The question of how the criminal law should treat negligently caused harm has always been practically and ethically problematic. While a wealth of authority exists for criminal negligence on the road, negligence in other contexts, particularly in the medical sphere, has rarely reached the criminal courts. This article explores the different ways in which negligence can be criminalised and argues that the law should not be held hostage by the peculiarities of road traffic negligence, and that the matter should be considered afresh for medical negligence. The conceptually difficult role of the Coroner in making pronouncements on criminal liability where the injury is fatal is also examined.