Personal paper: A case of murder and the BMJ

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Abstract
What was the evidence? The trial, at Chester Crown Court, was long, and the fact that both parents were solicitors led to more publicity than usual. Many medical experts were called by both prosecution and defence, including eight pathologists with Home Office, forensic, paediatric, ophthalmic, and neurological expertise. There were many days of pathological evidence. Opinion differed about the extent, nature, and cause of the unusual findings identified on the dead infants—for example, the exact number of petechial haemorrhages on the face, the location of bruises, the cause of the torn and bruised frenulum, the degree of haemorrhage at the back of the eye, whether the spinal cord had been damaged at more than one level, the timing of the old rib fracture, the likelihood of the recent rib dislocation being caused by resuscitation, the proportion of alveoli showing evidence of previous bleeding into the lungs, and the exact timing of the hypoxic damage identified in the brain. This heavy morphological evidence was supplemented by that from experts seeking, and failing to find, natural conditions, disorders, or events that could account for these abnormalities, which are generally associated with trauma. At the end of the trial none of the pathologists or clinicians had described or classified the death of either child as an example of sudden infant death syndrome. Several attributed the findings to physical abuse, with smothering and shaking as the probable causes of death.

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