R v Adomako

Facts

The appellant was the anaesthetist during an eye operation. A rubber tubing connecting the patient to a ventilator became disconnected. The appellant did not notice the disconnection for several minutes, by which time the patient had suffered irreversible brain damage and later died. The prosecution alleged that this failure constituted gross negligence manslaughter.

History

The appellant was convicted of manslaughter at the Crown Court. The Court of Appeal dismissed the appeal against conviction. The appellant appealed to the House of Lords.

Issue

Whether the test for gross negligence manslaughter requires a subjective awareness of risk, or whether an objective standard of gross negligence suffices; whether the Bateman test remains good law; whether professional defendants are subject to a different standard.

Held

Appeal dismissed. The conviction for gross negligence manslaughter was upheld.

Ratio

• The test for gross negligence manslaughter is whether the defendant's conduct departed from the proper standard of care incumbent upon him, involving a risk of death, to such an extent that the jury considers it criminal; no subjective foresight of risk is required.

The judgments

Key reasoning

• The House of Lords reviewed the historical development of gross negligence manslaughter from Bateman through to modern authorities.
• The court rejected the argument that Caldwell recklessness or subjective foresight should be imported into the offence.
• The court held that the civil standard of care, adjusted for the criminal context, provides the baseline, and that the jury's role is to determine whether the departure from that standard is so serious as to be criminal.
• The court clarified that the risk must be one of death, not merely of injury, and that the standard of care is that of a reasonably competent professional in the defendant's field.

Obiter

• The court indicated that the same principles apply to all cases of gross negligence manslaughter, not only medical cases.

Where it fits in the module

Adomako sits at the centre of the gross negligence manslaughter debate in Topic 2. It connects with Stone and Dobinson on omissions liability, with the causation cases such as Cheshire and Malcherek, and with later developments in cases like Misra and Srivastava and Evans. It also contrasts with the subjective recklessness approach in Cunningham and with Caldwell objective recklessness, which the House held need not be imported into the test.

Criticisms

• The objective test may criminalise mere incompetence without moral culpability, blurring the line between civil negligence and crime.
• The requirement that the jury decide whether negligence is 'gross enough' to be criminal gives insufficient guidance and risks inconsistent verdicts.
• The application of the same test to professionals and laypeople may not adequately account for the complexity of professional decision-making under pressure.
• The exclusion of a subjective element means a defendant who honestly but unreasonably believed there was no risk can still be convicted.