Wednesday, 3 August 2016

Is It Ethical?

Was I the only one concerned at the sentence passed down the other day on Muhiddin Mire? This from the Guardian:- 

Leytonstone knife attacker sentenced to life

A mentally ill taxi driver who cut the throat of a stranger at a London tube station has been given a life sentence with a minimum term of eight and a half years after a judge concluded the attacker was motivated by Islamic extremism. Muhiddin Mire, 30, who has paranoid schizophrenia, told police the rampage in December 2015 was an act of revenge for coalition airstrikes in Syria, which the UK government had voted to support three days previously.

Judge Nicholas Hilliard, the recorder of London, told Mire he would be immediately transferred to Broadmoor, the high-security psychiatric hospital in Berkshire. The type of sentence handed down to Mire means that if he is found to be free of symptoms and subject to review he could be transferred to prison to serve the remainder of the term. Hilliard said: “This was an attempt to kill an innocent member of the public for ideological reasons by cutting his throat in plain sight for maximum impact.”

Mire, who had downloaded Islamic State propaganda before the attack, was convicted in June of attempted murder for stabbing 56-year-old Lyle Zimmerman and threatening four other travellers at Leytonstone station, east London.

But doctors giving evidence to the hearing conflicted over whether Mire’s mental illness was the sole reason for the attack. Dr Shaun Bhattacharjee, a Broadmoor forensic psychiatrist, told the court Mire’s interest in extremism was a symptom of his mental disorder. But Dr Philip Joseph told the judge it was possible for Mire’s obsession with Islamic terrorism to be separate from the illness.

Ultimately, Hilliard sided with Joseph’s argument. “What the defendant was intent upon was designed to intimidate a section of the public that were there to witness what he was doing. This was not carried out in secret but very brazenly indeed. It was carried out to advance a religious or ideological cause, namely Islamic extremism.” Hilliard said Mire’s interaction with commuters in the tube station during the attack was evidence of his awareness of what was going on around him.

It was revealed during an earlier hearing that Mire was sectioned in 2006 and released with a prescription for antipsychotic medication after two weeks in hospital. He was put in touch with a community mental health team upon his release but soon lost contact with them and stopped taking the medication. In the years before the attack, Mire became increasingly unwell and was probably already exhibiting symptoms of paranoid schizophrenia.

Among “strange” ideas Mire had was a belief that the former prime minister Tony Blair was his guardian angel and that he had been possessed by evil spirits, the court heard. His paranoid delusions later manifested in a belief that he was under surveillance by the security services and was being followed.

Bhattacharjee told the court the prevailing culture – in this case a heightened state of tension over Islamic terrorism – could often inform schizophrenics’ delusions. As an example, Bhattacharjee said in the 1970s some paranoid schizophrenics experienced delusions related to the IRA and Irish terrorism.

During the attack, Mire shouted, “This is for my Syrian brothers. I’m going to spill your blood.” But Joseph told the same hearing that this interest in extremism was separate from his mental illness, not fuelled by it.

Mire told police in the hours after his arrest that the attack was an act of vengeance for coalition airstrikes in Syria. On 2 December, the government voted in favour of extending bombings against Isis targets in the Middle East to include Syria. He had images of the soldier Lee Rigby and a British Isis killer on his phone, along with material linked to the terror group. The court heard Mire started viewing Isis videos online three years before the attack.


There are a number of things I simply don't understand about this case, not least how someone mentally ill can be held criminally responsible for their actions? In addition, I've always been concerned about conflicting expert medical evidence when commissioned by either the prosecution or defence. Why can't the experts be commissioned by the court instead and avoid the suspicion that an experts opinion is being cherry-picked? Finally, I didn't understand the mechanism for sending him to Broadmoor Special Hospital straight after sentence, until I read this from the Mental Health Cop blog:-

Muhiddin MIRE was today sentenced by a criminal court following the attack at Leytonstone Underground station last December that made prominent national headlines. I admit, I had a bit of a job initially piecing together what exactly the court had done, following vague media reports that appeared somewhat to contradict themselves! One simply claimed the man had been sentenced to ‘life in jail’ whilst another that he would ‘begin his sentence at Broadmoor’. This made me wonder whether, in fact, the court had sentenced him to what’s known as a hybrid order – this turns out to be exactly what they’d done; so I thought I’d quickly explain it, in case of any doubt as to what this means!

Before I do, I’d observe that somewhere between being charged with attempted murder by the police and his sentencing today, he has been transferred between the criminal justice and mental health systems. When he first appeared at court, there would be no power for Magistrates to remand the defendant to hospital under the Mental Health Act. At or after his first appearance at the Crown Court, he could be transferred and that has obviously occured and facilitated a period of assessment by the psychiatrists who have given professional opinion to the sentencing judge. The defendant has pleaded guilty to the offence, notwithstanding that his mental illness is serious enough to mean he reaches the threshold for admission to hospital under the MHA.

