All child deaths set to be examined in effort to prevent abuse, accidents

TOKYO (The Japan News/ANN) - The Health, Labour and Welfare Ministry plans to introduce a system to examine all deaths of children under 18, in principle, for the purpose of preventing children dying from abuse or accidents, The Yomiuri Shimbun has learned.

The system will be called Child Death Review (CDR) (see below) and the ministry intends to implement it across the country as early as fiscal 2022. Starting in April this year, the ministry will introduce the CDR system at five local governments as a model project. By reviewing all cases of child death, the ministry aims to find abuse and accident cases that child consultation centers and police have failed to identify, and make use of the results to prevent such cases recurring.
 CDR is a framework in which children’s death certificates, measures taken by police, fire departments and child consultation centers, and other issues are examined from various viewpoints. The purpose is to prevent the recurrence of similar cases, rather than focusing on holding individuals and the relevant institutions and officials accountable, even when abuse or an accident is confirmed after the review.
 According to the ministry, about 3,800 children under the age of 18 died in 2018. Of them, about 70 children, or 2%, were subject to government investigations as child abuse deaths.
 However, a study group within the ministry collected and analyzed cases of the deaths of about 2,300 children under 18 from about 150 medical institutions nationwide for a period from 2014 to 2016. It found that 118 of those children were suspected to have died as a result of being abused, accounting for around 5% of the total. Based on this finding, the ministry expects other overlooked abuse cases will be exposed by using CDR to examine all child deaths.
 For the model project slated to start in April, the ministry will select five prefectural governments that, together with their local medical associations, will call on all medical institutions and doctors in the prefecture to submit death certificates and clinical records for children under 18. They will also ask the police and other relevant institutions to provide information. The documents and information will be analyzed by a review committee in each prefecture. Committee members will include pediatricians, medical examiners, police and fire department officials, public health nurses and officials from child consultation centers.
 Relevant institutions will be asked to provide such documents and information on a voluntary basis. The ministry will seek to gain their understanding by stressing the fact that the purpose is not to pursue those responsible but to prevent recurrence. The personal information of children and other people concerned will be strictly managed by the prefectural governments and medical associations.
 The review committee will propose measures to prevent recurrence to a prefectural government, based on its analysis of suspected child abuse cases and accidents that could have been otherwise prevented. The government will then utilize the proposal to create measures for preventing abuse and review its medical emergency system.

■ Child Death Review 
 The state of California introduced CDR in 1978. Britain also has a similar system. In Japan, a law to promote investigation into deaths will take effect in April, stipulating in an additional clause that the introduction of CDR must be considered about three years after the law goes into effect.

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