[15] At about 12.30 pm on 30 July 2007, the Accused presented himself to Fairfield Police Shop Front and was conveyed to Cabramatta Police Station where he participated in an ERISP in the presence of his uncle. It is fair to observe that the ERISP, which formed part of the evidence at the present inquiry, revealed a significant level of thought disorder in the Accused shortly after the offences."
4 These facts were not in contest before me. There was no dispute about the evidence from which they were derived, all of which was tendered without objection. The evidence clearly established the facts from which the present charges emerge and was substantially to the following effect.
5 Mr O'Grady said that he and the deceased moved into the guesthouse in May 2007. A short time after that they met the accused who would occasionally ask Mr O'Grady for a cigarette. On occasions the accused would come to their room and knock on the door for that purpose. Mr O'Grady said that when the accused talked to him he often did not make sense. Mr O'Grady said that he would talk about many different things and it was difficult to understand what he was talking about. He gave evidence in a statement that contains the same details of what occurred referred to earlier.
6 Mr O'Grady later took part in a photographic identification procedure at the police station. He was able without difficulty to identify the accused as the person who had entered his room and stabbed the deceased.
7 Mr Majok was also a resident of the guesthouse. At about 11.45am on 30 July 2007 he was sitting in his car outside the guesthouse when he heard a woman and a man screaming. The sound was coming from the room of the deceased and Mr O'Grady. The next thing that occurred was that Mr Majok saw the deceased coming out of the front door of the house bent over holding her stomach with blood all over her hand. She fell down on the front lawn of the house near the mailboxes.
8 Mr Majok then saw the accused running out of the front door. He jumped over the fence and ran down the street and out of sight. Mr Majok was able to give a description of the clothes that the accused was wearing. He then saw Mr O'Grady emerge from the house holding a knife and start to chase the accused. Mr O'Grady gave up the chase and threw the knife to the ground. He saw that the knife was a kitchen knife with a broken handle. He said that Mr O'Grady described to him what happened. The description was consistent with the later version given to the police by Mr O'Grady.
9 Mr Majok also later took part in a photographic identification procedure at the police station and identified the accused as the person he had seen at the time of these events.
10 Mark Jackson was also a witness to these events and gave an account of what he saw and heard that was consistent with the evidence of other witnesses.
11 Alan Tranter also lived at the guesthouse. He said that he had seen the deceased and Mr O'Grady in the company of the accused on about half a dozen occasions before the incident on 30 July 2007. He had seen them all leaving the house together and walking along Harris Street. He formed the view that there may have been some connection or friendship among them. Mr Tranter said that he regarded the accused as a bit strange and he formed the opinion that he was "a bit weird'. The accused used to say odd things to him occasionally. Mr Tranter was also a witness to some of the events that took place outside the guesthouse that were described by Mr Majok and Mr Jackson.
12 Patricia Kelly gave a statement to police about the accused. The accused is Mrs Kelly's grandson. She described his early life and troubled and difficult background. His parents separated when the accused was about 11. He originally stayed with his mother but later moved to live with his father. However, when he was about 15 the accused's father asked Mrs Kelly if the accused could come to live with her. That is what happened. She described how the accused subsequently "went down hill". He became untidy in his appearance and would tell her stories that made no sense. He was eventually taken to Liverpool Hospital following a noisy domestic incident and was diagnosed with schizophrenia. He was placed on medication. She became aware that there were times when the accused was sleeping on the streets and was not taking medication as prescribed. The accused told her that there were also times when he would spend the night riding on trains. He occasionally stayed with her overnight.
13 Shortly before he was arrested Mrs Kelly said that she had become very concerned about the accused's behaviour. She said that she could tell that he was not medicated. On one occasion he stood on her porch and started yelling at a man in the street for no apparent reason. On the Monday prior to his arrest he turned up at her house unannounced. His behaviour was odd and Mrs Kelly said that she could tell he was not right.
14 Expert forensic medical evidence confirmed that the deceased died of the effects of a knife wound to the chest that penetrated the aorta and entered the pulmonary artery through the left pleural cavity. The depth of the wound was approximately 8.5 cm from the skin surface of the left anterior chest to the vertebrae.
