COURT: The defendant faced one count of murder. She was committed to the Court of First Instance for trial on 16 December 2019. In February 2020, the defence invited the prosecution to consider a plea to manslaughter on the basis of diminished responsibility in full satisfaction of the count of murder on the indictment.
On 30 July 2020, the prosecution accepted the defendant’s plea to manslaughter on the basis of diminished responsibility. On 16 October 2020, the defendant appeared before me where she pleaded guilty to manslaughter on the basis of diminished responsibility and accepted the Summary of Facts which consisted of seven pages.
Prior to sentencing the defendant, I called for two psychiatric reports and a probation report. The defendant’s counsel, Mr Richard Wong, reserved all mitigation. At that time, that is today, as well, Mr Wong submitted the options in sentencing the defendant was either of imprisonment, probation or a hospital order.
I turn to the facts of this case. At the outset, I can say that this can only be described as a very tragic and sad case. The defendant, a single mother, tragically took the life of her only son who was aged 23 on or about 22 February 2019 at their home which they shared by strangling him with a USB cord. Thereafter, she attempted to commit suicide. At the time, the defendant was 56 years of age. She lived with her only son at their home in Tseung Kwan O.
How this offence came to light. On 23 February 2019, at about 10.05 pm a security guard of the building where the defendant lived found her staggering at the lift lobby on the ground floor. The defendant was unresponsive to questions. He recognised her as a resident of the building, an ambulance was called.
The ambulance crewmen suspected that the defendant was drugged because she could not answer questions properly, but there was no scent of alcohol. Inside the ambulance, the defendant ambiguously said that she and her son had taken rat poison at home yesterday. The ambulance crew then sought assistance from firemen. Firemen attended their home, broke open the locked door and found her son lying face up on the sofa in the living room. He had no vital signs. A strangle mark was found on his neck. He was certified dead on 23 February at 11.28 pm.
In the meantime, at the -- inside the Accident & Emergency of Tseung Kwan O Hospital at 11.38 pm, the defendant told a police officer she had eaten rat poison and drank more than half a bottle of Ko Leung wine at around 11 pm as she was unhappy. She vomited and felt dizzy. She saw her son sleeping on the bed. She left home on her own the next day, but she collapsed after taking a few steps.
On 24 February, while still at the hospital under caution, the defendant told the police officers that her son could not take care of himself and the defendant said she brought along her son, “because her son could not support himself financially” and that it happened at home at around 12.45 am on 22 February 2019.
She was arrested and cautioned for murder whereby she told the officer that she put sleeping pills into the soup for the son to drink. After he had fallen asleep, she strangled him with a charging cord until he had no response. Then she consumed rat poison and she did this only because she did not want to let go of him.
On 25 February, she was interviewed again this time by video-recorded interview in the presence of her sister, Chiu Yung-ping. In this interview, the defendant revealed much more detail. The detail is in the Summary of Facts and I shall summarise only part of what she said under caution.
The defendant had informed the police that she had insomnia and was depressed. She was an outpatient of a psychiatric clinic department in hospital. She only occasionally took the medications prescribed to her because taking the medications would cause dizziness. She had suicidal thoughts for quite some time. Initially she intended to commit suicide without killing her son, but later she believed that the son could not financially support himself after her death, so one or two days prior to the killing she decided to die together with her son.
On 21 February 2019, she bought food ingredients to cook soup. She crushed 20 sleeping pills of 10 milligrammes each and added them into the soup. The sleeping pills were prescribed to her by the government. The purpose of doing this was to drug her son with the sleeping pills which would enable her to strangle him after he fell asleep. She intended to commit suicide after killing her son.
On 22 February, shortly after midnight, her son returned home from work. She served him the soup. After drinking the soup, her son appeared to be dizzy, therefore, she helped him lie down on the sofa. At the time, her son was still breathing. After her son fell asleep on the sofa, she folded a white charging cord to make it double as thick before she strangled him with it. Her son vomited and struggled and tried to pull away the cord, but he no longer had much strength at the time.
The whole strangling process lasted for more than half an hour until the son’s face turned black. She confirmed his death by checking his cold hands and his lack of breath. After that, she consumed the Ko Leung wine with two packs of rat poison. Shortly after that, she vomited out all the rat poison. She then consumed around 10 sleeping pills and went to bed. She did not know why she left the flat or how she ended up in a hospital. She never told anyone about her plan of killing and committing suicide. She thought about writing a will, but she was afraid that it might be publicized, so she prepared a note instead.
