“CDR” To Prevent Recurrence of Abuse and Accidents November 13, 07:50
An effort to investigate the circumstances until the death of a child and prevent recurrence began in Gunma Prefecture as a national model project. A person in charge of hospitals, police, etc. held their first meeting on December 12 and confirmed that they will proceed with verification of cases where the cause of death is not clearly understood, and to compile recommendations by the end of this fiscal year.
Efforts to verify the circumstances up to the child’s death and prevent the recurrence of abuse and accidents are called the CDR-Child Death Review, and the Ministry of Health, Labour and Welfare has been implementing model projects in seven prefectures since this fiscal year with the aim of introducing the system.
Of these, the first meeting was held in Maebashi City on December 12 in Gunma Prefecture, attended by about 20 people from hospitals, police, local governments, etc.
At the meeting, opinions were exchanged on the cases of 48 children under the age of 18 who died in Gunma Prefecture between April and September last year.
According to the Ministry of Health, Labour and Welfare, about 3,800 children under the age of 18 died in the past year, and the proportion of “accidental accidents” such as suffocation, drowning, and death is higher than that of adults.
Gunma Prefecture wants to examine in detail the circumstances that led to death, mainly in cases where “accidental accidents” and the cause of death are not clearly understood, and to summarize recommendations that will prevent recurrence by the end of this fiscal year.
Dr. Fumiyoshi Mizoguchi of Maebashi Red Cross Hospital, who is at the center of the project, said, “The death of children due to accidents and abuse is likely to be prevented if there is support and measures at some stage. We would like to carefully examine each case and establish a mechanism to prevent recurrence.”
What is the CDR-Child Death Review?
“Child Death Review-CDR” is a system to investigate how a child dies and make use of it to prevent recurrence.
In cdR, medical institutions, police, child guidance centers, local governments, etc. work together to share detailed information about life, such as family environment, living conditions, and medical history, in addition to the situation at the time of the child’s death.
Then, at what point, we will verify what kind of support and measures could have prevented the death of children, and summarize recommendations for preventing recurrence.
In Japan, if a child dies for reasons other than illness, the Ministry of Health, Labour and Welfare if it is abuse, the Ministry of Education, Culture, Sports, Science and Technology (MEXT) if it is an accident at a school, and ministries and agencies are investigating according to the case.
However, there is no mechanism to examine the deaths of all children, and cases where sufficient verification has not been performed and missed abuse deaths have been considered problems.
The Ministry of Health, Labour and Welfare says, “We believe that by examining all deaths of children under the age of 18 across ministries, we can take more effective measures to prevent recurrence.”
What is the status of initiatives in Japan?
CDR began in the United States about 40 years ago, and research groups from the Ministry of Health, Labour and Welfare have been working toward institutionalization in Japan for four years.
However, in Japan, information related to the death of children is highly confidential, and due to consideration for the feelings of bereaved families, the difficulty of sharing information with related organizations has become a major issue.
Under these circumstances, the Basic Law on Child Development, which came into force in December last year, included the development of a system for the government to collect and utilize information on the cause of death of children.
Based on this, the Ministry of Health, Labour and Welfare is doing a model project for the creation of a system in Gunma, Yamanashi, Mie, Kyoto, Shiga, Kagawa, and seven prefectures in Kochi this fiscal year.
Through this project, the Ministry of Health, Labour and Welfare wants to establish a system that can confirm the circumstances of the death of children by examining how to collect and share information in consideration of bereaved families by fiscal 2022.
Bereaved families who lost their children in accidents “to prevent recurrence”
There have been a number of calls from bereaved families who have lost their children in accidents to prevent recurrence by conducting an investigation that went into the background of the accident.
Yasuhiro I, 46, of Yamato City, Kanagawa Prefecture, died nine years ago in July 2011 in a pool accident at a kindergarten where takahiro, the eldest son, who was three years old at the time, was attending. In addition to the police investigation, the Consumer Affairs Agency’s Safety Investigation Committee, the so-called consumer accident investigation committee, also entered into the investigation.
According to Mr. Ijima, as a result of the investigation, it was found that the teacher who was standing while playing in the pool of the kindergarten drowned while he was looking away.
Mr. Ijima said of the situation at the time, “I noticed an e-mail from my wife. When I arrived at the hospital, Takahiro had a heart massage, and then he heard from his teacher, “To be honest, I can’t help it anymore,” and I didn’t know what was going on.”
At home, Takahiro-kun is still smiling and photographing with his parents in the living room. There are also “Anpanman” vehicles and train toys that are popular with young children, and Mr. Iso said, “I can’t throw it away because I think my son will be sad.”
After the accident, Mr. Ijima, along with other bereaved families, participated in a study group called “Child Death Review- CDR” to prevent recurrence. I look forward to the system, but I also feel the current issues based on my own experience.
Mr. Ijima said, “There is a variation in the police’s response to bereaved families, and this is not going to be used for future measures, let alone sharing. In my case, the actual situation of the kindergarten was not investigated in detail until I was satisfied. I should have understood what had happened in the background, such as the teacher’s emergency response and how to pay attention on a daily basis.”
On top of that, he said, “I feel frustrated every time a child’s accident is repeated. Bereaved families try to accept the truth little by little by knowing the truth and move forward. And, it leads to the recurrence prevention. I don’t want anyone to experience what I and my wife experienced at the time.”
Note: “E” is “Indicated” and “Ne”.
Members of the research group “It is also necessary to consider the development of information handling methods”
In CDR, related organizations such as hospitals and police share and verify information about the death of children, but the problem is that they do not proceed smoothly from the viewpoint of protecting personal information.
According to the Ministry of Health, Labour and Welfare, it is legally said that providing and collecting children’s personal information for CDR is not a problem, but there are many related organizations that hesitate to provide information due to restrictions on local government ordinances, hospital rules, etc., and consideration for feelings of bereaved families.
Dr. Fumiyoshi Mizoguchi of Maebashi Red Cross Hospital, a member of the national research group who is working mainly on the model business in Gunma Prefecture, said, “There is also a view of life and death peculiar to Japan that we do not want to deal with the fact that we have passed away, and the confidentiality of information about the death of children is highly difficult to gather. Through the modeling business, we will spread awareness that CDRs are necessary to protect the lives of future children, and we will need to consider the development of laws regarding the handling of information in the future.”