Introduction..........................................................................................................................................

2
Causation and blameworthiness..........................................................................................................2
Purpose of establishing causal responsibility.......................................................................................3
Causation: The legal position................................................................................................................3
Factual Cause....................................................................................................................................3
1. omission as factual cause......................................................................................................3
2. Causes and conditions contracted........................................................................................4
3. Particular instances of factual causation..............................................................................4
Legal Cause........................................................................................................................................4
1. The general framework of imputing cause...........................................................................4
Particular examples of causal sequences giving rise to causation problems......................................6
A Subsisting conditions.....................................................................................................................6
1. Medical conditions: thin skull principle................................................................................6
2. Other subsisting conditions..................................................................................................6
3. Subsequent acts and events.................................................................................................7
a. Self-inflicted harm- the escape cases................................................................................7
b. Self-inflicted harm- contributory negligence....................................................................8
c. Self-inflicted harm- victim commits suicide......................................................................9
d. Third party reactions to the danger posed by the defendants conduct...........................9
e. Medical responses to the danger caused by the defendant............................................9
4. Breaking the chain of causation- intervening acts supersedes defendants act.................10
a. Intervening acts of third parties (Novus actus interveniens).........................................10
b. Intervening act by victim.................................................................................................10
c. When will inappropriate medical treatment break the chain of causation?.................11
d. Intervening events..........................................................................................................11
Summary.............................................................................................................................................12

1
Causation

Introduction
All result crimes require a causal link between the act of the defendant and the result. Result crimes
are those which bring about some form of harmful consequence. Criminal liability for result crimes
will be imposed when there is proof of an act of omission with necessary mental attitude which is
causally connected to the harmful consequence. A causal link is necessary to prove it does not
matter if it is incorporated in the definition of the offence or not. It must be proved that the
defendant has caused the harm.

For example, it does not matter whether he is charged under section 18 of the Offences Against the
person Act 1861 for causing grievous bodily harm or charged under section 20 of the same act for
maliciously inflicting grievous bodily harm. For both sections causation needs to be proved as
inflicting also requires a causal link. For murder it must be proved that the defendants act or
omission caused the death. For assault it must be proved that the defendant caused an undesirable
physical contact. The prosecution must show that there is a link between a particular act that the
accused committed and the criminal harm.

Case- A delivers a lethal dose of poison to B in the form of an adulterated chocolate. Having eaten
the chocolate, but before the poison has time to work, B is shot dead by C (or dies in a car accident).
The cause of death is the act of C. even though A poisoned B, his death was caused by being shot by
C.

Causation and blameworthiness

Causation and fault are separate elements of an offence. A person can be found to cause a harmful
result without being blameworthy and a person who may be blameworthy may not have caused the
result.

Case- A and B, two joy-riders, drive through an army roadblock. Although they present no threat to
the soldiers manning the roadblock, the soldiers, against orders, fire into the retreating car. The gun
of C, another soldier, asleep at his post, goes off accidentally when C is startled by the noise. The
resulting shot kills A. The shots of the other soldiers miss their target. C causes the death despite not
being blameworthy while the other blameworthy soldiers did not cause the death.

Causality is often influenced by judgement of fault. Courts are not willing to put causal
responsibility on blameless defendants. Thus, courts will attach criminal liability for harm to the
person who is blameworthy for creating the sequence of events that caused the harm.

For example, doctors who administer pain relief drugs for therapeutic purposes which accelerate the
time of death are not held liable for death. This was seen in the case of R v Dr Bodkins Adams
[1957]. Another case is Pagett [1983] where the defendant who used his girlfriend as a human
shield was held causally liable for her death even though the police officers had shot her.

Purpose of establishing causal responsibility

Without establishing causation there would be nothing to link the harm to the defendant.
Establishing a causal link allows us to determine how the victim has been wrong.

2
Causation: The legal position
Common law position can be found in the Draft Criminal Code Bill (1989). Clause 17 reads as follows:

1. A person causes a result when he/she

(a) does an act which makes a more than merely negligible contribution to its occurrence,
or
(b) omits to do an act which might have prevented its occurrence and which she/he is
under a duty to do according to the law relating to the offence.
2. A person does not cause a result where, after he does such an act or makes such an omission,
an act or event occurs which.
(a) is the immediate and sufficient cause of the result.
(b) he did not foresee; and
(c) could not in the circumstances reasonably have been foreseen.

