Millions of people in this country are prepared to go into a
shop, and part with a pound because they believe that it's possible
to win the National Lottery - despite odds of many millions to one
against success.
Yet a jury is asked to believe that potentially shorter odds -
that natural cot death can strike three times in one family - are
impossible.
So says "Meadow's Law", espoused by Crown expert Sir Roy Meadow,
which says that three deaths "must be murder - unless proved
otherwise".
Finding the needle
In this country, approximately 600 children each year die
suddenly and unexpectedly at some time between their first week of
life, and their first birthday.
In half of these cases, a clear medical reason for the death is
found at post mortem - which leaves 300 sets of parents with no
explanation, just the term "sudden infant death syndrome" (SIDS) to
cling to.
There
is increasing evidence that there is a
genetic abnormality in a number of these
cases - we don't know how many
Dr Bill Hunt, Royal College of Pathologists
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However, concealed among this distraught group are a handful of
parents who know exactly why their baby died - their abuse or
maltreatment.
Somehow the police and legal system is expected to root these out
and bring the offending parent to justice.
Among the thousands of families in the UK who have suffered a cot
death, those parents who have suffered a second - or perhaps even a
third stick out like a sore thumb.
As such, they draw special attention from the medical profession
- and the police.
If these cases are brought to court, part of the argument
advanced by the Crown is that since cot death is a relatively rare
event, the chances of a subsequent, or even third cot death are so
rare as to point towards abuse.
Cot death genes
But other experts say it is perfectly possible that lightning can
strike three times in the same family.
There may well be cot death genes, as yet undiscovered, they say,
which mean that in some families, the chance of repeated cot deaths
are much higher.
Professor Jean Golding, from the University of Bristol - who has
examined how genetic factors play a role in infant death, said she
was delighted that the jury had made such a "sensible" decision in
the Trupti Patel case.
"We are very much in the infancy of understanding how the genes
for cot death work.
"What the mother has been asked to do is prove her innocence
without the scientific means to do it."
Are there cot death genes?
|
Dr Bill Hunt, from the Royal College of Pathologists, said:
"There is increasing evidence that there is a genetic abnormality in
a number of these cases - we don't know how many.
"The difficulty there is this group who feel that all multiple
cot deaths and quite a number of single cot deaths are due to
homicide.
"The evidence isn't all that good. Unfortunately the CPS and the
police seem to consult them before they consult the other side."
Figure attacked
In the now infamous case of Sally Clark, a solicitor whose
conviction for killing two baby sons was later quashed on appeal,
prosecution expert Sir Roy Meadow quoted the chances of a second cot
death in this middle class family as one in 73 million.
The chances of this being a natural cot death, he said, were
"vanishingly small".
This provoked a storm of protest from statisticians - whose
calculations put the true figure far lower.
One made a simple analogy. If an archer fires a number of arrows
randomly at a wall, the chances of hitting the bullseye on a target
on that wall are very small.
However, if the archer fires his arrows at a blank wall, and then
the bullseye was drawn on later around two arrows that happened to
be close together, there would be far more chance of hitting the
bullseye.
That, he said, was exactly what had happened here - in a
collection of cot deaths, police had sought out two in the same
family and drawn the bullseye around them.
Individuals
One medical expert said that there may be another reason why
figures giving the probability of multiple cot deaths may be
misleading.
If you take the whole of the UK population, simple maths tells
you that one baby in every 1,600 born will die from cot death.
But, unless you believe that everyone in Britain is exactly the
same, things are not as simple as this.
For example, if you looked at the risk of a cot death among
couples in which the mother is under 27, has more than one previous
child, with both parents unemployed and are smokers, it increases to
approximately one in 200.
If none of these factors apply, then the chance falls to one in
8,500.
However, even if you break people down into broad stereotypes,
it's still impossible to reliably calculate the risk to any one
individual.
Dr Richard Wilson, a paediatrician and trustee of the Foundation
for the Study of Infant Deaths, said: "You simply can't take a group
risk and apply it to the individual family. It's just wrong."
Dr Wilson told BBC News Online that while studies showed that
families who lost one baby to cot death were at increased risk of a
recurrence, it still was not entirely clear why this might be
happening.
He said data showed that in families which had lost one child to
cot death, subsequent babies were at an increased risk of dying from
the same cause, or from a variety of natural causes, such as
meningitis.
"There are still some unknown factors out there that haven't been
found."
It is difficult to prove - for prosecution or defence - that, in
the face of these uncertainties, an individual cot death was either
definitely due to abuse, or definitely not.
Call for change
Part of the problem for the defence lies within the current
coroner's system, says Dr Wilson.
If a second or third cot death arouses suspicions, it is often
hard to prove anything about the first or second death - because the
standard post-mortem is not designed to spot obscure natural causes
of death.
"We need to change the whole coroner's system - they are not set
up to find a natural cause of death.
"The majority of these deaths are through natural causes."
The jury in the Patel case were told that the deaths of three
children effectively ruled out natural causes.
But, each year in the UK, a handful of families who lose a baby
to cot death lose another child in a similar fashion.
Researchers believe that roughly a quarter of these are due to
abuse, about a half to an identifiable natural cause, and the final
quarter unexplained - a natural cause that can't be discerned.
It is hard for a jury to grasp that such a tragic event could
happen not just once, but twice, and then three times to one family
- with no abuse.
But leading experts say that this cannot be ruled out.
Trupti Patel, who has maintained her innocence all the way
through her trial, was cleared of murdering her three babies on
Wednesday.