Monstrous Mothering: Understanding the Causes of and Responses to Infanticide

The deliberate killing of a child by its mother is abhorrent and is associated in the minds of many with mental illness and in particular with postnatal depression. However, at least 50% of perpetrators are neither "mad" nor "bad", and mothers who kill children are not "unhinged" by pregnancy or childbirth. We propose a different explanation: "blind rage" or "overwhelmed syndrome", whereby parents, stressed to breaking point by sleep deprivation or incessant baby crying, respond by lethally harming their child contrary to previous behaviour. The roots of this blind rage may be found in psychosocial disturbances, including the mother's own unsatisfactory experience of parenting which has caused attachment disorders. The legal framework guiding decisions to prosecute and structuring sentencing decision-making following conviction should acknowledge the exceptional stress experienced by such mothers postnatally. Health professionals including midwives and obstetricians should increase their vigilance and arrange referrals for mothers at risk of causing harm or committing infanticide.

[Regulatory evolution of the crime of infanticide]

The objective of the present study consists of the juridic-anthropological analysis of the infanticide, a phenomenon that nowadays is highly existent within the context of crime-settings. Particular consideration has been given to the legal developments of the infanticide act, which occurred simultaneously with the mutation of the socio-cultural contexts. Because the legislative process of the infanticide act has not evolved since 1981, it was possible to underline the criticisms and the inadequacy of such norm. Indeed, the legal norm has not always been able to provide an exhaustive answer concerning cases of infanticide. The process of humanisation of the law led to the introduction of a legal system, which describes the infanticide act as a condition of material and moral abandonment. This has become uncertain and ambiguous to interpret, risking to relegate the legislative matters of infanticide only to exceptional cases. The current study aims to highlight the criticisms and hypothesised different reform perspectives.

Nepal - exploited by older married man - young unmarried mother accused of infanticide

In Nepal, it is considered sinful for a woman to have sexual intercourse before marriage while the male is exonerated. The female will be branded a loose character outcast by family and society. Only a small percentage of women who feel the other way and stand mentally strong or who have family support come out to seek justice. Despite the stringent law, the loopholes in the justice mechanism re-victimise female victims. We report a case where a young unmarried pregnant woman who gave birth alone was charged with infanticide.

Maternal Infanticide and Filicide in a Psychiatric Custodial Institution in Hong Kong

OBJECTIVE

The aim of this study was to review the history, legislation, and psychiatric perspective of filicide, to compare the characteristics of mothers who committed neonaticide versus infanticide, and to discuss the infanticide law in Hong Kong.

METHODS

Data of mothers remanded to the Siu Lam Psychiatric Centre from 2008 to 2016 for filicide were reviewed, as were data of filicide from the Child Fatality Review Reports published by the Social Welfare Department.

RESULTS

From 2008 to 2016, eight mothers were remanded to Siu Lam Psychiatric Centre for filicide. Four were convicted of infanticide; the other four were convicted of manslaughter. Those convicted of infanticide were single and aged <18 years. They had concealed their pregnancies and received no antenatal care. They delivered at home and then either smothered or abandoned the newborn. They reported no suicidal attempts after the index offence and had no record of mental illness. They were given supervision orders instead of prison sentences. In contrast, those convicted of manslaughter were in their 30s and married. They were documented to have killed the victims by charcoal burning, strangulation, mutilation, or defenestration. They all attempted suicide immediately after the killing and had histories of mental illness: paranoid schizophrenia (n = 2), severe depressive disorder with psychotic symptoms (n = 1), and recurrent depressive disorder (n = 1). They were sentenced to Hospital Orders for unspecified periods.

CONCLUSIONS

In Hong Kong, the incidence of maternal filicide is low. However, the infanticide provision grants leniency to mothers, including those who show no evidence of mental illness.

