CRIMINAL CASE NO. 356 OF 2010
COURT: The defendant was charged with the murder of Madam Li Hau-mui (The victim) on 11 July 2010 inside the home occupied by them at Choi Kwai House, Choi Ming Estate, Tseung Kwan O.
On 13 June of this year, he pleaded not guilty to that charge but guilty to manslaughter on the basis of the partial defence provided for in section 3 of the Homicide Ordinance, namely the defence of diminished responsibility.
The prosecution were prepared to accept that plea in satisfaction of the indictment. Having seen the reports of four psychiatrists as to the defendant’s mental health at the time of the killing and now, I considered that that was an entirely proper course.
The Admitted Facts read in open court on that day and confirmed by the defendant revealed that the defendant was born in Mainland China in 1953. The victim, Madam Li Hau-mui, was 51 years of age when she died. The defendant and the victim married in 1986. In so far as the defendant’s date of birth is concerned, there is some doubt and it is suggested that he may have been born two years earlier. Irrespective of that, he was born either in 1953 or 1951.
The defendant and the victim and two of their children lived together in that flat in Tseung Kwan O. On the day that the victim died, neighbours heard the defendant scolding her loudly and the victim crying out for help. Later that day, at about 5.30 pm, the police received a telephone call from the defendant and, as a consequence, they and ambulance officers went to those premises.
Eventually, they were able to enter and found the victim dead on the floor, having sustained multiple chop wounds. Apart from the victim, the only other person present in the premises was the defendant. He was in what has been described as a very emotional state, crying and mumbling to himself. He admitted that he had killed the victim. Later that day, he was taken in custody to the Castle Peak Mental Hospital.
The victim, as it transpired, had died from multiple chop wounds inflicted by the defendant. Many of these were directed towards her head and neck. So extensive were the wounds that her head was almost severed. It suffices to say that the extent of the injuries she sustained was horrific. It was accepted, in the Admitted Facts, by the defendant that he attacked and unlawfully killed the victim on the afternoon of 11 July 2010 and that when he did so, he either intended to kill her or to cause her grievous bodily harm.
When this matter was first before me at a pre-trial review, psychiatric reports prepared on behalf of the defendant were placed before me and served upon the prosecution. Those psychiatrists, in their conclusions, indicated that the defence of diminished responsibility may have been available to the defendant.
Mr Tam, on behalf of the prosecution, requested that the prosecution be permitted to have the defendant examined in the light of those reports. The defendant readily consented to that course.
Eventually, two further reports were obtained from Dr C H Yuen and Dr K W Chow, both of whom are visiting psychiatrists at the Siu Lam Psychiatric Centre. Both were provided with the relevant materials from the committal bundle, the reports of the two psychiatrists engaged on behalf of the defendant, namely Dr W Y Yu and Dr Sylvia Chen, and they in due course prepared reports which are now before me.
Dr K W Chow is the defendant’s treating psychiatrist at the Siu Lam Psychiatric Centre. In his report, he indicated that he had seen him on a number of occasions since late July 2010. He said this in the latter parts of his report, and I read from paragraph 21:
“The defendant has a longstanding history of obsessive compulsive disorder featured by his reported thoughts and compulsive rituals, like checking and hand-washing behaviour. His problems have never been identified and treated in the past. His daily activities and working ability were markedly impaired by his symptoms and psychological distress associated with it. He developed depressive symptoms thereafter with depressed mood, poor sleep, multiple somatic complaints, negative thoughts and suicidal idea over the years. His depressive symptoms are up to the severity that he is suffering from major depressive episode for over a number of years.
After the cerebral vascular accident in 2002, the defendant suffered further from impairment in memory and attention. He also had emergence of auditory hallucination and personality change with increased irritability. These all can be accounted by the organic mental disorder secondary to the cerebral vascular accident.”
I pause here to observe that what the author of the report is there referring to is the fact that the defendant suffered a stroke in 2002 and later a second stroke in 2007. At paragraph 22 of his report, Dr Chow said this:
“I do agree with Dr W T Yu that the defendant is suffering from major depressive disorder. On top of this, defendant is also suffering from longstanding history of obsessive compulsive disorder as stated by Dr Sylvia Chen. Defendant’s psychiatric problem is further complicated and aggravated by the brain damage secondary to his cerebral vascular accident that he suffered from, cognitive impairment, personality change, emergence of auditory hallucination and deterioration in his mood symptoms.”
