31 ms·

A journey into the shaken baby syndrome/abusive head trauma controversy

• salubrioustoxin 3y ago
  Largely agree w article. However I think it's important to mention that there are other validated ways to detect abuse and that clinical decision making is, or at least should be, based on multiple lines of evidence. Especially with abuse. In ED and clinic I have had kids that screened positive for TEN 4 FACESp (see https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2778559 https://jamanetwork.com/journals/jamanetworkopen/fullarticle...). One of these babies ended up having b/l subdurals, likely abuse. In the end they may have called that "shaken baby", however there were multiple other red flags, the subdurals was only one piece, and the suspected mechanism of the subdurals was repeated drops / falls. Agreed "shaking" may not be the mechanism but the author lists other mechanisms that can lead to subdurals and retinal hemorrhage where NAT could play role, eg hypoxia via choking, repeated falls from pushing/drops, neglect in unsafe motor vehicle situations.
• kr0bat 3y ago
  I came to realize that there was a long-standing scientific controversy in the field, and I felt that I had no choice but to get to the bottom of things myself. Although I am not a medical doctor, I hold a PhD in neuroscience and am familiar with critically reading scientific literature. I decided that I would invest as much time as necessary to learn everything I possibly could on the subject. At that point, there was nothing in my life more important than finding out what had really happened to my son. This is why higher education (and academic mettle) is amazing
  • drt5b7j 3y ago
    [flagged]
    • dartos 3y ago
      And that’s solid advice for starting a tech company. (This is a y combinator website)
    • faeriechangling 3y ago
      I'm not dismissive of education. I learn on the job. I learn in my free time. I learn to further my career. I learn to help myself out. I learn for fun. What I resent is the absurd idea that going to a brick and mortar institutions for 4, 6, maybe 10 years, following a track the teacher and administration considered best, with the vast majority of those being educated getting an outdated curriculum, is an effective means of learning. This entire attitude is portrayed as pro-education but it's really just pro-institution. It's only an effective means of learning insofar that the credential you get at the end can open doors to opportunities to learn, a point I will readily concede. I also have done amateur medical research in my spare time and literally printed out some papers and taken them to my doctor and said "let's do this". This ended up being very successful and very productive. It's not what the OP did is something people who did fancy book lernin' through a SCHOOL can do only after years of toil. You can just pick up the skills you need as you go and get reasonable results.
      • dtdynasty 3y ago
        I think you underestimate the lack of self directed learning ability people have before going to a higher education institutions. I know I would have failed at solo learning without going to college before hand. Structured education can definitely help a majority of students who need to get to a point where self directed learning is effective. I have my qualms with higher education but its existence itself is not one of them.
  • dartos 3y ago
    I think that speaks more towards the author than higher education. Definitely a tangent, but attributing that attitude to higher education is like someone attributing a doctor saving their life to an act of god. Like yeah if you squint I guess that’s true. My experience with higher education has been that of administrators taking advantage of my naivety for profit, elitism towards those not in academia, and dismissal of any ideas that wouldn’t directly result in a grant or a good headline. I wouldn’t really say that the author’s “mettle” is a result of the same environment.
    • sanderjd 3y ago
      Yeah I dunno... I mean, a lot of these things are true, and they all are big problems, but also, in my experience, academics (at least in the sciences) do actually know how to read and understand research, which is an extremely difficult and useful skill.
      • hyperthesis 3y ago
        Yeah, I think "mettle" here is like a sword and shield and the ability to use them (read and understand scientific literature, and able to do so, self-directed, for years). But whether a person does use them, and for what, is entirely due to the person themselves.
      • j16sdiz 3y ago
        Isn't that just what PhD do? I meant going through piles of papers - most of them bring more new questions than answers - and stay sane
        • sanderjd 3y ago
          Yep. That's exactly what I'm saying. This is like the primary skill that people learn to get a PhD. It's true that people can learn it without getting a PhD, but hardly anyone does, because it kind of sucks and if you're doing it you may as well do it with the guidance of an advisor and get a credential at the end.
      • 3y ago
  • deleted 3y ago
    [deleted]
  • rossant 3y ago
    Yes, I met other parents with higher education/a scientific background (researchers, engineers...) and living the same situation with their child. They naturally question the assertions by healthcare professionals, they make their own research, they ask highly precise and relevant questions to such a point that most doctors are simply unable to answer... I remember that as I was questioning the diagnosis at the hospital and trying to make sure there wasn't another medical explanation, I was basically threatened by doctors who told me, "Just stop asking questions and accuse your nanny as everyone else, or you'll be the one in trouble". Apparently, it was very unusual for a parent to refrain from accusing the nanny when she was the suspect number 1! I actually know one case where the parents (with a high education) were "too fast" in exonerating their nanny and tried to find a second medical opinion on their own to find out why their child was sick. Well, the judicial system didn't like it and they ended up being accused themselves. Their child was taken away for 4 months. The trauma was so intense that their family didn't survive and they eventually divorced (that's unfortunately the fate of many, if not most families).
