Azaria's blood-stained matinee jacket that she wore on the day of her death

Analysis & Findings of the Fourth Coroner's Inquest

Finally Exonerated: 2012 Findings (pdf)

(Finding of Coroner Elizabeth Morris following
the third coroner's inquest
into the death of Azaria Chamberlain)

June 12, 2012


Analysis & Findings of the Third Coroner's Inquest
 
(Finding of Coroner John Lowndes following
the third coroner's inquest
into the death of Azaria Chamberlain)

December 13, 1995


Section 34 of the Coroners Act requires a coroner investigating a death to make findings, where possible. in relation to

(a) Identity of the deceased person.
(b) Certain of his or her personal particulars to enable registration of the death.
(c) The time and place of death
(d). The cause of death and
(e) Any relevant circumstances concerning the death. 

I propose to deal first with the cause of death, which is generally referred to, in the context of the medical cause of death. The cause of death is the real or actual cause of death (not the terminal cause of death); namely"... the disease injury of complication, not the mode of dying.” “(See Ex P Minister of Justice, Re Malcolm. Re Ingles (1965) NSWR 1598, at 1604 (McClemens J).

Since the first inquest before Mr. Barritt SM, it was thought that the quantity of blood on the jumpsuit and singlet indicated that Azaria Chamberlain had died. During the criminal trial, experts offered opinions as to the cause and manner of Azaria's death based on the distribution and apparent flow pattern of the blood staining upon the clothing. Further opinion evidence in that regard was given before the Royal Commission.

It was common ground between the experts that most of the blood staining on the jump suit originated from the outside of the fabric that most of the blood staining to the back of the collar was consistent with Azaria's body having been supine for a period while her blood was shed and that the blood stains on the left shoulder were consistent with her torso being in an upright position while her blood flowed. As noted by the Commissioner (at 187 of his Report) nit was therefore accepted that most of the blood staining originated from injury to the neck or head of the baby, with the blood flowing down the outside of the collar and neck area and soaking through to the singlet beneath.”

After examining all the evidence relating to the cause of the blood staining on the clothing and the location of the injuries' on Azaria's body Commissioner Morling said (at 189) that he was unable to conclude whether the blood staining on Azaria's clothing originated from injury to her head, neck or both.

The Commissioner was also unable to conclude with certainty whether or not the bleeding which caused the blooding staining occurred before or after Azaria's death (at 190). Commissioner Morling went on to say (at 190-191): In this situation the evidence does not indicate what the cause of death was or how the baby died".

However. it must be borne in mind that the Marling inquiry was not intent on discovering the cause of death as such. Therefore. I now turn to consider the evidence bearing upon the cause of death in light of the civil standard of proof.

The evidence in relation to the bloodstained jumpsuit is equivocal in terms of establishing the cause of death:

(1) Although the bleeding that caused the bloodstaining was due to an injury of some kind, it is not possible to determine the site of the injury, i.e. whether the injury was sustained to the head, neck or both areas. Nor can the means by which any such injury was inflicted be ascertained.

(2) It is not possible on the evidence to determine whether the injury, which produced the bleeding, which in turn resulted in the blood stained clothing, occurred before or after Azaria's death. In other words it is not possible to conclude that Azaria in fact died from the injury (whatever that might have been), which caused the bleeding which in turn, produced the bloodstains on the clothing.

It will be recalled that Mr. Galvin CM concluded that the cause of death was "extensive wounding to the child's neck." Although that Conclusion may have been open on the evidence which was then before the Coroner, a diversity of opinions as to the cause and manner of Azaria's death based on the distribution and apparent flow pattern of the blood staining on the clothing was presented both at the trial and at the Royal Commission. It was that further evidence, which was not before Mr. Galvin CM, which led the Royal Commissioner, and indeed also leads this inquiry, to being unable to conclude whether the blood staining on Azaria's clothing originated from an injury to her head, neck or both. That very same body of evidence also leads this inquiry to being unable to conclude on the balance of probabilities that that injury (whatever it might have been) caused death.

