The judge's view of competency evaluations.

In his textbook on management Drucker makes the point that it is one of the primary responsibilities of a manager to ascertain what the customers want; it is not always easy, however, for him to be sure what the customer wants, because he usually has more than 'one customer, each with varying needs. In an analogous way, it is a well-established principle of consultationliaison psychiatry that the consultant needs to know the particular attitudes, needs, and expectations of his consultees (including having an awareness of unstated questions and conflicts), rather than to view his function as merely that of examining and reporting on a patient in isolation from the hospital milieu. The liaison psychiatrist has the advantage of working in a relatively stable environment with a limited number of consultees, whom he can have some chance of getting to know well over an extended period of time. The forensic psychiatrist, however, especially in the setting of a large urban court clinic, faces a more formidable problem. Even if the psychiatrist envisions his role as that of a consultant to the court (offering advice on relatively limited issues, such as competency to stand trial), he must nevertheless attempt to be responsive to a large number of judges, with varying legal philosophies and knowledgeability about psychiatry, none of whom he is likely to know well. Thus, he is left with a considerable area of ambiguity in addressing the question as to what the judge really wants to know in ordering a competency evaluation on a particular defendant. It does not, of course, resolve the issue simply to note that the Supreme Court gave its answer to this question in the Dusky decision. There the court spelled out in relatively specific terms the requirement that a competent defendant should have, "the ability to consult with his lawyer with a reasonable degree of rational understanding," which included his having "a rational as well as factual understanding of the proceedings against him."3 Having this criteria for deciding the issue does not prevent the trial court judge. who is under pressure to decide and dispose of difficult and puzzling cases, from using the competency examination to develop information about other issues or even to circumvent the ultimate issues of guilt or punishment.