Infanticide and illegal infant abandonment in Malaysia

Infant abandonment and infanticide are poorly understood in Malaysia. The information available in the public arena comes predominantly from anecdotal sources. The aim of this study was to describe the prevalence and characteristics of infanticide and illegal infant abandonment in Malaysia and to estimate annual rates for the most recent decade. Summaries of data about infanticide and illegal infant abandonment were gathered from police records; the annual number of live births was ascertained from the national registry. The estimated inferred infanticide rates for Malaysia were compared with the infanticide rates among countries of very high, high, medium, and low rankings on the Human Development, Gender Inequality, and Gini indices. From 1999 to 2011, 1,069 cases of illegal infant abandonment were recorded and 1,147 people were arrested as suspected perpetrators. The estimated inferred infanticide rate fluctuated between 4.82 and 9.11 per 100,000 live births, a moderate rate relative to the infanticide rates of other countries. There are substantial missing data, with details undocumented for about 78-87% of cases and suspected perpetrators. Of the documented cases, it appeared that more boys than girls were victims and that suspected perpetrators were predominantly Malays who were women, usually mothers of the victim; the possibility of arrest bias must be acknowledged. Economic and social inequality, particularly gender inequality, might contribute to the phenomena of infanticide and abandonment. Strategies to reduce rates of infanticide and illegal infant abandonment in Malaysia will require strengthening of the surveillance system and attention to the gender-based inequalities that underpin human development.

Beyond pragmatism: defending the 'bright line' of birth

It is usually accepted by ethicists that birth does not alter moral status. Rather, it is thought that the rule according full legal rights at birth is pragmatic. Pragmatic reasoning is vulnerable to competing practical concerns and stronger moral principles. This 'bright line' has therefore been criticised both by those who believe personhood begins before birth and those who believe it begins afterward. In particular, a recent article by Giubilini and Minerva puts forward both pragmatic and moral arguments in favour of permitting infanticide, and the New South Wales Court of Criminal Appeal has suggested there is a strong case for abandoning the bright line (R v Iby (2005) 63 NSWLR 278). If we desire to defend current legal doctrine against such criticism, a medical and philosophical basis for the law should be articulated. This article suggests such a medical and philosophical basis. It argues that both the multiplicity of biological changes occurring in the neonate at birth and the extrauterine context (the world) provide a justification for the distinction drawn at law between abortion and infanticide. With reference to Robert Nozick's 'experience machine' thought-experiment and elements of phenomenological philosophy, it advances two propositions to explain the status-changing nature of the neonate's emergence out of the womb. First, that expressing sentience in the world is essential for the attainment of personhood. Second, that having become a person, the harm in killing is disruption of this engagement with the world and the reduction from personhood to non-existence. This is the distinction between a neonate's death and the termination of a foetus, underscoring the qualitative difference between the two sides of the bright line drawn in law.

[Identification of an exhumed unknown infant through DNA analysis]

The article reports on the exhumation and subsequent DNA analysis of the skeletal remains of an unknown male newborn from 1988. Molecular biological methods confirmed the maternity of a woman who was already convicted of infanticide. Since homicide could not be clearly proven and manslaughter becomes barred by the statute of limitation after 20 years, the woman cannot be held accountable for the alleged killing of her first child.

Dead infants and unmarried women--from forensic pathology reports 1910-12

The lack of access to contraceptives and poor control over their own pregnancies represented a major problem for women 100 years ago. An unwanted pregnancy could lead to social exclusion and loss of paid work, and clandestine births and infanticide thus posed a social problem. A review of the archives of the Norwegian Board of Forensic Medicine in the period 1910 to 1912 shows that one-fifth of all expert opinions were related to infants and pregnancy. Autopsies performed on children constituted over one-third of all forensic autopsies during this period. Although the reports provide a timely reminder of the value of hard-earned rights in Norway, the lack of control over their own sexuality and unwanted pregnancies are unfortunately still the reality for a large proportion of the world's women.

Travelling knowledge and forensic medicine: infanticide, body and mind in the Netherlands, 1811-1911

This article aims to explain why the notion of mania puerperalis, or puerperal insanity, was not used in the Netherlands to exonerate women accused of infanticide, in contrast to other countries. It applies the concept of ‘travelling knowledge’ as an approach to the history of forensic medicine, pointing to the fields of medicine and law as contact zones inviting, promoting or barring the transmission of knowledge. Although the notion of mania puerperalis was known in the Netherlands from 1822 on, psychiatric expertise was not requested in actual court cases of infanticide for several reasons. First, physicians and legal scholars continued to doubt the existence of this form of mania. Moreover, it was not always directly connected to infanticide. Also, the specific formulation of the law strongly determined what medical evidence was needed in court cases. Not only did the Code Pénal generally emphasise material evidence, the laws on infanticide specifically mentioned fear and therefore an additional reference to the mental condition of the accused was not needed. Most importantly, the article argues that the existing vocabulary on emotion, both vernacular and medical, already allowed for an analysis of psychic components.

After-birth abortion: why should the baby live?

