• Introduction
• The obligation to report a “reviewable death”
• Investigation of the “reviewable death” by the State Coroner
• Investigation of needs of the family by the Victorian Institute of Forensic Medicine
• Further Information

Introduction

The Victorian Government has introduced a new system for dealing with multiple child deaths in one family.  The changes were recommended by the 2003 “Report into the System for Dealing with Multiple Child Deaths” which was commissioned by the Premier, the Hon. Steve Bracks, after the deaths of four children from one Victorian family.  The Death Notification Legislation (Amendment) Act 2004 implemented the recommendations of this report and came into operation on 1 January 2005.  The intention of the legislation is to ensure that Victorian systems and processes for handling deaths are capable of dealing effectively and humanely with all cases of multiple child deaths within a family.  In doing so, the legislation seeks to balance the rights of grieving families with the public interest in ensuring that living children are protected in cases where intervention is necessary.

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The legislation provides that where there has been a second or subsequent death of a child in a family, this death is termed a “reviewable death” and must be reported to the State Coroner.  As of 1 January 2005 a doctor who is present at or after the death of a child must, where that death is a reviewable death, report the death to the State Coroner as soon as possible.  Reporting is mandatory and must be done regardless of the circumstances surrounding the death, including where the cause of death has been established.

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The legislation empowers the State Coroner to investigate a reviewable death to determine, if possible, the identity of the deceased, how the death occurred and the cause of death.  The State Coroner has the same investigative powers in relation to a reviewable death as he has in relation to a reportable death (i.e. a death that is unexpected, unnatural or violent or has resulted from accident or injury; see section 3 of the Coroners Act 1985). 

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The State Coroner may refer a reviewable death case to the Victorian Institute of Forensic Medicine (“VIFM”) for investigation.  The primary focus of the investigation is the health and safety of living siblings and the health of their parents.  Treating health professionals are invited to take part in this process.  The investigation can result in referral of a family to specialist medical services, notification being made to the Victorian Child Protection Service and/or a recommendation being made to the State Coroner that further investigation of the reviewable death is warranted. 

VIFM has appointed a Paediatric Liaison Coordinator to carry out these investigations.  The Coordinator is empowered by the legislation to collect, use and disclose personal and health information in relation to a reviewable death investigation.  The legislation authorises a person to whom such a request is made to provide the information requested.  (See sections 66A(3), (4) and (5) of the Coroners Act 1985)

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 The Report into the System for Dealing with Multiple Child Deaths 
 This is also available at www.dpc.vic.gov.au under Publications

 The Death Notification Legislation (Amendment) Act 2004 and the  Coroners Act 1985.
Also available at www.parliament.vic.gov.au under Legislation and Bills

The Second Reading Speech for the Death Notification Legislation (Amendment) Act 2004
Also available at www.parliament.vic.gov.au  under Hansard.

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