The blood staining on the clothing formed, of course, only one small part of a great volume of evidence adduced with a view to establishing the cause and manner of Azaria's death. However, the bloodstained clothing probably provided the strongest evidence indicating what the cause of death was and how the baby died. There is no other evidence, or sufficiently cogent evidence, either viewed alone, or taken in conjunction with the evidence relating to the bloodstained clothing, which is capable of reasonably satisfying me as to the cause of Azaria's death.

Finally. it should be noted that the absence of a body, and the consequential absence of a post-mortem examination and the results thereof, means that potentially vital evidence as to the cause and manner of death is not available to the coroner. One need go no further than the recent statements made by David Ranson in his article "The Coroner and the Rights of the Terminally III Act 1995 (NT)" (Journal of Law and Medicine at Vol 3 November 1995 at 169) as to the importance of a post-mortem examination: "In carrying out their investigations into deaths, coroners rely heavily upon the medical information provided by pathologists and in particular on the results of autopsy examinations. Indeed, the forensic autopsy is the mainstay of the information provided to a coroner for the purposes of investigating a death and determining the cause of death...the coronial system relies on autopsies to provided the best evidence of the cause, mode and circumstances of death." (at 173).

As stated above, the standard of proof in a coroner’s court is the civil standard i.e. the balance of probabilities. On the basis that that standard requires a belief amounting to reasonable satisfaction, the cause of death of Azaria Chamberlain is indeterminable, and must remain undetermined. Azaria Chamberlain died of cause or causes unknown.

Even if one were to apply the standard purely as a matter of objective probability (which it is submitted is not the appropriate approach), the appropriate finding as to the cause of death must remain an open finding.

Although Section 34 of the Coroner Act, unlike Section 37 (1) of the former Act, does not expressly require a coroner to ascertain the manner of death, subsection (v) of Section 34 {i.e. "any relevant circumstances concerning the death"} has a very wide ambit, and certainly includes the manner of death.

There have ever been only two theories as to the manner in which Azaria Chamberlain died. The first is that Mrs. Chamberlain murdered her daughter. The second is that Azaria had been taken by a dingo.

In terms of a coroner's verdict or findings, the first theory, if substantiated to the reasonable satisfaction of a coroner, would translate into a finding of death by violent means due to human intervention viz that Azaria Chamberlain died at the hands of Alice Lynne Chamberlain (without there being any ascription of criminal responsibility); the second theory, if substantiated, would result in a finding of accident or accidental death.

"Accident" in this context has been described as an unforeseen misfortune or mishap causing injury or harm which bears a casual' connection with the death {See Waller, "Coronial Law and Practice in New South Wales" at 23; and David McCann's article "Range of Findings open to the Coroner" in "The Aftermath of Death" (Editor High Selby at 16.). Jervis (9th ed at 86) refers to "accident as meaning on "unlooked - for mishap or an untoward event which was not expected or designed."

Although the Royal Commission of Inquiry into Chamberlain Convictions had to consider the two competing theories, its line of inquiry must be kept in context. The purpose of the Royal Commission was to enquire into and report on the correctness of the Chamberlain convictions.

In reaching the conclusion that there was a reasonable doubt as to the Chamberlain's guilt, Commissioner Morling concluded that the hypothesis that Mrs. Chamberlain murdered Azaria had not been proved beyond reasonable doubt.

Although the Commissioner was of the opinion that the evidence afforded considerable support for the dingo hypothesis, His Honor did not examine the evidence to see whether it had been proved that a dingo took the baby. To do so would, in \the words of Commissioner Morling, involve "... (a) Fundamental error of reversing the onus of proof and requiring Mrs. Chamberlain to prove her innocence (at 339 of the Report). In the circumstances His Honor went no further than to say: "It is impossible in the above summary to capture the whole effect of the voluminous evidence given on the matters which bear upon the dingo hypothesis but, taken in its entirety, it falls far short of proving that Azaria was not taken by a dingo. U(at 338 of the Report).

