## Facts

- Reverend David G. Konz, an insulin-dependent diabetic for about 17 years, stopped using insulin for religious reasons in March 1974, stating he would monitor his condition and use insulin if necessary.
- Stephen R. C. Erikson, a close friend, joined Reverend Konz in a “prayer pact” to resist taking insulin; Dorothy A. Konz (the decedent’s wife) knew of the pact.
- On March 23, 1974, as Reverend Konz showed symptoms consistent with dangerous insulin deprivation, Dorothy removed his insulin from the refrigerator and concealed it.
- Evidence permitted findings that Reverend Konz later attempted to obtain insulin and seek help, including attempting to use a telephone, but was prevented and later assured others he would not take insulin.
- That day, Dorothy and Reverend Konz went to a hospital to pick up a nurse friend where medical help and insulin were available; Reverend Konz did not request treatment.
- Reverend Konz’s condition worsened at home; neither Dorothy nor Erikson summoned medical assistance.
- Reverend Konz died the next morning from diabetic ketoacidosis.
- A jury convicted Dorothy and Erikson of involuntary manslaughter; the trial court arrested judgment for insufficient evidence; the Superior Court reversed and reinstated the convictions.

## Issues

1. Whether the evidence was sufficient to prove Dorothy Konz had, and culpably breached, a legal duty to obtain medical assistance for her husband, supporting involuntary manslaughter by omission.
2. Whether the evidence was sufficient to prove Erikson was an accomplice in the breach of duty, supporting his involuntary-manslaughter conviction.
3. Whether the trial court erred in granting arrest of judgment based on legal insufficiency.

## Decision

- The Supreme Court of Pennsylvania affirmed the Superior Court’s order reinstating the jury’s guilty verdicts.
- The court held the evidence, viewed in the light most favorable to the Commonwealth, was sufficient for a jury to find Dorothy had a legal duty to obtain medical aid and recklessly or with gross negligence failed to do so.
- The court held the evidence was sufficient to find Erikson intentionally aided and encouraged the fatal omission and was liable as an accomplice.
- The trial court’s arrest of judgment was therefore improper.

## Legal Principles

- Criminal homicide liability may be based on an omission when the defendant has a legal duty to act and the culpable failure to perform that duty is a direct and substantial factor in causing death.
- A spouse may have an affirmative duty to obtain medical assistance for the other spouse in an emergency when the need for aid is or should be apparent.
- Involuntary manslaughter may be established where a reckless or grossly negligent breach of a legal duty causes death.
- A victim’s religiously motivated refusal of treatment does not necessarily negate a caretaker’s duty once a life-threatening crisis is evident and the caretaker participates in or reinforces the deprivation of necessary care.
- Accomplice liability attaches where a defendant intentionally aids, encourages, or assists the principal’s duty-breaching omission that results in death.

## Conclusion

The court upheld involuntary-manslaughter convictions based on a spouse’s culpable failure to obtain emergency medical care for a diabetic husband and a friend’s accomplice participation, recognizing that a special relationship can impose a legal duty to act and that reckless breach by omission can support homicide liability.


Commonwealth v. Konz, 450 A.2d 638 (Pa. 1982)