The concept of unfitness to plead

The concept of unfitness to plead is central to conduct of a fair trial for someone accused of a crime. The historical origins go back several centuries, developing through a number of legislative changes. The modern concept of unfitness to plead arose from a number of legal cases in the 19th century. The Criminal Procedure (Insanity and Unfitness to Plead) Act 1991 followed a number of concerns over existing legislation. More recently, there have been a number of amendments made through the Domestic Violence, Crime and Victims Act 2004. This paper reviews the history and changes in legislation to the present day, and provides an example of the practical application of fitness to plead in practice. It also reviews relevant research and attempts to consider the future of this important medico‐legal term.