In simple words, a person is liable for a result and offence the defendant’s act, or omission must be
seen as having contributed to the harmful result which occurred and nothing abnormal should have
happened after the defendants act or omission to make it appropriate to ignore the defendants
contribution. The defendants act or omission must be the FACTUAL and LEGAL CAUSE of the harm.
The prosecution has to find an unbroken causal link between the defendant’s act and harmful
result.

Factual Cause
Where the harmful result would have occurred irrespective of the defendant’s act, he cannot be the
legal cause of that harm. So, where the defendant is not the factual cause of the harm, he cannot be
the legal cause.

White [1910] where the defendant poisoned his mother, but she died of a heart attack before the
poison could take effect. She not guilty of the murder because the poisoning had not caused the
death. The defendants action made no difference the mother would have died either way.

1. omission as factual cause.

The same rule applies to omissions as factual causes. Morby [1882] where the defendant had failed
to call a doctor when his children had smallpox for religious reasons. He was not held liable because
it could not be shown beyond reasonable doubt that the children could have been saved if proper
efforts would have been made to save him. In criminal law to find someone accountable is based on
finding the harmful result as the agents doing. The mere fact that he was in breach of his duty and
that satisfying the duty could have saved the child does not mean the death was his ‘doing.’ Even
today smallpox is dangerous, and, in many cases, medical cure is not successful so we could rarely be
sure if getting medical attention would have the patient’s life.

As a matter of justice, liability for consequences due to a breach of duty because of ignorance or
weak misjudgement won’t be imposed in the absence of the clearest evidence that the harmful
result could have been prevented.

2. Causes and conditions contracted.

A distinction must be drawn between factual causes and mere conditions to find out what causes a
consequence. Factual causes must be determined from the ‘but for’ conditions. Hart and Honoré
have described cause as “something which interferes with, or intervenes in, the course of events
which would normally take place”. To be a cause an event must be abnormal or extraordinary.
Abnormal is something that makes a difference between the accident and things going as normal.

3
Case- A gives B a knife for his birthday and B kills V with it does not mean that A’s act is a cause of
V’s death. What makes a difference is the ‘voluntary’ decision by the actor to stab V. It is not B, who
causes the stab V.

3. Particular instances of factual causation.

Case 1 and White (above) A is not the factual cause of the B’s death because his death would still
have occurred but for A’s conduct and his conduct made no difference. In white the defendants
mother died of a heart attack not because of the poison she gave her.

Case- A shoots B. He leaves him dying in the road. C, a driver who is not paying attention, runs over
B, advancing the time of death a few minutes. Both A and C are the factual causes of B’s death. An
act which advanced the time of death then is also a cause. A is the factual cause of death but for his
act B would not be dead. C’s the factual cause because but for his act B’s life would not have been
foreshortened.

Where a person has dies due to assault caused by 2 or more people it is held with medical evidence
that either wound could have caused the death and thus, all assassins are the factual cause of death.
Even where the prosecution is unable to prove that but for the action of one of them the death
would not have occurred. This makes the factual causation test somewhat reliable.

Legal Cause
Legal causes are referred to as assignable, attributable, proximate, blameable, or imputable causes.
Each term in its own way expresses the requirement that it must be fair to select the defendant to
bear responsibility but no precise formula exists to sustain this requirement. There are no ‘hard and
fast’ rules of causation.

However, if the defendant’s acts or omissions are a factual cause of the harmful result it will be
morally appropriate to hold him liable since there will be a direct link between a wrongful act of the
accused and the harm suffered by the victim. This may include shooting, punching, wounding, and or
poisoning the victim. The harm the victim suffers will be the defendant’s ‘doing’. In cases where a
third party has broken this chain of causation the defendant will not be held liable.

