The sudden unexpected death of an infant or child is
one of the worst events to happen to any family.
Bereaved parents expect and should receive appropriate,
thorough, and sensitive investigations to identify the
medical causes of such deaths. As a result, several parallel
needs must be fulfilled. Firstly, the needs of the family
must be recognised—including the need for information
and support. Further, there is the need to identify any
underlying medical causes of death that may have
genetic or public health implications; the need for a
thorough forensic investigation to exclude unnatural
causes of death; and the need to protect siblings and
subsequent children. Alongside this, families need to
be protected from false or inappropriate accusations.
Limitations in the present coronial system have led to
delays or failures to detect deaths caused by relatives,
carers, or health professionals. Several recent,
highly publicised trials have highlighted the possibilities
of parents facing such accusations. As a result of this the
whole process of death certification has come under
intense scrutiny.
We review the medical, forensic, and sociological
literature on the optimal investigation and care of
families after the sudden death of a child. We describe
the implementation in the former county of Avon of a
structured multiagency approach and the potential
benefits for families and professionals
