Four Medical Necessity Cases for Criminal Law
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R v Quayle and Others [2005]; Attorney General's Reference (No. 2 of 2004) [2005] EWCA Crim 1415
In this case, defendants appealed convictions related to cannabis cultivation or possession for pain management. They argued that using cannabis was necessary due to its pain-relieving effects and minimal side effects compared to conventional treatments. However, the court rejected the defence of necessity, emphasising that the legislative purpose behind the Misuse of Drugs Act 1971 would be defeated if medical use of cannabis on grounds of necessity were admitted. The court held that the threat of injury must be immediate and imminent, which continuous pain over time did not qualify as. The defendants also asserted a breach of Article 8 of the European Convention on Human Rights (ECHR) related to the right to privacy. The court, while acknowledging interference with the right of respect for private life, held that such interference was permissible if necessary in a democratic society. The court, however, deferred the decision to the relevant Minister, considering it a policy matter beyond the court's remit.
R v Altham [2006] EWCA Crim 7
In Altham, the defendant used cannabis for pain relief after a road accident. Charged with possession under the Misuse of Drugs Act 1971, he argued medical necessity. The court, relying on Quayle, denied the defence of necessity. It reiterated that the legislative scheme's purpose and effect would be in conflict with admitting such a defence. The defendant invoked Article 3 ECHR, arguing that the state subjected him to degrading treatment by prosecuting for using cannabis as the only means to alleviate his symptoms. The court clarified that the state's refusal to permit cannabis use did not constitute degrading treatment, as it did nothing to change the defendant's condition. The court emphasised the absence of a legal basis for a medical necessity defence.
Re A (Children) (Conjoined Twins: Surgical Separation) [2000] 4 AER 961
The case involved conjoined twins, Jodie and Mary, with a surgery proposed to separate them, knowing it would result in Mary's death. The court concluded that the operation would be lawful, likening it to self-defence. Ward LJ considered it lawful to kill Mary as a quasi self-defence measure, while Brooke LJ argued that necessity, not duress of circumstances, applied. The decision was rooted in the doctors' rational choice to adopt the lesser of two evils, allowing Jodie to have a near-normal life. The court distinguished R v Dudley & Stephens [1884], emphasising that the doctors were not selecting a victim but choosing the least detrimental alternative in a conflict of duties. The decision, limited to cases of medical necessity, poses challenges regarding decision-makers in such cases.
In this case, defendants appealed convictions related to cannabis cultivation or possession for pain management. They argued that using cannabis was necessary due to its pain-relieving effects and minimal side effects compared to conventional treatments. However, the court rejected the defence of necessity, emphasising that the legislative purpose behind the Misuse of Drugs Act 1971 would be defeated if medical use of cannabis on grounds of necessity were admitted. The court held that the threat of injury must be immediate and imminent, which continuous pain over time did not qualify as. The defendants also asserted a breach of Article 8 of the European Convention on Human Rights (ECHR) related to the right to privacy. The court, while acknowledging interference with the right of respect for private life, held that such interference was permissible if necessary in a democratic society. The court, however, deferred the decision to the relevant Minister, considering it a policy matter beyond the court's remit.
R v Altham [2006] EWCA Crim 7
In Altham, the defendant used cannabis for pain relief after a road accident. Charged with possession under the Misuse of Drugs Act 1971, he argued medical necessity. The court, relying on Quayle, denied the defence of necessity. It reiterated that the legislative scheme's purpose and effect would be in conflict with admitting such a defence. The defendant invoked Article 3 ECHR, arguing that the state subjected him to degrading treatment by prosecuting for using cannabis as the only means to alleviate his symptoms. The court clarified that the state's refusal to permit cannabis use did not constitute degrading treatment, as it did nothing to change the defendant's condition. The court emphasised the absence of a legal basis for a medical necessity defence.
Re A (Children) (Conjoined Twins: Surgical Separation) [2000] 4 AER 961
The case involved conjoined twins, Jodie and Mary, with a surgery proposed to separate them, knowing it would result in Mary's death. The court concluded that the operation would be lawful, likening it to self-defence. Ward LJ considered it lawful to kill Mary as a quasi self-defence measure, while Brooke LJ argued that necessity, not duress of circumstances, applied. The decision was rooted in the doctors' rational choice to adopt the lesser of two evils, allowing Jodie to have a near-normal life. The court distinguished R v Dudley & Stephens [1884], emphasising that the doctors were not selecting a victim but choosing the least detrimental alternative in a conflict of duties. The decision, limited to cases of medical necessity, poses challenges regarding decision-makers in such cases.
