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Prosecution must prove both factual and legal causation.
Factual Causation: but for the actions of D, the events would not have occurred.
o R v White 
The defendant put some poison in his mother's milk with the intention of killing her. V died of unrelated heart attack before poison took effect. D only liable for attempt.
Were the actions of D sine qua non?
o R v Dyson (1908)
The victim, a child, had meningitis. Dyson threw her down the stairs and she died. It was argued that the child was going to die in any event, and the actions of the defendant had not caused death.
Any action which accelerates death is a cause.
Legal Causation: D's actions must have been the operating and substantial cause of the outcome.
o R v Dalloway (1847)
D driving horse and cart, not holding reins. A child ran out in front of the cart and was killed. The defendant was not liable as he would not have been able to stop the cart in time even if he had been holding the reins.
The AR was not the operative and substantial cause of the death.
o R v Pagett (1983)
D took a girl hostage and used her as a human shield while he shot at police. The police fired back and killed six-month pregnant teenager.
The operative and substantial cause was Pagett's actions.
o R v Cato 
D purchased heroin and injected it into his friend.
Held that substantial does not mean 'really serious'. It means an act (or omission) that is not a 'de minimus,
o R v Hughes 
Lord Hughes and Lord Toulson said:
"Where there are multiple legally effective causes, whether of a road traffic accident or of any other event, it suffices if the act or omission under consideration is a significant (or substantial) cause, in the sense that it is not de minimis or minimal. It need not be the only or principal cause"
Novus Actus Interveniens
Bush v Commonwealth of Kentucky  Bush shot V. V recovered in bed with her sister who had scarlet fever, contracted scarlet fever and died.
Not reasonably foreseeable that the victim would be infected with scarlet fever by the doctor
R v Latif 
Customs intercepted £3.2m of heroin intended for
England. Replaced it with Horlicks. Latif not guilty of importing heroin as the acts of the officers had been an intervening cause.
o Environment Agency v Empress Car Company 
A troubling and confusing judgement which is hard to reconcile with Latif. Company had a poorly sealed diesel tank that had drained into a river. A saboteur had opened the seal.
HoL still held company laible. Lord Hoffman said it was not extraordinary or unforeseeable for someone to go onto premises and release the seal. The conduct was not unusual
Perhaps best explained in terms of public policy concerns over control of pollution
D can still be liable even when other causes were present.
o R v Benge (1865)
Foreman negligently supposed that next train not due for hours. Signalman and driver was also negligent.
Held that if the defendant's negligence mainly or substantially caused the accident, it was irrelevant that it might have been avoided if other persons had not been negligent.
o R v Pagett (1983)
No novus actus interveniens as only be a break in the chain of causation if the actions of the third party were
'free, deliberate and informed. This was not held to be the case here.' Goff LJ using words of Professor Hart.
The police officers' actions were neither free nor deliberate as automatic self defense.
Intervening Medical Treatment
R v Jordan (1956) 40 Cr.App.R. 1
D stabbed the victim. V was taken to hospital where he was given anti-biotics after showing an allergic reaction to them as well as excessive IV liquids despite showing intolerance.
Court held this was 'not normal and palpably wrong treatment' therefore a NAI.
o R v Smith  2 Q.B., 423
The defendant, a soldier, got in a fight at an army barracks and stabbed another soldier. Medics dropped injured soldier twice on route and gave treatment
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