So this is yet another example to prove the point that serious mental illness does not always equate to a lack of criminal responsibility for serious crimes. Indeed, as previously pointed out, attempted murder is the most difficult kind of assault to prove – because a charge of murder succeeds if it can be proved that the defendant intended to kill or seriously injure the victim; attempted murder requires proof of intent to kill. A notably higher threshold to satisfy.


A hybrid order means that the court can issue a ‘normal’ criminal sentence of imprisonment to any defendant over the age of twenty-one, but they will first be admitted to hospital under the Mental Health Act for treatment. It then depends how long the patient’s treatment lasts as to whether they are discharged from hospital or transferred to prison to complete that original sentence. All of this is done under s45A of the Mental Health Act 1983.

So in Muhiddin MIRE’s case, he was sentenced to ‘life imprisonment with a recommendation that he serve a minimum of 8.5yrs in jail’, commencing with the treatment aspect of the hybrid order. Let’s imagine he remains in hospital for 6yrs receiving treatment, he will then be transferred to prison for a minimum period of 2.5yrs before the Parole Board would be able to take any decision about his release from prison. Were his hospital treatment to last 9yrs, then release would beconsidered – but not necessarily granted! – as soon as the clinician in charge of his care recommended discharge from hospital. If the Parole Board did not grant immediate discharge, he would be transferred to prison to serve further time in jail until his case for release is reconsidered.

Finally, anyone made subject to a hybrid order after conviction for any offence specified in Schedule 1 of the Criminal Justice Act 2003, will be subject to the provisions of Multi-Agency Public Protection Arrangements, or MAPPA. These are arrangements which aim to ensure, amongst other things, post-release mechanisms through which public authorities cooperate to share information, to ensure risks are properly managed in the community, if or when a patient is discharged or prisoner released.

So this is the only form of sentence which combines two periods of detention: first in hospital and then in prison. These orders seem to becoming more popular amongst judges, the point being that they prevent people with serious mental illnesses who are convicted by the courts of being subject to a far shorter period of detention under a (restricted) hospital order than they would have done if they had been sentenced only to a period in prison.

And we could debate the ethics that sit behind that approach, all day long … on another day!


Somewhat strangely, I notice that the regular legal bloggers have yet to comment on this case.


  1. IPP for those with a mental illness - "we don't believe you're really ill, or we don't believe treatment will work, or we simply want you out of the way."

    An interesting shift in attitude, e.g. in 'One Flew Over the Cuckoo's Nest' McMurphy acted out to be transferred from prison to hospital, when he found that his determinate sentence morphed into unlimited detention at the mercy of medical staff.

  2. I, too, could not follow the sentencing logic in this case. The judge essentially reasoned that Mire was simultaneously 'mad and bad'. It reminded me of the Peter Sutcliffe – 'The Yorkshire Ripper' – case: in that case there was a consensus of psychiatric opinion that Sutcliffe was insane, but this was disregarded by the judge. It seems that sometimes other considerations, such as public opinion and political expediency, shape the court's decision-making. Was it the political need for a tariff that tipped the balance? I think a just outcome would have been a hospital order with restrictions.

    This from Wikipedia:
    'Sutcliffe was charged at Dewsbury on 5 January.[24] At his trial, he pleaded not guilty to 13 charges of murder, but guilty to manslaughter on the grounds of diminished responsibility. The basis of his defence was he claimed to be the tool of God's will. Sutcliffe claimed to have heard voices that ordered him to kill prostitutes while working as a gravedigger.
    He pleaded guilty to seven charges of attempted murder. The prosecution intended to accept Sutcliffe's plea after four psychiatrists diagnosed him with paranoid schizophrenia but the trial judge, Mr Justice Boreham, demanded an unusually detailed explanation of the prosecution reasoning. After a two-hour representation by the Attorney-General Sir Michael Havers, a 90-minute lunch break and another 40 minutes of legal discussion, the judge rejected the diminished responsibility plea and the expert testimonies of the psychiatrists, insisting that the case should be dealt with by a jury.
    Sutcliffe began his sentence at HMP Parkhurst on 22 May 1981. Despite being found sane at his trial, he was diagnosed with paranoid schizophrenia. Attempts to send him to a secure psychiatric unit were blocked. While at Parkhurst he was seriously assaulted by James Costello, a 35-year-old career criminal from Glasgow with several convictions for violence. On 10 January 1983, he followed Sutcliffe into the recess of F2, the hospital wing at Parkhurst Prison and plunged a broken coffee jar twice into the left side of Sutcliffe's face, creating four wounds requiring 30 stitches. In March 1984 Sutcliffe was sent to Broadmoor Hospital, under Section 47 of the Mental Health Act 1983.'

    1. I also had the Sutcliffe case in mind Netnipper. It does indeed appear as if public opinion plays a key part in sentencing decisions for notorious cases and I note the regular legal bloggers don't appear to have spoken.

