R v Cheshire [1991] 1 WLR 844 is an important English criminal law case on causation in homicide offences. The case deals with the circumstances in which negligent medical treatment may intervene between the defendant’s act and the victim’s death. The Court of Appeal confirmed that even when medical negligence is the immediate cause of death, the defendant remains liable if his conduct made a significant contribution to the result. This judgement has been influential in clarifying the limits of liability and how far a jury must examine competing causes of death.
Background of R v Cheshire Case
On 9 December 1987, the appellant, David William Cheshire, became involved in an argument inside a fish and chip shop. During the dispute, Cheshire shot a man, causing him serious injuries. The victim was rushed to hospital and underwent surgery.
In the aftermath of the operation, the victim developed complications relating to his breathing. To address this, doctors inserted a tracheostomy tube into his windpipe, which initially improved his condition. For several weeks, the tube remained in place. However, in early February 1988, the victim began to complain of breathing difficulties. He voiced concerns on 8 February and again on 14 February, shortly before his condition deteriorated rapidly. The victim subsequently died.
A post-mortem revealed that the cause of death was linked to the narrowing of the victim’s windpipe close to the site of the tracheostomy. The medical evidence suggested that the immediate cause of death was the failure of hospital staff to diagnose and treat the respiratory obstruction in time. Despite this, Cheshire was charged with murder, convicted at trial, and later appealed against his conviction.
The Legal Issue
The central question in R v Cheshire [1991] 1 WLR 844 was whether the chain of causation had been broken by the negligent medical treatment administered in hospital. Cheshire argued that his act of shooting the victim was not the true cause of death, as the fatal outcome resulted directly from the failings of medical staff.
The trial judge, however, directed the jury that it was sufficient to find that Cheshire’s actions made a “significant contribution” to the death. It was emphasised that the defendant’s conduct need not be the sole or even the main cause of death. The appeal therefore turned on whether this direction was correct in law, particularly in light of earlier case law such as R v Jordan.
R v Cheshire Judgement of the Court
The Court of Appeal dismissed the appeal. Lord Justice Beldam delivered the leading judgement. The Court held that the trial judge’s directions to the jury were correct and that the conviction should stand.
The Court reaffirmed that causation in criminal law does not require the defendant’s act to be the only cause of death. Instead, it is sufficient that the act made a significant contribution to the outcome. Where medical negligence has occurred, the defendant’s liability will only be excluded if the negligence is so independent of the original act, and so potent in bringing about death, that the defendant’s conduct can be regarded as insignificant.
Lord Justice Beldam referred to the earlier decision in R v Jordan. In that case, the Court had found that the medical treatment was “palpably wrong” and had broken the chain of causation. However, the Court of Appeal in R v Cheshire explained that such situations were exceptional. In most cases, even where negligence is present, the defendant remains responsible because his actions set in motion the chain of events that led to death.
Clarification of the Law on Causation
The decision in R v Cheshire [1991] 1 WLR 844 clarified several important points about causation in criminal law:
- Significant Contribution Standard
- The jury need only decide whether the defendant’s conduct made a significant contribution to the death.
- It does not matter whether the act was the sole or main cause.
- Role of Medical Negligence
- Medical negligence does not automatically break the chain of causation.
- Only where the negligence is extraordinary, wholly independent, and so potent in causing death that the defendant’s act is rendered insignificant, will liability be excluded.
- Practical Role of the Jury
- The Court underlined that juries are not required to conduct a detailed weighing of competing causes of death.
- Their task is to consider whether the defendant’s act substantially contributed to the outcome.
Conclusion
In conclusion, R v Cheshire [1991] 1 WLR 844 is a leading authority on causation in English criminal law. It established that a defendant remains liable for a victim’s death where his actions made a significant contribution, even if negligent medical treatment was the immediate cause of death. The Court of Appeal confirmed that only in rare and exceptional circumstances, such as those in R v Jordan, will negligence be considered so independent and potent that it breaks the chain of causation.
The judgement has provided a clear and enduring rule: criminal liability cannot be avoided by pointing to medical errors, unless those errors entirely overshadow the defendant’s conduct. This case therefore strengthens the link between the original wrongdoing and the eventual outcome, ensuring that offenders remain accountable for the harm they cause.