Intended for healthcare professionals

Head To Head Maudsley Debate

Do cases like that of Anders Breivik show that fanaticism is a form of madness? Yes

BMJ 2012; 345 doi: (Published 11 July 2012) Cite this as: BMJ 2012;345:e4612
  1. Max Taylor, professor of international relations1
  1. 1University of St Andrews, St Andrews, Fife KY16 9AX, UK
  1. Correspondence to: mt40{at}

The trial of Anders Breivik, who murdered 77 people in two attacks in Norway, has attracted considerable controversy because of the questions concerning his mental state. Max Taylor argues that such extreme fanatics should be considered insane, but Tom Fahy (doi:10.1136/bmj.e4647) believes that a psychiatric diagnosis is an abrogation of personal and societal responsibility

In psychiatric terms, cases like Anders Breivik’s present diagnostic difficulties. Psychiatry is not like the rest of medicine in that physical investigations such as a blood test or brain scan are rarely diagnostic. Instead, the psychiatrist has to rely on the cooperation of clients. This is especially difficult in court cases of “lone wolf” killers such as Breivik because the psychiatrist’s assessment can have a massive consequence on the outcomes of the trial.

Psychiatric definition

The fanaticism shown by Breivik is of such a degree that no extremist groups endorse his position; and this is exactly what happens in psychosis. Delusional people tend not to be able to gather supporters for their ideas because their …

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