• ls612 3y ago
  [flagged]
  • CodeAndCuffs 3y ago
    Are you asserting that the caution against shaking babies was intentionally constructed for the sole purpose of the state kidnapping children? For what motivation, to what end? How orchestrated? Who is "the state"? Do they have a hand picked squad of CPS investigators to kidnap children from their targets, or do they just use any CPS investigator? Are the investigators in on it, or are they just thinking they're helping kids? Can you cite references for any of the answers to any of these questions?
    • appleaday1 3y ago
      But the link in question does make it seem like being a nanny probably could have better protections in France if uh, the person lost 4 years due to this charge.
      • rossant 3y ago
        Things are even worse for other nannies. I know many who have been convicted to 8, 12 or even 15 years of jail, after 30 ou 40 years of perfect careers with no problem whatsoever. Some have appealed and were eventually acquitted, others are languishing in prison. We still have a lot of work to do to raise awareness among nannies about the legal risks of caring very young infants. It can happen to anyone: about 1/3000 babies are affected, and the risk is much higher with babies combining multiple risk factors (male sex, prematurity, low birth weight, high head circumference, respiratory problems, frequent infections, etc.).
    • ls612 3y ago
      [flagged]
• appleaday1 3y ago
  Wow, makes me wanna get a ph.d.
• drug-freedom 3y ago
  [flagged]
• hprotagonist 3y ago
  whoof. what an ugly trip! i’ve interacted with the author, who wrote a very nice spike sorting package called `phy` that i used several years back (and iirc turned me off using hdf5 as a result), and came away very impressed with what was so obviously a sharp mind. very odd to recognize the name in a totally other context. Not very pleasant to hear about such a rough time either!
  • bombcar 3y ago
    And if he hadn’t, that nanny would probably be in jail.
    • hprotagonist 3y ago
      i’m unsurprised by his level of meticulous detail. and mostly horrified by those sorts of repercussions being possible. the whole thing just gives one the serious heebie jeebies
• Justsignedup 3y ago
  The worst part here is: He spent months researching 500 medical papers to even realize this was a problem. No way in hell will a single defense lawyer get someone to be able to research enough to figure this out. As stated, how many people are in jail or lost their kids due to something that didn't actually happen. And how many people don't know that a minor bump in the head for a baby could be life threatening, but we just mark it as SIDS. And even worse, no medical doctor will go this hard trying to figure out how to defend a person they believe murdered a baby. It is the perfect combination of crap. Cyrille Rossant may save a lot of lives, in both parents and children, if this becomes common knowledge.
  • bombcar 3y ago
    I’ve heard credible rumors that SIDS is the “parent accidentally killed their child but we won’t tell them that” polite fiction.
    • ncallaway 3y ago
      Who have you heard these rumors from? How did you determine them to be credible? My assumption is that any citation to a rumor should be totally dismissed if these questions can’t be answered.
      • SpicyLemonZest 3y ago
        It seems to me that this rumor is just an alternate framing of the original commenter's assertion that "a minor bump in the head for a baby could be life threatening, but we just mark it as SIDS". I think it's fair to be skeptical of both, but it's worth reflecting on how the same factual assertions can come across as either "science-informed speculation" or "crazy unsubstantiated rumor" depending on how you say them.
        • bombcar 3y ago
          Exactly. And imagine you’re a doctor, and you have a dead child in front of you, crying parents, and a form to fill out. No possible way of filling out the form brings the child back to life, and one way makes it as easy as possible for everyone, and another results in potentially up to jail time. Now do this repeatedly during your long and illustrious career.
