R v Quick

R v Quick [1973] QB 910 is an English criminal case, dealing with sane-automatism. The court ruled that sane-automatism may not be used as a defence if the defendant's loss of self-control is attributable to any substance they consume or not. This case demonstrates the complications in distinguishing between insanity and automatism, and the effect that this lack of distinction has on trials.

The defendant was a nurse in a mental hospital, charged with assaulting a patient. He claimed that he had been acting involuntarily as a result of diabetic hypoglycaemia, induced by an over-generous insulin and had not neutralised its effects with food, which made him violently aggressive. The trial judge ruled that this constituted insanity, not automatism. Rather than risk the stigma of an acquittal on mental health grounds, the defendant changed his plea to guilty, got a conviction, and then appealed (this seems to have happened quite a lot). At appeal it was ruled that the trial judge was mistaken, and that diabetic hypoglycaemia was induced by an external factor, and therefore gave rise to automatism, not insanity. The defendant should never have been put in the position of feeling compelled to plead guilty. The Appeal Court did say, however, that if the hypoglycaemia were self-induced through negligence, it would not have been a defence.

Lawton LJ, in his judgment:

"a self-induced incapacity will not excuse ... nor will one which could have been reasonably foreseen as a result of either doing or omitting to do something, for example, taking alcohol against medical advice after using certain prescribed drugs or failing to have regular meals while taking insulin."

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