Forensic guide to child death

IN THE SECOND EDITION of this acclaimed text, Roger Byard, of the Forensic Science Centre in Adelaide, has expanded on his detailed survey of common and less frequent causes of death in childhood. The first edition, published in 1994 and written together with US forensic pathologist Stephen Cohle, was a work of great scholarship and has received extensive and justified acclaim. This new edition expands on the considerable strengths of the first and will no doubt be viewed as an excellent reference work in the field of paediatric sudden death investigation. This book is longer, has greatly enlarged chapters on non-natural death and sudden infant death syndrome (SIDS), and now has colour photographs to complement the numerous monochrome illustrations. Useful appendices include guidelines, checklists and protocols for the conduct of autopsies in specific circumstances, and an example of a “plain English” autopsy information pamphlet for parents.

Reflecting Professor Byard’s lifelong interest, the section on SIDS and associated conditions is excellent, providing a detailed overview of the syndrome and the conduct of investigations into such deaths. Similarly, there are well-structured chapters on non-natural deaths, written together with Dr Cohle. The rapidly evolving field of inflicted fatal childhood injury is reviewed in detail, and provides a balanced view on the pathophysiology of conditions such as the shaken infant syndrome and retinal haemorrhage.

As with all books, there are some shortcomings. Principal among these is the emphasis on the autopsy and anatomical pathology in the investigation of paediatric sudden death. Metabolic and inherited diseases are relatively under-represented, although a number of excellent encyclopaedic texts in this area are available. Similar criticism can be made on the paucity of detail on congenital heart disease and neuropathology. Again these areas have been extensively covered in other texts specific to those topics. These are minor quibbles, and do not detract from an excellent body of work. The main focus of the book is sudden death, both natural and unnatural, and this is covered admirably.

What is the target audience for this book? Childhood death is relatively uncommon in developed societies, and most general practitioners will see few childhood deaths in any single year. With a recommended retail price of $450 and 643 pages in length, this book is aimed primarily at paediatricians, paediatric pathologists and forensic pathologists. No doubt the legal profession will also show an interest, especially in the section on intentional trauma.

Johan A DuflouDeputy Director NSW Institute of Forensic Medicine, Glebe, NSW