• DoreenMichele 3y ago
  My oldest son has special needs. He's 2e -- gifted and learning disabled -- and has a serious medical condition associated with being very underweight. I put him in preschool to get him to talk. He could use sentences but wasn't. At the start of kindergarten, first, second and third grade, I spoke with the teacher, explained he was difficult, let them know I welcomed communication on any issue. They were thrilled and relieved. Parents are often part of the problem. By fourth grade, my son was no longer obviously "the weird kid." That teacher reported me to the social worker for letting him know up front my child was difficult and please don't hesitate to discuss things with me. The social worker called me, we talked for a bit. She knew both my kids. Laughed it off as a silly misunderstanding. Months later, his teacher let me know he did eventually get the memo that my child had quirky interpretations of social things. After my son finally got a proper diagnosis for his medical issue, he gained twenty pounds in one year and this did wonders for his social skills. Then he lost five pounds. He still felt better than he ever had and neither of us were concerned. His medical team implied I was in danger of being reported to children's services as an abusive mother. Because his condition predisposes people to being very underweight, pediatric clinics for the condition routinely include a dietitian and yet the standard recommended diet is "junk food" because it's high salt, high fat, high calorie and cheap. I had not been feeding him junk food, but I dutifully put a big bowl of snacks in the middle of the coffee table. He regained 2.5 pounds, they decided that was adequate and didn't need more follow up visits. We got home and, with no longer being under threat of being turned in as a neglectful or abusive parent, the first thing he did was hand me the bowl and tell me "We are never doing this again. I feel terrible!" We resumed feeding him a high quality diet in line with the high fat, high salt, high calorie recommendations. It's awful to be so protective of your children and be accused of abusing them based on no real evidence. I wish this project well.
  • crazygringo 3y ago
    > Then he lost five pounds. He still felt better than he ever had and neither of us were concerned. His medical team implied I was in danger of being reported to children's services as an abusive mother. But wasn't that valid cause for concern, especially for someone who should be a growing boy? If being underweight was a serious medical concern for him, losing 5 pounds seems like a big flashing red warning that something could be going wrong. Maybe I'm misunderstanding your story, but from what you've written, it sounds to me like their intervention successfully ensured he was eating enough when he wasn't before?
• itsmemattchung 3y ago
  > As a precautionary measure, the hospital followed mandatory reporting statutes and my wife and I temporarily lost custody of David. Thanks to our incredibly effective defense lawyer, we were cleared of all charges within two months, during which we stayed at the hospital 24/7 with David until we sorted out the legal procedures. Holy shit. Parents bring baby to ER ... results reveal that baby was shaken (article later confirms this was not the case) ... parents lose custody for 2 months. Horror story.
  • roughly 3y ago
    And: > [O]ur nanny was eventually cleared of all charges, but it took four years for the court to recognize my son’s medical condition (a rare occurrence in France, as I later discovered) during which we were forbidden to speak to her and she was forbidden to approach children, thus losing her means of livelihood.
  • cm2012 3y ago
    Not surprised it happened in France, they are much more of a nanny state (in good and bad ways) when it comes to parenting. Like the fact that paternity tests are banned unless you have a court order, etc.
    • huytersd 3y ago
      Can’t you just get a paternity test online? Otherwise that’s an insane situation, do they expect a dad to raise a kid that is not his?
      • sneak 3y ago
        It's not insane. Genetic lineage is the least important factor in whether or not a given kid is "yours".
        • huytersd 3y ago
          It’s by far the most important factor. Who are you to say it isn’t?
• Apocryphon 3y ago
  This is timely as the life of Robert Roberson is currently being decided based on this syndrome: https://news.ycombinator.com/item?id=37632122 https://news.ycombinator.com/item?id=37632122 https://www.themarshallproject.org/2023/09/15/texas-shaken-baby-syndrome-baby-death-robert-roberson https://www.themarshallproject.org/2023/09/15/texas-shaken-b...
  • dang 3y ago
    Yes and the current submission is a result of this subthreaed from there: https://news.ycombinator.com/item?id=37635094 https://news.ycombinator.com/item?id=37635094
  • deleted 3y ago
    [deleted]
  • suckitsam 3y ago
    From a related article on the case [1]: > Evans said the syndrome remains a fair medical diagnosis and also notes in the report that SBS was not the sole cause of child's death. There ought to be a law where lawyers deal with legal interpretations and advice and medical doctors deal with medical interpretation and advice. In a sane world, she'd be taken off the bench until she completes some remedial legal coursework and several dozen hours of medical talks from this century. [1] https://www.cbs19.tv/article/news/local/judge-denies-recommending-east-texas-death-row-inmates-appeal-exoneration-new-trial/501-39bfdd8e-b687-4065-9b34-25b60c320e6c
• ClumsyPilot 3y ago
  trully unbelievable, i lose faith in thr justice system day by day
  • parl_match 3y ago
    The justice system does the best it can with the information it has. It is far from perfect. It makes horrible mistakes all the time. The problem, of course, is improving it without knock-on effects making it worse. There are huge swaths of people doing the work required to make it better, every day. It's not as easy as turning a dial from "bad" to "good"
    • yieldcrv 3y ago
      and none as effective as this one person too many cooks in the kitchen
    • razeh 3y ago
      No. When it comes to evaluating forensic evidence lawyers are, by training, too process oriented to solve the problems. Ask a prosecutor what the error rate is for fingerprints or DNA evidence and you’ll get a blank stare. They don’t even try to measure it.
