American Academy of Pediatrics’ Failing Shaken Baby Syndrome Diagnoses: Use Tyranny When Science Fails
by Terri LaPoint
Health Impact News
The line between medicine and the justice system has been blurred. Certain doctors, especially those certified as Child Abuse Specialists or Child Abuse Pediatricians, have essentially become judge, jury, and executioner in cases involving Shaken Baby Syndrome (SBS) and Munchausen Syndrome by Proxy allegations.
The testimony of one of these doctors can result in a family being ripped apart with the child sent away to foster care or even adopted out by someone else. Parents and grandparents are sentenced to prison, even a lifetime in prison or death row, based on their testimony.
Clearly, these doctors have a tremendous amount of power, literally holding the fate of generations within their control.
What if they are wrong?
The American Academy of Pediatrics (AAP) recently issued a “consensus statement” regarding Abusive Head Trauma (their preferred name for what is more commonly known as Shaken Baby Syndrome).
It essentially asserts that there is no question that their way is the right way, that judges and the public need to recognize that they are right, and that anyone who says otherwise is just wrong.
There are doctors who challenge the dogma of the AAP regarding Abusive Head Trauma (AHT) or Shaken Baby Syndrome, sometimes at great cost to their careers.
Increasingly, attorneys and the public are questioning the assertions made by the doctors who hold themselves up as the ultimate authority over legal matters involving abuse.
Cases are being overturned, and innocent parents are being freed.
The consensus statement appears to be a response to the plethora of SBS cases being overturned in the courts, a statement to let people know that they are still in charge and that their dogma, to which the authors hold with almost religious fervor, is not to be challenged.
The Consensus statement on abusive head trauma in infants and young children was published in Pediatric Radiology on May 23, 2018.
Consensus is defined by Dictionary.com as “the majority of opinion” or “general agreement.”
A consensus by definition is agreed upon by “the majority,” but certainly not by everyone. It is not proof of facts. It simply means that a group got together, and most decided this was the way it’s going to be.
One has to ask if everyone was invited. Were there people who disagreed who were excluded from the consensus party? Are the majority intellectually honest enough to recognize when new evidence comes along that they may have been incorrect?
History, including the history of medicine, is replete with examples of the consensus being wrong, from thalidomide to leeches and lobotomies.
It was doctors who assured the public for decades, for example, that cigarettes were safe and even had medical benefits.
There is, and always should be, a place for scientific and medical consensus to be challenged. Scientific knowledge continues to develop.
Silencing the opposition is not science. It is tyranny.
The consensus statement on Abusive Head Trauma asserts, accurately, that the medical workup of children presenting with symptoms that sometimes occur in abused children “must exclude medical diseases that can mimic AHT.”
All too often, however, that does not happen.
Parents frequently have medical reports, from up to a dozen medical expert doctors, that refute the claims of the Child Abuse doctor, but the testimony of a single Child Abuse doctor is very often taken over the reports from other more qualified doctors.
In the “Executive Summary” of the consensus report, the authors establish their agenda of influencing courts, media, and public opinion that their opinion is the way that it should be:
The question in civil and criminal court cases involving allegations of unwitnessed abuse is the quality of the medical evidence and the integrity and expertise of the medical witness’s testimony.
Over the last decade, the courtroom has become a forum for medical opinions on the etiology of infant/child head injuries that runs the gamut … When pivotal medical testimony is contradictory, the message to the courts, the news media and the general public about infant injuries and safe caregiving is often confusing and inaccurate.
Professional medical societies use consensus statements to communicate general physician acceptance on a particular topic. These statements are vetted by the membership and designed to help physicians, news media and the public distinguish accurate medical information from non-evidence based or “courtroom-only” causation theories.
The formal dissemination of this information via a consensus statement is intended to help courts improve the scientific accuracy of their decisions involving public health issues.
The authors seek to “reduce confusion” by making their recommendations to judges and jurors.
They are right, they conclude by consensus, and they agree together that those who disagree with them are necessarily wrong.
They take issue with the fact that some in the “mass media” have “sensationalized” the use of the “triad” – “subdural hemorrhage, retinal hemorrhage and encephalopothy [brain swelling]” as being the criteria for diagnosing Shaken Baby Syndrome or AHT.
However, medical testimony by Child Abuse specialist doctors in virtually every Shaken Baby Syndrome case, we and other media have reported on, includes references by these very doctors to the “triad.” The media simply reported what the doctors themselves have testified against parents. In these cases, the specialists almost universally assert that the injuries “have to have been caused” by violent shaking or abuse, and all other explanations, even from other medical experts, are ridiculed and minimized.
The consensus report states:
The straw man “triad” argument ignores the fact that the AHT diagnosis typically is made only after careful consideration of all historical, clinical and laboratory findings as well as radiologic investigations by the collaboration of a multidisciplinary team.
Parents who come to Health Impact News with their stories frequently present evidence to us and to the courts that the doctors did not, in fact, “carefully consider” other findings or options.
