Airedale NHS Trust v Bland (1993)
AGís Ref (No 3 of 1994) (1996)
D was a doctor charged with the murder of one of his patients, who was terminally ill, by means of an overdose of painkillers. The court stressed that ìif life were cut short by weeks or months it was just as much murder as if it was cut short by yearsî. This statement qualified the rule that a doctor would not face criminal proceedings if he gave an injection towards the very end of a patientís life, to ease his suffering, even if it was known that this might well accelerate the death by a very small degree.
Airedale NHS Trust v Bland (1993)
Tony Bland was in a persistent vegetative state with no prospect of improvement or recovery, as a result of being badly crushed in the Hillsborough football stadium disaster in 1989. The NHS Trust applied to the courts for a declaration that it was lawful for doctors to withdraw life-supporting medical treatment, including artificial feeding, from the patient. The H of L gave permission to withhold further treatment, as long as three specified conditions were satisfied. One of these was that the patient had to be in a PVS with no hope of recovery.
Jodie and Mary were conjoined twins. Mary only stayed alive because a common artery allowed Jodie, the stronger twin, to circulate blood for both of them. However, doctors believed that if Jodie was not soon separated from Mary she too would die. The doctor faced a dilemma: if they went ahead with the operation, Mary would die and this could be classed as murder, following the principles laid down in Woollin. If the doctors did nothing and allowed Jodie to die, they could be guilty of gross negligence manslaughter. The C of A used the defence of utilitarian necessity to decide that the doctors would not be acting unlawfully. It can now be said that the circumstances in which a doctor will still be within the limits of lawful homicide have been increased.
Attorney Generalís Reference (No 3 of 1994) (1996)
D stabbed his girlfriend, who he knew to be about 23 weeks pregnant. The woman made a good recovery but seven weeks later she gave birth prematurely. The baby was born alive but died four months later, as a result of having been injured before birth by the stab wound. D was found guilty of GBH in relation to the mother, but the H of L decided that a murder charge could not be sustained in relation to the baby if D had not intended to kill or seriously injure the foetus itself. It was, however, decided that a manslaughter charge could be brought in these circumstances.
The H of L agreed that GBH had no special meaning, saying: ìbodily harmî needs no explanation and ìgrievousî means no more and no less than ìreally seriousî.
D was charged with inflicting GBH contrary to s.20 OAPA 1861 after punching a stranger in the face, breaking his nose. He was convicted after the jury was directed that GBH meant ìserious injuryî. The C of A dismissed Dís appeal, holding that the omission of ìreallyî was not significant.
D attacked V in a pub, hitting him many times with a chair. V subsequently died from his injuries. D appealed against his conviction, stating that the trial judge had misdirected the jury by saying that D was guilty of murder if he intended to cause serious harm. The H of L was unanimous in its opinion that the intention to cause GBH constitutes enough blameworthiness to amount to malice aforethought.
D poisoned his motherís drink, with the intention of killing her so he could inherit under her will. Hs mother was later found dead, with the poisoned drink beside her. However, medical evidence established that she had actually died of a heart attack, not poisoning. D was acquitted of murder as he had not in fact caused her death (he was, however, convicted of attempt).
D and V had been involved in a high-speed car chase. V lost control of her car and was killed. It was not clear what had happened prior to the car going out of control; the prosecution put it that Dís driving had led V to lose control of her car. The trial judge told the jury that they did not have to be sure that Dís driving was ìthe principal, or a substantial cause of the death, as long as you are sure that it was a cause and that there was something more than a slight or trifling linkî. The C of A confirmed that the contribution must merely be something more than ìa slight or trifling linkî.
D was being pursued by the police for several serious offences. He was hiding in his flat with his pregnant girlfriend. Armed with a shotgun, D came out of his flat, using his girlfriendís body to shield himself as he tried to escape. D then fired his shotgun at two officers, who immediately returned fire, killing Dís girlfriend in the crossfire. D was found guilty of manslaughter, but appealed against his conviction, arguing that in fact the police officers had been the cause of Vís death. The C of A rejected this argument, saying that it was reasonably foreseeable that the police would return fire either in self-defence or in the lawful exercise of their duty.
V jumped into a river to escape further violent assaults. This was held to be an entirely reasonable response in the circumstances and D was held responsible for Vís death.
V jumped out of a moving car travelling at 20-40 mph to escape Dís sexual advances. D had claimed earlier that he had beaten up other girls who had refused his advances. The C of A decided that Vís reaction to the threat was a reasonable one and that D was responsible for her injuries. The court stated that the matter would have been different if the girl had done something ìso ìdaftîÖor so unexpectedÖthat no reasonable man could be expected to foresee itî
The Ds had given a lift to a hitchhiker, V, who was on his way to the Glastonbury festival. Five miles further on, V jumped out of the moving car and was killed. The prosecution claimed that V had jumped because he was in fear of being robbed. The Ds were convicted of manslaughter and robbery but appealed. The C of A stressed that Vís conduct had to be proportionate to the threat of harm and ìnot so daft as to make his own act one which amounted to a novus actus interveniens and consequently broke the chain o causationî. The Dsí convictions were quashed because the jury had not been directed accordingly.
