Psychiatric evaluation of non-responsibility and diminished responsibility in criminal law: A scoping review

BACKGROUND: The assessment of discernment is central to the evaluation of criminal responsibility in forensic psychiatry. However, its conceptual ambiguity and methodological variability raise concerns regarding the reliability and consistency of expert assessments. OBJECTIVE: This scoping review aims to map how discernment is defined, assessed, and interpreted in the literature, and to identify the main conceptual, methodological, and contextual challenges associated with its evaluation. METHODS: A scoping review was conducted in accordance with the PRISMA extension for scoping reviews (PRISMA-ScR; Tricco et al., 2018). A total of 41 records were identified through database searches and additional sources; after removal of duplicates, 29 records were screened by title and abstract, and 26 reports were assessed for full-text eligibility. Seventeen studies were included in the qualitative synthesis. Data were extracted using a structured framework covering conceptual definitions, methodological approaches, reliability, contextual factors, and normative implications. RESULTS: The findings reveal that discernment is conceptualized as a multidimensional and heterogeneous construct, lacking a consensual definition. Assessment practices rely predominantly on unstructured clinical judgment, leading to methodological variability. Inter-expert disagreement emerges as a recurrent finding, particularly in cases involving partial impairment. Structured tools may improve consistency but do not fully address underlying conceptual ambiguity. Legal and institutional contexts significantly influence both evaluation practices and their outcomes. CONCLUSIONS: The assessment of discernment appears as a structured yet inherently interpretative process shaped by the interaction between conceptual, methodological, and contextual factors. Improving forensic psychiatric practice requires not only methodological standardization but also greater conceptual clarity and transparency in expert reasoning.