1. The general framework of imputing cause.

Where the victim suffers because of someone else, the person will only be the legal cause of the
harm victim suffered if the injury was caused by the wrongful act of the defendant rather than the
fact of the act.

a. The purpose of causation is to hold a person accountable for their wrongful act which
causes a harmful consequence. Where the result is caused by the wrongful act it is
appropriate to hold the defendant accountable.

Dalloway [1847] where a driver of a horse and cart was driving without his hands on the reins and a
child ran in front of the cart and died. The driver was only liable for the death it could be shown that
proper use of the rein could have avoided the accident. Although the driver was the factual cause of
the child’s death, he was not the blameable cause.

b. To be the legal cause the defendants act must have substantially contributed to the
harmful result it need not be the sole cause. The defendant is not seen as the cause of a
consequence if their causal contribution is negligible (insignificant).

Adams- a doctor prescribed a terminally ill patient with a life-threatening dose of drug for the
purpose of pain relief. The question before the court was whether the doctors act has caused the

4
patient’s death. Delvin J stated that the issue is that causation was not established simply upon
proof that the measures taken had the effect of accelerating the death, as long as the doctor was
exercising himself to relieve pain. Delvin j didn’t specify the reason for his conclusion, but it can be
assumed that he thought the doctors’ actions were too negligible (insignificant) to be causal.

Where there are other causes which contributed to or could have avoided the result, they do not
bear upon the issue of causal responsibility unless the later cause is so significant that it renders the
initial act insignificant.

R v Benge [1865] where the defendant a foreman platelayer failed to check the train s timetable to
ensure the men working for him were safe on the line. The train killed one of the men working. The
defendant argued that the driver of the train could have prevented the death if he kept a proper
lookout. It was held that the defendant’s contribution was so significant which was enough to
justify putting responsibility upon him for the death. (His contribution was too significant to be
ignored).

Smith [1959] the defendant stabbed his victim and appealed against his conviction for murder on
the ground that if he had not dropped multiple times on the way to get medical attention and if he
was diagnosed sooner and taken care of properly he would have survived. His conviction was
upheld. This is because the real issue was whether his contribution was substantial and operated at
the time of death. It was also held that.

“If at the time of death, the original wound is still an operating and a substantial cause, then the
death (is) the result of the wound albeit that some other cause is also operating. Only if it can be
said that the original wound is merely the setting within which another cause operates can it be said
that the death does not result from the wound . . . putting it another way only if the second cause
is so overwhelming as to make the original wound merely part of the history can it be said that
death does not flow from the wound”.

c. Is subsequent to a defendant’s ‘but for’ contribution, an independent voluntary act or

abnormal event occurs sufficient enough to cause another harm, the defendant’s ‘but for’
contribution of the harm will be ignored. Sometimes a later cause is too significant to be
ignored and, in such situations, causal responsibility will be put on the person who caused
the later harm. The subsequent act must be independent of the defendant’s original act
and must be sufficient enough in itself.

Case 1- B, feeling giddy from the effects of the poison, falls out of his bedroom window, thus killing
himself. A will remain responsible for the death as falling out the window was not independent of
the initial poisoning.

Case 2- B calls an ambulance. On the way to hospital, he is killed along with the ambulance crew, in a
car crash. Even though A’s act has caused B to call an ambulance, but B’s death is the same as the
crew’s death. A has not caused the death of the crew so he must not have caused B’s death. Death
by the car crash has not been made more likely by the fact of poisoning.

Case 3- As Case 1 except that B is taken to hospital still alive where he is given an antidote which
promotes a rapid recovery. He later dies in a terrorist bomb attack. In the case of intervening acts
(as opposed to natural events) the principle generally thought to be applicable is that causal
responsibility will only be change if the act is voluntary. Thus, A will not be responsible in Case 3
below as the terrorist’s action is voluntary and independent of A’s act.

5
Particular examples of causal sequences giving rise to causation problems
A Subsisting conditions
Generally, judges look for causes and exclude the fact that some condition was necessary to make an
act of causal significance.

1. Medical conditions: thin skull principle.

Where a victim suffers a subsisting medical condition which makes him vulnerable to injury inflicted,
the general rule is that the defendant must take the victim as he is. If the victim has haemophilia as
seen in State v Frazier [1936] or the eponymous this skull the defendant will be responsible for any
injury caused by the condition even if the condition was unforeseeable.