      • zamadatix 3y ago
        You're telling me no defense lawyer thinks about arguing the evidence is unreliable or are you just saying the prosecution throws everything they can find at their side of the case? The former seems extremely hard to believe (lest you're about to become the greatest defense lawmaker of all time due to wisdom shared in a short HN comment) and the latter seems to be evidence of the system working both well and as designed, not evidence it's badly faulty.
        • TedDoesntTalk 3y ago
          > latter seems to be evidence of the system working both well and as designed Prosecutors in America have one goal: close the case. At any cost, close the case. They are not interested in justice. They are not interested in finding the one who actually committed the crime. They are interested in closing the case. If that is “working as designed”, then we need to change the design.
• hammock 3y ago
  TLDR: There are issues with the way/how quickly we diagnose shaken baby syndrome without exploring other potential diagnoses, and with how severely/quickly we take kids away from their parents once we "think" we have a shaken baby
  • bluSCALE4 3y ago
    This doesn't do it justice. The damn name of the diagnosis makes it sound like a crime was committed. Guy runs an educational foundation on the issue that gets over 200 people a year asking for help in France alone.
  • pests 3y ago
    > we diagnose shaken baby syndrome without exploring other potential diagnoses It's more that 'shaken baby syndrome' is caused by more things than just a shaken baby (and evidence that shaking does not cause it even.) > the more neutral and objective term of “retino-dural hemorrhage of infancy” (RDHI).
  • boxed 3y ago
    It's much worse. There's no evidence of any baby shaking. At all.
    • rossant 3y ago
      Well, I was very surprised to discover that shaking appears to be a highly common and widespread form of child abuse in the world [1]. It may affect 2-3% of all babies in the US and other developed countries, and the rate may be 10x or more higher in other countries. I think it's reasonable to say that billions of babies may have been shaken in the past, yet the vast majority (of the order of 99.9% or even much more? [2]) are not diagnosed with shaken baby syndrome, since this diagnosis has an incidence of ~1/3,000 among children < 12 months in developed countries. In the countries where the incidence of shaking appears to be >50%, it is striking to note that the SBS diagnosis actually does not exist, i.e. doctors are not trained to diagnose it. On the other hand, actual cases of severe inflicted head injuries probably affect < 1/10,000 children < 12 months, and I think most of them involve external evidence of trauma. Those that do not probably involve extreme forms of shaking far beyond what most of the billions of "shaken babies" sustain. In other words, I've come to the likely conclusion that the intersection of babies who are effectively shaken, and babies who are labelled with "shaken baby syndrome", is an abysmal proportion of the first set, and a small proportion of the second. [1] https://www.sciencedirect.com/science/article/pii/S0749379708000639 https://www.sciencedirect.com/science/article/pii/S074937970... [2] Excerpt from the paper above: "the ratio of children hospitalized or dying from inflicted neurotrauma compared to the numbers of reported shaken children may be estimated at 1 to 152."
• sneak 3y ago
  > I couldn’t live with this uncertainty any longer. But first, I had to get my son back. As a precautionary measure, the hospital followed mandatory reporting statutes and my wife and I temporarily lost custody of David. Thanks to our incredibly effective defense lawyer, we were cleared of all charges within two months, during which we stayed at the hospital 24/7 with David until we sorted out the legal procedures. I would discover much later that we actually had been lucky to be allowed to do this, as most parents are abruptly separated from their babies for months after reporting takes place. This sounds very much like presumed guilt rather than presumed innocence.
  • Seattle3503 3y ago
    Is the criminal justice system in France based on a presumption of innonce?
    • armada651 3y ago
      Is that a serious question? Yes, the French justice system is based on a presumption of innocence, just like any other functioning democratic nation. It is a basic human right under the UN charter after all.
      • mlindner 3y ago
        You say that, but this doesn't seem like presumption of innocence. A country with a presumption of innocence doesn't take your child away from you without trial.
        • ascorbic 3y ago
          I'm willing to bet that almost all countries have a different standard of proof for taking a child away than for criminal trial, and none will wait for the outcome of a trial to do this.
          • mlindner 3y ago
• arp242 3y ago
  > Very often, abuse is diagnosed “by default”, because no known alternative explanation was found (or even actively sought). This is extremely dangerous, as it seems to indicate that no further medical discovery need ever be made in the future. Well, "dangerous" for who? For a lot of people involved in "child abuse" – from medical professionals to child services to the police – a false positive carries basically no consequences: you report it, or follow up, or do whatever your task is, "to be sure", and that's it. But a false negative can have a lot more consequences, including losing your job, lawsuits, becoming the centre of a media circus, becoming the target of an investigation yourself, etc. etc. Also see: most Amber Alerts should not have been sent, and are just simple cases of runaways, miscommunications, or family drama. But the official "pushing the button" to send out an alert has the same incentives as above. The incentives are pretty obvious.
