Court Opinion

ID: 9749691
Source: CourtListenerOpinion
Date Created: 2023-08-27 16:58:35.716758+00
Date Added: 2024-06-11T15:35:40.761473
License: Public Domain

OPINION OF THE COURT
FLAHERTY, Justice.
This is an appeal from an order of the Superior Court1 which reversed a decision of the Court of Common Pleas of the Thirty-First Judicial District granting a Motion in Arrest of Judgment to the appellants, Dorothy A. Konz and Stephen R. C. Erikson, subsequent to their being found guilty of involuntary manslaughter in a trial by jury. The prosecution of Dorothy Konz arose from her failure to comply with an alleged duty to seek medical assistance for Reverend David G. Konz, her husband, when he was stricken with a diabetic crisis which proved fatal. The prosecution of Erikson rested upon his alleged role as an accomplice in that breach of duty.
*641Viewed in the light most favorable to the Commonwealth, as verdict winner, the following facts were established at trial. In September, 1973, Reverend Konz, while serving as a teacher, counselor, and chaplain at United Wesleyan College, became acquainted with Erikson, a student at the College. A close friendship, based on their common interest in religion, formed between Erikson and Reverend Konz as the former became a regular visitor at the latter’s residence.
Reverend Konz was a thirty-four year old diabetic and had, for seventeen years, administered to himself daily doses of insulin. On March 4,1974, however, following an encounter on campus with a visiting evangelist speaker, Reverend Konz publicly proclaimed his desire to discontinue insulin treatment in reliance on the belief that God would heal the diabetic condition. He assured the president of the College and members of the student body that he would carefully monitor his condition and would, if necessary, take insulin. On only one or two occasions did the Reverend thereafter administer insulin. On March 18, 1974, however, Erikson and Reverend Konz formed a pact to pray together to enable the latter to resist the temptation to administer insulin.
Mrs. Konz was informed of the prayer pact, and, on the morning of Saturday, March 23, 1974, when her husband evidenced symptoms of insulin debt, she removed his insulin from the refrigerator and concealed it.2 Later that day, the Reverend attempted to obtain insulin from the refrigerator, and, upon discovering that the medicine had been removed, strongly indicated that it should be returned. He then attempted to proceed from room to room but his passage was blocked by Erikson. Harsh words were exchanged, and Erikson, after kneeling in prayer, forced the Reverend into a bedroom where, accompanied by Mrs. Konz, Erikson and the Reverend conversed for approximately one half hour. During that time, the Reverend tried to telephone police to obtain assistance but was prevented from doing so by Erik-son and Mrs. Konz, who, during a struggle with the Rever*642end, rendered at least that telephone permanently inoperable.3 Immediately after this confrontation, the Reverend, his wife, and Erikson returned amicably to the kitchen for coffee, and no further request for insulin was ever made. In addition, the Reverend approached his aunt who resided in the same household and stated, in an apparent reference to the preceding confrontation with Erikson, that “It’s all settled now,” and told her that there was no cause for concern. He also told his eleven year old daughter that “Everything is fine,” and indicated to her that he did not intend to take insulin. The Reverend then departed from the house, accompanied by Erikson, and returned an hour later. As the day progressed, Reverend Konz cancelled his speaking commitment for the following day and drove his wife to an institution having hospital facilities to pick up a close friend who was a practical nurse. Late on Saturday night, while waiting inside the institution for the nurse to complete her duties, the Reverend appeared very fatigued and complained that he was developing an upset stomach. Both of these conditions were symptomatic of lack of insulin, but neither the Reverend nor his wife requested that insulin, which was available at the institution, be administered. With regard to the Reverend’s condition at that time, the nurse observed that he travelled with unimpaired mobility, and that he was conversant, rational, and cognizant of his environs. Nevertheless, he made no mention of a need for insulin, and the nurse made no inquiry as to such a need because the Reverend had on a previous day become very upset at her inquiry as to his diabetic condition.