I turn now to the flat which is the crime scene. A scientific evidence officer, Mr Tam Chi-ching, attended the flat on 24 February 2019 for inspection. He found the son lying on the sofa. The son’s undershirt was stained with brown suspected vomit. A ligature mark of about 5 millimetres thick was noted around his neck. A broken flat USB cable of similar thickness was found hanging on a folding table beside the sofa. He found a suspected suicide note written in simplified Chinese. It was written on it, “Please dial this number and don’t be sad.”
A pot of soup was found on the stove next to the sink. Two torn opened and emptied plastic bags of rat poison were found amongst the trash in a rubbish bin.
The scientific evidence officer was of the view that it was consistent that the son had been strangled with the USB cable which was found hanging on the folding table and the possibility of him having been drugged could not be excluded. The presence of suicide note, a hanging loop made out of a charger cable, rat poison and emptied pill foil packs indicated there could have been a suicide attempt.
In respect of the toxicology, the Government Chemist detected the drug Zolpidem in the son’s blood and also in his stomach. Zolpidem, as stated by the pathologist, is a sleeping pill.
In the autopsy conducted by the pathologist, Dr Lam Wai-kwok, he found the cause of death was determined to be pressure on the neck. In other words, by means of strangulation. The drug, the sleeping pill detected, the sleeping pill drug Zolpidem detected in the stomach content indicated that the son had a recent consumption of the drug shortly prior to this death. The autopsy findings and the result of the toxicology analysis was in keeping with the fact that the son was given a bowl of soup mixed with some sleeping pills, then became unconscious, laid down on the sofa and was then strangled to death for a long period of time by a mobile phone cable.
I turn to the defendant’s background and mitigation. Mr Richard Wong has mitigated on the defendant’s behalf. He has asked me to treat her as a person of clear record as some 22 years ago she had a very minor offence for gambling in a gambling establishment to which she was fined $800. I do consider that offence to be long gone and spent.
The defendant is now 57 years of age. She was born in the mainland where she completed her secondary level education. She took up employment at the age of 18. The defendant met her ex-husband, the father of the son, in 1991 during a visit to Hong Kong. She married him in 1992, however, found he was unfaithful and irresponsible, yet she found herself pregnant in 1994 and started to feel depressed and then thought of terminating her pregnancy. The defendant was granted residence in Hong Kong in 1995 and gave birth to her son in July the same year. She separated from her husband shortly after that as her husband had deserted her and thereafter made no financial contribution nor contact with them her or her son. She divorced him in 2008.
She had worked as a cleaner, cleaning worker, from 2011 to 2016, then as a waitress for about one to two years before her latest job as a janitor for six months prior to this offence.
Her son was born in Hong Kong. The defendant described him as a slow learner since he was a toddler and had only marginal results on intelligence assessment and had dyslexia. He could not sustain employment after Form 5. I accept Mr Wong’s mitigation and what is referred to in the psychiatric report of Dr Wong Yee-him that the defendant was a very dedicated mother. She suffered from tremendous hardship when she raised her son as a single parent.
I accept she was extremely attached to her son and that she believed her son was over-dependent on her for his daily living and even for his own survival. There was, as Mr Wong says, no history of child abuse or neglect, quite to the contrary, she showed her son much empathy and concern. I have no doubt in my mind that the defendant will be guilt-ridden for the rest of her life.
As to the reason why, which led her to commit this offence, between late 2018 and January 2019, she experienced a number of stressors is what is stated in Dr Wong’s report at 12J. Her sister had developed cancer. Her son constantly blamed her for his own failure to find work. He scolded her for giving birth to him and this broke her heart. Her mother’s health had deteriorated and had frequent admissions to hospital. The defendant suffered from lip ulcers.
I turn now to the psychiatric evidence. The three psychiatrists considered that the defendant was suffering from an abnormality of mind at the time of this offence. The psychiatrist, Dr Jessica Lam of the Castle Peak Hospital and Siu Lam Psychiatric Centre, was the case medical officer of the defendant since her admission to Castle Peak in February 2019. She opined, inter alia, that at the time of the offence, the defendant was suffering from a major depressive disorder which is a recognized psychiatric disorder and a disease of the mind.