Conclusion
15 I am satisfied on the limited evidence available that the deceased died as the result of injuries she sustained following an attack upon her with a knife by the accused. I am also satisfied on the limited evidence available that Mr O'Grady sustained injuries at the same time that were caused when the accused attacked him with a knife. I am therefore satisfied beyond reasonable doubt that it was the deliberate acts of the accused that caused the death of the deceased and the injuries to Mr O'Grady.
16 However, I am not satisfied on the limited evidence available that the acts causing the death of the deceased or the injuries to Mr O'Grady were done with an intention to kill the deceased or to inflict grievous bodily harm upon her or with reckless indifference to human life, or in an attempt to wound Mr O'Grady with intent to murder him. My reasons for forming this view are set out below.
Defence of mental illness
17 It is uncontroversial that every man and woman is presumed to be sane and to possess a sufficient degree of reason to be responsible for his or her crimes until the contrary is proven. In order to establish a defence on the ground of mental illness it must be clearly proved that, at the time of committing the act the accused was labouring under such a defect of reason, from disease of the mind as not to know the nature and quality of the act he was doing or if he did know it, that he did not know what he was doing was wrong: R v M'Naghten (1843) 8 ER 718.
18 In cases involving a jury the jury would not be required to consider the defence of mental illness until it were satisfied that the offence had been proved beyond reasonable doubt: R v Stiles (1990) 50 A Crim R 13. I also observe that in considering whether an accused person committed the offence(s) charged, a jury would be instructed to ignore the question of mental illness when determining whether the accused had the intent charged, relying upon the presumption of sanity. In this way they may acquit on the defence of mental illness if they find that the accused did not have the necessary intention as a result of the defect of reason. If there were evidence of mental illness, a jury would not consider the question of intention or voluntariness separate and distinct from the issue of mental illness.
19 A "disease of the mind" is any disease capable of affecting the mind, whether it has a mental or physical origin and whether or not the defect of reason is temporary or permanent: R v Kemp [1957] 1 QB 399. Whether the condition amounts to a disease of the mind is a question of law: R v Falconer [1990] HCA 49; (1990) 171 CLR 30 at 60. A "defect of reason" is the inability of the accused to think rationally: R v Porter [1933] HCA 1; (1936) 55 CLR 182 at 189-190; Sodeman v The King [1936] HCA 75; (1936) 55 CLR 192 at 367.
20 A person does not know the nature and quality of his (or her) act if he does not know the physical nature of what he is doing or the implications of it. A person does not know what he was doing was wrong when he does not know that it was wrong according to ordinary standards of right or wrong adopted by reasonable persons (see Stapleton v The Queen [1952] HCA 56; (1952) 86 CLR 358 at 367), or where the accused cannot reason with some moderate degree of calmness in relation to the moral quality of what he is doing: Sodeman v The King (supra) at 215; R v Pangallo (1989) 51 SASR 254.
21 Medical evidence is not essential to prove insanity: Lucas v The Queen [1970] HCA 14; (1970) 120 CLR 171. The tribunal of fact cannot reject unanimous medical evidence unless there is evidence that can cast doubt upon it, but such evidence may be found in the behaviour of the accused. The tribunal of fact may decide between competing medical evidence. Medical witnesses may give evidence of their opinion as to whether the accused could appreciate the nature and quality of his acts or, if he could, whether he knew it was wrong: Thomas v The Queen [1960] HCA 2; (1960) 102 CLR 584.
22 The accused was born in 1979 and was therefore 28 years of age on 30 July 2007 when the events that give rise to the present charges occurred. The psychiatric medical history of the accused is long and significant. Its aetiology predates these events and must be considered in some detail. The medical opinions expressed concerning the accused and his mental condition are also unanimous. They are referred to in what follows.
Dr Nielssen
23 Dr Olav Nielssen is a psychiatrist. In his report dated 27 November 2007 he expressed the following opinion after examining the accused on 28 September 2007:
"Mr Grant was assessed to have a severe and disabling form of the chronic mental illness schizophrenia. The diagnosis was made on the basis of his account of typical symptoms of the illness and a pattern of treatment consistent with longstanding mental illness, and the gross disorganisation of thinking and the persecutory beliefs that were evident during the interview.