Insanity

Question 1

What is everyone presumed to be?

Answer 1

Sane
Have free will - choose course of action
Defence tries to distinguish between the responsible + those lacking responsibility

Question 2

What is the defence also known as?

Answer 2

Insane automatism

Question 3

What type of definition is insanity?

Answer 3

Takes a legal definition - little to do with a medical one

Question 4

What type of defence is insanity?

Name a case that illustrates this point

Answer 4

General defence
Used for any crime, including summary
- R v Horseferry Road Magistrates; Court ex parte K (1996)

Can be a complete defence, so long as required MR wasn’t formed

Question 5

What verdict does a successful plea of insanity lead to?

Answer 5

Jury return a special verdict of NG by reason of insanity
Judge makes an order (apart form murder, compulsory detention in mental hospital, release on authority of Home Secretary)
Cts still have power over you
NOT the same as an acquittal

Question 6

Before the Criminal Procedure (Insanity and Unfitness to plead) Act 1991 what did a successful plea result in?

Answer 6

Compulsory detention in a mental hospital

VERY LIMITED + RESTRICTIVE

Question 7

What has the Criminal Procedure (Insanity and Unfitness to pleas) Act 1991 been amended + replaced by?

Answer 7

Domestic Violence Crime + Victims Act 2004

Question 8

What does the Domestic Violence Crime + Victims Act 2004, give judges the power to make, if there is a successful plea of insanity?

Answer 8

For offences other than murder a judge may make:
- Hospital Order (with/ without restrictions)
- Supervison Order
- Absolute discharge
Also introduced limit on judge’s discretion - can’t make hospital/ restriction order wither medical evidence (also applies to murder cases)
This change is seen as being in line with the HRA 1998

Question 9

If a D pleads insanity, who had the burden of proof?

Answer 9

D must prove insanity on a balance of probabilities

Prosecution can call evidence to try + prove D = insane where they HAVEN’T pleaded insanity

Question 10

Under the 2004 Act, when is a judge allowed to make a hospital/ restriction order?

Answer 10

If they have evidence to support the need for the order
For safety of D + public
Seen to be in line with the HRA 1998

Question 11

If a D raises the defence of automatism, what issue can a judge rise?

Answer 11

Issue of insanity

Question 12

What is automatism?

Answer 12

Separate defence BUT relevant to insanity
Very little legal meaning, describes sense of unconsciousness
Successful plea results in acquittal

Question 13

What case laid down the rules of insanity?

Describe the case

Answer 13

M’Naghten (1843) HL - common law
D had obsession with PM + attempted to murder him
Killed secretary by mistake
Ct acquitted him on grounds of insanity
Due to public + media outcry, HL was asked to clarify legal rules on insanity as a defence
3 principles that must be proved to claim insanity

Question 14

What are the 3 principles that must be proven to claim insanity from the M’Naghten rules?

Answer 14

Must be established that at time of the offence, D was suffering from:

1. Defect of reason
2. Caused by disease of the mind
3. So either D didn’t know what he was doing/ didn’t know it was wrong

Question 15

What does a ‘defect of reason’ mean?

Name a case to illustrate this

Answer 15

Complete loss of reasoning power
Mere forgetfulness/ absent mindedness/ failing to use reasoning powers = insufficient

R v Clarke (1972) CA - stealing from supermarket

Question 16

Describe the case of R v Clarke (1972) CA

Answer 16

D charged with stealing form supermarket
D argued she had no intention of stealing
Had been acting absentmindedly; suffering from diabetes + depression
Judge ruled insanity = appropriate defence
D pleaded G to avoid insanity finding
On appeal, theft conviction = quashed
Not deprived of reasoning powers, just failed to use them
BUT D didn’t have MR for theft

Question 17

What is a ‘disease of the mind’?

Answer 17

Legal term NOT medical term
ID of psychiatric illness isn’t enough
Covers states of minds the doctors wouldn’t necessarily say are diseased of the mind
Legal terms: malfunctioning of the mind
Not confined to disease of brain alone, any malfunctioning of mind caused by something within body will do
Shown in R v Kemp (1957)

Question 18

Describe the case of R v Kemp (1957)

Answer 18

D suffered from arteriosclerosis (hardening arteries)
Caused problems with blood supply to brain, temporary blackouts
Attacked wife with hammer causing serious injury during one of these
Charged s20 GBH
Found NG by reason of insanity
Appeal: Ct upheld the finding; law = concerned with the mind, not the brain
= no distinction between a disease of the mind + a disease of the body affecting the mind

Question 19

How did Lord Denning describe the defence of automatism in the case of Bratty v Attorney General for N. Ireland (1963)?

Answer 19

‘An act which is done by the muscles without any control of the mind such as a spasm or a reflex action, or an act done b someone who isn’t conscious of what he is doing’

Question 20

What did Lord Devlin say about a disease of the mind?

Answer 20

‘Condition of the brain = IRRELEVANT + so the Q is whether the condition =curable/ incurable, transistor or permanent’

Question 21

Describe the case of R v Coley (2013)

What was held in this case?

