How Jared Lee Loughner's mental illness manifested itself and how he was judged to have recovered from it enough to understand the case against him are both classics in the treatment of schizophrenia and psychosis, says a Tucson psychiatrist.

At the same time, the legal handling of the case is a classic example of how insanity defenses are constructed in court, says a Tucson criminal defense lawyer.

Charles Raison, a professor of psychiatry in the University of Arizona College of Medicine, and lawyer Sean Chapman discuss the issues in a joint appearance on Arizona Illustrated.

"Legal insanity really is the idea that you do not have the ability to comprehend what you've done or understand the consequences of what you've done in a way that the rest of us would agree with or understand," Raison says.

"So most people who commit a crime for reasons that eventually succeed with an insanity defense, it's very clear that their motives for doing it make no sense to us, that there's nobody else in the world that would agree with them for why they should do it."

Chapman says the insanity defense seemed appropriate in the Loughner case, had it gone to trial, despite public doubts about such a defense.

"I think it really is the defense of last resort because the public is extremely skeptical about it," Chapman says. "But in some cases like this case, where I think probably both the government and the defense agreed that this gentleman was really seriously mentally ill, it is used and it is appropriately used."

Raison says people with schizophrenia often can be made better with medications that control the "positive symptoms" of the disease, those that often manifest themselves in violence.

Chapman says the worry for the prosecution in the Loughner case is first for what the victims think and second the possibility that there could be a verdict of not guilty by reason of insanity. In such an event, he would remain under treatment until judged competent, at which time he could be released.

"I'm certain that the U.S. attorney's office would not have offered this plea unless they had consulted and received agreement from the victims and the victims' families in this case," Chapman says.

He says it's unknown if Pima County Attorney Barbara LaWall will pursue a case against Loughner on state charges or if there is an agreement that she won't because of his plea deal in federal court.