In reaching the conclusion that there was a reasonable doubt as to the Chamberlain's guilt; Commissioner Morling found it unnecessary to consider the possibility of human intervention (other than by the Chamberlains) in the time between Azaria's disappearance and the finding of her clothes. However, he said that it was not impossible to imagine circumstances in which such intervention could' have occurred. He said: "It was not inconceivable that an owner of a domestic dog intervened to cover up its involvement in the tragedy or that some tourist, acting irrationally, interfered with the clothes before they were later discovered by others. (at 340 of the Report). Although there was not the slightest evidence to support either of those hypotheses, Commissioner Marling considered that the possibility of human intervention (other then by the Chamberlains) was another factor, which must be taken into account in considering whether the evidence established the Chamberlain's guilt beyond reasonable doubt.

However, it must not be forgotten that Commissioner Morling was not commissioned to inquire into and determine the cause and manner of death of Azaria Chamberlain for the purposes of the Coroners Act, in respect of which a different standard of proof, viz, the civil standard applies. Against that background it would be open to the present inquiry, applying a civil standard of proof, to record a coroners finding of death by violent means due to human intervention (without ascribing criminal responsibility to any person), despite the fact that the convictions against the Chamberlains were quashed. Such an outcome would not be illogical given the different objectives pursued by\ the criminal process and the coronial one, and the divergent standards of proof. However, for the reasons, which follow, even applying the civil standard of proof, the evidence does not reasonably support a coroner's finding of death by violent means due to human intervention.

In R v Wolverhampton Coroner: ex parte McCurbin (1990) 1 WLR 719 at 727 Woolf LJ conceded that although there was a "technical distinction" between the standard of proof in criminal proceedings and that in coronial proceedings, when a coroner had to consider a finding of unlawful killing, the gravity of the crime was so high the result would be the same. Whichever standard was applied. I do not agree that the distinction is purely technical, and it does not necessarily follow that in so far as a coroners finding of unlawful killing is concerned, the matter is so serious that the result would be the same, whatever standard of proof was applied.

The standard of proof in a Coroner's Court in Australia is the civil standard as governed by the Briginshaw principle. According to that principle the seriousness of an allegation, the inherent unlikelihood of an occurrence of a given description, or the gravity of the consequences flowing from a particular finding "are considerations which must affect the answer to the' question whether the issue has been proved to the reasonable satisfaction of the tribunal "(1938 60 CLR 336 at 361 - 362). It follows that clear, cogent or strict proof is necessary where criminal conduct is alleged in civil proceedings, for example a coronial inquest. It is however, wrong to read such a statement as being directed to the standard of proof, and as indicating the need for an elevated standard of proof in cases where criminal conduct is alleged. Rather, as The Honorable Mr. Justice D H Hodgson says in his article.” The Scales of Justice: Probability and Proof in Legal Fact – Finding (supra at 739-740), the circumstances that criminal conduct is alleged is a factor relevant to what material concerning the particular circumstances is to be considered adequate, so that the court can then reasonably act on the balance of probabilities. This approach does not ignore the mathematical probability of a particular event having occurred. It simply requires the fact- finder to not only look at the probabilities based on the available evidence of a particular event having occurred, but to determine whether the nature and quality of the evidence, is sufficient to reasonably satisfy the fact - finder that the particular event occurred.

After examining all the evidence I am unable to be satisfied on the balance of probabilities that Azaria Chamberlain died at the hands of Alice Lynne Chamberlain. It automatically follows that I am also unable to be satisfied on the balance of probabilities that Michael Leigh Chamberlain had any involvement in the death.

