Coronial inquests normally mark the end of a sad journey.
For the family of someone who has died in sudden or unusual circumstances, the inquest is often the last barrier to be crossed before attention can be turned completely to getting on with life as best one can.
What these families are often told is that the inquest is necessary to determine what lessons can be learned from their loved one's death, in order to prevent a repeat occurrence. There's no greater example of this than the bold findings of Rotorua Coroner Wallace Bain into the death of toddler Nia Glassie, which were released yesterday.
The tragic and horrific circumstances of Nia's death have already been well-canvassed. The 3-year-old girl died on August 3 2007 after being abused and ill-treated by members of her extended family, who were looking after her while her mother worked.
As part of his findings Dr Bain has called for state intervention and the monitoring of children in single parent homes where the family has previously come to the attention of authorities, where a mother worked fulltime and others cared for the children, and where domestic or child violence had been identified.
He's also called for the Ministry of Social Development to increase public education and for legislation to ensure compulsory sharing of information between government agencies and health providers, to help protect children from harm.
You can almost hear the cries of "big brother" emanating from certain sectors of society already.
But it's nothing of the sort.
What Dr Bain is suggesting is a necessary and long-overdue step towards reducing the horrific levels of child abuse in this country.
The coroner has acknowledged that his suggestions will be seen by some as drastic. He's right, and some will likely go a step further and condemn his ideas.
But instead, Dr Bain should be applauded.
Sadly, it's not hard to delve into this country's history of child abuse - the roll call of shame gets longer every year.
Even a cursory examination of the facts behind the deaths of children like wee Nia, James Whakaruru, Delcelia Witika, and more recently Sahara Jayde Baker-Koro, killed by former Wanganui man Kerry Ratana, reveals tell-tale signs.
Family dysfunction, social deprivation, unemployment, and addiction are regular themes.
There's no longer any excuse for inaction.
The current systems clearly aren't working, and Dr Bain's sensible suggestions should be given the serious consideration they deserve. If that means shunning the apologists who seek to justify the actions of those who maim and murder their own, then so be it.
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