  • hmottestad 3y ago
    It would be dangerous for the children. In the most extreme imaginable case we could discover a preventative measure for the brain bleed. Infants are routinely given vitamin K and vitamin D to prevent bleeding and to prevent bone development issues. Imagine if there was something else that could be given to prevent brain bleeds. That would save a lot of children.
  • olalonde 3y ago
    Indeed, it's especially problematic in the public sector. Since there's generally no reward for successful risk management, yet severe consequences for misjudgments, it fosters a culture of risk aversion. Another example is at the FDA, where an overemphasis on caution can inadvertently lead to more harm than good by delaying or preventing the approval of beneficial treatments.
• red75prime 3y ago
  Oh. And I thought that reddit outrage over the video of a father throwing his son in the air was just your standard modern hyperprotectiveness. Actually, the father risked lawsuit as it stands. The lack of common sense (and knowledge of physics) is off-putting.
  • mlindner 3y ago
    Did you read the article? The article claims the reverse. That this is not a real problem.
• hackernewds 3y ago
  > . As a precautionary measure, the hospital followed mandatory reporting statutes and my wife and I temporarily lost custody of David. Thanks to our incredibly effective defense lawyer, we were cleared of all charges within two months, during which we stayed at the hospital 24/7 with David until we sorted out the legal procedures. Woah
• stephen_g 3y ago
  Amazing that bit about child welfare organisations fighting against the science, when clearly taking children away based on false accusations is clearly far worse for the child’s welfare, not to mention the parents’! It’s just incredible the injustice that can be done in the name of protecting children. I really do wonder if it’s cultural or some kind of innate psychological irrarionality that seems stronger in some than others. I love kids and care deeply about their welfare, but people sometimes try to make me feel bad or that I’m the weird one for being able to think (I believe) fairly rationally about the risks and dangers that they face, instead of massively over-exaggerating! Or of course the opposite, keeping an appropriate eye on relations and acquaintances when people assume they’re totally safe but it’s actually somebody with that level of relation who’s likely to be a danger than a stranger.
  • duxup 3y ago
    My theory is that emotionally charged issues seem like a haven for people not thinking clearly and cover for hand waving or opposing any thoughtful analysis. I think there are people drawn to the absolutes. I can maybe see how it can be comforting to have a black and white issue to try to solve / help. A good side to be a part of in a world that to some seems very bad or confusing. Some old friends of mine are very much into these kinds of children’s issues. But when they talk to you about it it’s all emotion, it’s not even clear to me that they know much at all other than a sense that the bad guys are out there, maybe some strange legislation they support and so on. They’re not interested in justice, just this absolute sorta cause.
    • blast 3y ago
      Yes, this happens because most of us are unconsciously repeating our own histories.
    • rossant 3y ago
      I agree. This is clearly visible in trials where emotion plays a big part. An innocent childminder being charged with murder can't really compete with the extraordinarily charged testimony of grieving, devastated and sincere parents who have been made to believe in the strongest way possible that she killed their baby.
• TeeMassive 3y ago
  "What happened is that during my literature review, I disturbingly realized that what I had been told at the hospital, namely that subdural and retinal hemorrhage in infants are almost always caused by violent shaking even in the absence of external evidence of trauma, was an assertion based on very weak scientific foundations. And yet, this “shaking hypothesis” (sometimes referred to as the theory of the “triad”, since encephalopathy is frequently associated with the other two signs, subdural and retinal hemorrhage) has been taught as though it was a proven fact to generations of physicians all over the world. Every year, thousands of children are removed from their parents, and thousands are prosecuted, convicted, and even incarcerated, on the basis of this assertion. Law professor Deborah Tuerkheimer qualifies SBS/AHT as a “medical diagnosis of murder”. The very least we should expect for an assertion this powerful is that it should be based on reliable scientific foundations." This is why using experts for advice is great but everyone should still be encouraged to do their own research.
  • xpe 3y ago
    We need so much more than some combination of (1) trusting experts and (2) doing your own research. The first is practically necessary but unsatisfying given well-known concerns about scientific replication, knowledge dissemination, and industry incentives. The second isn't practical for most people. I don't have detailed interventions to suggest right now, but it seems clear that we need better _systems_ that result in less dogmatic behavior among experts and legal systems.
  • scott_w 3y ago
    How would doing your own research prevent the state from taking your child away and putting you in prison for murder?
