Mercy for killer mom

The tragic case of Tania Clarence, the South African mother who smothered her three severely disabled kids to "end their suffering", is likely to have far-reaching implications in the UK.

Clarence, 43, who smothered four-year-old Olivia and three-year-old twins Ben and Max in their sleep at their London home on April 22, was sentenced at the Old Bailey yesterday to a hospital order.

It was the end of the criminal trial but an equally important investigation will now unfold as authorities in the Kingston Borough conduct a major review of the case. The conduct of medical professionals and social services will be scrutinised. And depending on the findings and recommendations, this could lead to changes in the way authorities handle similar situations in the future, Clarence's legal team noted.

A family statement, read out by solicitor Richard Egan, said: "Gary Clarence will be ... assisting Kingston Borough Council in their review of the decisions taken in this case, and he hopes to be able to ensure that never again will a family have to endure the unbearable pressure that eventually overwhelmed the resources of his wife."

A Kingston Council spokesman said: "This is a terrible tragedy. The thoughts of everyone at the council are with the family and friends of the Clarences. Throughout the lives of the children we sought to work with partner agencies to ensure that the Clarence family was fully supported.

"The Local Safeguarding Children Board is undertaking a serious case review. The partnership will ensure that any learning from this review is incorporated into the work with children with disabilities and their families."

It emerged during the trial that the Clarences had been at war with the platoon of 60 medical staff treating their children. The parents placed the quality of life of the children above their longevity, leading to repeated clashes with doctors and healthcare staff.

The three had spinal muscular atrophy, a degenerative disease that weakens the muscles and can dramatically shorten life expectancy. Children with the disease generally cannot walk, stand or even sit unaided and develop scoliosis (curvature of the spine) as well as respiratory problems that make them susceptible to infection.

Although breathing and swallowing difficulties are rare, the three Clarence siblings had these difficulties. To allow them to breathe, their mother ventilated and suctioned mucous, often several times a night.

The decision by social services to abruptly replace a seasoned social worker assigned to the Clarences, because she was seen as being an advocate for the family, was described by one psychiatrist as "a trigger" for the tragedy.

Clarence's husband was on holiday in South Africa with their oldest daughter at the time of the smothering.

The court accepted that this all added to the "unbearable strain" for Clarence, who had a family history of depression.

She was made to feel that she was a bad parent for not wanting to subject her children to further suffering through invasive surgeries and procedures, "to no real end", her barrister Jim Sturman QC told the court. Some medical staff had wanted to take legal action over the Clarences' reluctance to agree to surgeries, and accused them of neglect.

Throughout her appearances in court Clarence has suffered breakdowns as the details of the Easter weekend deaths of her children were read out.

Yesterday, her solicitor, Egan, was so concerned about the impact sentencing might have on her that he sat beside her in the dock.

The judge, Sir Nigel Hamilton Sweeney, said it was "a very, very difficult and sad case".

He said the prosecution accepted that Clarence loved her children and had been grief-stricken that they were destined to die early and before her. She had devoted herself "entirely and ceaselessly to the care of the children".

He accepted the evidence of doctors who had said Clarence would not have killed her children had she not been in the grip of a "major depressive episode", which led to her attempting suicide.

"I am equally conscious that nothing I can do can adequately reflect the worth of the lives of Olivia, Ben and Max, who were lovely children."

He told Clarence: "It is equally clear that you are still mentally ill now. You remain vulnerable to a significant deterioration in your mental health with the concomitant risk of a return to suicidal thoughts . psychiatric supervision and regular psychological therapy is going to be required for the foreseeable future."

The Clarences' said in their statement: "Her daily struggle ultimately overwhelmed Tania's ability to cope with the enormity of the task she faced. Ultimately her story of dedication and love became a story of despair and utter hopelessness."