Sir: Szmukler (Psychiatric Bulletin, January 2000, 24, 6-10) and Maden (Psychiatric Bulletin, January 2000, 24, 37-39) make thoughtful comments on the need for external independent inquiries following homicides by those known to the psychiatric services. As someone who has chaired such an inquiry (Reference Prins, Ashman and SteelePrins et al, 1998) a few additional comments come to mind. First, the need for official and widespread dissemination of findings from the numerous inquiries that have been conducted so far. This is not to undervalue recent unofficial accounts such as those compiled by Reith (Reference Reith1998) and by the Zito Trust. Second, although Szmukler and Maden comment on the stress experienced by those being scrutinised and the impact on relatives, there is also the strain felt by inquiry panel members who try to establish a sense of ‘fair play’ for all parties. Third, it is important to remember the degree of arbitrariness that exists in the setting up of these inquiries. There is no similar mandate for an external independent inquiry into homicides committed by non-psychiatric patients, for example, those who may be under supervision by the probation service. Finally, it is a well recognised fact that whether an assault ends in the death of a victim may depend upon a degree of serendipity, for example, the thickness of a victim's skull, their general health or the availability of emergency services. I understand that the Department of Health has a working group considering the future of homicide inquiries. I await their report with interest.
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