Abortion is largely accepted even for reasons that do not have anything to do with the fetus' health. By showing that (1) both fetuses and newborns do not have the same moral status as actual persons, (2) the fact that both are potential persons is morally irrelevant and (3) adoption is not always in the best interest of actual people, the authors argue that what we call 'after-birth abortion' (killing a newborn) should be permissible in all the cases where abortion is, including cases where the newborn is not disabled.

[Infanticide or murder in a forensic psychiatric assessment. A case study 5-fold infanticide--the search of psychopathology]

OBJECTIVE

The difficulties to distinguish between infanticide and murder of the woman own child, experienced by both experts and the court, have been discussed on the example of the psychopathological description of the perpetrator killing five of her children, and data from the literature.

CASE

This paper describes an extremely rare case of the woman who has killed five of her children immediately after their birth over several years.

COMMENT

It is very difficult to decide whether the seemingly rational motivation to kill her own child shortly after their birth can be a proof of specific psychopathological state which is a consequence of childbirth or an assassination planned in cold blood. The act of killing a child by their own mother is so contrary to nature that it seems easy to find the ground for psychosis or a state of emergency. However, when neither of them has been proven the experts are left with the conviction of both diagnostic deficiency and inexplicability of human behaviour.

"After birth" abortion: a biomedical and conceptual nonsense

Recently, two authors suggested that killing a healthy newborn might be morally permissible, subsuming it under the heading of 'after birth abortion'. Their proposed new definition implies that infanticide should be permitted whenever II trimester abortion for social reasons is. The suggestion stirred public outcry; nonetheless it needs to be analyzed since some 20% of countries allow II trimester abortion for social reasons and 5% do this on demand. A proper delimitation of the definition of "abortion" is thus very important to ensure careful application; for this reason we have attempted a critical analysis of their arguments. In the area of pregnancy termination different moral standards are apparently applied in different countries, but many reasons exist why the equation between II trimester abortion for social reasons and the killing of healthy neonates is to be morally rejected in all cases. The "inversed reification" of the concept of infanticide as a more abstract, euphemistic 'after birth abortion' blurs the fundamental difference between a non-viable fetus and a viable neonate. The best-known and most widely utilized (although illegal) "social reason" for "late abortion" and "infanticide" is a pregnancy with a female fetus or neonate. If infanticide for neonates were to be considered morally permissible, specifically it is this practice that would be applied. And this should be rejected on two levels: conceptual, through a critique of the exclusive use of one specific notion of personhood, and pragmatic through refusal of gender-discriminatory forms of infanticide (the killing of female neonates). In conclusion, having investigated the new concept we have concluded that the term "after birth abortion" is biologically and conceptually nonsensical.

No worries, mate: a forensic psychiatry sabbatical in New Zealand

Sabbaticals were initially intended to take place one year of every seven and to provide an opportunity for study or travel. Psychiatrists rarely take sabbaticals, but they can be of tremendous value in widening professional and personal horizons. It is not merely the psychiatrist taking the sabbatical who reaps the benefits, but also the home institution and patients. Sabbatical-takers have an opportunity to learn across cultures, to experience a new system of medical care, and to develop a less provincial view of their work and indeed their place in the world. A sabbatical can be a time of substantial accomplishments, such as writing or reorganizing programs. In this article, the benefits of a forensic psychiatry sabbatical experience in New Zealand are described.

Filicide, medical empathy, directives of the Supreme Court and reduced punishment

The role of empathy in the preparation of legal-psychiatric assessments is a controversial issue which has been discussed in the professional literature and in the practice in Court. The focus of the controversy is the question of objectivity versus subjectivity in the examiner and the worries about empathy leading to over-identification with the examinee. In this paper the authors will discuss relevant literature. They will also, for explanatory reasons, analyze a landmark decision of the Israel Supreme Court dealing with a case of filicide--a decision which may be understood as giving an increased role to the empathic perceptions of the evaluating psychiatric expert".

