Emily Bazelon, senior editor at Slate and the Truman Capote law-and-media fellow at Yale Law School, and author of a recent 8-page article in The New York Times Magazine, looks at shaken baby syndrome from every angle.
Bazelon takes the reader through details of several court cases, introducing us to parents, caregivers on trial, prosecutors, defense attorneys, and expert witnesses to make the medical controversy she uncovers as personal as possible. Turns out that the simplistic diagnosis of shaken baby syndrome is itself based on shaky foundations.
A dozen years ago, the medical profession held that if the triad of subdural and retinal bleeding and brain swelling was present without a fracture or bruise that would indicate, for example, that a baby had accidently fallen, abuse must have occurred through shaking. In the past decade, that consensus has begun to come undone.
In 2008, the Wisconsin Court of Appeals, after reviewing a shaken-baby case, wrote that there is “fierce disagreement” among doctors about the shaken-baby diagnosis, signaling “a shift in mainstream medical opinion.” In the same year, at the urging of the province’s chief pathologist, the Ontario government began a review of 142 shaken-baby cases, because of “the scientific uncertainty that has come to characterize that diagnosis.”
In Britain, after one mother’s shaken-baby conviction was overturned, Peter Goldsmith, then attorney general, reviewed 88 more cases. In 2006, he announced doubts about three of the convictions because they were based solely on the triad; in the other cases, Goldsmith said, there was additional evidence pointing to the defendant’s guilt.So the syndrome itself is becoming much more complicated with experts backing down and changing sides. All this uncertainty means doctors and law enforcement NEED TO KNOW why small children die rather than leaping to "must be shaken baby syndrome". The result (hooray for basic science!) is that everybody involved is taking a much-needed look with the latest scanners at infant and toddler anatomy, the possibility of unnoticed birth injuries, the reality of infection-caused strokes, and more.
Bazelon spends several shocking pages describing how shaken baby syndrome was initially "discovered", perhaps more accurately, invented, by a neurosurgeon in the 1960s. Here's the story:
Much of the science of shaken-baby syndrome dates from the late 1960s, when a neurosurgeon named Ayub Ommaya conducted a brutal animal experiment to figure out how much acceleration it took to cause a head injury.
Ommaya took more than 50 rhesus monkeys and strapped each one into a chair mounted on wheels, leaving their heads unsupported. He placed the chair on a 20-foot-long track, and an air-powered piston sent the monkeys zooming into a wall. Fifteen emerged with some kind of cerebral hemorrhage. Eight of those also had injuries to the brain stem or cervical cord.
Ommaya’s experiment involved neither shaking nor infants. Still, two pediatric specialists, John Caffey and A. Norma Guthkelch, each wrote a paper that pointed to the work as evidence that unexplained subdural bleeding in babies could occur without direct impact to the head and with or without a visible neck injury. In the 1980s, the term “shaken-baby syndrome” came into broad use, and a national prevention and awareness campaign was set in motion.Shaken baby syndrome was a de facto reality. Sloppy science turned into common knowledge, which then became evidence presented to juries all around the western world.
COMMENT: Thanks to Emily Bazelon for this article helping the rest of us understand that there is some new light in the murky darkness of the subject of child abuse. Children need protecting, but it turns out the shaken baby syndrome accusations and prosecutions were closer to witch hunts than they were to justice. Audrey Edmonds, who spent years in prison before being released three years ago after her conviction was challenged, understands society's need to do something, even the wrong thing. “A baby has died,” she said simply. “They want to blame somebody.”
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