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R v Quick [1973] 3 WLR 26 Court of Appeal

The appellant was a charge nurse in a hospital. He attacked one of his patients whilst on duty. The patient was a paraplegic and suffered a fractured nose, black eyes and bruising. The appellant was charged with assault occasioning ABH under s.47 OAPA 1861. The appellant sought to raise the defence of automatism as at the time of the attack he was hypoglycaemic, in that he had taken too much insulin and eaten very little on the day in question. In addition he had consumed alcohol before the attack. The trial judge ruled that this gave rise not to automatism but insanity. The defendant then changed his plea to guilty and appealed.


The appeal was allowed and the conviction was quashed. His hypoglycaemia was caused not by his diabetes but by the external factor of insulin.

"In this case Quick's alleged mental condition, if it ever existed, was not caused by his diabetes but by his use of the insulin prescribed by his doctor. Such malfunctioning of his mind as there was, was caused by an external factor and not by a bodily disorder in the nature of a disease which disturbed the working of his mind. It follows in our judgment that Quick was entitled to have his defence of automatism left to the jury and that Mr. Justice Bridge's ruling as to the effect of the medical evidence called by him was wrong. Had the defence of automatism been left to the jury, a number of questions of fact would have had to be answered. If he was in a confused mental condition, was it due to a hypoglycaemic episode or to too much alcohol? If the former, to what extent had he brought about his condition by not following his doctor's instructions about taking regular meals? Did he know that he was getting into a hypoglycaemic episode? If yes, why did he not use the antidote of eating a lump of sugar as he had been advised to do? On the evidence which was before the jury Quick might have had difficulty in answering these questions in a manner which would have relieved him of responsibility for his acts. We cannot say, however, with the requisite degree of confidence, that the jury would have convicted him. It follows that his conviction must be quashed on the ground that the verdict was unsatisfactory."
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