Dyson [1908]- the defendant was held liable where a child died of meningitis which occurred after
the defendant had been neglected and treated the child poorly rendering the child vulnerable to the
disease.

This is rule also applies where a person dies due to fright when he suffers a heart condition. In
Murton [1862] the defendant was held responsible for his wife’s death who suffered an
undiagnosed medical condition and died of fright because the defendant had assaulted her. It was
held that the death could be caused by the fright alone as long as the causal chain was present of
the attack.

2. Other subsisting conditions.

When the defendant takes risk that the victim may be vulnerable then he also takes the risk of any
other subsisting condition which may have an impact on the harm the victim may suffer. Thus, the
defendant will be responsible if a minor injury becomes fatal due to a failure of for example, the
ambulance crew for arriving late due to subsisting poor weather.

Blaue [1975]- the defendant stabbed his victim, but the issue arose when the victim refused a
lifesaving blood transfusion because of religious reasons. The question was whether the defendant
was causally responsible. It was held that the victim decision was motivated by their belief and thus
it was a part of their characteristic (subsisting condition), and the defendant must have taken the
risk and he must take the victim as he finds them.

This decision was criticised on the question that why was the victim’s belief seen as a subsisting
condition rather than a new intervening cause. Would the decision be different if the victim took
the decision because of a fear of needles or a grudge towards the defendant. It has been argued, for
example, that her decision should break the chain of causation because it was free and informed,
that is, was a voluntary one. It was her decision which took her life not causally B’s.

The explanation for this decision is that death is caused by wounds not ideas. The victim idea was a
precondition of her death but no more caused it then if she stayed at home and treated herself. The
harm was intended, it was an operative cause of death, and it was within the range of harms
rendered foreseeable by the defendant’s unlawful act.

3. Subsequent acts and events.

Smith and Blaue show the effect of an intervening act, omission, or event which may contribute to
criminal harm. The effect is consistent with the continued responsibility of the defendant and may
also operate to divert responsibility from the defendant which is known as the sole cause.

6
a. Self-inflicted harm- the escape cases

This is where injury is caused by trying to escape from a threat posed by the defendant. General rule
is that the causal chain will not be broken between the defendant’s initial act and eventual injury.
But recently courts have set a notional limit on this rule. These terms are generally on foreseeability.

i. Where the victim’s response to the defendant’s act was reasonably foreseeable the
causal chain will not be interrupted.
Roberts [1971] the defendant was held responsible for the injuries caused to the victim
due to her jumping out of a moving car because of an assault threat. It was held that her
response was reasonably foreseeable.
R v Mackie [1973] where a 3-year-old child fell downstairs while trying to escape from
his abusive father. It was held that the escape must be the natural consequence of the
father’s act. The case was of manslaughter and the attempt was reasonably foreseeable
even though the harm isn’t serious.
ii. The victim’s response must be reasonable in the sense that it isn’t disproportionate or
daft (foolish) as seen in the case of R v Lewis [2010]. Where the reaction is daft the risk
will not be reasonably foreseeable. The issue arises where the victim overreacts and
suffers an unusual harm because of their personality. Even though the defendant could
be responsible to bear the risk because of subsisting conditions (above). Judges in many
cases mix this test with the test of voluntariness which creates ISSUES. This was seen
in-
R v Williams and Davis [1992] the victim was a hitch hiker and died because he jumped
out of a moving car in response of a threat from the defendant. It was held that the
victim’s response was voluntary and was not caused by the defendant thus, there was
no causal responsibility.
When deciding whether a response is involuntary, the question to be asked is whether
the response of the victim is within the range of responses which might be expected
from them if they’re placed in such situations. Another confusion was created when the
jury was asked to reach their conclusion by bearing in mind any particular characteristic
of the victim and that in such situations the victim may act without thinking. Thus, this
test is extremely ambiguous and confusing. It has two separate directions.
First is that the causal link will be broken if the victim acts in a way which is
unforeseeable while keeping the context in mind.
Second suggests that jury is able to ignore foreseeability if the victim’s response is
attributed to some characteristic based on voluntariness.
Another issue is that the judge didn’t specify the characteristic that needs to be
considered. For example, are characteristics the victims sex, age, or size. Or whether
they are their mental psyche like some disorder.
According to Blaue the requirement of foreseeability can also be ignored on a matter of
fairness by insisting on fault requirement.

b. Self-inflicted harm- contributory negligence.

