Paediatric forensic pathology

Paediatric forensic pathology

Introduction

Many medico-legal problems arise when children die from what appears to be unnatural causes. In the foetal period, mutations and developmental defects arising from viral infections, drug abuse, medication and anoxic states in the mother, as well as failed attempts to induce abortion, may become the subject of litigation involving the medical practitioner, the pharmaceutical industry and diagnostic laboratory personnel. During the neonatal period problems

can relate to stillbirth, viability, birth injuries, ``infanticide'', concealment of birth and abandonment, as well as establishment of paternity in cases of suspected nursery identification errors.

Infancy, representing life between 28 days and one year  -   an arbitarily decided time interval  -   is a period where sudden, unexpected infant death assumes disturbing proportions. From one to three years the toddler is at a stage where accidental poisoning by medicines, household poisons and plant toxins, drowning in a swimming-pool, falls, aspiration of foreign bodies, motor-vehicle accidents and child abuse occur.

As the child passes into the pre-school age (four to five years) and school age (five to ten years) and starts moving about relatively unprotected in the new environment, transport accidents, drowning, burns and firearm injuries take on greater significance.

During pre-adolescence (ten to twelve years) and adolescence (twelve to eighteen years) accidents become even more significant, as do sport injuries, alcohol and drug abuse, suicides and (as adulthood approaches) aberrations in sexual behaviour.