He concluded at paragraph 25:
“I am of the opinion that defendant, at the material time of the alleged offence, was suffering from such abnormality of mind arising from obsessive compulsive disorder, major depressive disorder and organic mental disorder as substantially impaired his mental responsibility for his acts.”
The defence of diminished responsibility he thought would be available to the defendant. Dr Yuen, in his report, agreed in every respect with the observations of Dr Chow.
Given the conclusions of all four psychiatrists that the defendant’s mental responsibility for his actions in killing the victim was substantially impaired by abnormality of mind, the issue then arises as to how he should be dealt with for the future.
On 13 June, in the light of the reports that I had received, I requested Drs Chow and Yuen to advise me whether the defendant was suitable to be dealt with pursuant to section 45 of the Mental Health Ordinance and, if so, where should I order that he be detained if that was appropriate and, two, should I fix a period of detention were that to be appropriate.
I have subsequently obtained further reports. In a report dated 17 June 2011, Dr Chow confirms his original diagnosis. He says, in conclusion, at paragraph 5:
“In view of the defendant’s current active psychiatric symptoms, his high violence risk posed to the society and the pessimistic prognosis of his course of illness, a high security treatment environment would be more appropriate to the defendant. I would therefore respectfully recommend the court to give him a Hospital Order under section 45 of the Mental Health Ordinance for an unspecified period. He could serve his sentence at Siu Lam Psychiatric Centre where provision has been made for him. His future disposal back to the hospital for further rehabilitation or to the community could be decided by the Mental Health Review Tribunal if he is given sentence for an unspecified period.”
In a report dated 27 June 2011, Dr Amy C Y Liu, also a visiting psychiatrist at the Siu Lam Psychiatric Centre, reported that as Dr C H Yuen was, at the time I made orders on 13 June and thereafter, on leave, she assumed responsibility to report on his behalf. She made herself familiar with all of the materials and, like the other psychiatrists, had extensive interviews with the defendant. Her conclusions in the light of my orders were as follows, at paragraph 6:
“In my opinion, Lee has been suffering from obsessive and compulsive disorder for decades before the indexed offence as evident by the persistent obsessive thoughts and compulsive acts throughout the years. Besides, he also suffers from major depressive disorder for a definite period of time before the indexed offence as evident by the depressive mood and suicidal thoughts. His clinical condition is further complicated by the cerebral vascular accident in 2002 which brought about impaired memory and concentration which contributed to organic mental disorder.
Given the long history of psychiatric symptoms, the severe degree of disability resulted, the slow progress upon the intensive treatment as Siu Lam Psychiatric Centre in the past one year and the irreversible nature of damage done by cerebral vascular events, the prognosis of the course of illness is deemed pessimistic.
As illustrated above, Lee is still suffering from active psychiatric symptoms which bring about great distress feelings to him. The violence risk to the society remains high. In view of the severity of his violent act in the offence, the poor prognosis and the unsatisfactory mental condition, if the court sees fit, it would respectfully recommend a Hospital Order under section 45 of the Mental Health Ordinance for an unspecified period.
Based on the listed factors, particularly the severity of the indexed offence and propensity of violence to other people, he is highly recommended to serve the sentence at a high security unit, that is the Siu Lam Psychiatric Centre.”
Mr Haynes, on behalf of the defendant, readily acknowledges the significance of the reports generally and the observations which are contained in them as to the prognosis of this defendant for the future. Tragically, the illness from which he suffers and the damage which has already been done by reason of earlier vascular incidents, his prognosis for recovery is deemed to be pessimistic.
Regrettably, the risk that he poses to society remains apparent and manifest and it is by reason of this that he inevitably must be detained in a highly secure environment, namely the Siu Lam Psychiatric Centre.
On behalf of the applicant, there have been placed before me a number of letters and, in particular, letters on behalf of the children of the defendant who indicate in them that they have fully appreciated the significance of the diseases from which he suffers and the significance of those in respect of his behaviour on that tragic day.
It is highly commendable to say that they have forgiven him his conduct, notwithstanding that that conduct has taken from them their mother. The applicant himself has written to the court expressing his remorse for his conduct and for the consequences of it.
I take all of these matters into account but, in the circumstances, having considered the reports of all of the psychiatrists and, in particular, the recommendations that have been made in light of the specific requests I made on 13 June, I am satisfied that the only appropriate order in the circumstances of this case is that the defendant be detained pursuant to section 45 of the Mental Health Order and I do not think it is appropriate to fix a term for that detention.