Mothers who kill: evolutionary underpinnings and infanticide law

Women who kill their children present a profound challenge to accepted notions of motherhood and the protection offered by mothers to their children. Historically, societies have varied in the sanctions applied to perpetrators of such acts, across both time and place. Where penalties were once severe and punitive for mothers, in modern times some two dozen nations now have infanticide acts that reduce the penalties for mothers who kill their infants. Embedded within these acts are key criteria that relate (a) only to women who are (b) suffering the hormonal or mood effects of pregnancy/lactation at the time of the offence which is (c) usually restricted to within the first year after delivery. Criticisms of infanticide legislation have largely centered on inherent gender bias, misconceptions about the hormonal basis of postpartum psychiatric disorders, and the nexus and contribution of these disorders to the offending in relation to issues of culpability and sentencing. Important differences between female perpetrators relative to the age of the child victim have also highlighted problems in the implementation of infanticide legislation. For example, women who commit neonaticide (murder during the first day of life) differ substantially from mentally ill mothers who kill older children. However, despite these shortcomings, many nations have in recent years chosen to retain their infanticide acts. This article reviews the central controversies of infanticide legislation in relation to current research and fundamental fairness. Using evolutionary psychology as a theoretical framework to organize this discussion, it is argued that infanticide legislation is at best unnecessary and at worst misapplied, in that it exculpates criminal intent and fails to serve those for whom an infanticide defense might otherwise have been intended.

Analysis of the relationship between neonaticide and denial of pregnancy using data from judicial files

OBJECTIVES

Using judicial files on neonaticides, (1) to examine the frequency of the association between neonaticide and denial of pregnancy; (2) to assess the accuracy of the concept of denial of pregnancy; (3) to examine its usefulness in programs to prevent neonaticides.

METHODS

Quantitative and qualitative analyses of data collected from judicial files during a population-based study carried out in 26 courts in 3 regions of France over a 5-year period.

RESULTS

There were 32 cases of neonaticides identified; 24, perpetrated by 22 mothers, were solved by police investigation. Aged 26 years on average, the mothers had occupations that resembled those of the general population and 17 had jobs, 13 were multiparous and 11 lived in a couple relationship. No effective contraception was used by women in 20 cases. Psychopathology was rare but mothers shared a personality profile marked by immaturity, dependency, weak self esteem, absence of affective support, psychological isolation and poor communication with partners. No pregnancy was registered nor prenatal care followed. Two (perhaps 3) pregnancies were undiscovered until delivery. No typical denial of pregnancy was observed in the other cases. Pregnancies were experienced in secrecy, with conflicting feelings of desire and rejection of the infant and an inability to ask for help. Those around the mothers, often aware of the pregnancy, offered none. In the absence of parallel clinical data, it is not possible to calculate the frequency of the association between neonaticide and denial of pregnancy.

CONCLUSIONS

The term 'denial of pregnancy' cannot fully reflect the complexity of emotions and feelings felt by all perpetrators of neonaticide and is used differently by different professionals. The term itself and its excessive generalization contribute to pathologizing women while absolving those around them and has little operational value in preventing neonaticides. The authors suggest rethinking the terms presently used to describe the phenomenon of pregnancy denial.

Commentary: postpartum psychosis, infanticide, and insanity--implications for forensic psychiatry

Two dozen nations have infanticide laws that decrease the penalty for mothers who kill their children of up to one year of age. The United States does not have such a law, but mentally ill mothers may plead not guilty by reason of insanity. As in other crimes, in addition to the diagnosis of a mental disorder, other factors, such as knowledge of wrongfulness and motive, are critical to the assessment. Postpartum psychosis has been described for 2,000 years and modern science supports a genetic component to the risk. Yet, the Diagnostic and Statistical Manual of Mental Disorders does not include it as a diagnosis, leading to difficulty in testimony. In this article, we discuss postpartum psychosis, infanticide law, and research regarding mothers who kill, and we make recommendations to forensic psychiatrists.

Postpartum psychosis and the courts

Although mental state defenses frequently are raised in cases of infanticide, legal criteria for these defenses vary across jurisdictions. We reviewed outcomes of such cases in states using M'Naughten or model penal code (MPC) standards for insanity, and the factors considered by the courts in reaching these decisions. LexisNexis and Westlaw searches were conducted of case law, legal precedent, and law review articles related to infanticide. Google and other Internet search engines were used to identify unpublished cases. Despite the differing legal standards for insanity among states, the outcomes of infanticide cases do not appear to be dependent solely on which standard is used. The presence of psychosis was important in the successful mental state defenses. This case series suggests that states that use the stricter M'Naughten standard have not been less likely than states with an MPC standard to adjudicate women who have committed infanticide as not guilty by reason of insanity.