Answer 21

D = regular cannabis user
Whilst on cannabis, went to neighbour’s house
Stabbed her partner causing serious injuries
D claimed he’d suffered ‘psychotic episode’
Ct: when assessing whether there was a disease of the mind, intoxicants taken voluntarily cannot cause such an event
PROMTES PUBLIC POLICY

Question 22

What are the 2 min judicial theories that have been developed?

Answer 22

1. Continuing danger theory

2. Internal/ external factor theory

Question 23

What is the continuing danger theory?

What case did it originate from?

Answer 23

Is the D still a danger to S?
Seems to be dictated by public policy
Originated from Bratty v A.G for N. Ireland (1963) HL

Later confirmed by the case of R v Sullivan (1984) HL

Question 24

Describe the case of Bratty v Attorney General for Northern Ireland (1963) HL

Answer 24

D strangled a girl with her stocking
Claimed it happened during epileptic seizure
Trial judge: this was an insanity plea
HL upheld this finding
Lord Denning: ‘any mental disorder which has manifested itself in violence + is prone to recur = disease of the mind’

Question 25

What did Lord Denning say in the case of Bratty v A.G for N. Ireland (1963) HL ?

Answer 25

'Any mental disorder which has manifested itself in violence + is prone to recur is a disease of the mind'

Question 26

Describe the case of R v Sullivan (1984) HL

Answer 26

D kicked + injured friend during epileptic fit Charged with GBH Medical evidence: D not aware of actions during fit D pleaded automatism Trial judge: insanity = appropriate defence D pleaded G + against judge's direction CA agreed with trial judge, conviction upheld Epilepsy = disease of the mind; during seizure mental faculties could be impaired = irrelevant if defect = temporary/ permanent

Question 27

What case can we use from Canada as persuasive precedent of 'an out of body' experience?

Answer 27

Rabey (1977) | The stress of day to day life causing someone to act criminally will not be allowed as an external cause

Question 28

What 2 cases illustrate the internal/ external theory?

Answer 28

R v Quick (1973) - external | R v Hennessy (1989) - internal

Question 29

Describe the case of R v Quick (1973)

Answer 29

D had HYPOGLYCAEMIC attack brought on after not eating enough after taking insulin Attacked patient at hospital where D = nurse Caused GBH Claimed he couldn't remember anything Trial judge: = plea of insanity NOT automatism D pleaded G + appealed CA: quashed his conviction; cause of his state wasn't diabetes but the insulin + incorrect use Therefore EXTERNAL factor, jury should've been allowed to consider automatism

Question 30

What distinction did the CA make in the case of r v Quick (1973)?

Answer 30

Distinction between conditions caused by an outside source (blow to head, wrongful use of medication) + internal sources Decided, if malfunctioning is caused by... INTERNAL source, correct defence = INSANITY EXTERNAL source, correct defence = AUTOMATISM Confirmed in Sullivan (1984)

Question 31

Describe the case of R v Hennessy (1989)

Answer 31

D = diabetic Charged with taking a vehicle + driving whilst disqualified At time, D hadn't taken insulin for 3 days due to stress, depression + suffering from HYPERGLYCAEMIA Judge ruled insanity = correct defence D pleaded G + appealed Appeal = rejected; cause of D's automatic state = diabetes (internal cause) CA: trial judge = correct to rule that this was insanity

Question 32

What case should you compare the R v Quick (1972)?

Answer 32

R v Hennessy (1989) Cases made distinction between internal vs external sources HYPOglycaemic vs. HYPERglycaemic

Question 33

What is the correct defence if the D was sleepwalking at the time of the offence? Name the case that illustrates this point

Answer 33

Internal/ external theory = applied strictly where D claims to have been sleepwalking Correct defence = insanity R v Burgess (1991)

Question 34

Describe the case of R v Burgess (1991)

Answer 34

Sleepwalking case D hit female friend with bottle + video recorder after falling asleep watching the film Also grasped her round the throat Charged with unlawful wounding Pleaded automatism Judge: appropriate defence = insanity Jury returned a special verdict CA dismissed the appeal against judge's ruling Held sleepwalking = caused by internal factor, therefore 'disease of the mind' - defence = insanity

Question 35

Once a suitable disease of the mind has been proved, what must the defence ALSO prove the D lacked at the time of the offence? Name the 3 cases that show these points

Answer 35

Knowledge as to 'nature + quality of the act OR if he did that he didn't know what he was doing was wrong' Nature/ quality: Codere (1916) It was wrong: R v Windle (1952) or R v Johnson (2007)

Question 36

What was held in the case of Codere (1961)?

Answer 36

(D cut wife's throat thinking it was a lot of bread) | The nature + the quality of the act was held to mean the physical rather than the moral nature of the act

Question 37

Describe the case of R v Windle (1952)

Answer 37

D killed suicidal wife with overdose of 100 aspirins When arrested said 'I suppose they will hang me for this' Despite medical evidence D = suffering from mental illness, he KNEW that poisoning his wife was legally wrong Ct upheld his murder conviction + rejected plea of insanity

Question 38

The ruling in R v Windle (1952) was confined by the CA in what case? Describe the case

Answer 38

R v Johnson (2007) D = schizophrenic, stabbed his neighbour Medical evidence showed he knew what he had done was legally wrong CA held insanity defence = unavailable to him EVALUATION: CA thought the decision in Windle = strict but felt that they were unable to depart from it, any changes should be made by P

Question 39

What is outdated about the defence of insanity?