Families with multi-generational medical histories of brittle bones conditions such as osteoporosis, osteogenesis imperfecta, and Ehlers-Danlos Syndrome report that their relatives’ histories are ignored.
Vaccine injury is never considered. Nor is the increasing incidence of infantile rickets.
General Consensus Does Not Equal Proof or Fact
Not surprisingly, there are doctors who disagree with the general consensus. The paper itself makes it clear that their dogma continues to be challenged, even by other medical doctors, in multiple courts.
Dr. David Ayoub, radiologist, regularly points to evidence of infantile rickets that is ignored by the Child Abuse Pediatricians in cases in which he is consulted.
Dr. Waney Squier of the U.K. used to believe what she was taught about SBS, until her own careful research as a world-renowned neuropathologist caused her to part ways with the majority consensus.
She is one of a growing group of doctors who challenges the consensus about Shaken Baby Syndrome or Abusive Head Trauma.
Health Impact News Editor Brian Shilhavy writes of Dr. Squier:
Dr. Waney Squier is a renowned British pediatric neuropathologist and considered the UK’s leading scientist in the field of pediatric neuropathology.
Dr. Squier has worked as a consultant at the John Radcliffe Hospital for 32 years.
Until 16 years ago, she vehemently supported and adhered to the mainstream belief that when a medical professional suspects that an infant has been violently shaken, they must examine the baby for the “triad” of injuries believed to be associated with shaken baby syndrome (SBS).
However, after examining the science behind SBS, Dr. Squier changed her opinion of SBS, and went from being a doctor who testified against parents and others who were accused of shaking their babies and injuring or killing them, to being a doctor who defended such parents and caregivers by offering other medical evidence that could explain such evidence apart from “shaking.”
Because she challenged the generally accepted theories about Shaken Baby Syndrome, she was the brunt of retaliation. Dr. Squier was banned from practicing medicine by the General Medical Council.
Dr. Squier gave a TedX Talk in November 2017, in which she states:
Experienced, highly qualified doctors are afraid to become expert witnesses and to challenge the hypothesis for fear of suffering the same fate as me. Instead, prosecution experts are emboldened and today cases are routinely decided on the basis of opinions such as “it is generally considered” or “most doctors believe that shaking causes the triad.”
These are articles of faith. They have no scientific foundation.
Science is not a democracy. Scientific fact is determined by experiment, by observation, not by how many people happen to believe in one hypothesis or another.
But today these opinions are unlikely to meet any significant challenge. And this leaves families defenseless against unfounded allegations of abuse.
Watch the entire TedX talk:
Health Impact News reporter, Christina England, quotes a letter written to the UK General Medical Council on behalf of Dr. Squier by Dr. Steven C. Gabaeff:
The attacks on those bringing and shining light onto alternative etiologies of the findings misused to misdiagnose abuse, is a response to a threat to establishment thinking and the establishment itself.
The challenges to existing dogma come from many quarters now and from many medical specialists with more knowledge and academic standing than the establishment MDs. The challengers have brought forth alternative thinking about the etiology of the findings misused to diagnose abuse.
This strategy of falsely accusing highly respected, leaders in their field who do not agree with their now doubtful, if not unproven, or false hypothesis, is not new.
To those with limited or essentially no knowledge of the deep nuances of child abuse pediatrics, the beliefs of the establishment would be, to start, assumed to be true.
The alliance of the child abuse establishment’s medical providers, the prosecutors of child abuse, the special units of police assigned to these matters, is both massive and powerful.
The establishment predictably is taken seriously by almost everyone.
In the 45 years since the early pediatrician created hypotheses that lie at the core of the fund of knowledge of child abuse pediatrics, hypotheses which were never true, went unchallenged for years. So long a period, that there was enough time to give both the doctors and the theories unwarranted credulity within the legal paradigm, where results of past cases is given weight.
In retrospect, these hypotheses, representing evolving science, were never subject to any testing that followed a valid scientific methodology. Anecdotal evidence, low grade observations studies, and a definitively unscientific belief structure, have been, and are, offered as validation for their unproven hypotheses to this day.
Dr. Gabaeff is a doctor of Emergency Medicine and Clinical Forensic Medicine. Several of his studies challenging the consensus are published by the National Institutes of Health, including one in which he points out that doctors use aspects of the triad, even independently, to accuse parents of abuse.
These studies include:
- Challenging the Pathophysiologic Connection between Subdural Hematoma, Retinal Hemorrhage and Shaken Baby Syndrome
- Investigating the possibility and probability of perinatal subdural hematoma progressing to chronic subdural hematoma, with and without complications, in neonates, and its potential relationship to the misdiagnosis of abusive head trauma
- Exploring the controversy in child abuse pediatrics and false accusations of abuse
The letter by Dr. Gabaeff is one of over 350 letters written by doctors, scientists, and lawyers to the British Medical Journal (BMJ) on behalf of Dr. Waney Squier, protesting the decision by the UK General Medical Council.
Apparently, there is not so much of a consensus about Shaken Baby Syndrome, as the group of doctors writing the consensus statement would have us believe.
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