343 U. S., at 799
    ; Davis v. United
    States, 
    160 U. S. 469
    , 486–487 (1895); M’Naghten’s Case, 10
    Cl. & Fin., at 210, 8 Eng. Rep., at 722; see generally 1
    LaFave, Substantive Criminal Law §8.3(a), at 598–599,
    and n. 1. This presumption dispenses with a requirement
    on the government’s part to include as an element of every
    criminal charge an allegation that the defendant had such
    a capacity.35 The force of this presumption, like the pre
    sumption of innocence, is measured by the quantum of
    evidence necessary to overcome it; unlike the presumption
    of innocence, however, the force of the presumption of
    sanity varies across the many state and federal jurisdic
    tions, and prior law has recognized considerable leeway on
    the part of the legislative branch in defining the presump
    tion’s strength through the kind of evidence and degree of
    persuasiveness necessary to overcome it, see Fisher v.
    United States, 
    328 U. S. 463
    , 466–476 (1946).36
    ——————
    35 A  legislature is nonetheless free to require affirmative proof of san
    ity by the way it describes a criminal offense, see Dixon v. United
    States, ante, at ___ (slip op., at 7–9).
    36 Although a desired evidentiary use is restricted, that is not equiva
    Cite as: 548 U. S. ____ (2006)                     27
    Opinion of the Court
    There are two points where the sanity or capacity pre
    sumption may be placed in issue. First, a State may allow
    a defendant to introduce (and a factfinder to consider)
    evidence of mental disease or incapacity for the bearing it
    can have on the government’s burden to show mens rea.
    See, e.g., State v. Perez, 
    882 A. 2d 574
    , 584 (R. I. 2005).37
    In such States the evidence showing incapacity to form the
    guilty state of mind, for example, qualifies the probative
    force of other evidence, which considered alone indicates
    that the defendant actually formed the guilty state of
    mind. If it is shown that a defendant with mental disease
    thinks all blond people are robots, he could not have in
    tended to kill a person when he shot a man with blond
    hair, even though he seemed to act like a man shooting
    another man.38 In jurisdictions that allow mental-disease
    and capacity evidence to be considered on par with any
    ——————
    lent to a Sandstrom presumption. See Sandstrom v. Montana, 
    442 U. S. 510
    , 514–524 (1979) (due process forbids use of presumption that relieves
    the prosecution of burden of proving mental state by inference of intent
    from an act).
    37 In fact, Oregon had this scheme in place when we decided Leland v.
    Oregon, 
    343 U. S. 790
    , 794–796 (1952). We do not, however, read any
    part of Leland to require as a matter of due process that evidence of
    incapacity be considered to rebut the mens rea element of a crime.
    38We reject the State’s argument that mens rea and insanity, as cur
    rently understood, are entirely distinguishable, so that mental-disease
    and capacity evidence relevant to insanity is simply irrelevant to mens
    rea. Not only does evidence accepted as showing insanity trump mens
    rea, but evidence of behavior close to the time of the act charged may
    indicate both the actual state of mind at that time and also an enduring
    incapacity to form the criminal state of mind necessary to the offense
    charged. See Brief for American Psychiatric Association et al. as Amici
    Curiae 12–13; Arenella, The Diminished Capacity and Diminished
    Responsibility Defenses: Two Children of a Doomed Marriage, 
    77 Colum. L. Rev. 827
    , 834–835 (1977); cf. Powell v. Texas, 
    392 U. S. 514
    ,
    535–536 (1968) (plurality opinion) (the “doctrines of actus reus, mens rea,
    insanity, mistake, justification, and duress” are a “collection of interlock
    ing and overlapping concepts which the common law has utilized to assess
    the moral accountability of an individual for his antisocial deeds”).
    28                   CLARK v. ARIZONA
    Opinion of the Court
    other relevant evidence when deciding whether the prose
    cution has proven mens rea beyond a reasonable doubt,
    the evidence of mental disease or incapacity need only
    support what the factfinder regards as a reasonable doubt
    about the capacity to form (or the actual formation of) the
    mens rea, in order to require acquittal of the charge.
    Thus, in these States the strength of the presumption of
    sanity is no greater than the strength of the evidence of
    abnormal mental state that the factfinder thinks is
    enough to raise a reasonable doubt.
    The second point where the force of the presumption of
    sanity may be tested is in the consideration of a defense of
    insanity raised by a defendant.          Insanity rules like
    M’Naghten and the variants discussed in Part II, supra,
    are attempts to define, or at least to indicate, the kinds of
    mental differences that overcome the presumption of
    sanity or capacity and therefore excuse a defendant from
    customary criminal responsibility, see Jones, 
    463 U. S., at 373, n. 4
     (Brennan, J., dissenting); D. Hermann, The Insan
    ity Defense: Philosophical, Historical and Legal Perspec
    tives 4 (1983) (“A central significance of the insanity de
    fense . . . is the separation of nonblameworthy from
    blameworthy offenders”), even if the prosecution has
    otherwise overcome the presumption of innocence by
    convincing the factfinder of all the elements charged be
    yond a reasonable doubt. The burden that must be carried
    by a defendant who raises the insanity issue, again, de
    fines the strength of the sanity presumption. A State may
    provide, for example, that whenever the defendant raises
    a claim of insanity by some quantum of credible evidence,
    the presumption disappears and the government must
    prove sanity to a specified degree of certainty (whether
    beyond reasonable doubt or something less). See, e.g.,
    Commonwealth v. Keita, 
    429 Mass. 843
    , 846, 
    712 N. E. 2d 65
    , 68 (1999). Or a jurisdiction may place the burden of
    persuasion on a defendant to prove insanity as the appli
    Cite as: 548 U. S. ____ (2006)                    29
    Opinion of the Court
    cable law defines it, whether by a preponderance of the
    evidence or to some more convincing degree, see 
    Ariz. Rev. Stat. Ann. §13
    –502(C) (West 2001); Leland, 
    343 U. S., at 798
    . In any case, the defendant’s burden defines the
    presumption of sanity, whether that burden be to burst a
    bubble or to show something more.
    3
    The third principle implicated by Clark’s argument is a
    defendant’s right as a matter of simple due process to
    present evidence favorable to himself on an element that
    must be proven to convict him.39 As already noted, evi
    dence tending to show that a defendant suffers from men
    tal disease and lacks capacity to form mens rea is relevant
    to rebut evidence that he did in fact form the required
    mens rea at the time in question; this is the reason that
    Clark claims a right to require the factfinder in this case
    to consider testimony about his mental illness and his
    incapacity directly, when weighing the persuasiveness of
    other evidence tending to show mens rea, which the prose
    cution has the burden to prove.
    As Clark recognizes, however, the right to introduce
    relevant evidence can be curtailed if there is a good reason
    for doing that. “While the Constitution . . . prohibits the
    exclusion of defense evidence under rules that serve no
    legitimate purpose or that are disproportionate to the ends
    that they are asserted to promote, well-established rules of
    evidence permit trial judges to exclude evidence if its
    probative value is outweighed by certain other factors
    such as unfair prejudice, confusion of the issues, or poten
    ——————
    39 Clark’s argument assumes that Arizona’s rule is a rule of evidence,
    rather than a redefinition of mens rea, see Montana v. Egelhoff, 
    518 U. S. 37
    , 58–59 (1996) (GINSBURG, J., concurring in judgment); 
    id., at 71
    (O’Connor, J., dissenting). We have no reason to view the rule otherwise,
    and on this assumption, it does not violate due process, see infra, at 31–
    39.
    30                   CLARK v. ARIZONA
    Opinion of the Court
    tial to mislead the jury.” Holmes v. South Carolina, 547
    U. S. ___, ___ (2006) (slip op., at 6); see Crane v. Kentucky,
    
