R v Smith (Thomas Joseph)
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R. v. Smith (Thomas Joseph)  2 QB 35,  A.C. is an English criminal law case, dealing with causation and homicide. The court ruled that negligence of medical staff does not break the chain of causation in murder cases.
The victim was stabbed, but the attending doctor did not realise the full extent of his injuries, causing death.
The court said that the stabbing was still the 'operating' cause of death, and therefore the defendant is guilty.
Facts: Smith stabbed the victim who died 4 hours later; A fellow member of his company had dropped the stab victim on the way to the hospital to get treatment. Once in emergency care, there was no blood transfusion. The victim was given saline solution (which, medically, is a gross error), and used artificial respiration - not knowing that the victim was suffering from a pierced lung). It was stated that with proper treatment, chances of the victim's survival was about 75%.
Issue: Did Smith cause the death of the stab victim? Defence: argued that death was not the sole and natural consequence of wound, and hence, did not flow directly from it.
Court: Essence of causation test – is that if at the time of death, the wound is still an operating and substantial cause, then death is caused by the wound, even though another operating cause may be present. This is often referred to as the chain of causation. If the original wound is merely a setting in which another cause operates, then it cannot be said that death resulted from the stab wound. Is the second cause so overwhelming so as to make the first wound merely part of the history?
One question to ask is: Can you show a new cause which disturbs the sequence of events?
Held: The Court looked to particular facts of the case, and Smith was convicted, as he satisfied the Essence of causation test. If the stabbed soldier had received proper treatment while in emergency care, he would have had a good chance of a complete recovery. Smith was consequently convicted of murder because the wound was in fact the “operating and substantial cause of death”. University students must be aware with this case.
R v Cheshire (1991)
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