The other psychiatrists, Dr Wong Yee-him and Dr Li Cheuk-wing, who examined the defendant in December 2019, opined, inter alia, the defendant was suffering from active effects of delusional disorder and a severe episode of major depressive disorder with melancholic features, respectively. Those opinions were expressed prior to the defendant’s plea of guilty. After the defendant’s plea of guilty, I called for a further two psychiatric reports. They were compiled by Dr Dorothy Tang and Dr Jessica Lam, the same psychiatrists as had written the opinion on the defendant’s abnormality of mind.
I have taken into account all the reports and they have all set out the background of the defendant. The defendant was known to the Mental Health Service when she presented with insomnia, anxiety and multiple physical discomfort in 1999 and was diagnosed to have anxiety disorder.
The defendant was voluntarily admitted to Kowloon Hospital in September to October 2016 for paranoid beliefs and suicidal idea. She was diagnosed to have delusional disorder and given antipsychotics. She had erratic drug adherence. She had a second voluntary admission to the Kowloon Hospital in March of 2007 after she attempted to burn charcoal as she had paranoid beliefs.
Her paranoia subsided with medications and she was arranged to have follow-up after her discharge. She reported to have remission of her paranoid beliefs but ongoing insomnia despite treatment and adjustment of medications. She was largely stable until six months prior to this offence. She had worsened insomnia with low mood, increased physical discomfort with recurrent lip and aphthous ulcers and abdominal discomfort.
Her mood further worsened around two weeks before the index offence. She felt helpless and hopeless due to her persistent physical problems and financial burden incurred from repeated consultation for physical issues. She had suicidal ideas and asked her siblings to help take care of her son if she was not around.
She prepared for her suicide. She went to the Mandatory Provident Fund office to attempt to simplify the arrangement in withdrawing her MPF for her son after she died. It is clear that on the day of the offence she had low mood and fatigue. She also had mood congruent nihilistic delusions that her teeth were missing. She had throat pain and new lip ulcers. Feeling hopeless and not thinking of any alternative way out she decided to kill her son before she attempted to end her own life. At the time of the offence, she was suffering from major depressive episode.
Mr Wong has tried his utmost to persuade the court to place the defendant on probation. In short, he has said that the defendant has been detained for 20 months. She had had treatment there. She has made much improvement and submits that she does not pose a great danger to the public. Effectively, he says she has served a term of imprisonment of about 2½ years given the fact that she has been detained for 20 months. He asks me to extend leniency to the defendant in view of her frank admission to the police officer and her immediate plea of guilty to manslaughter.
Although the defendant’s depression is largely in remission with her treatment during her remand it is clear to me that her insight into her mental health has improved but has remained partial. I refer to Dr Jessica Lam’s report, particularly as Dr Lam has been the case officer of the defendant since her early admission in 2019 immediately after this offence.
Dr Lam is of the view because of the severe nature of her psychotic depression with tendency of dangerous acting out, for example, her burning charcoal in 2017 and the present offence, her history of erratic medication adherence, her vulnerability to stress, for example, further mood and sleep decline after change of work, further psychological input and inpatient rehabilitation is recommended. Dr Dorothy Tang also recommends that the defendant have further inpatient treatment for her rehabilitation. Both Dr Tang and Dr Lam recommend a hospital order for one year under section 45 of the Mental Health Ordinance and to serve her sentence at the Siu Lam Psychiatric Centre.
I turn now to the sentence.
The probation officer has stated very clearly that probation with express reservation is a sentencing option provided that the defendant is not in need of inpatient treatment. As the defendant is in need of inpatient treatment, I do not consider probation to be a suitable option.
As I mentioned, I fully accept that you (the defendant) had assisted the police from the very outset and what you told them at the outset was confirmed by all the evidence. You have pleaded guilty and, as I said, you will feel guilty-ridden, no doubt, for the rest of your life.
Having considered all the relevant circumstances, including the nature of this offence, that is of manslaughter, the character and antecedents of yourself, all the character references, the letters written to me, the psychiatric evidence placed before me and the other available methods of dealing with you, I find the most suitable method of disposing of this case is by imposing a hospital order under section 45 of the Mental Health Ordinance and for you to be admitted to Siu Lam Psychiatric Centre for a specified period of 1 year as recommended by Dr Tang and Dr Lam, and I so order.