SIDS Network Web Site Sponsorship
For the month of February 2001 the SIDS Network web site is sponsored by John F. Maloney in memory of daughter Laura Maloney (10/7/67-1/9/68) and her Mother Denise Maloney (10/26/47-12/26/00).
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1. Comments from Dr. Henry Krous, Consultant in Pediatric Pathology for the AAP Committee on Child Abuse and Neglect Regarding the new AAP Policy, Distinguishing Sudden Infant Death Syndrome From Child Abuse Fatalities
Date: Tue, 6 Feb 2001
The AAP guidelines (http://www.sids-network.org/experts/abuse_aap_rec.htm) have created a storm of controversy, unfortunately much of it could have been avoided.
We (i.e., parents, medical examiners, scene investigators, child maltreatment specialists, etc) all want accurate diagnoses on all babies dying suddenly and unexpectedly.
All agree on essentially all of the guidelines. The one regarding examination of the body by the child maltreatment expert being the exception, I will address that later.
They are recommendations or guidelines, not rules or law,
It is my hope that when the dust settles that the medical examiner/coroners and child maltreatment experts in each jurisdiction will be able, and should, work out a system that accommodates the needs of both sets of medical specialists.
There are two very important and unfortunate controversies:
Regarding the first, members of NAME, the National Association of Medical Examiners, are furious about this recommendation, as I knew they would be, and for that reason I HAD STRONGLY RECOMMENDED THAT THE AAP RECOMMENDATIONS be finalized with the input of the NAME executive committee. Unfortunately that did not happen.
Regarding the second, I have been interviewed by the associated press and other newspapers and appeared in two television interviews and I have emphasized that all of us want accurate diagnoses based on thorough review of the medical history, careful investigation of the death scene and comprehensive postmortem examinations, and that all of the evidence indicates that the vast majority of SIDS cases have died of natural causes.
Highly positioned members of NAME will be addressing these guidelines at their meeting in a few weeks and I am sure they will respond to the AAP. It is my hope that this will be settled amicably with the least injury to SIDS parents, but this is going to take a while. There are some very bitter feelings now.
Henry F. Krous, MD
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