R v Malcherek [1981] 2 All ER 422, [1981] Crim. L.R. 401

Key point

  • The fact that death is brought about by a doctor’s decision to end life support does not break the chain of causation for murder as long as the decision was made competently


  • D stabbed his wife, V, who was later placed on a life support machine
  • Doctors switched off the machine as V showed no signs of brain activity
  • D was convicted of murder


  • Was there a break in the chain of causation by the doctors’ decision?

Held (Court of Appeal)

  • D was properly convicted of murder

Lord Lane CJ

  • The original injury was at the time of death a ‘continuing, operating and indeed substantial cause of the death’: p. 696
  • ‘Where a medical practitioner adopting methods which are generally accepted comes bona fide and conscientiously to the conclusion that the patient is for practical purposes dead, and that such vital functions as exist — for example, circulation — are being maintained solely by mechanical means, and therefore discontinues treatment, that does not prevent the person who inflicted the initial injury from being responsible for the victim’s death’: p 697
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