Upon returning home from this errand, Reverend Konz experienced increasing illness, vomiting intermittently Saturday night and Sunday morning, and remained in bed all day Sunday except for trips into the bathroom. On Sunday afternoon visitors arrived at the Konz residence. The Reverend, recognizing their voices, called to them from his room to inquire whether they wished to see him; having *643been informed of the Reverend’s nausea, however, the visitors declined to stay. As the Reverend’s condition worsened and he became restless, his wife and Erikson administered cracked ice but did not summon medical aid. The Konz’s eleven year old daughter then inquired as to why a doctor had not been summoned but Mrs. Konz responded that her husband was “going to be getting better.” Late Sunday night or early Monday morning everyone in the household fell asleep. On Monday morning at approximately 6 AM, while the others were still asleep, Reverend Konz died of diabetic ketoacidosis.
Appellants were found guilty by a jury of the crime of involuntary manslaughter pursuant to Section 2504 of the Pennsylvania Crimes Code, which provides: “A person is guilty of involuntary manslaughter when as a direct result of the doing of an unlawful act in a reckless or grossly negligent manner, or the doing of a lawful act in a reckless or grossly negligent manner, he causes the death of another person.” 18 Pa.C.S.A. § 2504. To impose criminal liability for an omission as opposed to an act, the omission must be “expressly made sufficient by the law defining the offense.” 18 Pa.C.S.A. § 301(b)(1), or “a duty to perform the omitted act [must be] otherwise imposed by law.” 18 Pa.C.S.A. § 301(b)(2). Since the involuntary manslaughter provision of the Crimes Code does not expressly address omissions as a basis for liability, only 18 Pa.C.S.A. § 301(b)(2) has potential applicability. The determinative issue on appeal, therefore, is whether Mrs. Konz had a duty to seek medical attention for her spouse. Under the circumstances of this case, we find no such duty to have been present; hei ce, the conviction of Mrs. Konz, and that of Erikson as . er accomplice, cannot be sustained.4
Courts have, in limited circumstances, departed from the longstanding common law rule that one human being is *644under no legal compulsion to take action to aid another human being. One such circumstance is where there exists a requisite status of relationship between the parties, as is present in the relationship of parent to child. Hence, a parent has been held guilty of involuntary manslaughter for failure to seek medical assistance for his sick child. Commonwealth v. Breth, 44 Pa.C. 56 (1915); Commonwealth v. Hoffman, 29 Pa.C. 65 (1903). See also Commonwealth v. Comber, 170 Pa.Super. 466, 469, 87 A.2d 90, 93 (1952) (dicta), rev’d on other grounds, 374 Pa. 570, 97 A.2d 343 (1953). The inherent dependency of a child upon his parent to obtain medical aid, i.e., the incapacity of a child to evaluate his condition and summon aid by himself, supports imposition of such a duty upon the parent.
The Commonwealth argues that the marital relationship gives rise to a similar duty to aid one’s spouse. Spouses, however, do not generally suffer the same incapacity as do children with respect to the ability to comprehend their states of health and obtain medical assistance. We reject, therefore, the holding of the Superior Court that the marital relationship gives rise to an unrestricted duty for one spouse to summon medical aid whenever the other is in a serious or immediate need of medical attention. Recognition of such a duty would place lay persons in peril of criminal prosecution while compelling them to medically diagnose the seriousness of their spouses’ illnesses and injuries. In addition, it would impose an obligation for a spouse to take action at a time when the stricken individual competently chooses not to receive assistance. The marital relationship gives rise to an expectation of reliance between spouses, and to a belief that one’s spouse should be trusted to respect, rather than ignore, one’s expressed preferences. That expectation would be frustrated by imposition of a broad duty to seek aid, since one’s spouse would then be forced to ignore the expectation that the preference to forego assistance will be honored.
Since there is no precedent in this Commonwealth addressing the existence of the particular spousal duty in question, it is to be noted that certain other jurisdictions *645have regarded the marital relationship as sufficient, in itself, to invoke a limited duty for one spouse to seek medical care for the other. In Westrup v. Commonwealth, 123 Ky. 95, 93 S.W. 646 (1906), the defendant’s pregnant wife insisted that she did not want medical aid for the birth of their child. Soon after giving birth, however, she suffered complications; the defendant then summoned a physician, but the physician was unable, at that point, to prevent the wife’s death. Finding that the defendant had acted in good faith and at his wife’s competent request in not obtaining aid sooner, the court found no breach of duty to the wife. Reversing the conviction, the court stated:
