Bill, a drug addict, asked Lena his wife to inject him with heroin. She protests but knowing he will do it himself if she refuses, complies with his request. A few minutes later, Bill fell unconscious. Lena felt his pulse which is faint. She panics and runs out of the house although she knows B is very ill, she fails to call the emergency service. After 2 hrs(fearing and undecided that she will be caught for heroin possession), she calls an ambulance. It takes a further hour for it to arrive as the ambulance workers decided to finish a game of cards. Bill dies. Discuss the liability of all parties involved. Medical autopsy shows that if Bill have received medical help within an hr of his collapse, his death would have been prevented.
Ans by the author:
Cases to look at: R v Ruffell, R v Sinclair Johnson and Smith….
In this case we first have to look for possible offences that Lena could be charged with. Murder? Manslaughter?
But for Murder…the actus reus(unlawful act) and mens rea(culpable state of mind) must be proven as well as no probable defenses such as insanity, automatism etc We also have to examine whether there is any break in the causal links between the unlawful act that Lena committed to Bill’s death.
Applying the law to the facts,
Lena could be charged with either murder or manslaughter….but the facts of this case seems to point out that Lena lacks the mens rea for unlawful killing of a human being, therefore the charge of murder may be dismissed.
Unlawful and dangerous act manslaughter: It must be proven that Lena committed an unlawful act which was objectively dangerous, causing the death of Bill (AG: Ref No. 3 of 1994) (Published in 1998).
To establish the actus reus of unlawful act manslaughter, it must be proven that Lena’s act of injecting the heroin was both a factual and legal cause of the death of Bill.
To determine the factual cause, the court may apply the “But For Test” as seen in (R v White).
“But for Lena injecting Bill with heroin, Bill would not have died” (R v White). Therefore it is determined that Lena’s action is a factual causation.
To determine the legal causation (the question of whether Lena’s conduct was the legal cause of Bill’s death we must apply the principles in R v Smith 1959 COA whereby Lena’s actions is the operating and substantive cause …additionally it must be proven by prosecution that Lena’s act need not be the sole cause or min cause as long as Lena’s act contributed significantly to Bill’s death (R v Cheshire 1991 CA). (Continuous, operating and substantive)
What defines significant contribution? We look at in the case of Cato 1976: The COA held that the prosecution had to prove that the injection of heroin was a cause of death and not merely de minimis. The vol. injected must fall beyond the de minimis range, bearing upon the acceleration of the victim’s death.
May it be argue by the defense that whether are there any possible break in the causal link caused by the negligent ambulance workers? (novus actus interveniens)?
Could the failure of the ambulance workers to arrive at the scene at timely fashion act as a break in the causal link? Let’s go back to R v Smith….if only the actions of the ambulance workers is SO OVERWHELMING in causing death that it rendered the victims initial wounds to be merely the setting will the chains of causation be broken.
The delay of the ambulance will not be the break in the causal link for the simple reason that Bill would have only been saved if medical attention was given within one hr of his collapse based on the autopsy….since Lena took two hrs to call for the ambulance, Bill would have died anyway looking at the facts of this case. (R v Sinclair Johnson and Smith)
Ambulance delay is not an overwhelming cause and the principles in Smith is not applicable.
Looking at the ambulance workers: whether or not Bill live or die, they ought to perform at their line of duty, thus they are also chargeable on the stance that they breach their duty of care to citizens. 1. assumption of duty once they join the medical team 2. wilfully breach of duty 3. breach of duty result in death(this third point however cannot be proven in this case.
Therefore…case closed……Lena can be charged with gross negligence manslaughter.
thelegalarguments 
It’s a great start. ..