  • kergonath 3y ago
    > This is why using experts for advice is great but everyone should still be encouraged to do their own research. Not everyone is equipped to do this kind of literature review (that’s not research), or have access to all these papers. Everyone needs to be critical and skeptical to a reasonable extent, but this kind of “do your own research” attitude is damaging. People just end up trusting dodgy but authoritative-sounding YouTube videos and blog posts because they cannot read scientific articles.
• p-e-w 3y ago
  > It is the perfect combination of crap. I think that's being way too charitable. In a world where people are incarcerated on a scale unprecedented in all of human history, and where prosecutorial success is measured by number of scalps taken, the assumption that this is plain malice designed to let the state rob a few more individuals of their freedom makes much more sense than it all being just a big pile of incompetence and misunderstandings.
  • dang 3y ago
    We detached this subthread from https://news.ycombinator.com/item?id=37667150 https://news.ycombinator.com/item?id=37667150.
  • WA 3y ago
    Source? Incarceration rate seems to be going down in western countries: https://news.un.org/en/story/2021/07/1096042 https://news.un.org/en/story/2021/07/1096042
    • p-e-w 3y ago
      The scale of incarceration is still unprecedented. A reduction by 27 percent doesn't change that. Imprisonment was an extremely rare phenomenon for much of history (as was police, for that matter). Today's incarceration rates would have to be reduced by 99+% in order to reach pre-modern levels, where large cities often had only a handful of cells in total, and rural areas had none at all.
      • lm28469 3y ago
        > Imprisonment was an extremely rare phenomenon for much of history (as was police, for that matter). And crimes weren't solved, people not prosecuted, criminals not punished For much of history life didn't even exist, that's not an argument for or against anything
        • watwut 3y ago
          Murder clearance rates went DOWN last decades in USA. Less of major crime is solved. Plus majority of it never went through tria, because trial is just too much risk. So, there are not all that many actual checks and balances
• murphyslab 3y ago
  It's interesting the instance cited about authors of a scientific paper being compelled to remove a reference because a peer reviewer alleged that the researcher behind it is "a lousy and dishonest researcher". What's more interesting is that PLOS ONE repeated the allegation. I am curious whether there is a case for defamation for the publication of such an allegation. https://journals.plos.org/plosone/article/peerReview?id=10.1371/journal.pone.0283297 https://journals.plos.org/plosone/article/peerReview?id=10.1... I've certainly had peer reviewers trying to get me to cite their own papers in my articles, however I've never seen an instance where a peer reviewer alleged that an article I've cited was by someone disreputable.
  • kergonath 3y ago
    > I've certainly had peer reviewers trying to get me to cite their own papers in my articles, however I've never seen an instance where a peer reviewer alleged that an article I've cited was by someone disreputable. I have recommended some citations to be removed as a reviewer. It’s not useful to keep citing discredited articles that should have been retracted. Keeping them in new articles just makes them more likely to be read uncritically and further propagate bullshit. OTOH, the argument is “the article is rubbish”, not some kind of as hominem attack because I don’t like the main author.
    • murphyslab 3y ago
      I can see encouraging authors to remove "zombie citations", but that should be rare nowadays, as many bibliographic databases will automatically flag retracted articles now, thanks to integration with the Retraction Watch database.
      • kergonath 3y ago
        Hopefully, yes. But there are a lot of articles that should be retracted, but that won’t be because of editorial policies or the fact that nobody actually cares.
• Racing0461 3y ago
  [flagged]
• katzenversteher 3y ago
  This always scared me because I don't even know what counts as shaking. Can you accidentally shake a baby? Can my 2 year old daughter get shaken baby syndrome when older children on an inflatable castle with her jump and bounce too wild around her (she can't jump yet but loves the bouncing)? I've also often seen parents throw their children a bit in the air and then catch them. The children like it and laugh. I'm not even speaking of law and police but medically. Can this seriously hurt my daughter?
  • CMCDragonkai 3y ago
    To protect against all possible harm against your child, perhaps consider wrapping them in a giant balloon so they are isolated from all possible outside influences. We either accept the randomness of fate or we live in self-made prisons.
    • gardenmud 3y ago
      I don't think this person is asking to protect against all possible harm. I find it strange that you seem to think it is unreasonable to not want your baby shaken so hard they die, and to want to clearly know how much force that is.
