Hypothetical situation

First to present the following, we're going to set out a simple definition from US Federal Law and California State Law, since I live in California with emphasis added to sections relevant to this example

From the US Code:

Title 18, § 1112

(a) Manslaughter is the unlawful killing of a human being without malice. It is of two kinds:
Voluntary—Upon a sudden quarrel or heat of passion.
Involuntary—In the commission of an unlawful act not amounting to a felony, or in the commission in an unlawful manner, or without due caution and circumspection, of a lawful act which might produce death.
(b) Within the special maritime and territorial jurisdiction of the United States,
Whoever is guilty of voluntary manslaughter, shall be fined under this title or imprisoned not more than ten years, or both;
Whoever is guilty of involuntary manslaughter, shall be fined under this title or imprisoned not more than six years, or both.

From the California State Law:

Penal Code Section 192

Manslaughter is the unlawful killing of a human being without
malice. It is of three kinds:
(a) Voluntary--upon a sudden quarrel or heat of passion.
(b) Involuntary--in the commission of an unlawful act, not
amounting to felony; or in the commission of a lawful act which might
produce death, in an unlawful manner, or without due caution and
circumspection. This subdivision shall not apply to acts committed
in the driving of a vehicle.
(c) Vehicular--


Alright, both definitions laid out here, we can begin. Both state that Involuntary Manslaughter, as highlighted here by the bold print, are cases of either where the commission of an unlawful act not amounting to a felony causes the death of a human being, where in the commission of a lawful act produces death, when acting in an unlawful manner, or without due caution or circumspection. This second circumstance is the key to the following hypothetical which involves two circumstances that appear similar but are treated differently:

Let's say a businessman is driving to work to make some big sale and he is driving very quickly although not recklessly wanting to make the meeting to make his big sale, get a nice healthy bonus, and move up in the company. On the way while driving he strikes a pedestrian as a he blows through a stop sign. He knows he hit the pedestrian but does not stop, after all he has a sale to make. Another passerby some time later, lets say ten minutes, notices the wounded and unconscious victim and calls for an ambulance. The ambulance arrives 15 minutes later, average response time you could say, and takes the person to a hospital. The medical personnel try everything they can but lose the patient. It is determined that the cause of death was a direct result of the injuries sustained in the crash. The businessman, by the way, has made the meeting, made his big sale, is the toast of the company, and pushed that whole mess to the back of his mind. Afterall, he did make a nice profit, bettered himself, and it couldn't have been that bad. A couple days later two police detectives arrive at his office while he is working, having just been told how he's going to get that big promotion, and is arrested on the spot for manslaughter by depraved indifference and is convicted, then sent to jail.


Here's our other situation. A patient is in a hospital, who has insurance that assures is full coverage and has never missed a premium, thanks to having passed out from excruciating pain. Upon arrival the the doctor wants to run a test to determine what it is, but to perform the needed tests they need approval from the insurance company. The patient believes he is ok, afterall he's never missed a premium and is fully covered. The doctor calls the company and the company refuses, giving some kind of creative reason as to why not, but in refusing they don't have to pay out for a very expensive test. The doctor delivers the news, the patient meets it with resigned regret, thinking there must be a good reason for this. Two months later there is a much more extreme repeat of the previous incident and the patient is rushed to the ER and given a full workup. They determine it is inoperable cancer, cancer that could have been treated and removed months before if it had been caught. The only thing keeping the test from being done was the insurance company's refusal to pay. The patient as a result dies. The insurance company saves money, and that's the end of that story.



Now lets look at this again. In both cases people chose not to act when they could have and if they had acted as one would expect a decent person to, then a life would have been saved. According to both statutes listed, the HMO and the businessman would be guilty of involuntary manslaughter by my interpretation. In the case of the businessman, he was engaging in an unlawful act, namely hit and run, that caused the death of a person. The HMO engaged in a lawful act, as it is legal for them to act as they did in this hypothetical, and as a result the patient in that situation died. Both cases according to the law are involuntary manslaughter. Yet in modern society the businessman, in real life, would be prosecuted to the fullest extent of the law, but the HMO would be left alone as it is ok for them to break one law in both letter and spirit while obeying the letter of another.

There is something terribly wrong with this picture, especially since it is the norm in this country today, isn't there?

First the doctor not the HMO should, to protect himself, from litigation later on, should have gone ahead and ran the test, The Doctor and the HMO could be sued for Depraved Indifference, However in all of these different situations, the Key is Legal Representation, no matter how unfair it may seem...