Bøylestad Lillian, Stray-Pedersen Arne, Vege Åshild, Osberg Silje, Rognum Torleiv
Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Acta Paediatr. 2020 Dec;109(12):2627-2635. doi: 10.1111/apa.15284. Epub 2020 Apr 20.
This study reviewed cases of sudden unexpected child deaths in Norway to determine the significance of death-scene investigations (DSIs) in establishing cause and manner of death, and thereby it is relevance to legal protection.
Data from forensic autopsy reports and DSIs were collected and analysed for cases of unexpected deaths in children below 4 years of age in Norway during 2010-2016.
Out of 141 cases, the death scene was investigated as a voluntary procedure in 75 cases and by the police in 41 cases. The cause of death remained unexplained in 81/141 (57%) of the cases, of which 46/141 (33%) met the criteria for sudden infant death syndrome (SIDS) or sudden unexplained death in early childhood (SUDC). The manner of death was determined in 102/141 (72%). Voluntary DSI increased the ability to rule out accidental suffocation, facilitated evaluations of environmental risk factors and enabled detection of possible neglect.
Death-scene investigations illuminate uncertainty about the cause of death, especially in grey-area cases where accidental suffocation, neglect or abuse is suspected. Knowledge about the course of events and the cause of death enhances both the child's and the caregiver's legal protection. Death-scene investigations should therefore be mandatory.
本研究回顾了挪威儿童意外猝死的案例，以确定死亡现场调查（DSI）在确定死因和死亡方式方面的重要性，及其与法律保护的相关性。
收集并分析了2010 - 2016年期间挪威4岁以下儿童意外死亡案例的法医尸检报告和死亡现场调查数据。
在141例案例中，75例的死亡现场调查是作为自愿程序进行的，41例是由警方进行的。81/141（57%）的案例死因不明，其中46/141（33%）符合婴儿猝死综合征（SIDS）或幼儿不明原因猝死（SUDC）的标准。102/141（72%）的案例确定了死亡方式。自愿进行的死亡现场调查提高了排除意外窒息的能力，便于评估环境风险因素，并能发现可能的疏忽。
死亡现场调查揭示了死因的不确定性，尤其是在怀疑有意外窒息、疏忽或虐待的灰色地带案例中。了解事件过程和死因可增强对儿童和照顾者的法律保护。因此，死亡现场调查应成为强制性要求。