Maternal neonaticide following traumatic childbirth: a case study

Recent work has documented the relatively high incidence of Posttraumatic Stress Disorder (PTSD) symptoms in women during the birth delivery process and afterwards, even in uncomplicated births. This phenomenon, however, has yet to be linked with cases of neonaticide (child homicide in the first 24 hr of life) or infanticide (child homicide within the 1st year of life). Women are more likely to experience mental disorder after childbirth than at any other time in their lives, and the intentional killing of an offspring by a mentally ill mother is likely underreported. The immediate postpartum period is a time of heightened vigilance by health providers and, when the tragic death of an infant occurs, forensic professionals should specifically assess for PTSD. As an illustration, the authors present a case of maternal neonaticide that was directly linked to PTSD without any other concomitant mental disorder. PTSD is a viable mitigating factor to be examined in legal defenses of infanticide either in isolation or in conjunction with other factors.

[Neonaticides in Hamburg, Germany, from 1998 to 2008]

In the analyzed period from 1998 to 2008, the autopsies performed at the Hamburg Institute of Legal Medicine included 13 cases in which an investigation for neonaticide had been initiated by the public prosecutor. The killed neonates showed a nearly equal distribution between both sexes. The most common method of neonaticide was suffocation. Most of the perpetrators were young, unmarried primipara with an average educational background. Almost all of them were suffering under psychological stress and had negated their pregnancy. In most cases, birth and neonaticide happened alone in their flat, and there was no medical attendance in any case. In the cases brought to court the women were charged with manslaughter (Section 212 German Criminal Code) and those found guilty were always granted a mitigated sentence pursuant to Section 213 Criminal Code.

The experience of pregnancy and childbirth for unmarried mothers in London, 1760-1866

This article explores the experience of pregnancy and childbirth for unmarried mothers in the metropolis in the eighteenth and nineteenth centuries. It draws upon, in particular, the infanticide cases heard at the Old Bailey between 1760 and 1866. Many of the women in these records found themselves alone and afraid as they coped with the pregnancy and birth of their first child. A great deal is revealed about the birthing body: the ambiguity surrounding the identification of and signs of pregnancy, labour and delivery, the place of birth and the degree of privacy, and the nature of, and dangers associated with, solitary childbirth.

Ambivalence toward mothers who kill: an examination of 45 U.S. cases of maternal neonaticide

Public opinion about neonaticide (the killing of a newborn within the first 24 hours of life) has varied across time and cultures. Some nations have passed legislation on behalf of maternal offenders with the assumption that childbirth, a time of unique biological change, may lead to mental disturbance. The United States, however, makes no such distinction; offenders are prosecuted under general homicide laws. Nevertheless, U.S. courts often consider a mother's emotional and physical condition prior to and during delivery. This study includes 44 female offenders and 45 infant deaths and highlights society's ambivalence toward neonaticide offenders. The authors suggest that this ambivalence may be attributed to: (1) the perception that an offender's emotional and physical turmoil during the birth and homicide reduces her culpability; (2) the sentiment that neonaticide offenders are more "redeemable" than other offenders; and (3) the uncertainty about the personhood of a fetus or newborn.

Infanticide and neonaticide: a review of 40 years of research literature on incidence and causes

The prevailing public view on women who kill their babies is that they are either monsters or psychotic, or both. The psychiatric and legal communities recognize that the issue is not as simply dichotomous as this. Evidence suggests that there are important distinctions to be drawn between different types of baby deaths and that this may have implications for identification, punishment, and/or treatment of potential and actual perpetrators. This article reviews and summarizes research, incidence statistics, and judicial and clinical outcomes ranging over four decades of work and sets out various ways forward in the study and prevention of infant murder.

Underascertainment of child abuse fatalities in France: retrospective analysis of judicial data to assess underreporting of infant homicides in mortality statistics

OBJECTIVES

Test the hypothesis of an underestimation of infant homicides in mortality statistics in France; identify its causes; examine data from the judicial system and their contribution in correcting this underestimation.

METHODS

A retrospective, cross-sectional study was carried out in 26 courts in three regions of France of cases of infant deaths submitted to the courts, 1996-2000, with follow-up of their files until case closing (1996-2008). For each case, cause of death established by the courts was compared with ICD cause of death as coded in official mortality statistics.

RESULTS

We examined 247 cases. Shortcomings in investigations were noted (autopsies: 75% of cases; fundus examination: 11%; diagnosis of sudden infant death syndrome [SIDS] without autopsy: 41%). Eighty deaths were considered homicides by the courts. Homicide rates in the court study are 2-3.6 times higher than those in mortality statistics. Nearly 1/3 of "accidental" deaths and 1/4 of deaths from unknown cause in mortality statistics are homicides. Mechanisms of underascertainment are: physicians' inappropriate death certification and underreporting of suspicious cases; inadequate investigation of cases; incomplete communication of final medical and forensic results to the mortality statistics department.

