I am posting an excellent analysis by Dr Matthew Weait, Senior Lecturer in Law and Legal Studies at Birkbeck College, London (and author of Intimacy and Responsibility: The Criminalisation of HIV Transmission) of the recent successful prosecution of a male migrant for ‘recklessly’ transmitting the sexually transmitted infection, gonorrhoea, through non-sexual means.

A Dangerous Development
by Dr Matthew Weait
Senior Lecturer in Law and Legal Studies
Faculty of Lifelong Learning
Birkbeck College, London

In the recent case of R v Peace Marangwanda [2009] EWCA Crim 60, the English Court of Appeal was called upon to hear an appeal against sentence that has potentially profound implications for debates surrounding the criminalisation of HIV and other serious sexually transmissible infections. Summarised, the facts were that the applicant (PM) had been charged with two offences of sexual activity with a child, contrary to section 9(1) and (2) of the Sexual Offences Act 2003. It had been alleged that PM had met the mother of the children (E and Z), started a relationship and moved in with her in September 2005. In November 2005 PM was diagnosed with gonorrhoea, and he received treatment. A month later, in December 2005, the children, E and Z, were diagnosed as having contracted gonorrhoea. PM was charged, prosecuted and tried in 2007 after E made a complaint fo sexual abuse. The jury could not agree on a verdict after hearing PM’s defence that he was not suffering from gonorrhoea at the relevant time, and that it was rather a severe from of thrush. A retrial was scheduled to take place in June 2007. Prior to the retrial a compromise was suggested by defence counsel whereby PM would plead guilty to two counts of recklessly inflicting grievous bodily harm contrary to section 20 of the Offences Against the Person Act 1861. on the basis that he had recklessly transmitted gonorrhoea to E and Z.

The plea was entered

“ … on the basis that the Defendant, whilst possessed of the knowledge that he was suffering from gonorrhoea, recklessly passed on the said gonorrhoea to the two complainants.

2. Such transmission was carried our not in any way by means of any sexual contact, direct or indirect. Such transmission was likely to have been occasioned in circumstances where the Defendant, after having touched himself and then failing to apply the proper hygiene standards, has then gone on to touch the children in an ordinary way. The Defendant would, on occasion, be involved in the daily care of the two young Complainants. This would include assisting with washing, dressing and general supervisory activities with the same.

3. It was foreseeable that such a condition as gonorrhoea could have been passed and accordingly the Defendant failed in ensuring that he adhered to the proper sanitary and hygienic principles which would have been ordinarily implied.”

PM was sentenced to two years immediate imprisonment on each count, to be served concurrently. He was also recommended for deportation, disqualified from working with children for life and made subject of a Sexual Offences Prevention Order.

PM appealed on a number of grounds, one of which was that he had pleaded guilty to offences that were not medically possible and another that, even if it were medically possible, he had not acted recklessly. (The two other grounds are not of such immediate relevance here and are not discussed – see the case report.) The Court of Appeal agreed that the sentence passed was manifestly excessive and that a sentence of 12 months on each count should have been passed, to be served concurrently. For legal reasons this meant that the order relating to not being able to work with children was quashed, but the other orders were upheld.

Discussion

This is an important and worrying decision for a number of reasons. The plea of guilty to the charges under section 20 were entered on the understanding that the gonorrhoea had been passed through casual touching. PM, it was accepted, cared for E and Z (which included physical touching). The pre-sentence report (which is prepared to assist the judge in sentencing) stated that

“The defendant has pleaded guilty to the offence in accordance with the basis of plea, namely that he inadvertently passed on gonorrhoea to the two children due to poor personal hygiene.

Mr Marangwanda was, at the time of the offence, in a relationship with the mother of the two victims. He was periodically living at the family home and as such will have regular conduct with the children.

The defendant accepts culpability in as much as he acknowledges he passed on the sexually transmitted infection to the two girls due to poor personal hygiene.

…

The defendant accepts that his behaviour was reckless and that as a result, two young children contracted a sexually transmitted infection.”

It was on this basis that PM was sentenced, and the Court of Appeal accepted the reasoning. It states (at paragraph 12) that

In the judgment of this court, by his plea, the defendant accepted the medical possibility of the transmission of that disease. As he knew he had gonorrhoea, provided he knew that that disease may be transmitted by transference of mucosa by hand, that transference would have constituted a reckless act …

The Court goes on to say (at para 13) that

… by virtue of the basis of plea and the applicant’s pleas, he must have been accepting the possibility that in a domestic or familial setting the disease could have been transferred. In such circumstances it would have been his duty to take the necessary protection to ensure there was no transference. We are not persuaded that there is anything in that ground of appeal.

This is, it is suggested, deeply problematic, as are other aspects of the case. First, the Court seems to be suggesting that there is a duty to take the necessary protection against the transmission of disease. With respect, there exists no such legal duty anywhere in English law. A person is not reckless because he fails to take precautions against transmission; he is reckless if it is established that he was aware of the risk of transmission. This might seem a fine distinction , but it is an important one. If the Court is thinking particularly of the positive obligation that a carer has towards children, then it should have articulated that far more clearly. In the absence of clarification it suggests that a person living with HIV has a positive obligation – enforceable at law – to prevent onward transmission to sexual partners. (And, in the light of the recent Hep B case, that those infected with Hep B may have a positive obligation to alert others not to share their razors, for example). This goes beyond the principles established in R v Dica and R v Konzani. The CPS Guidelines on prosecuting cases involving the sexual transmission of disease indicate that the appropriate use of condoms by a person living with HIV would ordinarily preclude a finding of recklessness – they do not (because the law does not require it) state that a person living with HIV is under an obligation to use a condom (or, of course, to disclose status).

Another problematic aspect of the decision is that appears to be a bad compromise. The plea was entered and accepted in part, it seems, to prevent E (the child complainant) to have to give evidence at a retrial. It is for this reason that what would otherwise have been a case involving alleged sexual offences was transmuted into one concerning offences against the person. This was arguably artificial, and (as the discussion above about the Court of Appeal’s comments about the nature of PM’s duty shows) has resulted in – it is suggested – flawed reasoning.

Finally, although it wasn’t addressed in the Court of Appeal’s judgment, there remains the question of knowledge and scientific evidence of transmission. What follows is speculative in the instant case, but important, I think, to bear in mind.

1. PM moved in with E and Z and their mother in September 2005. He was diagnosed with gonorrhoea in November 2005 and the children in December 2005. If there is any possibility that PM may have infected E and Z prior to his diagnosis, and before he had any reason to believe that he might be suffering from gonorrhoea, there was no case to answer (see R v Dica; R v Konzani).
2. If, as the Court of Appeal accepted (albeit because of the “artificial” nature of the settlement that was reached on plea to avoid retrial) that gonorrhoea may be spread manually as the result of poor manual hygiene, then questions should have been raised as to the possibility that the source of the infection may have been elsewhere. There appears to have been no scientific evidence adduced, and the prosecution did not – it appears – seek any. The CPS Guidelines make it clear that there needs to be compelling proof that the defendant is the source of a complainant’s infection – and (critically) that a guilty pleas should not be accepted unless the prosecution believes that there is sufficient evidence to prosecute. Cases involving HIV transmission have fallen because of this.

The Marangwanda case is unfortunate because it appears to be yet another example of the ways in which the ill-thought out approach of the courts to liability for the transmission of sexually transmissible diseases can – in the absence of clear thinking and understanding – have unintended effects.

Matthew Weait
23rd April 2009