A Philadelphia woman accused of a brutal knife attack that killed two women visiting Atlantic City in May was likely in a schizophrenic episode at the time, her family has said.

But whether Antoinette Pelzer could be found not guilty by reason of insanity depends on whether she meets the criteria of the defense under New Jersey law.

“There are a lot of people who commit crimes who are mentally ill but are not legally insane,” explained Dr. Robert Sadoff, a clinical professor of forensic psychiatry who has testified in about 100 such cases across the country.

Pelzer, 44, was indicted Tuesday on two counts of murder along with other crimes in the May 21 killing of Alice Mei See Leung, 47, and her mother, Po Lin Wan, 80, both of Scarborough, Ontario. The Canadian women were visiting Atlantic City when Pelzer allegedly approached Leung and began stabbing her as she walked along Pacific Avenue, about a half-block from AtlantiCare Regional Medical Center’s City Campus. Wan was attacked when she tried to help her daughter.

Officer Jacob Abbruscato came upon the scene and was able to disarm the attacker within 13 seconds, then-Atlantic County Prosecutor Ted Housel said shortly after the arrest.

Although no official announcement has been made of what defense will be used, indications are that psychological tests will be conducted on Pelzer.

Holly Bitters, Pelzer’s public defender, could not be reached for comment.

The question is not as simple as whether Pelzer knew right from wrong, explained Sadoff, who is director of the University of Pennsylvania’s Forensic Psychiatry Fellowship. Instead, it must be proved that at the time of the crime, the defendant did not know what he or she was doing was wrong.

First, the defense will have experts test the defendant to determine whether he or she meets the criteria set up under the M’Naghten Rule, named for Daniel M’Naghten, who was acquitted of the attempted assassination of England’s prime minister in 1843, when he was deemed insane. M’Naghten accidentally shot the prime minister’s secretary.

“In some cases, the defendant has had prior psychiatric history,” said defense attorney Jeffrey Zucker, who is not involved in the Pelzer case. “You also can find out when you interview the client, family, witnesses and anyone else whether there is the possibility of an insanity defense. Each case presents its own merits.”

If the defense’s experts agree that the criteria are met, those reports go to the prosecution, which then gets its own experts. The tests are videotaped so that the defense’s experts can watch them.

In some cases, both sides reach the same conclusion. That’s what happened last year when Zucker represented Anthony Milano.

Milano was charged with fatally stabbing Catherine McGowan, 89, his neighbor in the Village at Linwood, on Oct. 8, 2009. After experts on both sides agreed that Milano was legally insane, a hearing was held before Superior Court Judge Max Baker on Feb. 2, 2011. The evidence convinced Baker that Milano was not guilty by reason of insanity.

Milano still was given a sentence. But instead of serving his life term plus 45 years in prison, he will spend what will likely amount to the rest of his life in a psychiatric facility. Which one will depend on twice-yearly hearings, when the doctors overseeing Milano testify about his progress.

Milano is currently being held at the Ann Klein Forensic Center in West Trenton, where those in the legal system are kept. But at his next hearing, set for January, it’s expected that a recommendation could be made to move him to a less-restrictive hospital, Zucker said.

While that case saw agreement from the experts on both sides, the cases often go to court. Sadoff has testified in about 100 in his nearly 50-year psychiatric career, he estimated. He said the split has been about 60 percent for the defense and 40 percent for the prosecution.

“It’s more difficult when experts disagree,” Zucker said. “Then there’s a jury trial and it becomes a battle of the experts.”

Sadoff has seen cases go both ways.

“If you’re on the defense side ... the burden is on us to show (the defendant) was so mentally ill it affected his ability to know what he was doing was wrong,” he said. “The jury usually comes out with a guilty finding. I think juries are skeptical (to reach not guilty) when somebody commits a major crime to let them out.”

Sadoff said they try to explain that the person will not be put into society, but will go to a facility instead of jail if found not guilty.

In 13 states — not including New Jersey — there is a verdict option of guilty but mentally ill, in which the person would first go to a facility and then, when deemed fit, would be transferred to prison.

“It’s kind of a compromise,” Sadoff said. “The person will go to jail ultimately, but it’s also humane, because they will get treatment for their mental illness.”

This week, the U.S. Supreme Court refused to hear an appeal by an Idaho man who pleaded guilty to two murders after he was denied the insanity defense. Idaho is one of four states where the insanity defense was abolished. The case could have determined whether the defense should be a right.

Writing on behalf of the three dissenting justices, Justice Ruth Bader Ginsburg wrote that “the law has long recognized that criminal punishment is not appropriate for those who, by reason of insanity, cannot tell right from wrong.”

“Now this has to be discussed in academic circles,” Sadoff said.

“I’ve had several of these in different counties,” defense attorney Zucker said. “They’re tough things. It’s a tragedy for everybody.”

Contact Lynda Cohen:


Follow @LyndaCohen on Twitter