14 June 2005

Insulin-Induced Hypoglycemia = Involuntary Intoxication

Yasmeen (who's now off interning for the government) sent me a link to this case:

The Colorado Supreme Court has ruled 4-3 that involuntary intoxication from induced low blood-sugar content is a defense. Apparently, that portion of the decision was actually 7-0. The disagreement seems to have risen because he voluntarily injected himself with an overdose of insulin because he was anticipating eating ice cream and cake at his daughter's birthday.

Here's the opinion in toto. I haven't had the opportunity to read it yet.

For me there are three possible questions:

(1) Was the man acting in a manner which consistent with normal practice in the use of insulin?

(2) Did a doctor tell him he could use the medicine in the manner he did?

(3) Is there any reason to expect this kind of reaction in a normal individual?

Somebody read the case and tell me how far off base I am. For some strange reason, I plan to read the 6-8 cases that the Virginia Supreme Court handed down at the end of last week and don't think I'll be reading a Colorado case tonight.


Andy B said...

I'm not a legal professional, but if I'm reading the opinion right, all three of your questions are the trial court's problem, and that's exactly what the appelate courts ruled. And they're exactly right.

I'm not a medical professional, but I have two diabetic friends. The answer to (1) is yes--that's standard practice for diabetics--and I'd be surprised if the answer to (2) isn't also yes, because it's standard practice for diabetics. I'm not sure what you mean by (3): what kind of reaction, and in a normal diabetic or a non-diabetic? All diabetics do go into hypoglycemia occasionally; my friends do probably every month or two on average. It can't be prevented, only dealt with. And being already upset would naturally lead one to not quickly recognize that one is hypoglycemic.

I assert with certainty that if Garcia isn't eventually allowed to claim involuntary intoxication at trial, the law is an ass. Hypoglycemia is involuntary intoxication. The prosecution ought to have to produce evidence that hypoglycemia doesn't lead to violence in normal diabetics. (Maybe that's what you meant by (3).) I don't know whether that's actually true, but it's the question on which Garcia's moral guilt turns, and if I'm reading the opinion right, it's what his legal guilt ought to turn on too.

Full disclosure: I was once temporarily insane. (I was, correctly, involuntarily hospitalized as a suicide risk.) I take antidepressants to keep that from happening again. If I failed to take my pills, it would be my fault. Hypoglycemia isn't like that.

htom said...

Neither a legal nor medical professional, but I have a number of insulin-dependent diabetic relatives.

(1) That's standard practice. You are supposed to eat after doing so, however.

(2) Again, standard practice. The whole idea is to "smooth out" the peaks and valleys; more insulin if you're going to eat sugar, less if not.

(3) This is where it gets really messy. Was the intoxication unintentional? Hard to tell. He could have accidentally given himself too much, or accidentally not eaten enough -- and he could have intentionally done either or both of those things, hoping to have the excuse for the assault. One of my cousins-in-law does become "explosively grumpy" when he's in low-blood sugar, although his explosions are verbal, not violent.

I think that the trial court did error in requiring the insanity plea; if he intended the intoxication, that goes to premeditation and presumably guilt on the murder charge, but if it was accidental to me an intentional murder charge seems excessive, although I might vote as a juror to convict on the assault or maybe an attempted manslaughter charge.

There are a bunch of things that need to be addressed, on a case-by-case basis. People are different, and respond differently. Battling doctors, but that's the best we can do.