Causation and Intervening Acts in Criminal Law

According to Robin J.A. in Malette v Shulman[1], “the right of self-determination which underlies the doctrine of informed consent also obviously encompasses the right to refuse medical treatment. A competent adult is generally entitled to reject a specific treatment or all treatment, or to select an alternate form of treatment, even if the decision may entail risks as serious as death…The doctrine of informed consent is plainly intended to ensure the freedom of individuals to make choices concerning their medical care. For this freedom to be meaningful, people must have the right to make choices that accord with their own values regardless of how unwise or foolish those choices may appear to others.”[2] R v Blaue[3], a famous causation case in criminal law, brings to foreground a thought-provoking debate about whether an individual’s religious beliefs and other psychological values could be included in the ‘thin skull’ rule and whether the refusal to take lifesaving medical treatment breaks the chain of causation that exists between the defendant’s wrongdoing and the purported outcome of that wrongdoing. The facts of the case are as follows -
Blaue, the defendant, stabbed a woman numerous times after she refused to have sexual intercourse with him. She was a Jehovah’s Witness and was therefore not in favour of blood transfusions. After the stabbing, she was taken to a hospital and was told that she urgently needed to have a blood transfusion, without which she would die. Owing to her religious beliefs, she refused to consent with the suggested treatment. As a result, she died in the hospital. While giving the judgment, Lawton L.J. stated that “those who use violence on other people must take their victims as they find them.”[4] This, according to him, not only includes victims’ physical characteristics, but also their emotional, psychological and spiritual values and beliefs. This decision has proved to be extremely controversial and gives rise to various