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 injury 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 personal injury 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.