What is meant by diabetes?
Diabetes is a common chronic condition which currently affects three million people in the UK. It relates to the level of blood sugar in the individual’s blood and in certain cases can have a huge affect on the person.
Hyperglycemia versus hypoglycemia
Diabetes can be divided into either hyperglycemia or hypoglycemia.
What is the difference between the two?
Untreated diabetes is characterised by high blood pressure which is called hyperglycemia whereas diabetics on drug treatment where insulin is required to be taken can also suffer low blood sugar which is termed hypoglycemia. Hypoglycemia can cause effects which on the face of them are similar to alcohol consumption. Hyperglycemia can also cause similar mental impairment but to a lesser degree and with a much slower onset.
Diabetes and motoring offences
One of the main issues which can be affected by diabetes is dangerous driving. Accordingly drivers who are affected by diabetes must adhere to certain conditions.
The DVLA imposes strict conditions on diabetic motorists who must notify the DVLA of their condition and who are prohibited from driving Heavy Goods Vehicles (HGV’s). Furthermore, in order to reach the required visual standards all diabetic drivers of cars and motorcycles must recognise the symptoms of hypoglycemia and are issued with a detailed letter providing advice from the DVLA.
Most motoring accidents caused by drivers suffering with hypoglycemia
The risk of hypoglycemia – low blood sugar – is the main hazard to safe driving.
What is the reason for this?
The main reason for this is that it may endanger the life of the individual suffering from hypoglycemia as well of the lives of the other road users. Many accidents on the roads caused by hypoglycemia happen due to the driver continuing to drive even though they are experiencing warning signs of hypoglycemia. If an individual starts to experience warning signs of hypoglycemia whilst driving they must always stop as soon as is safely possible – if they do not it can often be fatal.
Are there any other offences which are often committed by individuals suffering from hypoglycemic episodes?
As well as offences caused by dangerous driving individuals suffering from hypoglycemia have also been arrested for certain public order and violent offences.
What does the criminal law say?
The forms of incapacity currently recognised by the criminal law of England and Wales are (sane) automatism and insanity – which includes insane automatism. The distinction between the two will depend on whether the cause is internal or external.
What must a defendant show to be able to plead automatism?
In order for a defendant to be able to plead automatism they must be able to show the following:
That they have suffered from a complete loss of voluntary control
That this was caused by an external factor – i.e. that he was not at fault in losing capacity
What must a defendant show to be able to plead insanity?
In order for a defendant to be able to plead insanity they must be able to show that there was a disease of the mind. A disease of the mind can include physical disorders such as diabetes as well as physciatric and neurological conditions, for example strokes and epilepsy.
When then can an individual state that they should be absolved from criminal prosecution due to a hypoglycemic attack?
When hypoglycemia occurs without any prior warning and prior fault then there will be no liability for crimes of specific intent. However, if the person has been reckless concerning their diabetes they may still be convicted due to self induced incapacity.
This means that a person who is reckless in managing their diabetes whilst knowing the possible consequences of their actions will have the requisite knowledge for a crime of basic intent in the same way as an individual will who is voluntarily intoxicated.
What is the difference between basic and specific intent?
An example of a crime involving specific intent would be that of murder as the defendant must have specifically intended to kill their victim. For example if an individual was suffering from a hypoglycemic attack and ended up killing an individual then they could plead the defence of automatism. However, this would not be a complete defence and would see the charge changed to manslaughter where specific intent is not required.
An example of a crime involving basic intent would be that of a battery where the application of unlawful force can be intended or it can be shown that the defendant was reckless. Recklessness is therefore not defined as specific intent meaning that an individual suffering from a hypoglycemic attack cannot use it as a defence for a battery.
How does this apply to the driving context?
In relation to motoring offences the diabetic will be found liable if he decides to drive – or continue to drive – whilst he exhibits symptoms of hypoglycemia and will be unable to plead automatism if hypoglycemia develops whilst driving.
When should a diabetic inform the DVLA of his condition?
The DVLA must be informed if one of the following happens:
That an individual suffers more than one episode of disabling hypoglycemia within 12 months or if their carer feels that they are at a high risk of developing disabling hypoglycemia
That an individual develops impaired awareness of hypoglycemia – that they have difficulty recognising the symptoms of low blood sugar
That an individual suffers disabling hypoglycemia whilst driving
What precautions should drivers who are required to take insulin follow when driving?
Drivers with insulin treated diabetes are advised to take the following precautions:
To not drive if they feel hypoglycemic
If hypoglycemia develops whilst driving to stop the vehicle as soon as possible in a safe location turning of the engine and taking themselves from the driving seat
To not resume driving until 45 minutes after the blood glucose level has returned to normal
To always keep an emergency supply of fast acting carbohydrate such as glucose tablets or sweets
To carry personal identification indicating they have diabetes such as a bracelet in case of injury in a road traffic accident