Two situations can be considered,

1) Where the harm wouldn’t have been caused without the victim’s negligence.
2) After the defendants act the victim does something which makes their injury worse.

7
 i. In both situations where there is contributory negligence on part of the victim or third
party the causal responsibility will not be diverted from the defendant as long as their
act played a substantial part in the outcome.

Walker [1824] the defendant’s argument that the if victim wasn’t drunk, he would’ve heard the
cart driver warnings. It was held that this in no answer to manslaughter when the cart driver was
over speeding and the injury was attributable to his act.

In very few cases it can be shown that the causal chain was broken by the victim’s negligence.
This can be shown where the defendant can prove that he wasn’t negligent or that the harm
wasn’t caused by his negligence. Thus, if the driver could prove that he could have done nothing
to avert the accident he would not be held responsible as seen in the case of Dalloway [1847].

ii. Where the victim’s injury became worse because of a failure to seek medical attention
or act upon medical advice where the defendants act substantially contributed to the
injury the causal sequence will not be broken.

Holland [1841]- the defendant had assaulted the victim with an iron bar. He was held
responsible for the victim’s death when he refused to amputate his finger to prevent getting
tetanus. It was held that the causal chain wasn’t broken and thus the defendant was responsible
for the victim’s death.

iii. Same rule applies where the contributory negligence is of a third party. This can be
seen in the American Case of-

People v Clark where the defendants appeal on a conviction for manslaughter was refused when the
victim had been removed from the hospital by their mother against medical advice, he died due to
being taken out of the hospital because he had a broken neck.

iv. In modern conditions is the victim refuses to submit to minor medical procedures or
doesn’t take proper care to avoid minor injuries becoming life threatening the causal
responsibility may not be put upon the defendant. This is because the principle of
causation is to ensure that the defendant is fairly selected as the cause. Therefore, in
cases where the victims conduct is deliberate is would be appropriate to hold them
responsible rather than the defendant. Thus, according to Blaue, the view here is that it
would be better if criminal liability would be attached to the defendant’s fault rather
than holding the defendant responsible for the victim’s injury. However, according to
Blaue and Holland omissions on part of the victim cannot break the chain of causation.

c. Self-inflicted harm- victim commits suicide.

The issue arises where the defendant’s actions trigger the victim to commit suicide. In Dhaliwal the
court held that the chain of causation will not be broken by the victim’s decision only where it could
be proven that the defendants act had triggered the victim to take the decision. In the case of
Dhaliwal, it wasn’t enough that the victim took the decision because the defendants general
behaviour became intolerable for her. Thus, defendant was not responsible.

R v Wallace [2018] the defendant threw acid on the victim which left him blin, paralysed and in
constant pain. Due to this he went to a euthanasia clinic where he was terminated. The defendant
was charged with murder and the trial judge refused to bring the question of causation due to the

8
lapse of time. However, the court of appeal held that this was wrong, and it was appropriate for the
jury to conclude that even though there was a lapse of time between the victim’s decision and
defendants act, the decision was still made because of the injury inflicted upon them by the
defendant. The question to be asked is whether the defendants act has fairly made a significant
contribution to the victim’s decision.

d. Third party reactions to the danger posed by the defendants conduct.

The chain of causation will not be broken where a third party tries to stop the danger caused by the
defendants conduct. For example, if a person wrestles with a bank robber who is holding a gun, it
will be the bank robber and not the third party who will be the legal cause of any subsequent harm if
the gun discharges.

But in some cases like Pagett [1983] where the defendant used his girlfriend as a human shield
when police officers fired at him he was held responsible for the victim’s death not the police
officers even though its disproportionate.

e. Medical responses to the danger caused by the defendant.

