The State v Patricia Makurumure

The accused was charged with murder for setting her husband alight on 20 September 2009 while he was asleep at home after arriving drunk. The deceased sustained 85% degree burns and died on 23 September 2009 from respiratory failure. The accused admitted the facts but pleaded diminished mental responsibility. She testified that while lying in bed beside her husband, she heard the voice of her late grandmother instructing her to kill her husband before he could kill her. She saw her husband as a short man and believed she was fighting these short men. The couple had been in an abusive marriage characterized by domestic violence and had an altercation on the fateful night before retiring to bed. The accused had a family history of mental illness (father had mental illness, cousin suffered epilepsy, aunt committed suicide). As a child, the accused suffered from fits treated by a spiritual healer. She had problems sleeping and experienced hallucinations related to healing powers in her church role.

• Whether the accused was suffering from a disease of the mind at the time of committing the offence
• Whether the accused had diminished mental responsibility under section 248 of the Criminal Law Code
• Whether the special plea of insanity should be accepted based on expert medical evidence
• Whether the accused knew the nature and quality of her conduct when she killed the deceased

The accused was found not guilty by reason of insanity. A special verdict was returned under section 29(2) of the Mental Health Act [Cap 15:12].

Where an accused person charged with murder establishes on a balance of probabilities through credible testimony and corroborative empirical medical evidence that at the time of committing the act, they were suffering from a disease of the mind (such as temporal lobe epilepsy) which caused them not to know the nature and quality of their conduct, a special verdict of not guilty by reason of insanity must be returned under section 29(2) of the Mental Health Act. The defense of diminished mental responsibility requires expert medical evidence confirming a diagnosable mental disorder, preferably supported by objective medical testing, and the accused's account must be consistent with the symptoms and manifestations of the diagnosed condition.

The court acknowledged that defenses of diminished mental responsibility ought to be treated with extreme caution as such defenses are easy to fabricate but difficult to rebut. The court noted that not every person acting under the influence of temporal lobe epilepsy will have no independent recollection of their conduct at the material time - this is the norm but there are exceptions. The court also observed that domestic encounters and altercations can trigger attacks in people susceptible to temporal lobe epilepsy, leading to irrational criminal conduct.

This is a Zimbabwean case, not a South African case. However, it illustrates the application of the insanity defense in circumstances where the accused suffers from temporal lobe epilepsy, a neurological disorder. The case demonstrates the evidentiary threshold required to establish diminished mental responsibility, including the need for credible expert medical evidence corroborated by empirical testing (EEG). It highlights the court's approach to distinguishing genuine mental illness from fabricated defenses, emphasizing that while such defenses must be treated with caution, they should be accepted where supported by credible scientific evidence. The case also shows how domestic circumstances (abusive relationships, altercations) can trigger episodes in persons susceptible to temporal lobe epilepsy.