    476 U. S. 683
    , 689–690 (1986) (permitting exclusion of
    evidence that “poses an undue risk of ‘harassment, preju
    dice, [or] confusion of the issues’” (quoting Delaware v. Van
    Arsdall, 
    475 U. S. 673
    , 679 (1986))); see also Egelhoff, 
    518 U. S. 37
    ; Chambers v. Mississippi, 
    410 U. S. 284
    , 302 (1973).
    And if evidence may be kept out entirely, its consideration
    may be subject to limitation, which Arizona claims the
    power to impose here. State law says that evidence of
    mental disease and incapacity may be introduced and
    considered, and if sufficiently forceful to satisfy the defen
    dant’s burden of proof under the insanity rule it will dis
    place the presumption of sanity and excuse from criminal
    responsibility. But mental-disease and capacity evidence
    may be considered only for its bearing on the insanity
    defense, and it will avail a defendant only if it is persua
    sive enough to satisfy the defendant’s burden as defined
    by the terms of that defense. The mental-disease and
    capacity evidence is thus being channeled or restricted to
    one issue and given effect only if the defendant carries the
    burden to convince the factfinder of insanity; the evidence
    is not being excluded entirely, and the question is whether
    reasons for requiring it to be channeled and restricted are
    good enough to satisfy the standard of fundamental fair
    ness that due process requires. We think they are.
    E
    1
    The first reason supporting the Mott rule is Arizona’s
    authority to define its presumption of sanity (or capacity
    or responsibility) by choosing an insanity definition, as
    discussed in Part II, supra, and by placing the burden of
    persuasion on defendants who claim incapacity as an
    excuse from customary criminal responsibility. No one,
    certainly not Clark here, denies that a State may place a
    Cite as: 548 U. S. ____ (2006)                    31
    Opinion of the Court
    burden of persuasion on a defendant claiming insanity, see
    Leland, 
    supra,
     at 797–799 (permitting a State, consistent
    with due process, to require the defendant to bear this
    burden). And Clark presses no objection to Arizona’s
    decision to require persuasion to a clear and convincing
    degree before the presumption of sanity and normal re
    sponsibility is overcome. See Brief for Petitioner 18, n. 25.
    But if a State is to have this authority in practice as
    well as in theory, it must be able to deny a defendant the
    opportunity to displace the presumption of sanity more
    easily when addressing a different issue in the course of
    the criminal trial. Yet, as we have explained, just such an
    opportunity would be available if expert testimony of
    mental disease and incapacity could be considered for
    whatever a factfinder might think it was worth on the
    issue of mens rea.40 As we mentioned, the presumption of
    sanity would then be only as strong as the evidence a
    factfinder would accept as enough to raise a reasonable
    doubt about mens rea for the crime charged; once reason
    able doubt was found, acquittal would be required, and the
    standards established for the defense of insanity would go
    by the boards.
    Now, a State is of course free to accept such a possibility
    in its law. After all, it is free to define the insanity de
    fense by treating the presumption of sanity as a bursting
    bubble, whose disappearance shifts the burden to the
    prosecution to prove sanity whenever a defendant pre
    sents any credible evidence of mental disease or incapac
    ity. In States with this kind of insanity rule, the legisla
    ture may well be willing to allow such evidence to be
    considered on the mens rea element for whatever the
    ——————
    40 Cf. post, at 3 (KENNEDY, J., dissenting) (“The psychiatrist’s explana
    tion of Clark’s condition was essential to understanding how he proc
    esses sensory data and therefore to deciding what information was in
    his mind at the time of the shooting. Simply put, knowledge relies on
    cognition, and cognition can be affected by schizophrenia”).
    32                        CLARK v. ARIZONA
    Opinion of the Court
    factfinder thinks it is worth. What counts for due process,
    however, is simply that a State that wishes to avoid a
    second avenue for exploring capacity, less stringent for a
    defendant, has a good reason for confining the considera
    tion of evidence of mental disease and incapacity to the
    insanity defense.
    It is obvious that Arizona’s Mott rule reflects such a
    choice. The State Supreme Court pointed out that the
    State had declined to adopt a defense of diminished capac
    ity (allowing a jury to decide when to excuse a defendant
    because of greater than normal difficulty in conforming to
    the law).41 The court reasoned that the State’s choice
    would be undercut if evidence of incapacity could be con
    sidered for whatever a jury might think sufficient to raise
    a reasonable doubt about mens rea, even if it did not show
    insanity. 
    187 Ariz., at 541
    , 
    931 P. 2d, at 1051
    . In other
    words, if a jury were free to decide how much evidence of
    mental disease and incapacity was enough to counter
    evidence of mens rea to the point of creating a reasonable
    doubt, that would in functional terms be analogous to
    allowing jurors to decide upon some degree of diminished
    capacity to obey the law, a degree set by them, that would
    ——————
    41 Though the term “diminished capacity” has been given different
    meanings, see, e.g., Morse, Undiminished Confusion in Diminished
    Capacity, 75 J. Crim. L. & C. 1 (1984) (“The diminished capacity
    doctrine allows a criminal defendant to introduce evidence of mental
    abnormality at trial either to negate a mental element of the crime
    charged, thereby exonerating the defendant of that charge, or to reduce
    the degree of crime for which the defendant may be convicted, even if
    the defendant’s conduct satisfied all the formal elements of a higher
    offense”), California, a jurisdiction with which the concept has tradi
    tionally been associated, understood it to be simply a “ ‘showing that the
    defendant’s mental capacity was reduced by mental illness, mental
    defect or intoxication,’ ” People v. Berry, 
    18 Cal. 3d 509
    , 517, 
    556 P. 2d 777
    , 781 (1976) (in banc) (quoting People v. Castillo, 
    70 Cal. 2d 264
    ,
    270, 
    449 P. 2d 449
    , 452 (1969); emphasis deleted), abrogated by Cal.
    Penal Code Ann. §§25(a), 28(a)–(b), 29 (West 1999 and Supp. 2006).
    Cite as: 548 U. S. ____ (2006)                    33
    Opinion of the Court
    prevail as a stand-alone defense.42
    2
    A State’s insistence on preserving its chosen standard of
    legal insanity cannot be the sole reason for a rule like
    Mott, however, for it fails to answer an objection the dis
    sent makes in this case. See post, at 10–18 (opinion of
    KENNEDY, J.). An insanity rule gives a defendant already
    found guilty the opportunity to excuse his conduct by
    showing he was insane when he acted, that is, that he did
    not have the mental capacity for conventional guilt and
    criminal responsibility. But, as the dissent argues, if the
    same evidence that affirmatively shows he was not guilty
    by reason of insanity (or “guilty except insane” under
    Arizona law, 
    Ariz. Rev. Stat. Ann. §13
    –502(A) (West
    2001)) also shows it was at least doubtful that he could
    form mens rea, then he should not be found guilty in the
    first place; it thus violates due process when the State
    impedes him from using mental-disease and capacity
    evidence directly to rebut the prosecution’s evidence that
    he did form mens rea.
    Are there, then, characteristics of mental-disease and
    capacity evidence giving rise to risks that may reasonably
    be hedged by channeling the consideration of such evi
    dence to the insanity issue on which, in States like Ari
    ——————
    42 It is beyond question that Arizona may preclude such a defense, see
    Fisher v. United States, 
    328 U. S. 463
    , 466–476 (1946), and there is no
    doubt that the Arizona Legislature meant to do so, see 
    Ariz. Rev. Stat. Ann. §13
    –502(A) (West 2001) (“Mental disease or defect does not include
    disorders that result from acute voluntary intoxication or withdrawal
    from alcohol or drugs, character defects, psychosexual disorders or im
    pulse control disorders. Conditions that do not constitute legal insanity
    include but are not limited to momentary, temporary conditions arising
    from the pressure of the circumstances, moral decadence, depravity or
    passion growing out of anger, jealousy, revenge, hatred or other motives in
    a person who does not suffer from a mental disease or defect or an abnor
    mality that is manifested only by criminal conduct”).
    34                    CLARK v. ARIZONA
    Opinion of the Court
    zona, a defendant has the burden of persuasion? We think
    there are: in the controversial character of some categories
    of mental disease, in the potential of mental-disease evi
    dence to mislead, and in the danger of according greater
    certainty to capacity evidence than experts claim for it.
    To begin with, the diagnosis may mask vigorous debate
    within the profession about the very contours of the men
    tal disease itself. See, e.g., American Psychiatric Associa
    tion, Diagnostic and Statistical Manual of Mental Disor
    ders xxxiii (4th ed. text rev. 2000) (hereinafter DSM–IV–
    TR) (“DSM–IV reflects a consensus about the classification
    and diagnosis of mental disorders derived at the time of its
    initial publication. New knowledge generated by research
    or clinical experience will undoubtedly lead to an in
    creased understanding of the disorders included in DSM–
    IV, to the identification of new disorders, and to the re
    moval of some disorders in future classifications. The text
    and criteria sets included in DSM–IV will require recon
    sideration in light of evolving new information”); P.
    Caplan, They Say You’re Crazy: How the World’s Most
    Powerful Psychiatrists Decide Who’s Normal (1995) (criti
    cism by former consultant to the DSM against some of the
    DSM’s categories). And Members of this Court have pre
    viously recognized that the end of such debate is not im
    minent. See Jones, 
    463 U. S., at
    364–365, n. 13 (“‘The only
    certain thing that can be said about the present state of
    knowledge and therapy regarding mental disease is that
    science has not reached finality of judgment’ ” (quoting
    Greenwood v. United States, 
    350 U. S. 366
    , 375 (1956)));
    Powell v. Texas, 
    392 U. S. 514
    , 537 (1968) (plurality opinion)
    (“It is simply not yet the time to write into the Constitution
    formulas cast in terms whose meaning, let alone relevance,
    is not yet clear . . . to doctors”). Though we certainly do not
    “condem[n mental-disease evidence] wholesale”, Brief for
    American Psychiatric Association et al. as Amici Curiae
    15, the consequence of this professional ferment is a general
    Cite as: 548 U. S. ____ (2006)                      35
    Opinion of the Court
    caution in treating psychological classifications as predi
    cates for excusing otherwise criminal conduct.
    Next, there is the potential of mental-disease evidence to
    mislead jurors (when they are the factfinders) through the
    power of this kind of evidence to suggest that a defendant
    suffering from a recognized mental disease lacks cognitive,
    moral, volitional, or other capacity, when that may not be
    a sound conclusion at all. Even when a category of mental
    disease is broadly accepted and the assignment of a defen
    dant’s behavior to that category is uncontroversial, the
    classification may suggest something very significant
    about a defendant’s capacity, when in fact the classifica
    tion tells us little or nothing about the ability of the defen
    dant to form mens rea or to exercise the cognitive, moral,
    or volitional capacities that define legal sanity.43 See
    DSM–IV–TR xxxii–xxxiii (“When the DSM–IV categories,
    criteria, and textual descriptions are employed for forensic
    purposes, there are significant risks that diagnostic infor
    mation will be misused or misunderstood. These dangers
    arise because of the imperfect fit between the questions of
    ultimate concern to the law and the information contained
    in a clinical diagnosis. In most situations, the clinical
    diagnosis of a DSM–IV mental disorder is not sufficient to
    establish the existence for legal purposes of . . . ‘mental
    diseas[e]’ or ‘mental defect.’ In determining whether an
    individual meets a specified legal standard (e.g., for . . .
    criminal responsibility . . .), additional information is
    usually required beyond that contained in the DSM–IV
    diagnosis”). The limits of the utility of a professional
    ——————
    43 Our observation about the impact of mental-disease evidence on
    understandings of capacity in no way undermines the assertion by the
    American Psychiatric Association, the American Psychological Associa
    tion, and the American Academy of Psychiatry in this case that
    “[e]xpert evidence of mental disorders . . . is . . . relevant to the mental-
    state issues raised by mens rea requirements,” Brief for American
    Psychiatric Association et al. as Amici Curiae 15.
    36                   CLARK v. ARIZONA
    Opinion of the Court
    disease diagnosis are evident in the dispute between the
    two testifying experts in this case; they agree that Clark
    was schizophrenic, but they come to opposite conclusions
    on whether the mental disease in his particular case left
    him bereft of cognitive or moral capacity. Evidence of
    mental disease, then, can easily mislead; it is very easy to
    slide from evidence that an individual with a profession
    ally recognized mental disease is very different, into
    doubting that he has the capacity to form mens rea,
    whereas that doubt may not be justified. And of course, in
    the cases mentioned before, in which the categorization is
    doubtful or the category of mental disease is itself subject
    to controversy, the risks are even greater that opinions
    about mental disease may confuse a jury into thinking the
    opinions show more than they do. Because allowing men
    tal-disease evidence on mens rea can thus easily mislead,
    it is not unreasonable to address that tendency by con-
    fining consideration of this kind of evidence to insanity,
    on which a defendant may be assigned the burden of
    persuasion.
    There are, finally, particular risks inherent in the opin
    ions of the experts who supplement the mental-disease
    classifications with opinions on incapacity: on whether the
    mental disease rendered a particular defendant incapable
    of the cognition necessary for moral judgment or mens rea
    or otherwise incapable of understanding the wrongfulness
    of the conduct charged. Unlike observational evidence
    bearing on mens rea, capacity evidence consists of judg
    ment, and judgment fraught with multiple perils: a defen
    dant’s state of mind at the crucial moment can be elusive
    no matter how conscientious the enquiry, and the law’s
    categories that set the terms of the capacity judgment are
    not the categories of psychology that govern the expert’s
    professional thinking. Although such capacity judgments
    may be given in the utmost good faith, their potentially
    tenuous character is indicated by the candor of the defense
    Cite as: 548 U. S. ____ (2006)             37
    Opinion of the Court
    expert in this very case. Contrary to the State’s expert, he
    testified that Clark lacked the capacity to appreciate the
    circumstances realistically and to understand the wrong
    fulness of what he was doing, App. 48–49, but he said that
    “no one knows exactly what was on [his] mind” at the time
    of the shooting, id., at 48. And even when an expert is
    confident that his understanding of the mind is reliable,
    judgment addressing the basic categories of capacity
    requires a leap from the concepts of psychology, which are
    devised for thinking about treatment, to the concepts of
    legal sanity, which are devised for thinking about criminal
    responsibility. See Insanity Defense Work Group, Ameri
    can Psychiatric Association Statement on the Insanity
    Defense, 140 Am. J. Psychiatry 681, 686 (1983), reprinted
    in 2 The Role of Mental Illness in Criminal Trials 117, 122
    (J. Moriarty ed. 2001) (“The American Psychiatric Associa
    tion is not opposed to legislatures restricting psychiatric
    testimony about the . . . ultimate legal issues concerning
    the insanity defense. . . . When . . . ‘ultimate issue’ ques
    tions are formulated by the law and put to the expert
    witness who must then say ‘yea’ or ‘nay,’ then the expert
    witness is required to make a leap in logic. He no longer
    addresses himself to medical concepts but instead must
    infer or intuit what is in fact unspeakable, namely, the
    probable relationship between medical concepts and legal
    or moral constructs such as free will. These impermissible
    leaps in logic made by expert witnesses confuse the
    jury. . . . This state of affairs does considerable injustice to
    psychiatry and, we believe, possibly to criminal defen
    dants. These psychiatric disagreements . . . cause less
    than fully understanding juries or the public to conclude
    that psychiatrists cannot agree. In fact, in many criminal
    insanity trials both prosecution and defense psychiatrists
    do agree about the nature and even the extent of mental
    disorder exhibited by the defendant at the time of the act”
    (emphasis in original; footnote omitted)); DSM–IV–TR
    38                       CLARK v. ARIZONA
    Opinion of the Court
    xxxii–xxxiii; P. Giannelli & E. Imwinkelried, Scientific
    Evidence §9–3(B), p. 286 (1986) (“[N]o matter how the test
    for insanity is phrased, a psychiatrist or psychologist is no
    more qualified than any other person to give an opinion
    about whether a particular defendant’s mental condition
    satisfies the legal test for insanity”); cf. R. Slovenko, Psy
    chiatry and Criminal Culpability 55 (1995) (“The scope of
    the DSM is wide-ranging and includes ‘conduct disorders’
    but ‘evil’ is not mentioned”). In sum, these empirical and
    conceptual problems add up to a real risk that an expert’s
    judgment in giving capacity evidence will come with an
    apparent authority that psychologists and psychiatrists do
    not claim to have. We think that this risk, like the diffi
    culty in assessing the significance of mental-disease evi
