Problem Question: Criminal Law, No.14

Problem Question: Criminal Law, No.14

Problem Question

Derek, a qualified doctor, works in a large hospital. One of his patients, Cedric, has been in a coma for several months. Cedric has no relatives, and Derek and his colleagues agree that he has no chance of recovering consciousness. Derek switches off the life support machine which is keeping Cedric alive; Cedric quickly dies. Later that day, Derek is treating another patient, Hilda. Hilda is suffering from serious cancer and is thought to have only a week left to live. She is in severe pain, so Derek injects her with a large dose of painkillers, even though he knows that this will accelerate her death. Hilda dies that night. That afternoon, Derek is working in the accident and emergency department. George and Ernest are brought in; they have been involved in a serious car crash. George is unconscious but otherwise appears unharmed. Ernest has lost a lot of blood in the accident and is in urgent need of a blood transfusion. Derek discovers that the hospital has run out of blood which matches Ernest’s blood group. He takes a blood sample from George, which proves to be the right type. He therefore removes a further litre of George’s blood, which he transfuses to Ernest. Both George and Ernest later recover. Could Derek be liable for Cedric’s death, Hilda’s death, or for any unlawful acts in relation to George?

Analysis

Cedric's Death

1. Gross Negligence Manslaughter

• Duty of Care:

◦ Derek, as a doctor, owed Cedric a duty of care. The duty of care extends to ensuring that any actions taken (or omissions) are in the best interests of the patient.

• Breach of Duty:

◦ In Airedale NHS Trust v Bland [1993], the House of Lords considered the withdrawal of life-sustaining treatment. The decision to stop life support was deemed lawful given Cedric's prognosis of no chance of recovery.

◦ Since Cedric had no chance of recovery, Derek's action to switch off the life support machine, while a significant intervention, falls within the bounds of medical judgment about the best interests of the patient.

• Causation and Liability:

◦ Omission vs. Commission: The act of switching off life support could be considered an omission in the legal sense. However, Derek’s actions were in line with established medical practice and legal precedent for cases where there is no chance of recovery.

◦ Chain of Causation: The decision to withdraw life support does not break the chain of causation as it aligns with the court’s findings in Bland where withdrawal of treatment was deemed lawful and not a criminal act.

Conclusion: Derek is unlikely to be liable for Cedric’s death as his actions were consistent with established legal and medical standards regarding patients with no chance of recovery.

Hilda’s Death

1. Murder

• Actus Reus and Mens Rea:

◦ Actus Reus: Derek administered a large dose of painkillers to Hilda, which accelerated her death.

◦ Mens Rea: Derek knew that the dose would accelerate Hilda’s death.

• Intention and the Woolin Test:

◦ In R v Woollin [1999], the test for indirect intention involves determining whether the result was a virtual certainty of death and whether Derek foresaw this as a virtual certainty.

◦ Derek’s intention was to relieve Hilda’s pain, but the knowledge that the dosage would hasten her death shows indirect intent.

• Constructive Manslaughter:

◦ Unlawful Act: Administering the dose that accelerates death could be construed as an unlawful act if it is not justified by the context.

◦ Dangerous Act: The administration of the drug, given the intent and outcome, would be considered dangerous.

◦ Causation: The act directly led to Hilda’s death.

Conclusion: Derek could potentially be liable for murder if it is found that he intended to cause death or knew that death was a virtual certainty. Constructive manslaughter may also be applicable if his actions were deemed unlawful and dangerous.

George’s Blood Transfusion

1. Battery

• Actus Reus: Derek took blood from George without his consent, which constitutes an act of battery.

• Mens Rea: Derek’s intent was to use the blood to help Ernest, but consent is a critical element in determining liability for battery.

◦ Consent: In R v Donovan [1934], consent is a valid defence unless the act is deemed unlawful or excessive. George did not consent to the removal of his blood.

◦ Medical Necessity: The medical context and the necessity of the transfusion for Ernest complicate the matter but do not negate the requirement for consent.

Conclusion: Derek’s actions in taking George’s blood without consent could constitute battery. Even though the act was intended to save another’s life, the lack of consent from George makes Derek potentially liable for this unlawful act.

Summary

• Cedric’s Death: Derek is not likely to be liable for Cedric’s death. His action of switching off the life support was consistent with medical and legal standards given Cedric’s prognosis.

• Hilda’s Death: Derek could be liable for murder or constructive manslaughter due to the indirect intention to cause death by accelerating her demise with a large dose of painkillers.

• George’s Blood Transfusion: Derek could be liable for battery due to the lack of consent from George for the blood removal, despite the beneficial outcome for Ernest.