      The Bulger case springs to mind as well where the astonishing decision was made to name the two boys.

    2. And also of significance, not to be overshadowed by high profile matters, in recent years the slashing of budgets has led to goodness knows how many sentences of imprisonment being handed down without any pre-sentence psychiatric assessment. The situation is then exacerbated by massively reduced health service provision within prisons, no diagnosis or suitable meds - or if there is a diagnosis there's no interest in making the effort to effect a hospital transfer - and then there's a request for the last gasp detention & assessment at the gate on release by the local CMHT expecting them to pick up the case.

  3. It's that lack of joined up thinking that defines recent Government thinking. There used to be a department that looked at the consequences of policy decisions 'across the piece' i.e. if you change benefit rules, what are the consequences for Health, Housing etc or, if you change the policy on GP services, what would happen to A&E and so on. The universal mantra of cut cut cut appears to have had a massive knock on effect across the board. No PSRS = more Mentally Disordered Offenders in custody where there are no services, add less staff = increase in suicides and assaults in prisons, poorer throughcare etc etc. Any Government worth its salt should have recognised this instead of blaming 'legal highs' (which also wouldn't be a problem if prison security hadn't been compromised as well). It could all have been avoided by a credible Ministry. The MoJ remain an embarrassment.

    1. Could not agree more. The issue of resources is never given its proper place in any discussion about criminal justice. All the remodelling of the system is forever couched in the language of efficiencies and doing more with less. And one of these efficiencies has been the virtual disappearance of psychiatric assessments,whose demise pre-dated but oiled the works for the dumbed-down reformatted pre-sentence reports. These reports, especially for those sentenced to custody were key opportunities to make sound and comprehensive assessments and hopefully shape future assessments in evaluating risks and needs.

      All the talk focusses on 'efficiencies' but never on the resultant deficiencies - as though the system could be run on thin air. Just as there is a need for a living wage to meet the necessities of life, so equally there must be a level of resource to finance service delivery. When there isn't, as in the NHS, services are rationed, waiting lists grow and clinical need gets redefined by accountants at the cost of human suffering. In criminal justice, it means corners are cut and what were once considered core tasks become peripheral; it means staff numbers are depleted and the system is in a state of permanent crisis, which gets translated into increased death rates and hopelessness and boredom; a prison system that keeps many in long beyond their tariffs because it simply cannot resource rehabilitation programmes. When you consider the millions it is costing to keep IPPs in custody, the so-called efficiencies are nothing of the sort – they are simply examples of being penny-wise and pound foolish.

  4. I was once involved with a case where a young man was compulsorily detained on a Mental Health Section as a consequence of psychosis seemingly influenced by illicit drug use. He was nineteen.

    He was not under probation supervision at the time of the mental health compulsory admission. He was apparently allowed weekend home leave from which he returned and was readmitted under the MH section.

    Within hours of returning to the hospital he was allowed parole within the grounds of the hospital and by his later admittance came upon a very elderly woman inpatient who had been in hospital for decades, also in the grounds who he raped.

    When the hospital authorities realised what seemed to have happened the police were called and he was discharged there and then by the medical officer as fit to plead. He was charged with alternatively, gross indecency, attempted rape & rape. Pre Trial in interview he admitted the lesser charge and denied the other two but was convicted of rape, on account of the description he gave in evidence of what actually happened. Apparently he had taken illicit drugs during his leave from the hospital.

    I had been instructed by Probation Management to write a pre trial SER (1980s) and did so on the basis of his firm admittance of gross indecency, he gave a different description of the sexual encounter in evidence to what he gave me.

    In sentencing him to seven years youth custody, there was no psychiatric aspect to the sentence imposed - you are a loathsome man who has done a loathsome thing, said Judge Greenwood in handing down sentence, he also criticised my assessment in my SER in open court and ordered me to attend him in his chambers immediately after the court rose.

    In private he lambasted me for raising the man's expectations of a hostel placement as an alternative to prison - only in regard to the lesser charge (I had made it obvious such an adjudication would not be considered if either attd rape or rape had been proved)

    I thanked the judge for his observations and never wrote another SER pre trial again unless specifically ordered by a court. - (At the time it was an issue of contention and there was long standing industrial action from Napo).

    I was livid got no support from management and did not take it to the union.

    Mostly I thought the hospital were wrong in either readmitting him on the MH section after his weekend leave or alternatively in discharging him when the allegation was discovered and also in not providing adequate supervision of two vulnerable patients.

    The next time I saw him was in the Young Offenders Place then in Leicester, cannot recall the name, he was in a catatonic state on ordinary location and no conversation was possible. His mother was distraught - I moved on from that job before he was considered for parole.

    Abusing the mental health regulations within the criminal justice system is nothing new and it is very sad it continues to this day.