  • DoingIsLearning 3y ago
    Generally throwing kids around (within reason) is absolutely safe, specially at +2yrs. Rough play is very much part of development for all mammals including us. Perhaps something to help you cope with this is that our brain although fragile has a lot of redundancy around it. On a fall or bounce our neck will decelerate our fall/bounce, there is no need to be an athlete, our muscles have a contraction reflex if they are violently streched (myotatic reflex), less so for very young babies with weak neck muscles (think less than 6/9 months). Then our skull is filled with fluid which has inertia so the force on the skull is not directly transmitted to the brain. You have to slush the liquid around quite a bit before your brain experiences any meaningful force. Effectively it is only with some extreme force or internal bleeding compressing the brain that brain damage would occur.
• mlindner 3y ago
  > As a precautionary measure, the hospital followed mandatory reporting statutes and my wife and I temporarily lost custody of David. Are people absolutely nuts? Is this just a thing in France or is this elsewhere in Europe or even the US? You're actively encouraging people to not bring their children to the ER by doing this crazy nonsense.
  • switch007 3y ago
    Definitely a UK thing too. If you take your kid to A&E you can guarantee every person who interacts with you is required to be on the lookout for abuse. You get probing questions by the doctors as veiled accusations and you may get protection services knocking on your door the next day.
  • rossant 3y ago
    This is a thing in most Western countries! Especially in the US. It dates back to the 1960s [1]. Most parents don't realize that anytime they interact with a medical doctor (or another professional), they interact with someone who was trained to detect "signs of abuse", which basically can be anything out of the ordinary. They are required by law to report any suspicion of abuse, and they can be prosecuted if they fail to do so. The incentives are pretty clear. Unfortunately, while this obviously protects some children, there are adverse effects such as an enormous waste of human and financial resources to unsubstantiated reports [2]. To quote Wikipedia (this is more generally about hotline calls but this also affects healthcare professionals): "There are approximately 3.6 million calls each year nationwide (..) affecting on average 1 out of 10 U.S. families with children under the age of 18 each year (there are 32.2 million such families). (...) Of those substantiated, over half are minor situations and many are situations where the worker thinks something may happen in the future. Each year, approximately 85% of hotline calls either do not warrant investigation or are not substantiated. Approximately 78% of all investigations are unsubstantiated and approximately 22% are substantiated, with around 9% where "alternative responses" are offered in some states, which have a focus on working with the family to address issues rather than confirming maltreatment." On this topic, I highly recommend "Take Care of Maya" on Netflix. [1] https://en.wikipedia.org/wiki/Mandatory_reporting_in_the_United_States https://en.wikipedia.org/wiki/Mandatory_reporting_in_the_Uni... [2] https://lawreview.law.ucdavis.edu/issues/50/1/Articles/50-1_Eichner.pdf https://lawreview.law.ucdavis.edu/issues/50/1/Articles/50-1_... [3] https://en.wikipedia.org/wiki/Factitious_disorder_imposed_on_another https://en.wikipedia.org/wiki/Factitious_disorder_imposed_on...
• rapatel0 3y ago
  This doesn’t surprise me. We have massive systemic issues in medical science and care delivery. - Medical science handles variation by simply assuming that large enough samples will average out variation. This loses a ton of information as the “average person” is a construct that almost certainly doesn’t exist. - news media on medical science glosses over all uncertainties in the name of clickbaity sensationalism. - lawyers are the incentivized by our adversarial legal system to adopt aggressively hyperbolic interpretations of the science to sue people and extract money. - medical associations then tweak policies to protect against malpractice Run this loop enough times and lots of noise gets amplified. My hope is the AI+sensors ushers in the era of truely personalized medicine.
  • deleted 3y ago
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  • idoubtit 3y ago
    Basically, you want to replace statistics ("large enough samples will average out variation") with AI. I'm afraid that's cargo cult instead of science. AI can lie. It means a "truely personalized medicine" would sometimes poison its patients. See for instance Donald Knuth experiment with Chat GPT, starting with "Answer #3 is fouled up beautifully!" with some totally wrong AI answers https://www-cs-faculty.stanford.edu/~knuth/chatGPT20.txt https://www-cs-faculty.stanford.edu/~knuth/chatGPT20.txt Of course medical science could make a better use of statistics, get help from AI, and discern more profiles (e.g. one US adult out of two is obese, and it's often unclear how to adjust medication to person mass). But that's a long process, with no obvious path, and much distinct from the magic "AI will solve it all".
