Facts
The defendant stabbed the victim, who was taken to hospital. About eight days later the wound was mainly healed. The victim showed intolerance to an antibiotic, terramycin, which was stopped, but it was later given again and large quantities of liquid were also given intravenously. He died of pneumonia and the fresh medical evidence before the appeal court was that this treatment was the cause of death.
History
The defendant was convicted of murder at trial. He appealed against conviction.
Issue
Whether negligent medical treatment breaks the chain of causation between the defendant's act and the victim's death.
Held
Appeal allowed; murder conviction quashed.
Ratio
- Medical treatment breaks the chain of causation only if it is palpably wrong or so independent of the original injury that it becomes the sole cause of death.
The judgments
Court of Appeal (majority)
The court quashed the murder conviction. On the fresh medical evidence the treatment was abnormal and palpably wrong, and was the cause of death, with the stab wound being no more than the setting in which that treatment was given.
Key reasoning
- The original wound was healing and no longer a substantial cause of death.
- The medical treatment was negligent in administering a known allergen.
- This negligence was so independent that it became the sole cause of death.
- Therefore the chain of causation was broken.
Where it fits in the module
This case introduces the causation debate in criminal law, contrasting with Smith (1959) which required the original wound to be an operating and substantial cause at the time of death, and Cheshire (1991) which held that medical negligence rarely breaks the chain unless it is truly independent. It also relates to Blaue (1975) on the thin skull rule and Roberts (1971) on victim's own actions.
Criticisms
- The 'palpably wrong' test is vague and difficult to apply.
- It creates a distinction between medical negligence that is a response to the injury and that which is independent, which can be arbitrary.
- Later cases have narrowed the scope, making it rare for medical negligence to break the chain, potentially undermining the principle.
- The decision may place too much weight on the quality of medical care rather than the defendant's responsibility for creating the need for treatment.
Written with AI (nvidia/nemotron-3-ultra-550b-a55b) on 1 November 2026, reviewed for errors by a second model (claude-sonnet-5.5 (Claude Code reviewer)). Read the case itself at (1956) 40 Cr App R 153. Spotted an error? Tell us.