R v Quick [1973] QB 910

Diabetes and defences – automatism or insanity in hypoglycaemia cases


The appellant (a nurse at a hospital) was a diabetic who suffered from hypoglycaemia (low blood sugar). He had taken insulin in the morning for his condition but had not eaten much during the day and had imbibed alcohol. This lead to an episode in which he blacked out and attacked his victim, who suffered black eyes, bruising and a fractured nose. He later passed out and denies any recollection of the events. At trial he was charged with assault occasioning Actual Bodily Harm contrary to s.47 Offences Against The Person Act 1861 and was convicted. He had attempted to rely on the defence of automatism, but the trial judge ruled that only the defence of insanity would be available.


On Appeal, the issue was whether a hypoglycaemia sufferer can rely on the defence of automatism or whether only the defence of insanity is available for this condition.


It was held that a sufferer of hypoglycaemia can rely on the defence of automatism because the associated episodes (and the one in this case) are caused by the insulin (or lack thereof) which is an external factor, rather than by the diabetes, which is an internal factor. Therefore the conviction was quashed. No defence would be available for self-induced hypoglycaemia however. A sufferer of hyperglycaemia on the other hand would have to rely on the defence of insanity as episodes associated with that condition are caused by naturally occurring high blood pressure.