By Jeremy Laurance
The acquittal of Trupti Patel, the innocent mother cleared of killing three of her babies, has led to uncertainty about cot deaths that could lead to guilty parents getting away with murder, British doctors say.
Although the verdict on Mrs Patel, which the jury reached in 90 minutes, has been widely welcomed, it is expected to make securing future convictions more difficult.
The Foundation for the Study of Infant Deaths said 6 percent of cot deaths - 22 children out of the 366 who died of the syndrome last year - were suspicious.
George Haycock, professor of child health at Guy's Hospital, London, and adviser to the foundation, said the Patel case, and that of Sally Clark, a solicitor convicted and later cleared of killing her two children earlier this year, would nudge the pendulum from a presumption of guilt in such cases towards a presumption of innocence.
While accepting that the presumption of innocence was right - especially because evidence has emerged in recent years to suggest that some children who died in mysterious circumstances had previously unsuspected disorders - he said: "It would be a great pity if the pendulum swung too far the other way and with all the publicity surrounding these cases there is a danger that that could happen."
Professor Haycock said the adversarial legal system was unsuited to cases dependent on complex scientific evidence. He said proposals had been made for courts to appoint experts in such cases to provide a report independent of both parties. "It is an idea that has been suggested, though it is not part of English legal practice."
Harvey Marcovitch, a consultant paediatrician and editor of Archives of Disease in Childhood, said: "As a doctor you are suspicious of any baby who comes into hospital with an injury. The vast majority will turn out to have an innocent explanation, but there will be a number where you just do not know. There is no doubt that parents are injuring their children and will make it more difficult to pick up. The general public don't know and don't want to believe it."
He defended the achievements of Professor Sir Roy Meadow, the paediatrician who was a prosecution witness in the Patel case and whose evidence has been widely criticised for identifying mothers who harmed their children when no one wanted to believe it was possible.
"The Beverley Allitts of this world might not be behind bars but for him," he said, referring to a nurse convicted in the early Nineties of killing four children.
Dr Marcovitch described a case in which he had admitted a baby to hospital with suspected pneumonia and heart failure, including symptoms of pulmonary oedema (water on the lungs). "The baby was very ill but it was not clear why. We treated both diseases and he made a miraculous recovery."
The speed of recovery did not make sense, given the serious illnesses with which the baby had been diagnosed. But he was discharged from hospital with only a question mark against the diagnosis. Five months later, the mother admitted to a health visitor that she had tried to smother the baby but had panicked and called an ambulance when she saw blood trickling from its mouth. That tallied with the pulmonary oedema Dr Marcovitch saw on admission, which was not at that time recognised as a sign of suffocation.
"I thought afterwards, was there anything about that woman that gave me the slightest bad feeling? The answer was no. It would not have occurred to me for a millisecond that that woman might have harmed her child," he said.
It was later revealed that the woman, who had post-natal depression, had never wanted children but felt unable to seek an abortion because of her religious beliefs. After the birth, she looked for information on how to kill the baby without being detected.
"That is a lesson," Dr Marcovitch said. "But which is worse, missing one or finding someone guilty who is in fact innocent?"