Medical treatment in accordance with clinical practice which accelerates the death of the victim is
not capable of breaking the chain of causation and are not the cause of death. In such situations the
chain of causation is hardly ever broken. This can be seen in-

Malcherek [1981] where it was held that the defendant who had caused the injury was the cause of
death and not the doctor who had turned off the life support after the victim was brain dead.

Even if the medical treatment provided is not in accordance with proper clinical procedures it is
very unlikely that the medical profession will be held liable because the initial injury stayed the
operative cause. This can be seen in-

Smith [1959] where the victim dies of a stab wound to the lung, but not before dropping twice
before getting medical attention. He was misdiagnosed and didn’t receive an artificial respiration till
later. The defendant was still held liable as the question to be answered was whether his
contribution was substantial and operative at the time of death. Even though other contribution
played a part in his death. Another case where this principle was applies is-

Cheshire [1991] where the defendant had shot the victim in their leg and abdomen which left the
victim with respiratory problems. The doctors had performed a surgery, but it was performed
negligently. The defendant was still held responsible for the victim’s death. However, if it could
have been proven that the doctor’s negligence was independent of the defendant’s act and so
potent by itself to cause the victim’s death then the defendants act could have been seen as
insignificant.

4. Breaking the chain of causation- intervening acts supersedes defendants act.

a. Intervening acts of third parties (Novus actus interveniens)
Generally, the defendant will bear the causal responsibility for the consequences of his unlawful
actions intended or foreseen to cause risk of harm to the victim. However, in some situations the
defendant may not be held responsible because of an unconnected independent voluntary act by a
third party. This is because the rule of causation is that the defendant will be held liable for any risk
or harm caused by their act. If the victim dies of negligent treatment the defendant would still be
responsible, but he won’t be responsible if the victim is shot dead.

9
The issue here is that why do we hold defendants responsible for harms voluntarily produced by
some other third party when there is an option to hold the defendant responsible only for the harm
they have attributed to the consequence.

In criminal law there are certain offences which have a scheme behind them which ensure that the
defendant is only charged for the harm they are responsible for. This is especially in cases where
there are two joint parties involved to injure the victim where the one of the defendants withdraws
and other party carries on killing the victim. (Covered in chapter 19).

The defendant will remail liable for the death because of their initial participation in the attack.
However, the defendant may escape liability by proving that his initial act had no correlation with
the death of the victim and that his co-attackers had caused the death. This can be seen in-

Rafferty [2007]- where the defendant was a joint party to beat the victim. The defendant withdrew
attack after punching and kicking the victim and left the scene. The other co-attackers took the
victim to the sea and drowned him. It was held that the drowning of the victim was completely
different from the defendant’s initial participation which he was responsible that it overwhelmed
those injuries produced by the defendant and broke any causal chain between the death and
defendants act.

However, a deviation from this principle is that voluntary acts of third parties break the chain of
causation. This was seen in the case of Environment Agency v Empress Car Co [1995] where the
defendant a company was held liable when a trespasser actions caused polluted matter to release
into the river. It was held that since the intervention was reasonably foreseeable, the company
cannot defend themselves by saying they didn’t cause such a situation. Therefore, this shows that
there is still uncertainty in the principle of causation.

The question is whether interventions of third parties break the chain of causation initiated by the
defendant’s initial wrongful act, if the third party’s intervention is independent and voluntary or
only if they are independent, voluntary, and unforeseeable?

b. Intervening act by victim

An informed voluntary act of the victim can break the chain of causation. This can be seen in-

Dalby [1982]- the defendant was accused of manslaughter. The defendant had supplied controlled
drugs to the victim who died due injecting them. The issue of causation arose which was whether
the defendant had caused the death of the victim. If the test of foreseeability was to be used, he
would be held responsible because it was reasonably foreseeable that the person would use the
controlled drugs in this was. If the test of voluntariness was to be used the defendant would not be
responsible because the victim is responsible for his own actions. It was held that the victims own
free will broke the chain of causation between the defendant’s initial act and the victim’s death.