I have reached those conclusions after having regard to the considerations referred to in Briginshaw and Briginshaw (supra). I do not consider that the evidence is sufficiently clear or cogent, or that material facts have been strictly proved to such an extent, as to lead me to be reasonably satisfied that Azaria died at the hands of her mother. In reaching that conclusion I have had regard to the whole of the evidence, that is to say, all the evidence pointing to the involvement of the Chamberlains, and all the evidence given on the matters, which bear upon the dingo hypothesis. In relation to the involvement of the Chamberlains in the death of Azaria Chamberlain, I have reached the same conclusion as Commissioner Morling: the only difference is that the Commissioner was applying the criminal standard of proof whereas I have applied the civil standard of proof on the balance of probabilities.

I would add that if one were to reject the "belief' approach to the civil standard of proof, and apply to the evidence in the present case the "objective probability" approach, which merely requires a probability greater than 50 percent of the event in question having occurred, the same result would obtain: I would still be unable to conclude that Azaria died at the hands of Alice Lynne Chamberlain.

Unlike the Marling Inquiry, the present inquiry, which is charged with the duty of ascertaining the cause and manner of Azaria's death, must go on to consider alternate findings. It was not part of Commissioner Morling's commission to determine whether the dingo hypothesis had been proved.

Applying once again the "belief' approach to the civil standard of proof to the evidence, I am unable to be reasonably satisfied that Azaria Chamberlain died accidentally as a result of being taken by a dingo from her tent at the camp site at Ayers Rock.

I have approached the matter in the following way:

(1) One of the factors referred to in Briginshaw and Briginshaw (supra) as affecting the answer to the question whether the fact (or facts) sought to be proved has been established to the reasonable satisfaction of the fact-finder is "the inherent unlikelihood of an occurrence of a given description" having taken place.

At page 310 of his Report, Commissioner Morling stated: "The defense asserted that Azaria had been taken by a dingo, an event for which there was no known precedent. It was therefore a novel case". Of course, one does not expect that human beings; in particular young babies, will ordinarily be taken and killed by a dingo. First, that circumstance is a factor, which may itself be relevant to the question of probabilities. Secondly, it is a factor, to use the words of The Honorable Mr. Justice Hodgson (supra at 739-740), "relevant to what material concerning the particular circumstances is to be considered adequate so that the court can then reasonably act on the balance of probabilities.

(2) In light of the factors referred to above. I have closely examined all the evidence given on matters, which bear upon the dingo hypothesis, and which was before the Royal Commission. That evidence is conveniently summarized in the Morling Report at pages 328-340.

(3) Although a finding that Azaria died at the hands of her mother has been discounted at an earlier stage, the evidence supporting that hypothesis cannot be ignored when considering a finding of accidental death. That body of evidence, as much as the evidence which supports the dingo hypothesis, is relevant to whether or not I can be reasonably satisfied that Azaria Chamberlain died accidentally as a result of being taken by a dingo.

(4) Although I agree with Commissioner Morling that the evidence affords considerable support for the view that a dingo may have taken Azaria, the evidence is not sufficiently clear, cogent or exact to reasonably support such a finding on the balance of probabilities.

When I have come to consider the possible findings in this case I have purposely not taken into account further alternate hypotheses involving human intervention (other than by the Chamberlains) or accidental death due to causes other than the one put forward. The reason for that is that there is not the slightest evidence supporting any such hypotheses. Although Commissioner Morling took the view (as did some of the judges in the High Court) that the possibility of human intervention (other than by the Chamberlains) may be a matter relevant to the creation of a reasonable doubt concerning the Chamberlain's guilt, I do not believe it would be proper in the context of a coronial inquest, which is after all concerned with ascertaining the cause and manner of death, to consider hypotheses which are not open on the evidence. If, however, I have erred in the approach, which I have taken, and I should have considered further hypotheses not raised on the evidence, their consideration would have, if anything, diminished the cogency of the evidence supporting the two dominant hypotheses, and not altered the conclusions, I have reached.

