Criminal Law

R v. Blaue

[1975] 1 WLR 1411

Facts

The accused, Blaue, entered the home of an eighteen-year-old woman.
He demanded sexual intercourse.
When she refused, he stabbed her several times.
The victim was taken to hospital and was found to require an urgent blood transfusion.
Medical evidence indicated that she would probably survive if she received blood.
The victim was a Jehovah’s Witness.
Because of her sincere religious beliefs, she refused the transfusion even after doctors explained that refusal might lead to death.
She consequently died from the blood loss caused by the stab wounds.
Blaue argued that the victim’s refusal of medical treatment, rather than the stabbing, was the legal cause of death.
He contended that her choice was unreasonable and broke the chain of causation.

Whether the victim’s refusal of a life-saving blood transfusion broke the chain of causation.
Whether an accused must take the victim’s religious beliefs and personal convictions as he finds them.
Whether the stabbing remained an operating and substantial cause of death.

The accused must take the victim as found.
This is known as the thin-skull rule.
The rule applies not only to the victim’s physical weaknesses but also to psychological characteristics, beliefs and personal convictions.
A victim’s response will break the chain of causation only where it is so independent of the accused’s act that the original injury is no longer an operating and substantial cause of death.
The criminal law does not permit the accused to argue that the victim should have acted differently to save herself.
The victim has no legal duty to accept medical treatment for the benefit of the accused.

Blaue intentionally stabbed the victim and created the medical emergency.
The victim would not have faced the decision concerning a blood transfusion but for those wounds.
At the time of death, the stab wounds remained the source of the blood loss.
The refusal of treatment did not remove, reverse or replace the original injuries.
It merely allowed the consequences of those injuries to continue.
The Court rejected the idea that causation should depend on whether judges considered the victim’s religion reasonable.
The thin-skull rule requires the accused to accept the complete person, including:
physical condition;
psychological makeup;
religious conscience;
personal convictions.
If the law accepted Blaue’s argument, a person who attacked a victim with unusual beliefs would receive greater protection than one who attacked a victim holding conventional beliefs.
That would improperly shift responsibility from the assailant to the injured person.
The Court also distinguished refusal of treatment from an independent act that becomes a new cause of death.
Doctors had not caused a separate fatal injury.
The victim had not introduced an unrelated danger.
She simply declined a medical intervention that might have prevented the consequences of the stabbing.
The stabbing therefore remained both factually and legally causative.
Blaue could not reduce his liability by arguing that a different victim would have survived.

The Court of Appeal held that the victim’s refusal of a blood transfusion did not break the chain of causation.
Blaue had to take the victim as he found her, including her religious beliefs.
The stab wounds remained an operating and substantial cause of death.
His conviction for manslaughter was upheld.
Use this case for: the thin-skull rule includes the victim’s beliefs, and refusal of treatment does not ordinarily relieve the original attacker of liability.