    dence, supports the State’s decision to channel such expert
    testimony to consideration on the insanity defense, on
    which the party seeking the benefit of this evidence has
    the burden of persuasion.
    It bears repeating that not every State will find it
    worthwhile to make the judgment Arizona has made, and
    the choices the States do make about dealing with the
    risks posed by mental-disease and capacity evidence will
    reflect their varying assessments about the presumption
    of sanity as expressed in choices of insanity rules.44 The
    point here simply is that Arizona has sensible reasons
    to assign the risks as it has done by channeling the
    evidence.45
    ——————
    44 A State in which the burden of persuasion as to a defendant’s san
    ity lies with the prosecution might also be justified in restricting
    mental-disease and capacity evidence to insanity determinations owing
    to the potential of mental-disease evidence to mislead and the risk of
    misjudgment inherent in capacity evidence. We need not, in the
    context of this case, address that issue.
    45 Arizona’s rule is supported by a further practical reason, though
    not as weighty as those just considered. As mentioned before, if sub
    stantial mental-disease and capacity evidence is accepted as rebutting
    mens rea in a given case, the affirmative defense of insanity will proba
    Cite as: 548 U. S. ____ (2006)
    39
    Opinion of the Court
    F
    Arizona’s rule serves to preserve the State’s chosen
    standard for recognizing insanity as a defense and to avoid
    confusion and misunderstanding on the part of jurors.46
    For these reasons, there is no violation of due process
    under Chambers and its progeny, and no cause to claim
    that channeling evidence on mental disease and capacity
    offends any “ ‘principle of justice so rooted in the traditions
    and conscience of our people as to be ranked as fundamen
    tal,’ ” Patterson, 
    432 U. S., at 202
     (quoting Speiser, 
    357 U. S., at 523
    ).
    * *    *
    The judgment of the Court of Appeals of Arizona is,
    accordingly, affirmed.
    It is so ordered.
    ——————
    bly not be reached or ruled upon; the defendant will simply be acquitted
    (or perhaps convicted of a lesser included offense). If an acquitted
    defendant suffers from a mental disease or defect that makes him
    dangerous, he will neither be confined nor treated psychiatrically
    unless a judge so orders after some independent commitment proceed
    ing. But if a defendant succeeds in showing himself insane, Arizona
    law (and presumably that of every other State with an insanity rule)
    will require commitment and treatment as a consequence of that
    finding without more. It makes sense, then, to channel capacity evi
    dence to the issue structured to deal with mental incapacity when such
    a claim is raised successfully. See, e.g., Jones, 
    463 U. S., at 368
     (“The
    purpose of commitment following an insanity acquittal . . . is to treat the
    individual’s mental illness and protect him and society from his potential
    dangerousness”).
    46 The rule also deals in a practical way with those whose insanity
    has been shown to make them dangerous to others. See n. 45, supra.
    Cite as: 548 U. S. ____ (2006)            1
    Opinion of BREYER, J.
    SUPREME COURT OF THE UNITED STATES
    _________________
    No. 05–5966
    _________________
    ERIC MICHAEL CLARK, PETITIONER v. ARIZONA
    ON WRIT OF CERTIORARI TO THE COURT OF APPEALS OF
    ARIZONA, DIVISION ONE
    [June 29, 2006]
    JUSTICE BREYER, concurring in part and dissenting in
    part.
    As I understand the Court’s opinion, it distinguishes
    among three categories of evidence related to insanity: (1)
    fact-related evidence as to the defendant’s specific state of
    mind at the time of the crime, e.g., evidence that shows he
    thought the policeman was not a human being; (2) expert
    opinion evidence that the defendant suffered from a men
    tal disease that would have affected his capacity to form
    an intent to kill a policeman, e.g., that he suffers from a
    disease of a kind where powerful voices command the
    sufferer to kill; and (3) expert opinion evidence that the
    defendant was legally insane, e.g., evidence that he did not
    know right from wrong. Ante, at 16–18.
    I agree with the Court’s basic categorization. I also
    agree that the Constitution permits a State to provide for
    consideration of the second and third types of evidence
    solely in conjunction with the insanity defense. A State
    might reasonably fear that, without such a rule, the types
    of evidence as to intent would become confused in the
    jury’s mind, indeed that in some cases the insanity ques
    tion would displace the intent question as the parties
    litigate both simultaneously.
    Nonetheless, I believe the distinction among these
    kinds of evidence will be unclear in some cases. And
    though I accept the majority’s reading of the record, I
    2                    CLARK v. ARIZONA
    Opinion of BREYER, J.
    remain concerned as to whether the lower courts, in set
    ting forth and applying State v. Mott, 
    187 Ariz. 536
    , 
    931 P. 2d 1046
     (en banc), cert. denied, 
    520 U. S. 1234
     (1997),
    focused with sufficient directness and precision upon the
    distinction.
    Consequently, I would remand this case so that Ari
    zona’s courts can determine whether Arizona law, as set
    forth in Mott and other cases, is consistent with the dis
    tinction the Court draws and whether the trial court so
    applied Arizona law here. I would also reserve the ques
    tion (as I believe the Court has done) as to the burden of
    persuasion in a case where the defendant produces suffi
    cient evidence of the second kind as to raise a reasonable
    doubt suggesting that he suffered from a mental illness so
    severe as to prevent him from forming any relevant intent
    at all.
    For this reason, I dissent only from Parts III–B and III–
    C of the Court’s opinion and the ultimate disposition of
    this case, and I join the remainder.
    Cite as: 548 U. S. ____ (2006)          1
    KENNEDY, J., dissenting
    SUPREME COURT OF THE UNITED STATES
    _________________
    No. 05–5966
    _________________
    ERIC MICHAEL CLARK, PETITIONER v. ARIZONA
    ON WRIT OF CERTIORARI TO THE COURT OF APPEALS OF
    ARIZONA, DIVISION ONE
    [June 29, 2006]
    JUSTICE KENNEDY, with whom JUSTICE STEVENS and
    JUSTICE GINSBURG join, dissenting.
    In my submission the Court is incorrect in holding that
    Arizona may convict petitioner Eric Clark of first-degree
    murder for the intentional or knowing killing of a police
    officer when Clark was not permitted to introduce critical
    and reliable evidence showing he did not have that intent
    or knowledge. The Court is wrong, too, when it concludes
    the issue cannot be reached because of an error by Clark’s
    counsel. Its reasons and conclusions lead me to file this
    respectful dissent.
    Since I would reverse the judgment of the Arizona Court
    of Appeals on this ground, and the Arizona courts might
    well alter their interpretation of the State’s criminal re
    sponsibility statute were my rationale to prevail, it is
    unnecessary for me to address the argument that Ari
    zona’s definition of insanity violates due process.
    I
    Clark claims that the trial court erred in refusing to
    consider evidence of his chronic paranoid schizophrenia in
    deciding whether he possessed the knowledge or intent
    required for first-degree murder. Seizing upon a theory
    invented here by the Court itself, the Court narrows
    Clark’s claim so he cannot raise the point everyone else
    thought was involved in the case. The Court says the only
    2                    CLARK v. ARIZONA
    KENNEDY, J., dissenting
    issue before us is whether there is a right to introduce
    mental-disease evidence or capacity evidence, not a right
    to introduce observation evidence. See ante, at 15–25.
    This restructured evidentiary universe, with no convincing
    authority to support it, is unworkable on its own terms.
    Even were that not so, however, the Court’s tripartite
    structure is something not addressed by the state trial
    court, the state appellate court, counsel on either side in
    those proceedings, or the briefs the parties filed with us.
    The Court refuses to consider the key part of Clark’s claim
    because his counsel did not predict the Court’s own inven
    tion. It is unrealistic, and most unfair, to hold that Clark’s
    counsel erred in failing to anticipate so novel an approach.
    If the Court is to insist on its approach, at a minimum the
    case should be remanded to determine whether Clark is
    bound by his counsel’s purported waiver.
    The Court’s error, of course, has significance beyond this
    case. It adopts an evidentiary framework that, in my
    view, will be unworkable in many cases. The Court classi
    fies Clark’s behavior and expressed beliefs as observation
    evidence but insists that its description by experts must be
    mental-disease evidence or capacity evidence. See ante, at
    16–18. These categories break down quickly when it is
    understood how the testimony would apply to the question
    of intent and knowledge at issue here. The most common
    type of schizophrenia, and the one Clark suffered from, is
    paranoid schizophrenia. See P. Berner et al., Diagnostic
    Criteria for Functional Psychoses 37 (2d ed. 1992). The
    existence of this functional psychosis is beyond dispute,
    but that does not mean the lay witness understands it or
    that a disputed issue of fact concerning its effect in a
    particular instance is not something for the expert to
    address. Common symptoms of the condition are delu
    sions accompanied by hallucinations, often of the auditory
    type, which can cause disturbances of perception. 
    Ibid.
    Clark’s expert testified that people with schizophrenia
    Cite as: 548 U. S. ____ (2006)           3
    KENNEDY, J., dissenting
    often play radios loudly to drown out the voices in their
    heads. See App. 32. Clark’s attorney argued to the trial
    court that this, rather than a desire to lure a policeman to
    the scene, explained Clark’s behavior just before the kill
    ing. 
    Id.,
     at 294–295. The observation that schizophrenics
    play radios loudly is a fact regarding behavior, but it is
    only a relevant fact if Clark has schizophrenia.
    Even if this evidence were, to use the Court’s term,
    mental-disease evidence, because it relies on an expert
    opinion, what would happen if the expert simply were to
    testify, without mentioning schizophrenia, that people
    with Clark’s symptoms often play the radio loudly? This
    seems to be factual evidence, as the term is defined by the
    Court, yet it differs from mental-disease evidence only in
    forcing the witness to pretend that no one has yet come up
    with a way to classify the set of symptoms being described.
    More generally, the opinion that Clark had paranoid
    schizophrenia—an opinion shared by experts for both the
    prosecution and defense—bears on efforts to determine, as
    a factual matter, whether he knew he was killing a police
    officer. The psychiatrist’s explanation of Clark’s condition
    was essential to understanding how he processes sensory
    data and therefore to deciding what information was in his
    mind at the time of the shooting. Simply put, knowledge
    relies on cognition, and cognition can be affected by
    schizophrenia. See American Psychiatric Association,
    Diagnostic and Statistical Manual of Mental Disorders
    299 (4th ed. text rev. 2000) (“The characteristic symptoms
    of Schizophrenia involve a range of cognitive and emo
    tional dysfunctions that include perception”); 
    ibid.
     (Symp
    toms include delusions, which are “erroneous beliefs that
    usually involve a misinterpretation of perceptions or
    experiences”). The mental-disease evidence at trial was
    also intertwined with the observation evidence because it
    lent needed credibility. Clark’s parents and friends testi
    fied Clark thought the people in his town were aliens
    4                    CLARK v. ARIZONA
    KENNEDY, J., dissenting
    trying to kill him. These claims might not be believable
    without a psychiatrist confirming the story based on his
    experience with people who have exhibited similar behav
    iors. It makes little sense to divorce the observation evi
    dence from the explanation that makes it comprehensible.
    Assuming the Court’s tripartite structure were feasible,
    the Court is incorrect when it narrows Clark’s claim to
    exclude any concern about observation evidence. In decid
    ing Clark’s counsel failed to raise this issue, the Court
    relies on a series of perceived ambiguities regarding how
    the claim fits within the Court’s own categories. See ante,
    at 15–25. The Court cites no precedent for construing
    these ambiguities against the claimant and no prudential
    reason for ignoring the breadth of Clark’s claim. It is
    particularly surprising that the Court does so to the det
    riment of a criminal defendant asserting the fundamental
    challenge that the trier of fact refused to consider critical
    evidence showing he is innocent of the crime charged.
    The alleged ambiguities are, in any event, illusory. The
    evidence at trial addressed more than the question of
    general incapacity or opinions regarding mental illness; it
    went further, as it included so-called observation evidence
    relevant to Clark’s mental state at the moment he shot the
    officer. There was testimony, for example, that Clark
    thought the people in his town, particularly government
    officials, were not human beings but aliens who were
    trying to kill him. See App. 119–121, 131–132, 192–197,
    249–256; Tr. of Bench Trial in No. CR–2000–538, pp. 110–
    112, 131–132, 136, 226–228 (Aug. 20, 2003); 
    id.,
     at 24–25,
    59–60 (Aug. 21, 2003). The Court recognizes the existence
    of this essential observation evidence. See ante, at 16–17.
    The Court holds, nonetheless, that “we cannot be sure”
    whether the trial court failed to consider this evidence.
    Ante, at 24. It is true the trial court ruling was not per
    fectly clear. Its language does strongly suggest, though,
    that it did not consider any of this testimony in deciding
    Cite as: 548 U. S. ____ (2006)            5
    KENNEDY, J., dissenting
    whether Clark had the knowledge or intent required for
    first-degree murder. After recognizing that “much of the
    evidence that [the defense is] going to be submitting, in
    fact all of it, as far as I know . . . that has to do with the
    insanity could also arguably be made . . . as to form and
    intent and his capacity for the intent,” the court concluded
    “we will be focusing, as far as I’m concerned, strictly on
    the insanity defense.” App. 9. In announcing its verdict,
    the trial court did not mention any of the mental-illness
    evidence, observation or otherwise, in deciding Clark’s
    guilt. 
    Id.,
     at 331–335. The most reasonable assumption,
    then, would seem to be that the trial court did not consider
    it, and the Court does not hold otherwise. See ante, at 20.
    Clark’s objection to this refusal by the trier of fact to
    consider the evidence as it bore on his key defense was
    made at all stages of the proceeding. In his post-trial
    motion to vacate the judgment, Clark argued that “prohib
    iting consideration of any evidence reflecting upon a men
    tally ill criminal defendant’s ability to form the necessary
    mens rea violates due process.” Record, Doc. 406, p. 8.
    Clark pressed the same argument in the Arizona Court of
    Appeals. See Appellant’s Opening Brief in No. 1CA–CR–
    03–0851 etc., pp. 46–52 (hereinafter Appellant’s Opening
    Brief). He also noted that the trial judge had erred in
    refusing to consider non-expert testimony—presumably
    what the Court would call observation evidence—on
    Clark’s mental illness. 
    Id.,
     at 47–48. (“The trial court
    therefore violated [Clark’s] right to present a defense
    because [the] court refused to consider any evidence, in
    cluding the multiple testimonials of lay witnesses . . . in
    deciding whether he could form the requisite mens rea”).
    The appeals court decided the issue on the merits, holding
    that the trial court was correct not to consider the evi
    dence of mental illness in determining whether Clark had
    the mens rea for first-degree murder. See App. 351–353.
    It offered no distinction at all between observation or
    6                     CLARK v. ARIZONA
    KENNEDY, J., dissenting
    mental-disease evidence.
    Notwithstanding the appeals court’s decision, the Court
    states that the issue was not clearly presented to the state
    courts. See ante, at 21–24. According to the Court, Clark
    only raised an objection based on State v. Mott, 
    187 Ariz. 536
    , 
    931 P. 2d 1046
     (1997) (en banc), see ante, at 21–24,
    and Mott’s holding was limited to the exclusion of mental-
    disease and capacity evidence, see ante, at 19. The Court
    is incorrect, and on both counts.
    First, Clark’s claim goes well beyond an objection to
    Mott. In fact, he specifically attempted to distinguish Mott
    by noting that the trial court in this case refused to con
    sider all evidence of mental illness. See Record, Doc. 406,
    at 8; see also Appellant’s Opening Brief 48. The Court
    notices these arguments but criticizes Clark’s counsel for
    not being specific about the observation evidence he
    wanted the trial court to consider. See ante, at 22. There
    was no reason, though, for Clark’s counsel to believe addi
    tional specificity was required, since there was no evident
    distinction in Arizona law between observation evidence
    and mental-disease testimony.
    Second, Mott’s holding was not restricted to mental-
    disease evidence. The Arizona Supreme Court did not
    refer to any distinction between observation and mental-
    disease evidence, or lay and expert testimony. Its holding
    was stated in broad terms: “Arizona does not allow evi
    dence of a defendant’s mental disorder short of insanity
    either as an affirmative defense or to negate the mens rea
    element of a crime.” 
    187 Ariz., at 541
    , 
    931 P. 2d, at 1051
    ;
    see 
    id., at 540
    , 
    931 P. 2d, at 1050
     (“The legislature’s decision
    . . . evidences its rejection of the use of psychological testi
    mony to challenge the mens rea element of a crime”). The
    Court attempts to divine a fact/opinion distinction in Mott
    based on Mott’s distinguishing a case, State v. Christensen,
    
