Norm Smith Medallist
- Aug 21, 2016
- AFL Club
There is also murder misdiagnosed as SIDS.
Studies of sudden infant death syndrome (SIDS) have identified important risk factors. Educating parents not to put infants to sleep prone may have contributed towards the decline in SIDS. However, lack of specific defining features for the syndrome has meant that deaths due to unnatural causes, such as suffocation, where there have not been postmortem findings to indicate a cause of death, have been misdiagnosed as SIDS.
In the early 1980s, Emery 2 and Taylor and Emery 3 suggested that 10% of deaths classified as SIDS may not be due to natural causes. Improvements in a range of areas are contributing to the decrease in the number of deaths of infants from natural causes,4 but limited progress has been made in identifying or preventing infant deaths due to filicide. This difficulty is being addressed. For example, guidelines have been published by the Committee on Child Abuse and Neglect 5 with respect to identification and investigation of sudden infant deaths.
Meadow 4 has described clinical features associated with 81 children identified as having been killed by their parents. This series was drawn from 18 years' experience and thus represents only a small proportion of infant deaths. Dramatic and controversial in the study of a related area have been the covert video recordings 6 7 made of parents of children deliberately engaging in life threatening child abuse. While the numbers are again small they have served as graphic illustrations of the existence and form of a type of child abuse which is difficult for clinicians to imagine. The necessity for such evidence is illustrated by the report from Samuels and colleagues 6 of the incredulity some judges and magistrates expressed that a parent could have behaved in such a way, even after they had viewed the video evidence.
Thus, studies to date have focused initially on the question of whether child murder has been misdiagnosed as SIDS and progressively on identification and general features of such cases. Our paper provides an unusual perspective. It is a summary of a verbatim first person account by a woman who smothered two of her own children. These deaths were misdiagnosed as SIDS. They were followed by further assaults on other people's children, one of which resulted in death. Its value is in the way she presents herself to the listener, rather than as a presumed account of her underlying psychological processes.