Inquiry into Pediatric Forensic Pathology in Ontario
November 23, 2007
Cross-examination of Dr. Jack Crane, Dr. Christopher Milroy, and Dr. John Butt by Suzan Fraser, counsel for Defence for Children International-Canada.
The following is an excerpt from the transcript of the Inquiry into Pediatric Forensic Pathology in Ontario. For the official transcript, or for more information about the Inquiry, visit the Inquiry web site: http://www.goudgeinquiry.ca.
[Page 1]
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THE INQUIRY INTO PEDIATRIC FORENSIC
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PATHOLOGY IN ONTARIO
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8 ********************
9
10
11 BEFORE: THE HONOURABLE JUSTICE
STEPHEN GOUDGE,
12
COMMISSIONER
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14
15
16 Held at:
17
Offices of the Inquiry
18
180 Dundas Street West, 22nd Floor
19
Toronto, Ontario
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24
November 23rd 2007
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. . . . .
[Page 104]
18 CROSS-EXAMINATION BY MS. SUZAN
FRASER:
19
MS. SUZAN FRASER: Mr.
Commissioner,
20 gentlemen, my name is Sue Fraser,
and I'm here on behalf
21 of an organization called Defence
for Children
22 International which is an
independent grass roots
23 organization founded in Geneva in
1979.
24
And its mission is to promote the rights
25 of the child, and I have some
questions on their behalf
[Page 105]
1 today. And I'll -- I'll start with Dr. -- with Professor
2 Milroy, and if the others feel
the need to jump in,
3 please do so.
4
But I'll -- I've got my fifteen (15)
5 minutes of fame, so I'll try to
be -- to be quick. I
6 take it, Dr. Milroy, that it's a
fundamental part of
7 pathology that you engage in this
work in order to
8 understand disease and illness in
order to prevent it;
9 that's part of what you do?
10
DR. CHRISTOPHER MILROY:
Yes. I think --
11 I mean, forensic pathology is --
is ultimately about
12 public safety.
13
MS. SUZAN FRASER: All
right. And public
14 safety in more then one (1) way;
both in terms of the
15 actual medical side of it, in
terms of illness
16 prevention, but also in terms of
the criminal justice
17 side of it that you become an
actor in the criminal
18 justice system?
19
DR. CHRISTOPHER MILROY:
Absolutely.
20
MS. SUZAN FRASER: All
right. And I'm
21 interested in the medical part of
that for the moment.
22 That in understanding how people
come to their end, we
23 can understand how we can prevent
that, isn't that fair?
24
DR. CHRISTOPHER MILROY:
That's correct.
25
MS. SUZAN FRASER: All
right. And we
[Page 106]
1 have heard from Dr. Pollanen and
Dr. McLellan that the --
2 in terms of our understanding of
deaths -- understanding
3 the deaths of children from zero
(0) to five (5) are
4 generally considered to be more
complex.
5
Is that something that you would agree
6 with?
7
DR. CHRISTOPHER MILROY:
I agree.
8
MS. SUZAN FRASER: And
-- and, Dr. Crane,
9 you as well, that zero (0) to
five (5) is a more complex
10 range?
11
DR. JACK CRANE: Yes,
I would.
12
MS. SUZAN FRASER: And
I take it from
13 understanding this and looking at
the overview reports,
14 that we have one (1) -- one (1)
of the most difficult
15 categories appears to be where
there is a sudden
16 unexpected death that could be
SIDS or some -- some
17 suspicious event, but at the end
of the day you may --
18 may not be able to determine
whether it is caused --
19 whether it's a naturally
occurring event or an unnatural
20 event, is that fair?
21
DR. CHRISTOPHER MILROY:
Yes.
22
MS. SUZAN FRASER:
And, Dr. Crane, you'd
23 agree as well?
24
DR. JACK CRANE: I
would, yes.
25 MS.
SUZAN FRASER: And Dr. Butt?
[Page 107]
1
DR. JOHN BUTT: Yes.
