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Clinical Director of CMH entitled to raise concerns about discharge of patient
M.C. v. Clinical Director - Central Mental Hospital  IEHC 341 (High Court, Eagar J, 20 June 2016)
An accused was found guilty but insane, but was subsequently reclassified as a person ‘not guilty by reason of insanity’ under the Criminal Law (Insanity) Act 2006. Following periodic reviews, the Review Board recommended that she be discharged subject to detailed conditions, which included the location of residence and an obligation that she inform her treating team of certain harmful behaviours. Subsequently, it was recommended that the conditions be varied. The Clinical Director of the Central Mental Hospital refused to make the necessary arrangements to implement the variation in the order, having raised concerns about her domestic arrangements. The patient sought judicial review of this decision. This was refused on the grounds that the Review Board had a duty to respond to the concerns of the Clinical Director: ‘In the absence of detailed responses to these issues, the acknowledgement that the Clinical Director was entitled to disagree with the decision of the Board, and the Review Board requesting the Clinical Director to reconsider his position in correspondence put before the Court, I am satisfied that there has not been a breach of statutory duty.’
Proposed evidence from psychiatrist fell outside statutory definition of insanity
DPP v. Ramzan  IECA 148 (Court of Appeal, Edwards J, 11 May 2016)
In a trial for a drugs offence, the accused applied to adduce expert evidence to support a plea of not guilty by reason of insanity. The trial judge refused the application, on the grounds that the relevant legislation required that such expert evidence be given by a consultant psychiatrist. Three of the proposed witnesses were not consultant psychiatrists. The fourth, based in the United Kingdom, was not registered in Ireland, which was a requirement under section 2 of the Act of 2006. On appeal to the Court of Appeal, it was held that the UK-based psychiatrist would have been an appropriate witness. However, his report stated, in relation to the accused: ‘He says he knew what he was doing and what he was doing was wrong but went along with it as he was afraid.’ The fact that the accused had admitted to the psychiatrist that he understood the nature and quality of the act, and that he knew it was wrong, meant that the evidence from the psychiatrist in question would fall outside the statutory definition of insanity.
Onus on accused to establish diminished responsibility on the balance of probabilities
DPP v. Heffernan  IECA 310 (Court of Appeal, Edwards J, 21 December 2015)
A person accused of murder sought to raise the defence of diminished responsibility (which would have give risen to a verdict of manslaughter). The judge directed the jury that the accused had the burden of proof in this regard, and that the standard was the balance of probabilities. On appeal, it was submitted that the burden of proof remained with the prosecution at all times, and that the standard of proof was beyond a reasonable doubt. The Court of Appeal dismissed the appeal, on the grounds that the 2006 Act created a ‘special verdict’, subject to the pre-existing common law rules as to the burden and standard of proof in insanity cases. These were that the burden was on the accused to establish diminished responsibility, on the balance of probabilities.
Premeditation not necessarily inconsistent with diminished responsibility
DPP v. Tomkins  IECCA 82 (Court of Criminal Appeal, MacMenamin J, 16 October 2012)
A person accused of murder sought to raise the defence of diminished responsibility, as well as a defence of provocation. The trial judge directed the jury that premeditation was inconsistent with a defence of provocation, but did not specifically direct them that it was not necessarily inconsistent with diminished responsibility. Although that issue had not been raised by the defence at trial, the Court of Appeal held that the jury were likely to have been left with an ‘incomplete and erroneous view of the law’. The conviction was quashed and a retrial directed.
First published in Law Ireland in March 2018