CONCLUSIONS

In a country where neither transportation of the body to a hospital nor autopsy is obligatory, judicial data can make an important contribution to correcting mortality statistics.

PRACTICE IMPLICATIONS

This study led to the first French protocol for investigating sudden unexpected deaths in infancy (SUDI). The protocol includes a physician "training" section focused on understanding the symptomatology and risk factors of violence, as well as the quality of death certification.

"Killed by its mother": infanticide in Providence County, Rhode Island, 1870 to 1938

This article analyzes infanticide based on the Coroners' Records for Providence County, Rhode Island, from the 1870s to 1938 to determine doctors' and coroners' attitudes toward mothers who killed. The nineteenth century witnessed a medical discourse on the possibility of postpartum insanity as a cause of infanticide. While some women claimed temporary insanity, and some doctors and coroners legitimated this defense, its application to mothers who killed was arbitrary. They determined who deserved this diagnosis based on the woman's character, her forthrightness, and extenuating circumstances. Infanticide divided the profession nationally and at the local level and prevented doctors or coroners from speaking in a united voice on the issue. This article does not attempt to follow cases of infanticide through to jury verdicts. Instead, it provides an opportunity to analyze the circumstances women faced that led them to kill their newborns, and to analyze the responses of doctors and coroners to these mothers who killed. Unlike the findings of other studies, neither physicians nor coroners in Rhode Island were united in a claim of ignorance to save these women from guilty verdicts.

Socio-cultural aspects of the high masculinity ratio in India

The paper aims to explicate those factors accountable for the continuing imbalance in the sex ratio and its further masculinization over the whole of the 20th century. Here it is contended that the traditional practice of female infanticide and the current practice of female foeticide in the contemporary period, especially in the north-west and Hindi-speaking states, have significantly contributed to the high masculinity ratio in India. In addition, increasingly higher survival ratios of male children, particularly from the 1951 census onward, have been the prime reason for a declining proportion of females in the Indian population. As the Indian value system has been imbued with a relatively higher preference for sons, improvements in health facilities have benefited males more than females, giving rise to a highly imbalanced sex ratio in the country. This scenario, however, has steadily tended to alter in favour of greater balance in sex ratio.

Women's policy networks and the Infanticide Act 1922

This article examines the reason for the passage of the 1922 Infanticide Act, arguing that it owes much to the influence and work of women's policy networks. Historians have disagreed as to why the Act was passed with relative suddenness in the early 1920s, at a time when infanticide was generally considered a much less pressing social issue than it had been in Victorian England. Moreover, several Bills brought between 1908 and 1913 proposing that the law on this subject be amended so that women who killed their newborns no longer faced the death penalty had all failed. Importantly, the roles of juror and lay magistrate had become open to women in 1920, following the passage of the Sex Disqualification (Removal) Act 1919. The public interest generated by a case of newborn murder tried at the Leicester Assizes in 1921 (particularly amongst women's organizations, including the suffragette group the Women's Freedom League) led several leading women with political connections to push for a change in the law. Without the pressure these women could bring to bear on civil servants and politicians, attempts to bring in new legislation on infanticide would have been postponed well into the twentieth century.

Maternal and paternal filicides: a retrospective review of filicides in Finland

The purpose of this retrospective study was to illustrate the differences in maternal and paternal filicides in Finland during a 25-year period. In the sample of 200 filicides [neonaticides (n = 56), filicide-suicides (n = 75), other filicides (n = 69)], the incidence was 5.09 deaths per 100,000 live births: 59 percent of filicides were committed by mothers, 39 percent by fathers, and 2 percent by stepfathers. The mean age of the maternal victims (1.6 y) was significantly lower than that of the paternal victims (5.6 y), but no correlation between the sex of the victim and the sex of the perpetrator was found, and the number of female and male victims was equal. The sample of other filicides (n = 65) was studied more closely by forensic psychiatric examination and review of collateral files. Filicidal mothers showed mental distress and often had psychosocial stressors of marital discord and lack of support. They often killed for altruistic reasons and in association with suicide. Maternal perpetrators also dominated in filicide cases in which death was caused by a single episode or recurrent episodes of battering. Psychosis and psychotic depression were diagnosed in 51 percent of the maternal perpetrators, and 76 percent of the mothers were deemed not responsible for their actions by reason of insanity. Paternal perpetrators, on the other hand, were jealous of their mates, had a personality disorder (67%), abused alcohol (45%), or were violent toward their mates. In 18 percent of the cases, they were not held responsible for their actions by reason of insanity. During childhood, most of the perpetrators had endured emotional abuse from their parents or guardians, some of whom also engaged in alcohol abuse and domestic violence. The purpose of this study was to examine the differences between maternal and paternal filicides in a sample of 200 cases in Finland. This report also provides a psychosocial profile of the perpetrator and victim in 65 filicides and a discussion of the influence of diagnoses on decisions regarding criminal responsibility.

