Forensic Pathology for Police - Brainshare Public Online Library

532 20 Deaths in Infancy and Childhood
has occurred (Fig. 20.28). Postmortem anus dilation is a recognized entity. Only
if associated trauma (bleeding, bruising) is identified should the finding raise suspicion.
Microscopic identification of inflammation is not sufficient to prove abuse,
considering the location. Similarly, the presence of a non-intact hymen should not
necessarily be considered evidence of abuse, although associated fresh or remote
trauma should raise concern.
Violent Older Child
These cases involve some type of altercation between the parent and an older child
(usually a teenager), often related to drug or alcohol problems in the child. The
situation is precipitated by the child. For example, an intoxicated teenager arrives
home and begins shouting at his mother. The father enters the argument, tempers
flare, and the teenager begins to attack his father. Eventually, the son produces a
knife, but the son ends up dying from stab wounds. These cases essentially mimic
cases that would otherwise be considered “domestic violence” cases.
Drug and Alcohol Abuse
These cases involve drug and/or alcohol abuse issues within the parent, rather than
within the child. It is not uncommon for other filicide category types to involve
parents who are intoxicated. In addition, cases of infant overlay associated with
maternal (or paternal) intoxication may be placed in this category.
Seizure Disorder
This is perhaps the least common (and least believable) category of filicide explanations.
The classic example that is described in the literature involves an epileptic
mother, who, following a seizure, placed her baby on the fire and her kettle in the
baby’s crib. A more believable example is a case wherein a friend stops by the home
of an epileptic mother to find her on the floor, obviously in a post-ictal (post-seizure)
state, lying atop her dead infant.
Innocent Bystander
These cases involve the inadvertent death of a child, usually during an attempt by
one parent to kill his or her spouse, or another person. An example involves a toddler,
being held by his mother, when her boyfriend shoots her multiple times, killing
both mother and child. A subtype would be a feticide, in which an unborn child is
killed when the mother is killed.