SALT LAKE CITY — As a chief resident at Primary Children's Medical Center, one of Dr. Hilary A. Hewes' administrative responsibilities was to review every fatality that occurred in the hospital that year and to present her findings to the residents she supervised.
"I just got so sad with all these abuse cases. It was depressing to review all these cases of healthy, beautiful children who died unnecessarily," Hewes said.
It also piqued her curiosity about the prosecution of these cases.
"What does happen to the people who abuse children to the point of killing them?'' Hewes asked. "How well are the charges brought forth and prosecutors are able to convict them?"
The answer to that question was a study that compared conviction rates for perpetrators of child abuse homicides and adult homicides. The rates are strikingly similar, researchers found.
A review of Utah homicides between January 2002 and December 2007 found an 83 percent conviction rate for suspects charged with adult homicides. Among suspects in child abuse homicide cases, researchers calculated a conviction rate of 88.2 percent.
“Suspects of child abuse homicide are convicted at a rate similar to that of suspects of adult homicide and receive similar levels of felony conviction and severity of sentencing,” the authors wrote.
The study, "Judicial Outcomes of Child Abuse Homicide," has been published in the October issue of Archives of Pediatric & Adolescent Medicine, one of The Journal of the American Medical Association/Archives journals.
The researchers had hypothesized that suspects of child abuse homicide are convicted less often than suspects of adult homicide and that people convicted of such offenses received lighter sentences.
However, the researchers' analysis of 334 homicides determined that there were no significant differences in the level of felony or severity of sentencing for suspects of child abuse homicide versus adult homicide.
"Under the Utah criminal justice system, suspects of child abuse homicide are not treated differently than suspects of adult homicide," the authors wrote.
The researchers found that the suspects in child abuse homicides were most often male, a parent of the victim and Caucasian.
"Our study may be limited by the homogeneity of the Utah population, which is primarily of white race/ethnicity," they wrote.
Thirteen percent of suspects in child abuse homicide cases had a prior felony conviction, researchers found.
Victims of child abuse homicide tend to be young, male and Caucasian, researchers found. The "mechanism of injury" was most frequently abusive head trauma.
The study, which purports to be one of the first comparisons of suspects of child abuse homicide versus adult homicide, adds "a new perspective to the literature, in which much of the prior work has focused on sexual abuse or mixed abuse judicial outcomes," researchers wrote.
Hewes, the principal investigator, said the similar conviction rate of suspects charged with child abuse homicide can be attributed to a number of factors.
While presenting the team's findings at a national conference, a number medical professionals from throughout the country told Hewes, "You don't realize how lucky you are that you have a good medical examiner who is tuned into child abuse cases," she said.
Credit also is due to law enforcement undertaking thorough criminal investigations of the death, the efforts or prosecutors and the Child Fatality Review Team.
"Hopefully it shows we value children in Utah," Hewes said.
Veteran prosecutor Rob Parrish, who for more than 25 years has advocated for children and/or prosecuted crimes against them, said there is little literature comparing the conviction rates of the two types of offenders.
However, there has been a sea change how society at large views crimes against children.
Early in Parrish's career, it was rare that the perpetrators of child abuse homicide were charged with an offense greater than manslaughter. Then, juries were reluctant to convict people of these offenses because many defendants were a parent of the child victim.
"There's sort of built in empathy we don’t have in other types of offenses," Parrish said, explaining that many people have had the experience of being stressed out when caring for a difficult child, though most people do not act out on their child.
But in recent years, the statutes and sentencing schemes have aided the prosecution of these cases.
"People are willing to accept, 'Yeah, bad things happen to children that may not be intentional, but someone needs to be punished,'" Parrish said.
"That's the good news. That's the strong positive message of this study. That's how it should have been all along," he said.
Parrish, who regularly conducts training for prosecutors and others who work in child abuse prevention, said Utah has long been on the forefront of rigorous case screening and prosecution, which results in more successful prosecutions.
Homicide is one of the top five causes of childhood deaths in the United States.
Nationally, some child abuse homicide cases are misclassified as accidental deaths and may not be brought to the attention of law enforcement, which can skew statistics.
"However, Utah is a state with a strong child fatality review team, which minimizes the number of misclassified cases," the researchers wrote.
Hewes said reviewing the cases of child abuse homicide brought to the forefront the need to prevent child abuse.
People need to be aware of parents who, on occasion, may need help when they are overwhelmed with parenting. Aside from helping family and friends, parents need to know about community resources that can offer assistance.
"We need to prevent it in the first place," she said. "Anything we can do to protect children is the most important thing."
Like Hewes, Parrish said the key lies in enhanced prevention efforts because child abuse homicides still occur with shocking regularity.
"We've had six deaths in Salt Lake County just since April of this year. It's very concerning," he said.