Post-sentence evidence of health deterioration is admissible on a sentence appeal where it demonstrates the true significance of medical conditions that existed at the time of sentence, even if undiagnosed. Such cases remain rare and exceptional, but where incarceration has caused a significant and unanticipated deterioration in a complex pre-existing medical condition, the Court of Appeal may re-sentence with substantial leniency. The question for the Court in such cases is not whether the sentencing judge erred, but whether a different sentence should be substituted on the material now before the Court.
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