Where the husband neglects to provide necessaries for his wife, or medical attention in case of her illness, he will be guilty of involuntary manslaughter, provided it appears that she was in a helpless state and unable to appeal elsewhere for aid, and that the death, though not intended nor anticipated by him, was the natural and reasonable consequence of his negligence.
Id. at 97, 93 S.W. at 646 (emphasis added). Hence, prior to his wife’s lapsing into an unexpected and helpless condition, the defendant was not obliged to override the mature, conscious, and rational decision of his wife to forego assistance.
A limited spousal duty was similarly recognized in State v. Mally, 139 Mont. 599, 366 P.2d 868 (1961), wherein the defendant’s wife was in poor physical condition prior to the occurrence of an accident in which both of her arms were fractured. After the accident, defendant allowed his wife to lay in a semi-comatose condition while she decried the need for aid for two days before he summoned a physician, and this delay caused her death. Affirming defendant’s involuntary manslaughter conviction, the court stated:
We are aware that the large majority of homicide cases involving a failure to provide medical aid involve a parent-child relationship. This is undoubtedly due to the fact that a person of mature years is not generally in a helpless condition. However, fact situations do arise, such as the *646instant case, wherein it is apparent that an adult is as helpless as the newborn. The record is replete with evidence that [decedent] could not have consciously or rationally denied medical aid.
Id. at 609, 366 P.2d at 873 (emphasis added.)
Unlike the foregoing cases, however, the instant case is not one wherein there is evidence of the stricken spouse having unintentionally entered a helpless state, or of having been less than competent to consciously and rationally deny medical aid. Rather, the record supports only the conclusion that subsequent to the incident on Saturday, March 23,1974, when Reverend Konz was briefly restrained in a bedroom by Erikson, the Reverend was in such mental condition as to fairly understand and appreciate his situation and had ample opportunity to request assistance but chose, instead, to forgo medical treatment. Hence, assuming that one spouse owes the other a duty to seek aid when the latter is unwillingly rendered incompetent to evaluate the need for aid, or helpless to obtain it, that duty would not have been breached under the facts presented.5
*647Subsequent to being restrained by Erikson in a bedroom for one half hour on the Saturday preceding his death, Reverend Konz elected on numerous occasions not to obtain insulin. The record does not support the inference raised by the Superior Court that the Reverend was, against his will, and until his death, continuously held incommunicado as an isolated captive of Erikson and Mrs. Konz while being denied the opportunity to secure medical assistance.
After announcing that the confrontation with Erikson was “settled,” Reverend Konz could easily have addressed a request for insulin to his aunt, to his daughter, to the clergyman to whom he spoke to cancel a speaking engagement for Sunday, to persons at the hospital facility to which he drove Saturday night, to the nurse with whom he conversed late Saturday night, or to visitors at his home on Sunday. The Reverend not only remained silent as to a desire for insulin, however, but even took the initiative to *648reassure his aunt and daughter that there was no cause for concern. This course of behavior is inconsistent with any conclusion other than that the Reverend, by Saturday evening, had become firmly resolved to abstain from the administration of insulin. Had the Reverend been dissatisfied with his treatment, as a diabetic would be in the event of being forcibly denied insulin, he presumably would have attempted to obtain the medication or to call his dissatisfaction to the attention of persons with whom he came in contact. Yet, the record is devoid of any evidence that such an effort was made. Nor can the Reverend’s acquiescence be attributed to a lack of mental competency to comprehend and militate against his plight. The testimony of the nurse with whom the Reverend conversed on Saturday night, as well as the Reverend’s reaction to the presence of visitors in his home on Sunday, indicate clearly that the Reverend was in an alert and rational condition. Hence, the conclusion is inescapable that Reverend Konz, having been a diabetic for seventeen years, was aware of the importance of insulin to the preservation of his life but competently chose to forego treatment. Under this circumstance, we find no breach of duty to have been incurred by Mrs. Konz in her failure to seek medical aid for her husband.6
Order reversed and appellants discharged.
NIX, J., files a concurring opinion.
McDERMOTT, J., files a dissenting opinion in which LARSEN, J., joins.

