Antoine (Pierre Harrison), R v (2000) HL
General's Reference (No3 of 1998)  CA
Bailey, R v (1983) CA
Burgess, R v (1991) CA
Egan, R v  CA
H, R v  HL
DPP v (1997) QBD
Hennessy, R v (1989) CA
Kemp, R v (1957) Devlin J, Bristol Assizes
Pinochet, R v (1999) HL
Quick, R v (1973) CA
T, R v (1990) Snaresbrook Crown Court
Rabey, R v (1997) Ontario Appeal Court
Sullivan, R v (1983) HL
Windle, R v (1952) CA
Other cases at the
[Insanity - fitness to plead -
diminished responsibility cannot be raised at beginning of trial -
General's Reference (No3 of 1998)  CA
[Insanity - "did the act or made the omission
charged" does not require proof of mens rea]
D broke into a house with a light on to protect himself from evil,
believing he was Jesus Christ. D was armed with a snooker cue,
smashed open the front door and forced entry. He was insane on the
night, and so could not form any intent; but was fit to stand trial. The
trial judge wrongly followed R v Egan
 and ruled that the Crown had to prove mens rea, which
of course they could not. He
therefore directed the jury to acquit.
Held: The judge was wrong. Whether ‘the defendant did the act or made
the omission charged’ (Trial of Lunatics Act 1883)
required the Crown to prove the ingredients which
constituted the actus reus of the crime, but not the mens rea. Accordingly, the defendant’s state of mind would cease to be relevant.
Not guilty because of judge's ruling
[Insanity - automatism - self-induced - available for specific or basic intent in
D seriously injured
new partner with an
iron bar. He said
assaulted the partner to teach him a lesson for associating with the
diabetic took insulin and drank some sugared water but he had nothing to
eat. D claimed he acted in a state of automatism caused by
not complicate the issue with alcohol or drugs.
Automatism, even if self-induced could provide a defence to a crime of
basic intent crime (unless caused by intoxication). What must be
considered is whether D, in view of his knowledge of the likely results
of his actions, was sufficiently reckless. It was not necessarily
reckless to fail to take food after a dose of insulin.
non-insane (self-induced) automatism, no injustice at trial.
^[Violence whilst sleepwalking is insanity]
D wounded a female neighbour friend whilst sleepwalking. They had been
watching videos and she fell asleep on the sofa, he hit her with a
bottle and a video recorder and grabbed her round the throat. He
was sleepwalking at the time.
Internal cause, therefore disease of mind.
Sleep is normal (medically) and sleepwalking not regarded as mental
disorder, but violence whilst sleepwalking is abnormal. It is a disease
of the mind caused by internal factors. This condition was transitory
and unlikely to recur, but a functional or organic internal cause.
of murder by reason of
Egan, R v 
^[Insanity - mens rea not relevant]
D snatched a handbag from a woman on a train. He was found unfit
to plead. An admission order to hospital was made even though
mens rea could not be proved.
Held: The sole issue raised for the jury's
consideration was the identity of the bag snatcher. The full
direction was unnecessary where the defendant did not raise the issue of
whether he thought his conduct was dishonest or not.
Disapproved in Antoine
^[Insanity defence not available for strict liability offences]
his Chevrolet whilst over the limit for drink driving.
Insanity is only valid defence to an offence requiring
Driving with excess alcohol is not such an offence.
Remitted to the justices to convict.
H, R v  HL
^[Insanity unfitness procedure not contrary to HR
D aged 13 indecently assaulted a 14 year old girl. The first jury
found him unfit to stand trial (s 4 of the Criminal Procedure
(Insanity) Act 1964); the second jury found he had done the acts
charged (s 4A of the Act).
Held: The finding of the second jury,
(4A) was not incompatible with
art 6 of the European Convention on
Human Rights, simply because he could not give instructions and
participate fully in his defence.
S4A provided that the basic facts against D, shorn of issues concerning
intent, should be investigated in open court with counsel representing
their interests. S4A procedure was not to decide whether the accused
person had committed a criminal offence, and could result in acquittal
but not in a conviction or punishment. If it led to a hospital order,
there could be a full criminal trial if the accused person recovered. It
was difficult if not impossible to conceive of a criminal proceeding
culminating in the imposition of any penalty.