    129 Ariz. 32
    , 
    628 P. 2d 580
     (1981) (in banc), where evidence
    about behavioral tendencies was deemed admissible. See
    Cite as: 548 U. S. ____ (2006)            7
    KENNEDY, J., dissenting
    ante, at 19. Christensen, though, also addressed an expert
    opinion; the difference was that the evidence there con
    cerned a “character trait of acting reflexively in response to
    stress,” not a mental illness. Mott, 
    supra, at 544
    , 
    931 P. 2d, at 1054
    . Since the Court recognizes the Arizona Court of
    Appeals relied on Mott, the expansive rule of exclusion in
    Mott—without any suggestion of a limitation depending on
    the kind of evidence—should suffice for us to reach the so-
    called observation-evidence issue. Even if, as the Court
    contends, see ante, at 15, Mott is limited to expert testi
    mony, the Court’s categories still do not properly interpret
    Mott, because the Court’s own definition of observation
    evidence includes some expert testimony, see ante, at 17.
    It makes no difference that in the appeals court Clark
    referred to the issue as inability to form knowledge or
    intent. See Appellant’s Opening Brief 46–52. He did not
    insist on some vague, general incapacity. He stated,
    instead, that he “suffered from a major mental illness and
    was psychotic at the time of the offense.” Id., at 48. Even
    if Clark’s arguments were insufficient to apprise the state
    court of the argument, “[o]ur traditional rule is that ‘[o]nce
    a federal claim is properly presented, a party can make
    any argument in support of that claim; parties are not
    limited to the precise arguments they made below.’ ”
    Lebron v. National Railroad Passenger Corporation, 
    513 U. S. 374
    , 379 (1995) (quoting Yee v. Escondido, 
    503 U. S. 519
    , 534 (1992)). The claim is clear. Though it seems to be
    obscure to this Court, it was understood by the Arizona
    Court of Appeals, which stated: “Clark argues that the trial
    court erred in refusing to consider evidence of his mental
    disease or defect in determining whether he had the req
    uisite mens rea to commit first-degree murder.” App. 351.
    When the question is what the state court held, it is not
    instructive for this Court to recast the words the state
    court used.
    The razor-thin distinction the Court draws between
    8                    CLARK v. ARIZONA
    KENNEDY, J., dissenting
    evidence being used to show incapacity and evidence being
    used to show lack of mens rea directly does not identify
    two different claims. Clark’s single claim, however char
    acterized, involves the use of the same mental-illness
    evidence to decide whether he had the requisite knowledge
    or intent. The various ways in which the evidence is
    relevant in disproving mens rea hardly qualify as separate
    claims. The new arguments allowed in Lebron and Yee, by
    comparison, were far more disconnected from the initial
    bases for the alleged violations. See Lebron, 
    supra, at 378, 379
     (for purposes of showing state action, petitioner could
    argue that Amtrak was a Government entity even though
    he argued below only that it was a private entity with
    close connections to Government entities, because the
    claim was simply “that Amtrak did not accord him the
    rights it was obliged to provide by the First Amendment”);
    Yee, supra, at 534, 535 (petitioners could argue that an
    ordinance constituted a regulatory taking, even though they
    arguably asserted in the Court of Appeals only a physical
    taking, because the claim was simply “that the ordinance
    effects an unconstitutional taking”). If we give this latitude
    to litigants in civil cases, surely we must do so here. Fur
    thermore, to the extent any ambiguity remains on whether
    the claim was raised, the proper course is to remand. See
    Bradshaw v. Richey, 546 U. S. ___, ___ (2005) (slip op., at 6)
    (per curiam). Unless the state court clearly decides an
    issue on state-law grounds, which the Court does not
    contend occurred here, there is no bar to our review of the
    federal question. See Harris v. Reed, 
    489 U. S. 255
    , 261–
    262 (1989).
    Before this Court Clark framed the issue in broad terms
    that encompass the question whether the evidence of his
    mental illness should have been considered to show he did
    not at the time of the offense have the knowledge or intent
    to shoot a police officer. See Brief for Petitioner i (“Ques
    tions Presented for Review: (1) Whether Arizona’s blanket
    Cite as: 548 U. S. ____ (2006)            9
    KENNEDY, J., dissenting
    exclusion of evidence and refusal to consider mental dis
    ease or defect to rebut the state’s evidence on the element
    of mens rea violated Petitioner’s right to due process under
    the United States Constitution, Fourteenth Amend
    ment?”), 22 (“Here, the trial court held that under the
    Mott rule it was obliged to find as a fact that [Clark] knew
    he was shooting a police officer to death—a necessary
    factual element of the only form of first degree murder
    charged against [Clark]—while simultaneously refusing to
    consider [Clark’s] evidence that an acute episode of his
    chronic paranoid schizophrenic illness prevented him from
    actually having that knowledge” (emphasis omitted)), 31–
    32 (the Arizona courts erred in holding Clark “could be
    punished as though he had this knowledge and intent
    although he may not in fact have had either”); Reply Brief
    for Petitioner 3 (challenging the trial judge’s refusal “to
    give any consideration to the mental-illness evidence in
    making his factual findings as to whether [Clark] did or
    did not act with the state of mind required for a first-
    degree murder conviction”). An entire section of Clark’s
    opening brief argues that the evidence of mental illness
    should have been considered to rebut the prosecution’s
    inference of knowledge or intent from the factual circum
    stances of the crime. See Brief for Petitioner 13–21. This
    line of argument concerns facts of behavior and amounts
    to more than a claim of general incapacity.
    Clark seeks resolution of issues that can be complex and
    somewhat overlapping. In the end, however, we must
    decide whether he had the right to introduce evidence
    showing he lacked the intent or knowledge the statute
    itself sets forth in describing a basic element of the crime.
    Clark has preserved this issue at all stages, including in
    this Court.
    II
    Clark was charged with first-degree murder for the shoot
    10                   CLARK v. ARIZONA
    KENNEDY, J., dissenting
    ing of Officer Jeffrey Moritz. “A person commits first-
    degree murder if,” as relevant here, “[i]ntending or know
    ing that the person’s conduct will cause death to a law
    enforcement officer, the person causes the death of a law
    enforcement officer who is in the line of duty.” 
    Ariz. Rev. Stat. Ann. §13
    –1105(A)(3) (West Supp. 2005). Clark chal
    lenges the trial court’s refusal to consider any evidence of
    mental illness, from lay or expert testimony, in determining
    whether he acted with the knowledge or intent element of
    the crime. See App. 9; see also Mott, 
    187 Ariz., at 541
    , 
    931 P. 2d, at 1051
    .
    States have substantial latitude under the Constitution
    to define rules for the exclusion of evidence and to apply
    those rules to criminal defendants. See United States v.
    Scheffer, 
    523 U. S. 303
    , 308 (1998). This authority, how
    ever, has constitutional limits. “ ‘Whether rooted directly
    in the Due Process Clause of the Fourteenth Amendment or
    in the Compulsory Process or Confrontation Clauses of the
    Sixth Amendment, the Constitution guarantees criminal
    defendants “a meaningful opportunity to present a com
    plete defense.” ’ ” Holmes v. South Carolina, 547 U. S. ___,
    ___ (2006) (slip op., at 4) (quoting Crane v. Kentucky, 
    476 U. S. 683
    , 690 (1986), in turn quoting California v. Trom
    betta, 
    467 U. S. 479
    , 485 (1984)). “This right is abridged
    by evidence rules that ‘infring[e] upon a weighty interest
    of the accused’ and are ‘ “arbitrary” or “disproportionate to
    the purposes they are designed to serve.” ’ ” Holmes, su
    pra, at ___ (slip op., at 4) (quoting Scheffer, 
    supra, at 308
    ,
    in turn quoting Rock v. Arkansas, 
    483 U. S. 44
    , 58, 56
    (1987)).
    The central theory of Clark’s defense was that his
    schizophrenia made him delusional. He lived in a uni
    verse where the delusions were so dominant, the theory
    was, that he had no intent to shoot a police officer or
    knowledge he was doing so. It is one thing to say he acted
    with intent or knowledge to pull the trigger. It is quite
    Cite as: 548 U. S. ____ (2006)           11
    KENNEDY, J., dissenting
    another to say he pulled the trigger to kill someone he
    knew to be a human being and a police officer. If the trier
    of fact were to find Clark’s evidence sufficient to discount
    the case made by the State, which has the burden to prove
    knowledge or intent as an element of the offense, Clark
    would not be guilty of first-degree murder under Arizona
    law.
    The Court attempts to diminish Clark’s interest by treat
    ing mental-illness evidence as concerning only “judgment,”
    rather than fact. Ante, at 36. This view appears to derive
    from the Court’s characterization of Clark’s claim as rais
    ing only general incapacity. See 
    ibid.
     This is wrong for
    the reasons already discussed. It fails to recognize, more
    over, the meaning of the offense element in question here.
    The mens rea element of intent or knowledge may, at some
    level, comprise certain moral choices, but it rests in the
    first instance on a factual determination. That is the fact
    Clark sought to put in issue. Either Clark knew he was
    killing a police officer or he did not.
    The issue is not, as the Court insists, whether Clark’s
    mental illness acts as an “excuse from customary criminal
    responsibility,” ante, at 30, but whether his mental illness,
    as a factual matter, made him unaware that he was shoot
    ing a police officer. If it did, Clark needs no excuse, as
    then he did not commit the crime as Arizona defines it.
    For the elements of first-degree murder, where the ques
    tion is knowledge of particular facts—that one is killing a
    police officer—the determination depends not on moral
    responsibility but on empirical fact. Clark’s evidence of
    mental illness had a direct and substantial bearing upon
    what he knew, or thought he knew, to be the facts when
    he pulled the trigger; this lay at the heart of the matter.
    The trial court’s exclusion was all the more severe be
    cause it barred from consideration on the issue of mens rea
    all this evidence, from any source, thus preventing Clark
    from showing he did not commit the crime as defined by
    12                   CLARK v. ARIZONA
    KENNEDY, J., dissenting
    Arizona law. Quite apart from due process principles, we
    have held that a bar of this sort can be inconsistent with
    the Confrontation Clause. See Delaware v. Van Arsdall,
    