. Commonwealth v. Konz, 265 Pa.Super. 570, 402 A.2d 692 (1979).

. The insulin was returned to the refrigerator sometime prior to Sunday night.

. There was testimony as to the existence of two telephones in the residence.

. In view of our disposition on the issue of duty, appellants’ allegations of trial error, as well as a challenge by appellant Erikson to the applicability of the accomplice theory of culpability to the crime of involuntary manslaughter, need not be addressed.

. The dissenting opinion of Mr. Justice McDermott states that Reverend Konz’s “last visit to the world was to take his daughter shopping for shoes” and that appellants then “purposely isolated him and denied him access to help.” This assertion is completely unsupported by the record and ignores the crucial and uncontroverted fact that, subsequent to that shopping trip, and subsequent to the incident where appellants restrained Reverend Konz from taking insulin, he drove his wife to a hospital facility where he could easily have obtained insulin and where he remained for some time without ever ■ requesting medical assistance. This fact formed the basis of the trial court’s granting of appellants’ motions in arrest of judgment and, along with other uncontroverted evidence of record ignored by the dissenting opinion of Mr. Justice McDermott, compels our reinstatement of the trial court’s judgments of acquittal.
The opinion of the court of common pleas en banc was written by the judge who presided at trial and heard all the evidence presented. After recounting the facts and reasonable inferences to be drawn therefrom in the light most favorable to the Commonwealth as verdict winner, that opinion states:
The acts of the defendants on Saturday afternoon in keeping the decedent from his insulin and preventing him from calling the police were, we believe, substantial factors which resulted in the jury returning a guilty verdict. However, reprehensible as they may be, these acts could not be the cause of Reverend Konz’s *647death, since the reverend had ample opportunity to obtain medical assistance when he went to Cedarbrook [the county nursing home, which had hospital facilities] that night. Since, from the medical testimony presented, there can be little doubt that medical aid on Saturday night would have saved his life, criminal liability cannot attach to the Defendants’s actions on Saturday, [citation omitted].
It cannot be said that the Defendants were responsible for the decedent’s diabetes. It is also clear from the evidence that the decision to withdraw from insulin was made by the decedent alone. While the Defendants encouraged Reverend Konz to abide by his decision, there is no evidence of any physical coercion by the Defendants after [Saturday,] March 23, 1974. There is no evidence of any request for insulin or medical assistance by decedent after that date. This is a situation where the decedent was attempting to cure himself by faith and prayer and the defendants honored his wishes in this matter.
In summary, the Commonwealth has failed to prove that the decedent was not physically or mentally capable of summoning medical aid or expressing his desire that others summon medical aid for him. The Commonwealth has failed to prove that decedent made such a request after Saturday afternoon and that the defendants ignored this request.
Since the Commonwealth has failed to present sufficient evidence to show the existence of a legal duty or that the defendants’ omission to act was the cause of the decedent’s death, the defendants’ motion [in arrest of judgment] must be granted.

. We note our disagreement with that portion of the dissenting opinion of Mr. Justice McDermott which asserts that the issue of appellants’ legal culpability was “put squarely before the jury.” The dissent relies exclusively upon an isolated excerpt from the trial court’s lengthy charge to the jury, where the court instructed that if Reverend Konz had chosen to refuse the taking of insulin, appellants were entitled to a verdict of not guilty. However, the dissent fails to mention that the trial court gave numerous additional instructions which would have permitted the jury to return verdicts of guilty notwithstanding Reverend Konz’s rational decision to abstain from seeking medical assistance.