The defendant was indicted for Murder in the Second Degree and other related crimes. During this nonjury trial, the issue of causation of death was presented to this Court. The defense alleged that the victim had recovered from the gunshot wound he suffered and actually committed suicide by refusing nourishment and medical treatment.
A Bronx County Injury lawyer said that on October 17, 1991, the victim suffered a gunshot wound to his head while driving a cab in Bronx County. He was removed to Lincoln Hospital where he was diagnosed with a gunshot wound to the neck with transection of the right internal carotid artery and facial nerve paralysis. The victim contracted pneumonia which was treated and eventually cured. Since the victim continued to have difficulty speaking and swallowing a month after his admission, testing was performed but revealed no significant injury.
The victim communicated by writing on a note pad and nodding in response to questions. He was interviewed in this manner by Detectives concerning the incident. The victim commenced and participated in rehabilitation for speaking, swallowing and walking at a Hospital on November 13, 1991.
On December 4, 1991 the victim improved sufficiently to permit his transfer to another Hospital for further rehabilitation. On admission he was found, among other diagnosis, to be unable to swallow and to require feeding by tube. The victim became depressed and distraught at his slow progress. On December 19, 1991, the victim pulled out his feeding tube and refused its reinsertion even after being advised of its vital necessity.
Although the victim expressed a desire to return to regular food, he did not eat any when it was provided to him. He ingested only ice water and liquids.
On December 27, 1991, an autopsy was performed. The external examination revealed a severely emaciated body with almost a completed absence of subcutaneous body fat and atrophy of the skeletal muscles. The Medical Examiner found that the victim suffered a gunshot wound to the head and neck with a line of metallic fragments in the wound’s path between the right ear and left cheek.
To be found guilty of intentional murder, a defendant must intend to cause the death of another person and actually cause the death of that person. Proof of causation is mandatory for any homicide prosecution.
If a defendant’s actions are “a sufficiently direct cause” of the death, criminal liability exists. The question is whether the “ultimate harm is something which should have been foreseen as being reasonably related to the acts of the accused.” If the defendant set in motion “the chain of events which ultimately resulted in the victim’s death” homicide can be attributed to the defendant. As long as the defendant’s actions are “at least a contribut[ory] cause” of death, homicide charges are appropriate.
When death is attributed to more than one cause, the issue of causation becomes more complicated. If multiple injuries cause death together, each participant is criminally liable for the death if his actions were factors in the victim’s demise.
In the case at bar, the intervening event was the victim’s refusal of nourishment and medical treatment–in effect, his suicide. A review of the case law sheds little light on this situation.
Apparently no New York courts have dealt directly with the issue of suicide as an intervening event and whether it breaks the chain of causation. However, treatment of the issue of removal of life support systems does aid the analysis. A court of concurrent jurisdiction found a defendant properly charged with manslaughter in the first degree for the death of a victim she mortally wounded after a nurse turned off the victim’s life support system. Although it was unclear whether the victim’s cardiac arrest was caused by the removal of the life support system, the court found that the defendant who stabbed the victim was criminally liable because “the clear medical evidence was that at the moment of death the initial stabbing continued to operate as a significant direct contribution thereto.”
Whether the second actor committed a crime “should no longer provide escape to the initial perpetrator whose vicious act propelled the victim to certain and extended death and which act at the time of the victim’s release from artificial life supports, continued to be a substantial contribution to that death.”
The court found no difference if the removal of the life support system had been accomplished by the victim herself. In Vaughn, the victim was not recuperating and was being supported by artificial life supports. In the instant case, however, the victim was recuperating and was not in extremis.
Applying the rationale of the above cited cases to the facts herein, this Court concludes that the People have met their burden of proving causation. The victim acted voluntarily in refusing nourishment and medical treatment. However, his inability to ingest food orally was directly caused by the gunshot wound he suffered.
The gunshot wound created the difficulty swallowing and the difficulty swallowing prevented him from ingesting food orally. The gunshot wound set in motion a chain of events resulting in hospitalization, difficult swallowing, and forced feeding, the cessation of which resulted in death. The gunshot wound forged a causative link between the initial injury and death and was a sufficiently direct and contributing event which eventually resulted in death. The suicide does not operate as an intervening act that excuses criminal liability because death was not solely attributable to this secondary agency.
Cases involving injuries sustained by victims should be referred to lawyers who can protect their rights and file complaints for the compensation for the damage brought about by the injury. Here in Stephen Bilkis and Associates, you can consult our Bronx County Injury Attorneys, who are always available to serve you. In case of personal injuries, you can also consult our Bronx County Personal Injury Lawyers.