[Surprising discovery: dismembered body found in a commercial laundry--medicolegal differentiation between infanticide, corpse dismemberment and stillbirth]

The discovery of a dismembered corpse, especially that of a newborn, represents a significant challenge for forensic investigators. The cause of the dismemberment, be it natural, accidental, or criminal, must be determined. Another important question to distinguish between neonaticide and stillbirth is whether the infant was alive after birth. The present case - a dismembered infant corpse discovered in the washing at a commercial laundry - describes a forensic investigation which could avoid premature or wrong conclusions by identifying the corpse as a stillbirth that was accidentally disposed of in the laundry after an autopsy had been performed.

[Infanticide by throwing the child from the 10th floor of a building]

Childbirth after denial or concealment of pregnancy has an increased risk of mortality for both mother and child. Interdisciplinary cooperation between professional groups is needed to explore the psychological and criminological aspects of infanticide. The case of a primipara mother, who threw her mature and viable newborn from the 10th floor of a high-rise building shortly after a concealed pregnancy, is reported. Forensic medical issues, as well as the characteristics of the offence and the perpetrator, are described.

Baby P: déjà vu or distinctive?

As in the case of Victoria Climbié, the case of Baby P triggered national outrage and widespread reforms to the child protection system in England. But the Baby P case is unique in several key ways. The context and differentiating elements of the Baby P case are explored, as is the public, political and media reaction, the use of new technologies, the main recommendations of the Laming report that followed it, and the role played by New Labour.

[Self-deliverance or infanticide?]

Self-deliverance by a woman in labour is nowadays a very rare event. The authors report the case of a 24-year-old primipara and a newborn of 49 cm length and 2484 g body weight with a complex pattern of injuries on the head, neck, shoulder and back who had breathed for at least 15 to 30 minutes after birth and died from massive craniocerebral trauma and lesions in the oral and cervical region. As one of the experts considered it possible that the skull fractures were exclusively due to the self-deliverance, the woman was acquitted of the charge of manslaughter. This hypothesis is critically discussed on the basis of the presumable course of the delivery and the literature.

Intent, the ethos of a caring society and justice

A paradoxical New Zealand case of a father who killed his five-month-old severely impaired daughter is discussed. The jury found the father not guilty of murder despite his confession that he acted so as to bring about her death. Standard constructions do not capture any reason for the jury to acquit him on the ground of lack of intent. The case also raises the issue of social mores in relation to difficult ethical decisions and the problems in trying to capture those in legislation or guidelines. The analysis discusses an alternative conception of intent according to a broader understanding of the patient's life story and the events surrounding the act in question and also the reasons why policy and legislative needs may distort bioethical analysis and argument in relation to difficult human situations.

[The shaken baby syndrome: a serious diagnosis on an insecure foundation?]

The discussion concerning the causes of infantile subdural bleedings (SDB) as well as retinal hemorrhages has become quite controversial in the last few years. The long-standing interpretation that most of these cases are the result of abuse--especially by the shaken baby syndrome (SBS)--was doubted, and the role of accidental events was emphasized. In many cases, there are no objective witnesses who observed the incident and no unambiguous traces of abuse, so that the diagnosis "shaken baby syndrome" often has to be established indirectly. A subdural bleeding (SDB) in an infant can undoubtedly be due both to an accidental and an intentional injury. Therefore, the SDB itself does not allow to draw far-reaching conclusions as to its cause. However, if an infant died or was hospitalized in a deep coma with several bridging vein ruptures and minor subdural bleeding, these findings are not compatible with an alleged minor fall. In the presence of several bridging vein ruptures, most authors are of the opinion that this is the result of a significant traumatization. In contrast to most other reports, the reliable demonstration of BV ruptures is a routine element of the postmortem diagnostic procedures at the Berlin institute of forensic medicine. In this way, a mechanical trauma can be clearly identified as the cause of the infant's death. If several bridging veins are torn, this proves a significant trauma and rules out a banal incident. The current controversial discussion on the reliability of the SBS diagnosis often makes it difficult not only for the clinician, but also for the forensic expert, to draw safe conclusions in the presence of a combination of findings long considered typical of the shaken baby syndrome. This situation is the background for presenting and discussing the major SBS findings reported in the literature and comparing them with our own expiriences. In our opinion there is still no justification for a fundamental change in the position to interpret such cases as a consequence of severe trauma caused by another person.

