## Facts

- Two unrelated homicide prosecutions were consolidated for appellate review: one against John Eulo and one against Robert Bonilla.
- In each case, the defendant shot the victim in the head; the victim was taken to a hospital, placed on a ventilator, and supported by medical devices and drugs.
- Physicians performed neurological examinations showing irreversible loss of brain function, including absent responses to stimuli and absent brain-stem reflexes; testing indicated no spontaneous respiration and no electrical brain activity on EEG.
- Doctors concluded, using accepted medical standards, that each victim had suffered irreversible cessation of all brain function and pronounced death on that basis while cardio-respiratory functions were artificially maintained.
- After the brain-death determination, life support was withdrawn and/or organs were removed for transplantation; thereafter cardio-respiratory activity ceased.
- Eulo was convicted of manslaughter; Bonilla was convicted of first-degree manslaughter and criminal possession of a weapon; intermediate appellate courts affirmed (Bonilla with a dissent).
- On appeal, defendants argued that the victims were not legally dead when organs were removed or support was stopped, and that medical actions severed causation; they also challenged the adequacy of jury instructions on death.

## Issues

1. Whether “death” in New York criminal statutes includes, absent a specific statute, irreversible cessation of the functioning of the entire brain, including the brain stem, when heartbeat and breathing are artificially maintained, as determined by accepted medical standards.
2. Whether withdrawal of life support or organ procurement after a brain-death declaration is a superseding cause that relieves a defendant of homicide liability.
3. Whether the trial courts committed reversible error by not specifically instructing juries on brain-based criteria for determining death.

## Decision

- The Court of Appeals affirmed both convictions.
- The court construed “death” to include either (a) irreversible cessation of breathing and heartbeat, or (b) when those functions are artificially maintained, irreversible cessation of all functions of the entire brain, including the brain stem, determined in accordance with accepted medical standards.
- The court held that organ removal or termination of artificial support after brain death does not relieve a defendant of criminal responsibility; such medical steps do not break the causal chain.
- The court held that, in context and given the medical testimony, the jury instructions were not misleading and did not require reversal despite not expressly defining brain death.

## Legal Principles

- For New York homicide statutes, legal death may be shown by either irreversible cardio-respiratory cessation or irreversible cessation of all functions of the entire brain, including the brain stem, when determined according to accepted medical standards.
- The content of the common-law term “death” may reflect advances in medical knowledge; recognizing brain-based criteria is consistent with traditional legal concepts and does not require legislative action in the first instance.
- When a defendant’s conduct causes brain death, subsequent physician decisions to procure organs or withdraw artificial support are not superseding causes; the defendant remains a but-for and proximate cause of death.
- Jury instructions are sufficient if, taken as a whole and in light of the evidence, they allow jurors to decide causation and death without being misled, even if they do not provide an explicit brain-death definition.

## Conclusion

New York’s highest court held that brain death, determined by accepted medical standards, constitutes legal death for homicide purposes and that post-declaration organ procurement or withdrawal of artificial support does not sever causation, thereby affirming the manslaughter convictions.


People v. Eulo, 63 N.Y.2d 341 (N.Y. 1984)