Medico-legal infant deaths in Malta (1956-1971) : with special reference to “cot deaths”

Abstract

Medical practitioners in Malta are not legally authorised to complete the certification of death if this is sudden and unexpected, or if it is the result of violence or poisoning, or if poisoning is suspected. If there is any suspicion of foul play in any form the death also falls under the same legal provisions. There are no exceptions to this rule, and the age of the subject is no consideration. Such deaths are therefore reported to the police authorities who refer the case to the Magistrate. An inquiry into the death is held by the Magistrate, and a medico-legal autopsy forms an integral part of this investigation in all instances. During the last 16 years, 1956-1971, there were 148 deaths among infants, 2 years of age and under, that were the subject of medico-legal inquiry in Malta, with a population of about 33o,ooo, and an average population density of 2,700 per square mile. Of these deaths 35.8 per cent were unexpected, and the infants were found dead in their cot. They are here being referred to as “cot deaths”. This is the first study of infant deaths in Malta. It is based on a retrospective analysis of the causes of these deaths, to evaluate these causes, and to investigate the association of crime with infant destruction. This survey includes a study of the problem of “cot deaths” or the “sudden infant death syndrome” (S.I.D.S.) and to record the epidemiology of such deaths.