Why does Georgia require autopsies and fatality reviews of children who die in a manner that is “suspicious or unusual” from SIDS, from unintentional or intentional injures, or when unattended by a physician?
What has Georgia’s Child Fatality Review Commission accomplished in its review of suspicious child deaths since 1990? House Bill 923, introduced as part of Gov. Nathan Deal’s 2014 legislative package, attempts to answer these questions.
In 1990, when the General Assembly created the Child Fatality Review Commission, the Georgia Bureau of Investigation employed no doctor pathologists in its medical examiner’s office. Two PhDs in microbiology performed autopsies at the request of local coroners, elected to a county office with no qualifications other than being at least 21 years old..
Although coroners are still elected in approximately 154 counties, the GBI today employs 14 medical pathologists, one a dual board-certified pediatrician and forensics pathologist; they performed about 490 autopsies on children in 2013. We clearly have made progress in the professionalization of the state’s medical examiner’s office. We can assume such progress assists local law enforcement to prosecute and make accountable those who abuse and murder children.
The child death review process, however, has not accomplished the legitimate goal of preventing children’s deaths, nor has it improved data sharing among state agencies that touch the lives of vulnerable children. HB 923, along with new federal legislation passed in late 2012, will enhance Georgia’s child death review in the following ways:
• The Child Fatality Review Commission will be moved from the Office of Child Advocate to the GBI, which will provide greater coordination among law enforcement agencies.
• Multiple conflicting confidentiality statutes and regulations will be amended to remove barriers to data sharing; 2009 legislation that gave additional authority to the Department of Family and Children Services to redact certain facts from child abuse records will be repealed.
• The Department of Public Health will have an enhanced role, with epidemiology professionals to identify with greater precision children who are most susceptible to neglect and abuse. At a minimum, the protection of medically fragile children should be improved.
The Child Fatality Review Commission has an important state function, but it needs to be updated and refocused on prevention and data sharing in a more precise and scientific manner. Gov. Deal’s legislation should pass. Together, we can redouble our efforts to prevent the unnecessary and cruel deaths of children.
State Rep. Mary Margaret Oliver, D-Decatur, represents District 82.