Given that I am unable to be reasonably satisfied on the evidence that Azaria died at the hands of Alice Lynne Chamberlain or alternatively that Azaria died accidentally as a result of being taken by a dingo, the only finding that can be recorded is an open finding. (See Jervis 11th ed at 253 in relation to an open finding).

An open finding is unavoidable as I am unable, after applying the requisite standard of proof and its inherent degrees of reasonable satisfaction, to choose between the two main competing hypotheses concerning the death of Azaria Chamberlain (the choice between the two being a mere matter of conjecture), and to prefer one hypothesis over the other (See Holloway v McFeeters 1956 94CLR 470). An open finding is tantamount to a statement that on all of the evidence the cause and manner of Azaria's death cannot be determined, and must remain unknown.

Before returning an open finding, I have heeded the warning that an open verdict should only be returned in the last resort where there is insufficient evidence to enable a coroner to reach one of the other positive verdicts.

I have also considered the submission made by Mr. Tipple to the effect that "in the circumstances that have occurred, the return of an "open finding" would be inappropriate because it would do less than justice to the findings of the Marling Report and would lead to speculation that the death was due to causes other than "accidental causes".(See page 5 of the written submissions). Mr. Tipple also submitted that B... now that the innocence of the Chamberlains has been authoritatively restored and proclaimed, it would lead to great mischief if their right to the status of innocence was undermined by the formal recording of an "open finding" in relation to the death." (Ibid).

With due respect, these submissions are based on a number of fundamental misconceptions concerning the scope of the Marling Report, the relationship of the presumption of\incidence to the coronial process, and the nature and function of the coronial process.

As stated above, the purpose of the Royal Commission was to enquire into the correctness of the Chamberlain convictions, and to report accordingly. The Marling Report concluded as follows (at 342):

“It follows from what I have written that there are serious doubts and questions as to the Chamberlain's guilt and as to the evidence in the trial leading to their conviction. In my opinion, if the evidence before the Commission had been given at the trial, the trial judge would have been obliged to direct the jury to acquit the Chamberlains on the ground that the evidence could not justify their conviction.

In Re Conviction of Chamberlain (1988) 93 FLR 239 the Court of Criminal Appeal of the Northern Territory, having found in the light of fresh evidence that there had been a miscarriage of justice in former criminal' proceedings, quashed the convictions against Mr. and Mrs. Chamberlain. The quashing of the Chamberlain convictions must be kept in proper perspective.

It is not the purpose of a criminal trial to establish the innocence of the accused: rather its purpose is to establish the person's guilt, the standard of proof being beyond reasonable doubt. Consistent with this purpose, a criminal trial begins with the assumption that the accused is not guilty. That is reflected in the presumption of innocence, which underlies our system of criminal law: a person is presumed innocent until proven guilty.

It is often said that the presumption of innocence requires that the facts necessary to establish criminal liability must be proved beyond reasonable doubt. However, that is. a misconception. In II Evidence: Its History and Policies" (Butterworths 1990) Julius Stone (at 215) says:

“The rule requiring proof beyond a reasonable doubt in criminal cases has really nothing to do With the law of presumptions, nor, indeed with the proof of any particular fact involved in a criminal trail. It is a special standard of sufficiency of persuasion on all the evidence which must be satisfied before there can be conviction in criminal cases. It does not come into operation until the process of submitting the evidence is at an end. The law of presumptions, on the other hand, is concerned with the process of submitting evidence. The presumption of innocence will prevail or be destroyed in exactly the same way as any other presumption. In criminal cases, however, there will come into operation, before guilt can be found, the additional requirement of persuasion beyond reasonable doubt on all the evidence."