Appeal dismissed absolute discharge confirmed
^[Insanity - distinguishing between insanity and automatism - internal factors caused by external influences are insanity]
D, a diabetic, took a car without consent and drove whilst disqualified. Had not taken
insulin because of stress anxiety and depression.
Not taking insulin - leading to hyperglycaemia
is insanity. And it is insanity either alone or together with
the stress anxiety and depression. It is not automatism.
Stress and anxiety are
unique nor accidental factors but constituted a state of mind which was
prone to recur.
D was not suffering from automatism.
D an elderly man suffered with
arteriosclerosis caused unconsciousness, attacked
wife with hammer during the night.
Hardening of the arteries may cause damage to the brain cells which may
be a "disease of the mind" but the physical state of brain irrelevant, it is whether the mental faculties
of reason, memory and understanding are impaired or absent; in this case
it was the flow of blood that affected the mind, not destruction of
"That may be a matter of
importance medically, but it is of no importance to the law, which
merely has to consider the state of mind in which the accused is, not
how he got there."
“...mind in the
M’Naghten Rules is used in the ordinary sense of the mental faculties of
reason, memory and understanding...”.
D was unaware of his actions during a 'blackout'
caused by a disease of the body that affected the mind.
Per curiam: The condition of the brain, whether the
defect of reason is transient or permanent or whether it is curable, is
Guilty but insane
(the old special verdict)
- fitness to stand trial]
former Chilean dictator faced extradition to
for murder and torture.
Insane, not extradited but returned to
[Insanity - automatism - an external factor is required]
D, a nurse, assaulted a patient.
He was a diabetic, had taken insulin and not eaten sufficient food. He
drank whisky and rum he could not remember the assault. He pleaded
D was suffering from automatism, which is a mental abnormality caused by
an external factor. He was not suffering from insanity caused by
hypoglycaemia (low sugar in the blood) by taking insulin prescribed by
his doctor. [Distinguished from hyperglycaemia high blood sugar
occurring naturally, which would be insanity]
self-induced incapacity will not excuse ... nor will one which could
have been reasonably foreseen as a result of either doing or
omitting to do something, for example, taking alcohol against medical
advice after using certain prescribed drugs or failing to have regular
meals while taking insulin.'
R v Bailey
[External cause such as rape is sufficient to establish automatism]
committed robbery and assault with two others. D was acting as though in
Evidence of a disassociative state resulting
from something qualitatively different to the ordinary stresses of life
– in this case rape - would indicate an external cause.
The jury nevertheless convicted.
[Defences - insanity - disease of the mind -
D was rejected by a girlfriend and so he battered her. He argued that
this was an external cause. (A Canadian case.)
that a "disassociative
state"; resulting from
'... the ordinary
stresses and disappointments of life which are the common lot of
not amount to an external cause.
It follows that evidence of such a
state" would indicate a disease of the mind.
^[Insanity - epilepsy is insanity, not automatism]
an 86 yr old neighbour – for whom he customarily did acts of kindness -
in the head and body while having epileptic fit.
Epilepsy is insanity, (not automatism) it affects the mind, not an
external cause such as drugs or alcohol.
A defence of non-insane automatism, for which the
proper verdict would be a verdict of not guilty, might be available in
cases where temporary impairment of the mental faculties, not being
self-induced by drink or drugs, results from some external factor such
as a blow to the head causing concussion.
Comment: On his conviction, a probation order, with
medical supervision, represented an altogether more advantageous outcome
than the order which the court would have been obliged to make if the
defence of insanity had been established
R v (1952) CA
- doing wrong means legally, not morally wrong]
his insane wife who was always threatening suicide. He killed her with
100 aspirin. He said “I suppose they will hang me
for this?” indicating he knew it was legally wrong, whereas he thought
it was morally right.
Knowledge that an
act is ‘wrong’ means legally not morally wrong. Killing terminally ill
spouse may be morally justified but is criminal offence. Claimed he had
communicative insanity (folie a
(sentence of death upheld)
Comment: Diminished responsibility could now
be argued in such cases.
The ratio in Windle has been doubted in
R v Dean
Johnson (2007) EWCA Crim 1978. The High Court of Australia in
Stapleton (1952) 86 CLR 358 refused to follow Windle.