D was married and had three children. At one point, D told her husband she felt depressed and overwhelmed, and he suggested that she talk to her mother and a friend. A fourth child was born. D suffered severe depression and tried to commit suicide by taking an overdose of an antidepressant that had been prescribed for her father. She was admitted to the psychiatric unit of Methodist Hospital. After her release six days later, she began seeing a psychiatrist, Dr. Eileen Starbranch, as an outpatient. On July 20, 1999, D was found in the bathroom, holding a knife to her neck. Dr. Starbranch recommended that appellant be admitted to Spring Shadows Glen Hospital. D was admitted, against her wishes, the next day. At Spring Shadows Glen, D told a psychologist, Dr. James Thompson, that she had had visions and had heard voices since the birth of her first child. Dr. Starbranch ranked D, at the time of her admission to Spring Shadows Glen, among the five sickest patients she had ever seen. Before discharging appellant from the hospital, Dr. Starbranch told D and her husband that D had a high risk of another psychotic episode if she had another baby. D saw Dr. Starbranch for the last time on January 12, 2000. She told Dr. Starbranch that she had stopped taking her medication in November 1999. In November 2000, D's fifth child was born. In March 2001, D's father died. D was admitted to Devereux Hospital in League City on March 31, 2001. D was placed on a suicide watch. D began an outpatient program. Dr. Saeed recommended that someone stay with her at all times and that she not be left alone with her children. D's mother went to appellant's home every day. She observed that D was almost catatonic, did not respond to conversation or made a delayed response, stared into space, trembled, scratched her head until she created bald spots, and did not eat. D was re-admitted and was discharged, seeming to be better. D was re-admitted and was discharged, seeming to be better. D was able to take care of her children but was still uncommunicative and withdrawn. She smiled infrequently and seemed to have no emotions, but the husband did not think it was unsafe to leave her alone with the children. Dr. Saeed decided to taper her off of Haldol. D denied having any suicidal or psychotic thoughts. D was no longer taking Haldol, and Dr. Saeed adjusted the dosages of her other anti-depressant medications. On June 20, 2001, Police discovered four dead children, soaking wet and covered with a sheet, lying on D's bed. The fifth child, Noah, was still in the bathtub, floating face down. D was quiet and cooperative with the police officers.
This part is not in the casebook.
At trial, ten psychiatrists and two psychologists testified regarding D's mental illness. Four psychiatrists and a psychologist testified that D did not know right from wrong, was incapable of knowing what she did was wrong, or believed that her acts were right. The State's sole mental-health expert in the case, testified that D, although psychotic on June 20, knew that what she did was wrong. Dr. Dietz reasoned that because D indicated that her thoughts were coming from Satan, she must have known they were wrong; that if she believed she was saving the children, she would have shared her plan with others rather than hide it as she did; that if she really believed that Satan was going to harm the children, she would have called the police or a pastor or would have sent the children away; and that she covered the bodies out of guilt or shame. Also, the Dr indicated that D was acting on a TV episode. D was found guilty. Following the verdict and before the punishment phase of the trial, D learned that the State's expert witness, Dr. Dietz, had presented false testimony. It is uncontested that the testimony of Dr. Dietz regarding his consultation on a 'Law & Order' television show having a plot remarkably similar to the acts committed by D was untrue and that there was no 'Law & Order' television show with such a plot.