Nationwide protocol is needed for investigating baby deaths
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《英国医生杂志》
An inquest into every sudden infant death and a rule that autopsies in such cases be performed only by pathologists with paediatric training are among radical reforms called for this week by a working group of two UK royal colleges.
The recommendations come after widespread public concern over the cases of Sally Clark and Angela Cannings, who served years in prison before their convictions for murdering their babies were overturned on appeal, and Trupti Patel, who was acquitted of murdering three of her babies.
Key recommendations are for a nationwide protocol for the investigation of unexpected baby deaths and greater scrutiny of expert witnesses by the courts.
Baroness Helena Kennedy's working group highlighted the shortage of paediatric pathologists
Credit: KIRSTY WIGGLESWORTH/PA
The group, set up by the Royal College of Paediatrics and Child Health and the Royal College of Pathologists, aims to minimise the risk of wrongful convictions, while protecting children and helping professionals learn more about the causes of sudden infant deaths.
One problem highlighted by the Clark case is that in only a minority of such cases in England and Wales is an autopsy carried out by a specialist paediatric pathologist. The group calls for all postmortem examinations to be carried out either by paediatric pathologists or by pathologists with special paediatric training.
There is a severe shortage of paediatric pathologists. But the group, chaired by the Labour peer Helena Kennedy QC and with representatives from pathology, paediatrics, the police, coroners, and social services, believes that a drive to provide extra training to adult and forensic pathologists could produce the necessary staff in around two years.
The Department of Health is providing ￡1.2m ($2.1m; 1.8m) for a one year training course to convert adult histopathologists into paediatric pathologists.
Coroners would have to be prepared to let babies' bodies be taken outside their area if necessary for a specialist autopsy, the report says. They should order the retention of tissue "in perpetuity."
Under the proposed national multi-agency protocol, similar to one already used in Avon and Somerset, a paediatrician and a police officer would visit the parents at their home within 24 hours of the death, to look at the scene of the baby's death and talk to the parents about the events leading up to the death.
Parents should be treated sensitively, and professionals involved should keep an open mind, says the report, because in more than 90% of cases no evidence is shown that the baby was mistreated.
Judges would play a more active role in scrutinising expert witnesses before they gave evidence, checking their expertise in the area in which they propose to testify and whether they have recent clinical experience.
In criminal cases—as often happens now in care cases—there would be a pretrial review, with experts on both sides meeting to clarify the issues.(Clare Dyer, legal corresp)
The recommendations come after widespread public concern over the cases of Sally Clark and Angela Cannings, who served years in prison before their convictions for murdering their babies were overturned on appeal, and Trupti Patel, who was acquitted of murdering three of her babies.
Key recommendations are for a nationwide protocol for the investigation of unexpected baby deaths and greater scrutiny of expert witnesses by the courts.
Baroness Helena Kennedy's working group highlighted the shortage of paediatric pathologists
Credit: KIRSTY WIGGLESWORTH/PA
The group, set up by the Royal College of Paediatrics and Child Health and the Royal College of Pathologists, aims to minimise the risk of wrongful convictions, while protecting children and helping professionals learn more about the causes of sudden infant deaths.
One problem highlighted by the Clark case is that in only a minority of such cases in England and Wales is an autopsy carried out by a specialist paediatric pathologist. The group calls for all postmortem examinations to be carried out either by paediatric pathologists or by pathologists with special paediatric training.
There is a severe shortage of paediatric pathologists. But the group, chaired by the Labour peer Helena Kennedy QC and with representatives from pathology, paediatrics, the police, coroners, and social services, believes that a drive to provide extra training to adult and forensic pathologists could produce the necessary staff in around two years.
The Department of Health is providing ￡1.2m ($2.1m; 1.8m) for a one year training course to convert adult histopathologists into paediatric pathologists.
Coroners would have to be prepared to let babies' bodies be taken outside their area if necessary for a specialist autopsy, the report says. They should order the retention of tissue "in perpetuity."
Under the proposed national multi-agency protocol, similar to one already used in Avon and Somerset, a paediatrician and a police officer would visit the parents at their home within 24 hours of the death, to look at the scene of the baby's death and talk to the parents about the events leading up to the death.
Parents should be treated sensitively, and professionals involved should keep an open mind, says the report, because in more than 90% of cases no evidence is shown that the baby was mistreated.
Judges would play a more active role in scrutinising expert witnesses before they gave evidence, checking their expertise in the area in which they propose to testify and whether they have recent clinical experience.
In criminal cases—as often happens now in care cases—there would be a pretrial review, with experts on both sides meeting to clarify the issues.(Clare Dyer, legal corresp)