    475 U. S. 673
     (1986). In Van Arsdall the Court held a state
    court erred in making a ruling that “prohibited all inquiry
    into” an event. 
    Id., at 679
    . At issue was a line of defense
    questioning designed to show the bias of a prosecution
    witness. In the instant case the ruling in question bars from
    consideration all testimony from all witnesses necessary to
    present the argument that was central to the whole case for
    the defense: a challenge to the State’s own proof on an
    element of the crime. The Due Process and Compulsory
    Process Clauses, and not the Confrontation Clause, may be
    the controlling standard; but the disability imposed on the
    accused is every bit as substantial and pervasive here as it
    was in Van Arsdall.
    Arizona’s rule is problematic because it excludes evi
    dence no matter how credible and material it may be in
    disproving an element of the offense. The Court’s cases
    have noted the potential arbitrariness of per se exclusions
    and, on this rationale, have invalidated various state
    prohibitions. See Holmes, supra, at ___ (slip op., at 9)
    (rule excluding, in certain cases, evidence that a third
    party may have committed the crime “even if that evi
    dence, if viewed independently, would have great proba
    tive value and even if it would not pose an undue risk of
    harassment, prejudice, or confusion of the issues”); Rock,
    
    supra, at 56
     (rule excluding all hypnotically refreshed
    testimony “operates to the detriment of any defendant who
    undergoes hypnosis, without regard to the reasons for it,
    the circumstances under which it took place, or any inde
    pendent verification of the information it produced”);
    Washington v. Texas, 
    388 U. S. 14
    , 22 (1967) (rule excluding
    accomplice testimony “prevent[s] whole categories of de
    fense witnesses from testifying on the basis of a priori
    categories that presume them unworthy of belief”).
    Cite as: 548 U. S. ____ (2006)           13
    KENNEDY, J., dissenting
    This is not to suggest all general rules on the exclusion
    of certain types of evidence are invalid. If the rule does
    not substantially burden the defense, then it is likely
    permissible. See Scheffer, 
    523 U. S., at
    316–317 (uphold
    ing exclusion of polygraph evidence in part because this
    rule “does not implicate any significant interest of the
    accused”); 
    id., at 318
     (KENNEDY, J., concurring in part and
    concurring in judgment) (“[S]ome later case might present
    a more compelling case for introduction of the testimony
    than this one does”). Where, however, the burden is sub
    stantial, the State must present a valid reason for its per
    se evidentiary rule.
    In the instant case Arizona’s proposed reasons are insuf
    ficient to support its categorical exclusion. While the
    State contends that testimony regarding mental illness
    may be too incredible or speculative for the jury to con
    sider, this does not explain why the exclusion applies in all
    cases to all evidence of mental illness. “A State’s legiti
    mate interest in barring unreliable evidence does not
    extend to per se exclusions that may be reliable in an
    individual case.” Rock, 
    483 U. S., at 61
    . States have
    certain discretion to bar unreliable or speculative testi
    mony and to adopt rules to ensure the reliability of expert
    testimony. Arizona has done so, and there is no reason to
    believe its rules are insufficient to avoid speculative evi
    dence of mental illness. See Ariz. Rules of Evid. 403, 702
    (West 2005). This is particularly true because Arizona
    applies its usual case-by-case approach to permit admis
    sion of evidence of mental illness for a variety of other
    purposes. See, e.g., State v. Lindsey, 
    149 Ariz. 472
    , 474–
    475, 
    720 P. 2d 73
    , 74–75 (1986) (en banc) (psychological
    characteristics of molestation victims); State v. Hamilton,
    
