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Invited Critique
March 2003

An International Perspective

Arch Pediatr Adolesc Med. 2003;157(3):292. doi:10.1001/archpedi.157.3.292

Beckwith's observations are welcome. I am dismayed at the level of confusion about the definition of SIDS, which was highlighted at the 7th SIDS International Conference in Florence, Italy, in 2002. The unfortunate consequences of various well-intentioned proposals on definitions and diagnoses produce an increasing variability of international diagnostic practices and eliminate the possibility of meaningful intercountry comparisons. The effect has been an increasing reluctance of pathologists and coroners in many countries to apply the diagnosis of SIDS. The term unascertained is booming, accounting for very low rates of SIDS being reported in some countries. This has also led to an escalation of parental blame, which Beckwith has tried hard to soften.

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