R v Blaue [1975] 1 WLR 1411

Chain of Causation – Manslaughter – Novus Actus Interveniens – Victim’s Own Act – Egg shell Skull Rule


After the victim refused the defendant’s sexual advances the defendant stabbed the victim four times.  Whist the victim was admitted to hospital she required medical treatment which involved a blood transfusion.  The victim was a Jehovah’s Witness whose religious views precluded  accepting a blood transfusion.  She was informed that without a blood transfusion she would die but still refused to countenance treatment as a result of her religious conviction.  The victim subsequently died and the defendant was charged with manslaughter by way of diminished responsibility.  The defendant appealed.


Did the victim’s refusal to accept medical treatment ritute a novus actus interveniens and so break the chain of causation between the defendant’s act and her death?  Whether the test laid down in R v Roberts (1971) 56 Cr App R 95 was to be applied because of an omission on behalf of the victim.


The appeal was dismissed.  The stab wound and not the girl’s refusal to accept medical treatment was the operating cause of death.  The victim’s rejection of a blood transfusion did not break the chain of causation.  The defendant must take their victim as they find them and this includes the characteristics and beliefs of the victim and not just their physical condition.  Unlike in R v Roberts (1971) 56 Cr App R 95 the victim’s decision was an omission and not a positive act and so the test was not of whether the omission was reasonably foreseeable.  In the case of omissions by the victim ‘egg-shell skull’ rule was to be applied.  Even if R v Roberts (1971) 56 Cr App R 95 is applied the victim’s response was foreseeable taking into account their particular characteristics.