2
MS. SUZAN FRASER: All
right. And
3 similarly, in adults, you may
have somebody who is
4 suffocated, and you are not able
to determine whether
5 they're suffocated or may have
died by natural causes.
6
This is a problem with forensic pathology
7 on this area; is that fair?
8
DR. CHRISTOPHER MILROY:
Yes. It's --
9 it's particularly so at the
extremes of life or I mean,
10 to overcome somebody who is
active and an adult is much
11 more difficult then if they're
elderly infirmed or if
12 they're young and unable to
resist.
13
MS. SUZAN FRASER: All right. But -- but
14 you may not see any signs in an
adult as you might not in
15 a child, is that fair?
16
DR. CHRISTOPHER MILROY:
That's correct.
17
MS. SUZAN FRASER: All
right. And on the
18 other end of the spectrum, you
may have a child who comes
19 before you, who -- where you see
clear signs of abuse and
20 your question may be whether the
abuse is all connected
21 with how they came to their end,
isn't that fair?
22
DR. CHRISTOPHER MILROY:
That's correct.
23
MS. SUZAN FRASER: All
right. Now -- and
24 we have seen cases like this in
the overview reports
25 where there are signs of abuse,
but the question
[Page 108]
1 ultimately is, is that connected
to how the child came to
2 their end. And that may be a question that we
don't
3 know. Is that fair?
4
DR. CHRISTOPHER MILROY:
That's correct.
5
MS. SUZAN FRASER: All
right. And so, in
6 some respects the issue then
becomes the nature of the
7 charge; whether a charge of child
abuse could be
8 sustained versus a charge of
manslaughter or murder.
9
Is that fair?
10
DR. CHRISTOPHER MILROY: Yes, those are
11 the -- obviously, homicide or
assault or child abuse and
12 neglect. There are obviously different
jurisdictions
13 have different, similar laws.
14
MS. SUZAN FRASER:
And I take it that
15 there is a role for forensic
pathologists to play in
16 terms of determining whether
there has been abuse when a
17 deceased child comes before
them. Is that fair?
18
DR. CHRISTOPHER MILROY:
Yes.
19
MS. SUZAN FRASER:
Okay. And would you
20 then agree that the review of
deaths -- just moving away
21 then from understanding that role
of the forensic
22 pathologist, would you agree that
the review of death is
23 an important process in understanding
how children come
24 to their end?
25
DR. CHRISTOPHER MILROY:
Yes.
[Page 109]
1
MS. SUZAN FRASER: All
right. And just -
2 - Ms. Langford asked Dr. Crane
some questions about the
3 short falls and the high falls
that -- I take it that
4 when you're working on an
evidence-based model that you
5 actually have to ne -- you need
the evidence, in order to
6 come up with an understanding as
to how many children die
7 from a short fall, and how many
children die from a high
8 fall.
9
Is that -- is that fair?
10
DR. CHRISTOPHER MILROY:
You need an
11 evidence base and you need,
therefore, people to do
12 research and put it into the literature,
yes.
13
MS. SUZAN FRASER: All
right. And I take
14 it then that there is merit to
systemic tracking of
15 children's deaths and how
children come to their death
16 even outside of the criminal
justice system. Is that
17 fair?
18
DR. CHRISTOPHER MILROY:
Yes.
19
MS. SUZAN FRASER: All
right. And in
20 England, do you have a system by
which you track how
21 children die?
22
DR. CHRISTOPHER MILROY:
There are --
23 obviously there is a national --
there's an Office of
24 National Statistics.
25
MS. SUZAN FRASER:
Yes.
[Page 110]
1
DR. CHRISTOPHER MILROY:
And there is --
2 they're obviously coronial inquests. Some areas have
3 their own developed child death
review panels, but there
4 isn't, to my knowledge, a --
there's not a systematic or
5 child death review -- nothing
prescribed by legislation.
6
MS. SUZAN FRASER: All right. And do you
7 see there being a benefit in
tracking how children die;
8 in reviewing the deaths of those
from zero (0) to say
9 seventeen (17), in understanding
how children come to
