## Facts

- Sonney Pelham drove while intoxicated, with a blood alcohol content between 0.19 and 0.22, and rear-ended William Patrick’s vehicle on December 29, 1995.
- Patrick suffered catastrophic injuries, was placed on a ventilator, and remained on life support for months while experiencing infections, multi-organ system failure, and related complications.
- On May 30, 1996, Patrick’s family authorized removal of the ventilator consistent with Patrick’s previously expressed wishes; Patrick died about two hours later.
- The deputy medical examiner determined the cause of death was sepsis and bronchopneumonia resulting from multiple injuries from the collision.
- Pelham was indicted for first-degree aggravated manslaughter; the trial court denied a motion to dismiss based on the argument that removal of life support was an independent intervening cause.
- The jury was charged on second-degree death by auto and instructed that removal or refusal of life support does not break causation if the death was the natural result of the defendant’s actions; the jury convicted Pelham.
- The Appellate Division reversed for a new trial, concluding the intervening-cause instruction improperly removed an element of causation from the jury.
- The Supreme Court of New Jersey granted certification.

## Issues

1. Whether a victim’s removal from life support, consistent with the victim’s wishes, can be an independent intervening cause that breaks causation between a defendant’s conduct and the victim’s death.
2. Whether instructing the jury that removal of life support is legally insufficient to sever causation improperly invaded the jury’s role on the causation element.

## Decision

- The Supreme Court of New Jersey reversed the Appellate Division and reinstated Pelham’s conviction for second-degree death by auto.
- The court held that withdrawal of life support consistent with the victim’s wishes is, as a matter of law, foreseeable and not an independent intervening cause severing criminal liability when death is the natural result of the defendant’s conduct.
- The court held the instruction did not violate the jury-trial right because the jury still decided factual causation and whether the statutory elements were proven beyond a reasonable doubt; the court’s statement addressed only the legal sufficiency of the asserted intervening cause.

## Legal Principles

- Criminal causation includes factual causation (“but for” causation) and legal causation (whether it is fair to hold the defendant responsible in light of intervening causes and foreseeability).
- An intervening cause breaks the chain of causation only if it is independent and sufficient to sever the causal connection between the defendant’s conduct and the death.
- A victim’s lawful decision, or surrogate decision consistent with the victim’s wishes, to withdraw life-sustaining treatment is foreseeable following catastrophic injury and is not, as a matter of law, an intervening cause that relieves the initial wrongdoer of liability.
- A jury may be instructed that withdrawal of life support does not sever causation, while still requiring the jury to determine whether the defendant’s conduct caused the injuries and whether death was the natural result of those injuries.

## Conclusion

The court reinstated the death-by-auto conviction, holding that a victim’s lawful withdrawal from life support, made consistent with the victim’s wishes, is foreseeable and cannot sever criminal causation when the defendant’s conduct set in motion the fatal chain of events and the death was the natural result of the injuries inflicted.


State v. Pelham, 176 N.J. 448, 824 A.2d 1082 (N.J. 2003)