In another drug related case of Finlay, the defendant had filled the syringe it was held that the test
of foreseeability would be used as the defendant had caused the death because the event was
reasonably foreseeable. The causal responsibility of the defendant was not undone by the voluntary
act of the victim because according to the case of Environment Agency v Empress [1999] the
consequence could have been avoided.

Therefore, it can be concluded that independent voluntary acts of the victim or third party break the
chain of causation. The test of foreseeability remains the main test in strict liability cases (Empress).

10
c. When will inappropriate medical treatment break the chain of causation?
Beldam LJ stated in Cheshire that in most extraordinary and unusual cases the defendant will not be
responsible for injuries or death suffered by medical treatment. This case was not one of them
because actions towards fixing one medical problem may lead to another issue. Another point is that
according to earlier cases (above) death because of negligent medical treatment are also seen as
being caused by the defendant’s actions. In the American case of-

Kane [1915]- it was held that where the death of the victim is solely caused by the medical
professional and had no connection with the defendants initial actions the defendant ill not be held
responsible. This can also be seen in the case of

Jordan [1956] where the defendant had stabbed the victim. The victim was taken to the hospital
where with treatment his wound was healing. However, due to negligent treatment he died of
pneumonia which was said to caused by direct result of the negligent treatment given to him. Thus,
the defendant was not the cause of death.

In the following cases negligent medical treatment will break the chain of causation-

i. The treatment was not given for the diagnosis but for other reasons such as mistake or
mischief. This would be unusual and extraordinary because ordinary medical treatment
is based on recovery of the patient from the diagnosed condition (won’t be applicable
where the diagnosis is wrong). For example, where the medical professional negligently
or purposely administers a deadly poison or overdoses a prescribed drug the defendant
will be discharged from the responsibility of death.
ii. Where proper treatment was given for the diagnosis and the victim was recovering but
not fully recovered. The treatment given was so misinformed that is caused the
defendants death. For example, administering a drug the victim is allergic to or
transfusing blood that is known to be contaminated. This would be an extraordinary
event and the defendants act would hardly be considered as causing the death. Also,
removing a patients life support while they are recovering would also break the chain of
causation. This also won’t be applicable where the diagnosis is incorrect.

d. Intervening events.
The defendant is only responsible for unforeseen consequences of his unlawful actions. They will not
be responsible for abnormal events that occur.

Case- the victim is given a poison and taken to the hospital where he is given an antidote and
survives. But before he is discharged, he contracts a deadly virus as a direct consequence of being in
hospital. One direction is that the defendant’s actions created the risk of the victim being in
hospital. On the other hand, it could be a coincidence. The real cause of death is the virus not the
poison and thus, the chain of causation is broken.

In the American case of Bush v commonwealth [1880] the wounded victim who contracted scarlet
fever from his surgeon and died due to the disease. The chain of causation between the wound and
death was broken since the fever was not the consequence of the wound.

Summary
Where an unlawful act of the accused is the factual cause of a criminal harm it will normally also be
the legal cause. The defendant will be the factual cause of a criminal harm if the harm would not
have occurred, but for the defendant’s act or, exceptionally, if it would have been sufficient in itself
to cause the harm in the absence of another, independently operating, concurrent cause. It is

11
generally no objection to the ascription of legal cause that the harm suffered or the manner in
which it came about was unexpected, nor that the victim or others contributed to its occurrence.
This general rule is subject to the following qualifications. The accused will not be the legal cause of
a criminal harm if his causal contribution is trivial. If, subsequent to the defendant’s act, another act
or event occurs which is independent of this act and is a sufficient cause of the criminal harm this
act or event may break the chain of causation linking the defendant’s act with the ensuing harm.
In the case of intervening acts of a third party, the chain of causation will be broken by their
voluntary action. Persons reacting to danger are not deemed to act voluntarily. In the case of
intervening acts of the victim, the chain of causation may also be broken by the victim’s voluntary
act. The victim’s act will not be treated as voluntary, however, if it is by way of direct reaction to the
defendant’s unlawful act unless perhaps it is an abnormal reaction. Intervening events will break
the chain of causation if they are abnormal, in the sense of not being such events as are rendered
more likely to occur by reason of the defendant’s conduct.

12