The quashing of the Chamberlain convictions by the Court of Criminal Appeal of the Northern Territory entitled Mr. and Mrs. Chamberlain to the presumption of innocence "with which the law clothes all persons unless and until their guilt has been proved beyond reasonable doubt" (See the judgment of Asche CJ at 241). At the trial the presumption of innocence had been destroyed by reason of the prosecution having adduced evidence and proved the Chamberlain's guilt beyond reasonable doubt. However, the existence of a grave doubt as to the guilt of the Chamberlains in light of fresh evidence demanded. the quashing of the convictions. The quashing' of the convictions signified the continuation (or if you like the prevailing) of the presumption of innocence; because as Nader J rightly observed (at 254): "in the absence of a conviction, innocence is presumed." After the quashing of the convictions the Chamberlains were exactly in the same position as an accused found not guilty, in which case the presumption of innocence continues. As it is not the function of a criminal trial to establish the innocence of an accused person, but to ask and answer the question whether the accused is guilty of the crime charged beyond all reasonable doubt, the continuing presumption of innocence in favor of the Chamberlains means that in the eyes of the criminal law Mr. and Mrs. Chamberlain are innocent.

It is in this sense that Mr. Tipple's statements that "the innocence of the Chamberlains has been authoritatively restored and proclaimed,  and they have a right to the status of innocence should be understood.

In order for Mr. Tipple's submissions as to the deleterious effect of an open finding to succeed it would have to be shown (a) that an open finding would do less then justice to the Morling Report and (b) that such a finding would undermine the Chamberlain's status of innocence and thereby occasion great mischief.

The first point to be made is that the laws of the Northern Territory do not preclude civil proceedings being brought against a person, previously acquitted in criminal proceedings, for compensation, arising out of the same set of facts advanced earlier with a view to establishing criminal guilt. Such proceedings may be brought either at common law or pursuant to statute, for example, the Crimes (Victims Assistance Act) Act. Consequent upon the quashing of their convictions, Mr. and Mrs. Chamberlain enjoy the same status as an acquitted person. But the continuing presumption of innocence in favor of Mr. and Mrs. Chamberlain does not theoretically bar the institution of civil proceedings based on the same set of facts, which led to their ultimate acquittal (though in practical terms, the particular circumstances of the case do not lend themselves to such subsequent litigation).

Where a person who is acquitted of criminal charges (either at first instance or at a later time) is proceeded against in subsequent civil proceedings on the same set of facts, that person is presumed innocent in relation to any allegations of criminal conduct until the contrary is proved on the balance of probabilities according to the principles enunciated in Briginshaw v Briginshaw (supra; see, in. particular, the following part of Dixon J's judgment at pp 362-4: "When in a civil proceeding, a question arises whether a crime has been committed, the standard of persuasion is, according to better opinion, the same as upon other civil issues… But, consistently with this opinion, weight is given to the presumption of innocence and exactness of proof is expected"). It follows that the presumption of innocence, rather than being undermined by subsequent civil proceedings, continues, that is to say until the contrary is proved according to the civil standard.

What must be kept firmly in mind is that in the above context criminal and civil courts perform different functions, and in discharging their respective tasks apply different standards of proof, and even where an allegation of criminal conduct is alleged in civil proceedings the presumption of innocence applies, and the defendant in the civil suit is presumed innocent until the allegation is proved.

If the law raises no objection to subsequent civil proceedings for compensation in cases where the person sued has been earlier acquitted of criminal charges, then subsequent coronial proceedings are equally unobjectionable, particularly in light of the purposes of a coronial inquest, which are indeed limited. Unlike in the case of subsequent civil proceedings for compensation arising out of the commission of an offence, which inevitably require the fact finder to decide whether or not the defendant was "guilty" of the offence, it is not the function of a coroner to determine any question of criminal or civil liability, to apportion guilt or attribute blame (R v H M Coroner for North Humberside and Scunthorpe: Ex parte Jamieson (1994) 3 WLR 82). The essential task of a coroners court is to ascertain cause' and manner of death. Married to those aspects is the unique consequence of coronial proceedings that the findings of a coroner are not conclusive and binding on any other court (Sewell, "Law of Coroner" (1843) p20); nor do a coroner's findings affect rights or liabilities (See Jacobs JA in Ex parte Flock. re Featherstone (1967) 86 WN (Pt 2) (NSW) 349 at 353). "An inquiry before a coroner is merely in the nature of a preliminary investigation. It is not of any force" (Bird v Keep (1918) 2 KB 692).