Answer 39

THE DEFINITION Stems from M'Naghten case in 1843 Takes little account of medical + psychiatric progress since 1843 Law is out of step with modern medicine 1953 Royal Commission on Capital Punishment reported dotters thought M'Naghten rules = 'obsolete + misleading'

Question 40

What is a problem with the way that insanity is defined?

Answer 40

Takes LEGAL definition not medical Victorians associated insanity with failure of reasoning powers BUT medical sickens now recognises that the mind includes emotions + personality Current definition = meaningless to psychiatrists

Question 41

What is a problem with the 'all or nothing' approach that the defence of insanity seems to have?

Answer 41

= no verdict of partially insane D = either sane or insane This is harsh + could be potentially unjust

Question 42

What is the problem with psychiatrists + the jury identifying if a D was insane at the time of the offence?

Answer 42

Lack reliable means of doing so Medical experts may disagree amongst themselves about a diagnosis + could distort the medical evidence is sympathetic to a D BUT its the jury, not doctors, that decide if D = insane May ignore medical evidence when deciding if D = legally insane when offence = committed

Question 43

What issues arise with the stereotype attached to the defence?

Answer 43

People who use the defence for reasons such as sleepwalking (burgess) or epilepsy (Bratty and Sullivan) are not actually insane BUT there = a stigma attached Defence has been criticise for encouraging a 'dangerous + outdated' approach to epileptics

Question 44

How can the internal/ external factor theory be considered harsh?

Answer 44

Because it seems absurd to apply the M'Naghten rules to diabetics Diabetes that causes hyperglycaemia (Quick) can raise automatism BUT diabetes that causes hypoglycaemia (Hennessy) can only plead insanity = SAME METABOLIC DISORDER!

Question 45

What comments did the Law Commission make on the Ct's ruling in the case of R v Burgess (1991)? What have Canadian Ct done about this issue?

Answer 45

Sleepwalking case - creates problems for a D who pleads NG on basis that they = asleep at time of the offence Supreme Ct of Canada agreed with trial judge in the case of Parks (1992) that defence of automatism could be considered for charges of (attempted) murder Said internal/ external theory was 'only mean to be used as an analytical tool + not as an all-encompassing cause theroy'

Question 46

What case shows English Cts taking a more generous approach to cases of sleepwalking, after the case of R v Burgess (1991)?

Answer 46

R v Thomas (2009) D had longstanding sleep disorder During nightmare, thought he was attacking an intruder in his camper van D = actually strangling wife of 40 years Prosecution had been seeking an insanity verdict, until heard about his condition Prosecution offered no evidence - case = dismissed

Question 47

What does the ruling in the case of R v Kemp (1957) show us about the defence of insanity?

Answer 47

= irrelevant whether disease which affects the functioning of the mind = physical/ mental in origin Definition seems to be based mainly on maximum public safety + policy rather than legal principles/ definitions used by medical professionals

Question 48

What act replaced the Criminal Procedure (Insanity + Unfitness to Plead) Act 1991? What did it remove? Why is this seen as better?

Answer 48

Domestic Violence, Crime and Victims Act 2004 States there MUST be medical evidence which justifies detention in a hospital, even in murder cases Seen to fit better with the HRA 1998 + addresses previous criticisms

Question 49

What did the British Medical Association recommend to the Royal Commission on Capital Punishment 1953?

Answer 49

The M'Naghten Rules should be abolished or at least amended to be in line with current medical knowledge

Question 50

What did the 1975 Butler Committee recommend replacing the insanity verdict with?

Answer 50

'NG on evidence of medical disorder' | Would remove the sigma of being labelled insane

Question 51

What did the Law Commission in 2013 suggest in their 'Criminal Liability' discussion paper?

Answer 51

Current defence should be abolished + replaced with a special verdict of 'not criminally responsible by reason of recognised medical condition' Defence = available where: 1. D suffered from recognised medical condition + 2. At time of offence D lacked criminal capacity i.e completely lacking the capacity to rationally form a judgement about the relevant conduct/ circumstances OR understand the wrongfulness of the relevant conduct OR control their physical act in relation to the charge

Question 52

What was proposed by the 1989 Law Commission's Draft Criminal Code?

Answer 52

Proposed a mental disorder verdict based on medical evidence

Question 53

What are 4 proposed reforms to the current defence of insanity?

Answer 53

1. Abolish/ amend M'Naghten Rules, in line with current medical knowledge (British Medical Association) 2. 'NG on evidence of a medical disorder' verdict IOT avid stigma (Butler Committee 1975) 3. Mental disorder verdict based on medical evidence (1989 Law Commission Criminal Code draft) 4. Abolish/ replace whole defence with special verdict 'not criminally responsible be reasons recognised medical condition' - where D suffered from recognised medical condition + lacked mental capacity at time of the offence (Law Commission 2013, Criminal Liability paper)