A dreadful failure of the mental health system

Recently there was a story about a woman who killed her severely autistic daughter. The mother was convicted on a count of murder and sentenced to 4 years in jail, in a case that is as damning on the mental health system in New Zealand as it is tragic.

There is no doubt that killing Ruby Knox was wrong. There is also no doubt that it involved premeditation. But the motive for Donella Knox killing her is completely different. This was not done for monetary benefit or similar. This was in respect a sort of mercy killing.

Yes, Ruby was killed by her mother. In a conventional sense, one would call it murder. But this is not a conventional case. Ruby’s mother clearly loved her daughter dearly and based on the evidence, the decision to kill her daughter would have been a harrowing decision for her to make. And it is quite possibly given the immense stress that having a child requiring 24 hour care, with no assistant caregiver to relieve the workload, she herself was mentally unwell – on the point of complete breakdown; driven to desperation in a sense only she would understand.

Thus I do not think this could be called murder. Ultimately Donella did commit murder, but when the facts are considered, it was more of a mercy killing/self defence, knowing further harm to herself was inevitable, and that Ruby was going to continue to suffer. And the possibility of Donella Knox committing murder in the future is zero. She poses no threat to society. And in some respects, caring for Ms Knox was a life sentence in itself – no holidays, no relief care givers or care other than that offered by her friends who by their own admission are not qualified care givers.

Ruby had additional medical issues that made Ms Knox’s job even harder. A severely autistic person is quite unpredictable. When backed into a corner or in a situation they do not know how to handle, they can quickly turn violent and need to be restrained. Ruby also had spina bifida, could not speak, had a severe intellectual disability and could not comprehend what she was doing, as well as complications from surgery, among other issues.

It is quite the blight on the New Zealand health system that 24/7 care givers are only paid $1.50/hr more than the minimum wage. These are people are trying to look after a person incapable of looking after themselves, who need to be fed, toileted, showered, bedded, but who also protect them and anyone in their presence. There is little incentive to want to work in a crucial sector where you are responsible for the well being of someone who can go from peaceful to violent in a flash, not because they have. A care giver also has significant trouble having their own lives, as they are on round the clock call, yet need just like everyone else occasional holidays and time out.

Thus, the move by friends of Donella Knox to raise awareness of the issue and prevent such a sad case ever happening again, is commendable.

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