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September 16, 1998

The Death of Innocents

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;280(11):965-967. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-11-jbk0916

To the Editor.—JAMA published a review of the book entitled The Death of Innocents: A True Story of Murder, Medicine, and High-Stakes Science,1 as well as a letter from Dr Gilbert-Barness2 in response to the review. Both the authors of the book and the reviewer, Dr Wecht,3 criticized my work, but neither communicated with me prior to publication. Contrary to the allegations in the book and repeated by Wecht, the research was not conducted for self-aggrandizement or to gain academic recognition and secure funding for empire building. I never built up a sudden infant death syndrome (SIDS) research team, never asked anyone for funds, and have never promoted or financially benefited from apnea monitors to prevent SIDS. The 6 articles I published with original findings on SIDS 22 to 24 years ago constitute less than 3% of my scientific publications over the years. However, these 6 articles changed the direction of SIDS research from the view that SIDS occurred in normal children to the view that the victims had chronic abnormalities that predisposed them to their demise. Of the 7 markers for SIDS that I proposed, 6 have been independently confirmed by other investigators.4 Most require time-consuming quantitative histologic analysis and hence have not been adopted for routine forensic investigations. Their central theme is that some SIDS victims have abnormalities in breathing control, and at death their hearts continue beating for a time after breathing ceases. Evidence to support this thesis has been confirmed by other investigators.5,6 This insight does not constitute a cause of SIDS; rather, it identifies one among multiple common final pathways to death in SIDS.

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