    177 Ariz. 403
    , 408–410, 
    868 P. 2d 986
    , 991–993 (App.
    1993) (psychological evidence of child abuse accommoda
    tion syndrome); Horan v. Indus. Comm’n, 
    167 Ariz. 322
    ,
    325–326, 
    806 P. 2d 911
    , 914–915 (App. 1991) (psychiatric
    14                    CLARK v. ARIZONA
    KENNEDY, J., dissenting
    testimony regarding neurological deficits).
    The risk of jury confusion also fails to justify the rule.
    The State defends its rule as a means to avoid the com
    plexities of determining how and to what degree a mental
    illness affects a person’s mental state. The difficulty of
    resolving a factual issue, though, does not present a suffi
    cient reason to take evidence away from the jury even
    when it is crucial for the defense. “We have always
    trusted juries to sort through complex facts in various
    areas of law.” United States v. Booker, 
    543 U. S. 220
    , 289
    (2005) (STEVENS, J., dissenting in part). Even were the risk
    of jury confusion real enough to justify excluding evidence in
    most cases, this would provide little basis for prohibiting all
    evidence of mental illness without any inquiry into its likely
    effect on the jury or its role in deciding the linchpin issue of
    knowledge and intent. Indeed, Arizona has a rule in place
    to serve this very purpose. See Ariz. Rule of Evid. 403.
    Even assuming the reliability and jury-confusion justifi
    cations were persuasive in some cases, they would not
    suffice here. It does not overcome the constitutional objec
    tion to say that an evidentiary rule that is reasonable on
    its face can be applied as well to bar significant defense
    evidence without any rational basis for doing so. In Van
    Arsdall, for example, the Court rejected the application of
    Delaware Rule of Evidence 403, which allows relevant
    evidence to be excluded where its probative value is sub
    stantially outweighed by the risk of unfair prejudice or other
    harms to the trial process. 
    475 U. S., at 676
    , and n. 2.
    While the Rule is well established and designed for a legiti
    mate function, the Constitution prevented an application
    that deprived the defendant of all inquiry into an important
    issue. 
    Id., at 679
    . Other cases have applied this same case-
    specific analysis in deciding the legitimacy of an exclusion.
    See, e.g., Rock, 
    supra, at 62
     (the “circumstances present an
    argument for admissibility of petitioner’s testimony in this
    particular case, an argument that must be considered by the
    Cite as: 548 U. S. ____ (2006)           15
    KENNEDY, J., dissenting
    trial court”); Chambers v. Mississippi, 
    410 U. S. 284
    , 302
    (1973) (“In these circumstances, where constitutional rights
    directly affecting the ascertainment of guilt are implicated,
    the hearsay rule may not be applied mechanistically
    to defeat the ends of justice”); cf. Scheffer, 
    523 U. S., at 318
     (KENNEDY, J., concurring in part and concurring in
    judgment).
    The Court undertakes little analysis of the interests
    particular to this case. By proceeding in this way it de
    values Clark’s constitutional rights. The reliability ra
    tionale has minimal applicability here. The Court is
    correct that many mental diseases are difficult to define
    and the subject of great debate. See ante, at 33–34.
    Schizophrenia, however, is a well-documented mental
    illness, and no one seriously disputes either its definition
    or its most prominent clinical manifestations. The State’s
    own expert conceded that Clark had paranoid schizophre
    nia and was actively psychotic at the time of the killing.
    See App. 254–257. The jury-confusion rationale, if it is at
    all applicable here, is the result of the Court’s own insis
    tence on conflating the insanity defense and the question
    of intent. Considered on its own terms, the issue of intent
    and knowledge is a straightforward factual question. A
    trier of fact is quite capable of weighing defense testimony
    and then determining whether the accused did or did not
    intend to kill or knowingly kill a human being who was a
    police officer. True, the issue can be difficult to decide in
    particular instances, but no more so than many matters
    juries must confront.
    The Court says mental-illness evidence “can easily
    mislead,” ante, at 36, and may “tel[l] us little or nothing
    about the ability of the defendant to form mens rea,” ante,
    at 35. These generalities do not, however, show how
    relevant or misleading the evidence in this case would be
    (or explain why Arizona Rule of Evidence 403 is insuffi
    cient for weighing these factors). As explained above, the
    16                   CLARK v. ARIZONA
    KENNEDY, J., dissenting
    evidence of Clark’s mental illness bears directly on mens
    rea, for it suggests Clark may not have known he was
    killing a human being. It is striking that while the Court
    discusses at length the likelihood of misjudgment from
    placing too much emphasis on evidence of mental illness,
    see ante, at 33–38, it ignores the risk of misjudging an
    innocent man guilty from refusing to consider this highly
    relevant evidence at all. Clark’s expert, it is true, said no
    one could know exactly what was on Clark’s mind at the
    time of the shooting. See ante, at 37. The expert testified
    extensively, however, about the effect of Clark’s delusions
    on his perceptions of the world around him, and about
    whether Clark’s behavior around the time of the shooting
    was consistent with delusional thinking. This testimony
    was relevant to determining whether Clark knew he was
    killing a human being. It also bolstered the testimony of
    lay witnesses, none of which was deemed unreliable or
    misleading by the state courts.
    For the same reasons, the Court errs in seeking support
    from the American Psychiatric Association’s statement
    that a psychiatrist may be justifiably reluctant to reach
    legal conclusions regarding the defendant’s mental state.
    See ante, at 37. In this very case, the American Psychiat
    ric Association made clear that psychiatric evidence plays
    a crucial role regardless of whether the psychiatrist testi
    fies on the ultimate issue: “Expert evidence of mental
    disorders, presented by qualified professionals and subject
    to adversarial testing, is both relevant to the mental-state
    issues raised by mens rea requirements and reliable. . . .
    Such evidence could not be condemned wholesale without
    unsettling the legal system’s central reliance on such
    evidence.” Brief for American Psychiatric Association
    et al. as Amici Curiae 15.
    Contrary to the Court’s suggestion, see ante, at 35–36,
    the fact that the state and defense experts drew different
    conclusions about the effect of Clark’s mental illness on
    Cite as: 548 U. S. ____ (2006)           17
    KENNEDY, J., dissenting
    his mental state only made Clark’s evidence contested; it
    did not make the evidence irrelevant or misleading. The
    trial court was capable of evaluating the competing con
    clusions, as factfinders do in countless cases where there
    is a dispute among witnesses. In fact, the potential to
    mislead will be far greater under the Court’s new eviden
    tiary system, where jurors will receive observation evi
    dence without the necessary explanation from experts.
    The fact that mental-illness evidence may be considered
    in deciding criminal responsibility does not compensate for
    its exclusion from consideration on the mens rea elements
    of the crime. Cf. ante, at 33. The evidence addresses
    different issues in the two instances. Criminal responsi
    bility involves an inquiry into whether the defendant
    knew right from wrong, not whether he had the mens rea
    elements of the offense. While there may be overlap be
    tween the two issues, “the existence or nonexistence of
    legal insanity bears no necessary relationship to the exis
    tence or nonexistence of the required mental elements of
    the crime.” Mullaney v. Wilbur, 
    421 U. S. 684
    , 706 (1975)
    (Rehnquist, J., concurring).
    Even if the analyses were equivalent, there is a different
    burden of proof for insanity than there is for mens rea.
    Arizona requires the defendant to prove his insanity by
    clear and convincing evidence. See 
    Ariz. Rev. Stat. Ann. §13
    –502(C) (West 2001). The prosecution, however, must
    prove all elements of the offense beyond a reasonable
    doubt. See Mullaney, 
    supra,
     at 703–704; In re Winship,
    
