Her psychiatric history — institutionalization in 1916 following the munitions factory incident, commitment to Dalldorf Asylum in 1920, a later institutionalization in the United States — has sometimes been cited as relevant to the question of whether she was capable of sustained deliberate deception or whether she was in some way genuinely confused about her own identity. Mental health history does not establish dishonesty, and it does not establish genuine belief. People with psychiatric histories are capable of deliberate deception; people without them are capable of holding false beliefs about their own identities.
The DNA results describe what her biology was. They do not describe her inner experience. They exclude the Anastasia claim and support the Schanzkowska identification. They do not reveal whether she woke each morning certain she was the Tsar’s daughter or whether she knew from the beginning exactly who she was.
What is established in the record: she maintained the claim from sometime around 1922 until her death in 1984 — more than six decades. She maintained it in the face of rejection by close Romanov relatives. She maintained it through decades of legal proceedings in which the evidence against the claim accumulated. She maintained it in Charlottesville, with a husband who supported the claim as fully as she did.
The claim shaped her entire adult life. Whether it was genuine belief, performance, or something in between, it was the organizing principle of her existence from early adulthood to death.
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## The Tissue Sample and the Ethics of Retrospective Testing
The testing of biological material retained from a living person’s medical treatment — without that person’s knowledge or consent, conducted after their death — raises questions that are worth acknowledging even if the legal framework at the time did not require consent.