D had misread a train timetable so that the track had not been re-laid by the time a train arrived. D had also failed to put any fog signals in place and had positioned a flagman too close to the station. The train driver failed to stop and an accident occurred, causing many deaths. D was charged with manslaughter. The judge ruled that, provided that Dís negligence had been the main or a substantial cause of the accident, it was no defence to state that the deaths might have been avoided if the other people involved had played their part correctly.
The Ds had stabbed and injured their respective victims so badly that they had to be put on life support machines. The Ds tried to argue that when these machines were switched off by doctors, this broke the chain of causation and it was actually the doctors who had caused the death. The C of A rejected this argument, describing the notion that Malcherek and Steel had not caused death as ìbizarreî.
D cut Vís hand with an iron instrument. The wound became infected and V developed blood poisoning, but he ignored medical advice that he should have his finger amputated. As a result, lockjaw set in and V died. Despite the fact that the amputation would have probably saved Vís life, D was found guilty of Vís murder. The question for the jury to consider was simply whether the wound inflicted by D was the cause of death.
D stabbed V, who was admitted to hospital where she was told that a blood transfusion was necessary to save her life. Due to Vís religious beliefs as a Jehovahís Witness, she refused the treatment and died shortly afterwards. Medical evidence indicated that V would have survived had she accepted the blood transfusion. D was convicted of manslaughter. D appealed, arguing that Vís refusal of treatment was unreasonable and so broke the chain of causation. The C of A upheld Dís conviction, saying that ìthe question for the court is what caused Vís death. The answer to this is the stab wound. The fact that V refused to stop this end coming about did not break the causal connection between the act and the deathî.
V was in hospital after a very severe attack on him by D. Whilst there, he was discovered to have an ulcer. Due to his serious condition caused by the attack, the ulcer could not be operated upon. It burst and V died. The C of A upheld the principles stated in Blaue and D was convicted of Vís death.
D slashed V with a Stanley knife, severing an artery. V died two days later from the wounds but (for reasons that are unclear) failed to do anything to staunch the blood flow. D was convicted of murder. The cause of Vís death was blood loss which, in turn, was caused by stab wounds inflicted by D. Hence, D caused Vís death.
V had been stabbed. He was admitted to hospital and given a drug called terramycin to prevent infection, to which he had previously proved allergic. This treatment was described in court as ìpalpably wrongî. Furthermore, large quantities of liquid had been administered intravenously which led to V contracting pneumonia, the medical cause of death. By the time of Vís death, his stab wounds had practically healed. Dís conviction for murder was quashed, although the court did point out that in cases where normal treatment was given, the original injury would be considered to have caused the death. The C of A has since described this case as ìvery exceptionalî; to date, however, Jordan has never been expressly overruled.
V, a soldier, was stabbed twice by D in a barrack-room fight. While being carried to the medical station, v was dropped twice. The medical staff were very busy and so did not treat V for 45 minutes. When V was eventually seen, the doctor did not realise the full extent of his injuries and consequently administered treatment which was described in court as ìthoroughly bad and might well have affected his chances of recoveryî. V died an hour later and D was convicted of murder. The court stated that provided that the original wound was still an ìoperating and substantial causeî at the time of the death, D would still be liable for the death even though some other cause of death was also operating.
D shot V in the stomach and the leg during an argument. V was admitted to hospital where he underwent major surgery. The operation was successful but V developed breathing problems and had to have a tracheotomy tube inserted. Two months later, V died of a heart attack, as a result of his windpipe becoming obstructed. It was argued that this was due to the negligence of the hospital when the tracheotomy tube was fitted and that it had therefore broken the chain of causation. By the time of Vís death, the gunshot injuries had almost healed and were no longer life-threatening. D was convicted of murder. The C of A stated that D would not be excused from liability unless the negligent treatment ìÖwas so independent of his acts and in itself so potent in causing death, that they regard the contribution made by his acts as insignificantî. The court also stressed that it was only in ìthe most extraordinary and unusual caseî that medical treatment would break the chain of causation.
V, a 71 year old man, was attacked by D late one evening. V was taken to hospital suffering facial bruising and chest pain. He developed pneumonia and died two days later. D tried to argue that V would not have died if he had been given sufficient oxygen and evidence given by experts supported this. D was found guilty of murder and the C of A upheld the conviction, stressing again that if Dís attack had made a significant contribution to Vís death it was immaterial whether ìincompetence or mistake in treatmentÖmay have also contributed significantly to the deathî.