    397 U. S. 358
    , 364 (1970). The shift in the burden on the
    criminal responsibility issue, while permissible under our
    precedent, see Leland v. Oregon, 
    343 U. S. 790
     (1952),
    cannot be applied to the question of intent or knowledge
    without relieving the State of its responsibility to establish
    this element of the offense. See Sandstrom v. Montana, 
    442 U. S. 510
    , 524 (1979) (jury instruction that had the effect of
    placing the burden on the defendant to disprove that he had
    18                    CLARK v. ARIZONA
    KENNEDY, J., dissenting
    the requisite mental state violates due process). While
    evidentiary rules do not generally shift the burden
    impermissibly, where there is a right to have evidence
    considered on an element of the offense, the right is not
    respected by allowing the evidence to come in only on an
    issue for which the defendant bears the burden of proof.
    See Cool v. United States, 
    409 U. S. 100
    , 103 (1972) (per
    curiam) (jury instruction that allowed jury to consider
    accomplice’s testimony only if it was true beyond a rea
    sonable doubt “places an improper burden on the defense
    and allows the jury to convict despite its failure to find
    guilt beyond a reasonable doubt”); Martin v. Ohio, 
    480 U. S. 228
    , 233–234 (1987) (State can shift the burden on a
    claim of self-defense, but if the jury were disallowed from
    considering self-defense evidence for purposes of deciding
    the elements of the offense, it “would relieve the State of its
    burden and plainly run afoul of Winship’s mandate”). By
    viewing the Arizona rule as creating merely a “presump
    tion of sanity (or capacity or responsibility),” ante, at 30,
    rather than a presumption that the mens rea elements
    were not affected by mental illness, the Court fails to
    appreciate the implications for Winship.
    The State attempts to sidestep the evidentiary issue
    entirely by claiming that its mental-illness exclusion
    simply alters one element of the crime. The evidentiary
    rule at issue here, however, cannot be considered a valid
    redefinition of the offense. Under the State’s logic, a
    person would be guilty of first-degree murder if he know
    ingly or intentionally killed a police officer or committed
    the killing under circumstances that would show knowl
    edge or intent but for the defendant’s mental illness. To
    begin with, Arizona law does not say this. And if it did, it
    would be impermissible. States have substantial discretion
    in defining criminal offenses. In some instances they may
    provide that the accused has the burden of persuasion
    with respect to affirmative defenses. See Patterson v. New
    Cite as: 548 U. S. ____ (2006)          19
    KENNEDY, J., dissenting
    York, 
    432 U. S. 197
    , 210 (1977). “But there are obviously
    constitutional limits beyond which the States may not go
    in this regard.” 
    Ibid.
     If it were otherwise, States could
    label all evidentiary exclusions as redefinitions and so
    evade constitutional requirements. There is no rational
    basis, furthermore, for criminally punishing a person who
    commits a killing without knowledge or intent only if that
    person has a mental illness. Cf. Robinson v. California,
    