Judgments of culpability in a filicide scenario

Previous research has indicated that potential jurors are likely to use personal biases, such as those based on gender and ethnicity, in their judgments of culpability of criminal defendants in addition to, or instead of, the facts of the crime. The present paper seeks to extend this literature to the crime of filicide; to examine whether male defendants are judged more harshly than female defendants, as is the case for domestic violence and sexual abuse. 214 participants were provided with a scenario of filicide in which the gender of the perpetrator, the gender of the child, and the family's social class were randomly assigned. Participants were asked to rate the culpability of the defendant in the case. Results indicated that, unlike for other violent crimes, participants did not use gender or social class biases in their judgments of criminal culpability.

The civil liability for damages of the criminally insane

As a rule, mentally ill patients are held to be responsible for their acts just like everyone else. Notwithstanding, the law in Israel contains special rules which distinguish individuals with mental illness from other people. The instructions laid out in article 34h of the Israeli Penal Law empower the court to release a defendant from criminal responsibility. To do this the following criteria must be met: (a) the defendant was mentally ill, (b) he/she was in a psychotic state at the time he/she performed the felony, (c) his/her mental illness deprived him/her of his/her abilities in at least one of the two following areas: 1] he/she could not understand what he/she was doing, or the forbidden nature of the act; 2] he/she was incapable of preventing him/herself from carrying it out. In the case presented, a mentally ill individual was charged with the murder of his child and with an attempt to murder another child. The court ruled him to be legally insane and therefore non-punishable. He was later sued by the other child's parents for damages on the grounds of the assault tort. The issue in question was how does the fact that the defendant was ruled legally insane while committing the wrong doing affect the legal ruling of the defendant's liability especially regarding the tort of assault? The Magistrate's Court ruled that the Israeli Tort Law did not determine exemption from responsibility for the mentally ill. Liability for damages will be imposed upon an individual whenever the prerequisites to define a tort are met, even if the mental requisite is an outcome of one's mentally ill state. The District Court determined that an individual who intended to inflict harm is guilty of assault, even though the intent was an outcome of his mental state. Lack of volition due to one's inability to refrain from action does not constitute a defense for assault. In this case liability for damages was imposed on the defendant. The Court related to the issue of justice according to which an innocent person's damages should not remain uncompensated, and the assailant was required to pay damages to the victim.

[Forensic approach of infanticide and neonatal death]

The foetal of neonatal death brings up many questions as well on the physiopathological level as on the medico-legal one. We consider here the various natural and violent origins which allow understanding this difficult forensic activity. The approach of forensic anthropology and recent medical techniques (X-rays and echography) are also studied in order to be helpful to the medical examiner.

Murder, mercury, mental illness: infanticide in nineteenth-century Ireland

BACKGROUND

Infanticide has been described in almost every human society.

AIMS

To present a case of infanticide from nineteenth-century Ireland and explore related diagnostic, therapeutic and judicial issues.

METHODS

This paper uses original archival material from the Central Mental Hospital, Dublin to present a case of infanticide and inform an exploration of related issues.

RESULTS

In 1892, 'Dora', a thirty-four year old servant from Dublin, was found guilty of the murder of her eight-month old child and sentenced to indefinite detention at the Central Mental Hospital, Ireland's only inpatient forensic psychiatry facility. The subsequent experiences of Dora ("a case of melancholia") illustrate many of the diagnostic, therapeutic and judicial issues surrounding infanticide in nineteenth-century Ireland.

CONCLUSIONS

There were strong links between social circumstances and infanticide in nineteenth-century Ireland, compounded by myriad diagnostic and therapeutic challenges associated with forensic psychiatric committal and lengthy detention in poorly-therapeutic facilities .