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.
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