Even a positive finding in the present case that Azaria Chamberlain died at the hands of Alice Lynne Chamberlain, provided such a finding was open on the evidence, would not violate the integrity of the Morling Report; nor would it create mischief by undermining the Chamberlain's status of innocence. First, the coroner's function is entirely different to that bestowed upon the Marling Inquiry, and a court exercising criminal, jurisdiction. A coroner's court is not concerned with the determination of criminal liability. Secondly, where a coroners finding of unlawful homicide or a finding of death by violent means due to human intervention is under consideration the presumption of innocence applies until the contrary is proved to the requisite 'standard of proof. However, even where the presumption of innocence is displaced in coronial proceedings, that is not inconsistent with the continuation of the presumption of innocence arising out of an acquittal in criminal proceedings, given the limited function of coronial proceedings. Thirdly, the criminal standard of proof does not apply to coronial proceedings; the applicable standard of proof is the civil standard on the balance of probabilities. Finally, the findings of a coroner do not affect rights or liabilities, and are of no binding force.

However, we are dealing here with an open finding. An open finding would have even less capacity (substantially less) to undermine or otherwise have a deleterious effect on the Chamberlain's status of innocence. An open finding is still the product of proceedings, which are limited in nature and function. Further, an open finding does not disturb the presumption of innocence with which all inquests must begin when considering unlawful homicide or death by violent means due to human intervention as a possible finding. Ah open finding leaves the presumption completely intact.

Thus far, Mr. Tipple's submissions as to the deleterious effect of an open finding on the Chamberlain's status of innocence cannot be sustained. However, Mr. Tipple also submits that an open finding would lead to speculation that the death was due to causes other than accidental causes, and presumably create mischief. I now deal with that submission.

An open finding will, by its very nature, lead to speculation that Azaria's death was due to non-accidental causes. However, undoubtedly such speculation existed within the community even after-the findings of the Morling Report and the subsequent quashing of the Chamberlain convictions. Such speculation continues to this very day. Regardless of the outcome of the present inquest, whether it were to result in a . positive finding (one implicating either Mrs. Chamberlain or the dingo}, or an open finding, speculation over the cause and manner of Azaria's death would remain. What is important, however, is that any such speculation, inevitable as it is, can never disturb the unassailable fact that as a matter of public record the "law of the land holds Mr. and Mrs. Chamberlain to be innocent. "

I foresee that many members of the community may disagree with the conclusion I have reached., Two factors may go a long way towards explaining that lack of unanimity. The first is the fact that I have had the advantage of having all the evidence before me. The second is that the mental processes leading up to my decision have been confined and structured by a set of legal principles governing the standard of proof in coronial cases.

Pursuant to the provisions of Section 34 of the Coroners Act I make the following findings:

(1) The name of the deceased was Azaria Chantel Loren Chamberlain, the daughter of Michael Leigh Chamberlain and Alice Lynne Chamberlain.

(2) Azaria Chantel Loren Chamberlain, a female Caucasian, was born at Mount Isa Queensland on 11th June 1980. Her usual place of residence was 3 Abel Smith Parade, Sunset, Mount Isa, Queensland.

(3) Azaria Chantel Loren Chamberlain died at Ayers Rock on 17th day of August 1980.

(4) As to the cause of her death and the manner in which she died the evidence adduced does not enable me to say. I therefore return an open finding and record the cause and manner of death as unknown.

Dated this 13th day of December 1995.

Mr. John Lowndes
Coroner for the
Northern Territory.


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