Wed, May 07, 2014 - Page 9 News List

‘Shaken baby syndrome’ prosecutions uncertain, ‘speculation’

By Waney Squier

While scientific evidence over the past three decades has undermined the shaken baby hypothesis, no new evidence has emerged to support it. Instead, several researchers have relied upon the data in older studies to calculate the statistical probability of inflicted brain injury when certain features (such as intracranial hemorrhage, retinal hemorrhage, brain swelling and seizures) are present. These probabilities are then offered as the basis for diagnosis and as evidence in court.

However, the reasoning behind the studies on which these researchers rely is circular and based on assumptions now known to be unreliable. For example, in some studies, the researchers decided arbitrarily that falls of less than 1m could not harm a baby, so parents who described such a fall must be lying. Other studies viewed the parents’ inability to explain the findings as evidence of abuse.

Given these flaws, reviews of old studies do not provide a reliable evidence base for diagnosing abuse. They simply predict the likelihood that specific findings will be categorized as abusive and that, consequently, the child’s caregiver at the time will be accused or convicted of abuse, regardless of the accuracy of the diagnosis.

Leading proponents of the SBS hypothesis now acknowledge that the triad is a “myth,” that SBS diagnoses consist of “informed speculation” and that the hypothesis is supported solely by confessions. Some courts are following suit, with one US federal judge describing the types of confessions obtained as “worthless as evidence” and another saying that given recent developments, claims of SBS may be “more an article of faith than a proposition of science.”

No one questions whether infants can be damaged or killed by violent shaking or abuse; of course they can. The real issue is whether shaking or abuse can be inferred on the basis of a hypothesis that lacks scientific support. In no other area of medicine and law would an unproved hypothesis provide a basis for diagnosis, let alone criminal prosecution.

Given the developments of the past decade, we now face the possibility that for the past 30 years, we have been wrongly imprisoning parents on the basis of a flawed hypothesis.

Waney Squier is a pediatric neuropathologist at John Radcliffe Hospital in Oxford, England.

Copyright: Project Syndicate

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