    370 U. S. 660
    , 666 (1962). The State attempts to bring the
    instant case within the ambit of Montana v. Egelhoff, 
    518 U. S. 37
     (1996); but in Egelhoff the excluded evidence con
    cerned voluntary intoxication, for which a person can be
    held responsible. Viewed either as an evidentiary rule or a
    redefinition of the offense, it was upheld because it “com
    ports with and implements society’s moral perception that
    one who has voluntarily impaired his own faculties should
    be responsible for the consequences.” 
    Id., at 50
     (plurality
    opinion). An involuntary mental illness does not implicate
    this justification.
    Future dangerousness is not, as the Court appears to
    conclude, see ante, at 38–39, n. 45, a rational basis for
    convicting mentally ill individuals of crimes they did not
    commit. Civil commitment proceedings can ensure that
    individuals who present a danger to themselves or others
    receive proper treatment without unfairly treating them
    as criminals. The State presents no evidence to the con
    trary, and the Court ought not to imply otherwise.
    The State gains little support from Fisher v. United
    States, 
    328 U. S. 463
     (1946). There the defendant re
    quested an instruction from the trial court that the jury
    consider his mental deficiencies in determining his capac
    ity for premeditation and deliberation. 
    Id., at 470
    . The
    Court noted that “[i]n view of the status of the defense of
    partial responsibility in the District and the nation no
    contention is or could be made of the denial of due proc
    ess.” 
    Id., at 466
    . This dictum may be attributable to the
    20                    CLARK v. ARIZONA
    KENNEDY, J., dissenting
    fact that the cases recognizing a defendant’s evidentiary
    rights and the prosecution’s duty to prove all elements
    beyond a reasonable doubt were still decades away. It
    may also reflect the fact that the jury instructions as given
    did seem to allow the jury to consider evidence of mental
    deficiency if it disproved the elements of the offense. See
    
    id., at 467, n. 3
     (The jury instructions stated, “ ‘It is further
    contended that even if sane and responsible, there was no
    deliberate intent to kill, nor in fact any actual intent to
    kill. Therefore if not guilty by reason of insanity, the
    defendant at most is guilty only of second degree murder
    or manslaughter’ ”). Even further ambiguity comes from
    the fact that the defense in Fisher concerned a claim that
    the petitioner was “mentally somewhat below the average”
    with a “psychopathic personality” of aggression. 
    Id., at 467
    . This general claim of mental deficiencies was rele
    vant to the “theory of partial responsibility,” 
    id., at 470
    , he
    wanted the jury to consider. Unlike the mental illness
    here, though, which concerns inadequacy of perception
    and information processing, the petitioner’s claim may not
    have been relevant to mens rea unless mens rea were
    redefined to include an element of responsibility. Fisher’s
    language, then, does not control this case.
    While Arizona’s rule is not unique, either historically or
    in contemporary practice, this fact does not dispose of
    Clark’s constitutional argument. To the extent Fisher
    may have suggested the contrary, subsequent cases make
    clear that while the existence of the rule in some jurisdic
    tions is a significant factor to consider, see Egelhoff, 
    supra, at 43
     (plurality opinion), it is not dispositive for evaluation
    of a claim that the accused was foreclosed from introduc
    ing evidence crucial to the defense. The evidentiary exclu
    sion of accomplice testimony the Court invalidated in
    Washington was, in fact, well established. See 
    388 U. S., at
    21–22. The exclusion of hypnotically refreshed testi
    mony likewise had some support when the Court held it
    Cite as: 548 U. S. ____ (2006)           21
    KENNEDY, J., dissenting
    unconstitutional as applied to a defendant’s own testi
    mony. Rock, 
    483 U. S., at 57
    . While 13 States still impose
    significant restrictions on the use of mental-illness evi
    dence to negate mens rea, a substantial majority of the
    States currently allow it. Brief for United States as
    Amicus Curiae 22–23, and n. 13. The fact that a reason
    able number of States restrict this evidence weighs into
    the analysis, but applying the rule as a per se bar, as
    Arizona does, is so plainly unreasonable that it cannot be
    sustained.
    Putting aside the lack of any legitimate state interest
    for application of the rule in this case, its irrationality is
    apparent when considering the evidence that is allowed.
    See Washington, 
    supra, at 22
     (“The absurdity of the rule is
    amply demonstrated by the exceptions that have been
    made to it”). Arizona permits the defendant to introduce,
    for example, evidence of “behavioral tendencies” to show
    he did not have the required mental state. See Mott, 
    187 Ariz., at 544
    , 
    931 P. 2d, at 1054
    ; Christensen, 
    129 Ariz., at
    35–36, 
    628 P. 2d, at
    583–584. While defining mental
    illness is a difficult matter, the State seems to exclude the
    evidence one would think most reliable by allowing unex
    plained and uncategorized tendencies to be introduced
    while excluding relatively well-understood psychiatric
    testimony regarding well-documented mental illnesses. It
    is unclear, moreover, what would have happened in this
    case had the defendant wanted to testify that he thought
    Officer Moritz was an alien. If disallowed, it would be
    tantamount to barring Clark from testifying on his behalf
    to explain his own actions. If allowed, then Arizona’s rule
    would simply prohibit the corroboration necessary to make
    sense of Clark’s explanation. In sum, the rule forces the
    jury to decide guilt in a fictional world with undefined and
    unexplained behaviors but without mental illness. This
    rule has no rational justification and imposes a significant
    burden upon a straightforward defense: He did not commit
    22                  CLARK v. ARIZONA
    KENNEDY, J., dissenting
    the crime with which he was charged.
    These are the reasons for my respectful dissent.
    

Document Info

Docket Number: 05-5966

Judges: Souter, Breyer

Filed Date: 6/29/2006

Precedential Status: Precedential

Modified Date: 3/2/2024

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