    • xpe 3y ago
      (I'll bring a conciliatory bias to this conversation. Under what interpretations might the ^ and ^^ comments be saying mostly the same thing?) >> My hope is the AI+sensors ushers in the era of truely personalized medicine. > AI can lie. The first hope is compatible with the second fact. It is possible that carefully _designed_ AI systems (that have different architectures than 'vanilla' LLMs) can serve a useful purpose here. There is a lot of interesting conversation to be had in 'the conciliatory zone', leaving plenty of opportunities to disagree when it is warranted. > Basically, you want to replace statistics ("large enough samples will average out variation") with AI. I'm afraid that's cargo cult instead of science. There is a whole lot of _assuming_ going on here, followed by a mischaracterization. This is not the paragon of curious conversation. I don't expect perfection, but I still think we should try. I don't mean to pick on any one person; I do this sometimes as well. I'm just pointing it out because, well, it is right here, right now. Think about the impact on the system. Seeing the anti-pattern above too often can drive people away. I think it does. Who remains? People who somehow aren't bothered by it? Downselecting in this way is self-defeating. I'm probably just as frustrated as anyone here (if not more) regarding (i) the state of medicine, (ii) perceptions of what current AI technology can do, and (iii) many other serious problems. But we shouldn't not let this frustration bleed into our personal interactions. It is both a waste of our time and (worse) damaging to the community ethos when we take an unnecessarily pessimistic view of _each other_. Some online fora are 'good enough' (though flawed) to help us connect and build bridges as _people_. It doesn't help when we fall into the all-too-common pattern of sniping without asking questions first and clarifying meaning. Again, nothing personal. This is more of a rant and request.
• charles_f 3y ago
  Once my kid cut his butt cheek falling off his bike (to this day I don't know how). I brought him to the hospital for sutures, and was asked to live the room while he was questioned. I felt very uncomfortable, and almost guilty, while this lasted for all of 5 minutes. I cannot imagine losing custody of your child while he's in an emergency situation for a couple months. This must be a nightmare.
  • stef25 3y ago
    > was asked to live the room while he was questioned Is that even legal ? Anyone trying to get between my kids and I is going to have a very bad day.
    • charles_f 3y ago
      I am thinking it's even mandated from the medical personnel
    • rightbyte 3y ago
      It might be a bad idea persoannly to become angry in such a situation if the local social service is authoritarian. But as an altruistic move for the greater good it is good.
      • logicchains 3y ago
        >But as an altruistic move for the greater good it is good. That's only the case if overall children taken away from their parents end up with better outcomes than in societies where children aren't taken away from their parents, have you seen any data showing this is the case? Children in foster care tend to have horrifically bad outcomes, statistically speaking.
        • bluGill 3y ago
          Children in foster care start off in a much worse situation than average. Or at least that is the normal case, there are exceptions like the article. Many parents of 'mentally disabled' kids put the kids in foster care because the parents need a break from the constant care of a kid who isn't normal. Many other kids end up in foster care because they have been abused. Both of those will make the kids much worse than normal and thus much harder to care for. Kids that are close to normal but end up in foster care often end up adopted fairly quick - there are plenty of families who want a kid but not their own (I personally know several people with genetics they don't want to pass on - there are other good reasons to not want someone else's kids) - but they will try to select a kid who is going to be easy to raise thus kids who will end up normal don't spend much time in foster care.
• Muromec 3y ago
  Oh the good old, violent Easter European bias mixed into crap science.
  • woof 3y ago
    Seems like the bias is on your part… Which is ironic, given the articles content…. Or do you have _evidence_?
    • Muromec 3y ago
      No, I don't have any bias, it's everybody else having biases. To be sure, I just checked how many times before I was biased (it's zero times), so I can't be now.
    • fishnchips 3y ago
      The username kinda suggests an Eastern European (https://en.wikipedia.org/wiki/Ilya_Muromets https://en.wikipedia.org/wiki/Ilya_Muromets) so I read the post as a personal opinion that the bias exists.
    • coldtea 3y ago
      Not everything comes with evidence, nor is everything a court case. If you have experienced racism again and again though, you can often tell when you see it, or you can quite safely deduce it in a case or wrong treatment, even without hard proof.
      • jauzj 3y ago
        [flagged]
        • TRiG_Ireland 3y ago
          Well, now you've learned something.
        • achenet 3y ago
          If you happen to get a bit into the whole Nazi classification of races (don't, you almost certainly have something better to learn), you'll find that they made a distinction between Germanic "Aryan" types and Slavs.
• fnordpiglet 3y ago
  This article reminded me of another local story about a doctor who provides assessment beyond the knee jerk child protection industrial complex - https://www.seattletimes.com/seattle-news/child-abuse-or-medical-problem-wa-doctor-pushes-back-on-questionable-cases/ https://www.seattletimes.com/seattle-news/child-abuse-or-med... This also reminds me a lot of the indoctrination we went through at the hospital when my daughter was born. Despite being a high risk pregnancy we were railroaded into a natural birth. After nearly 24 hours of horrific labor she spiked an extremely high fever and they had to do a c-section, making us feel like failures. They found that our daughter wouldn’t have made it otherwise. We were castigated because my wife took medicines that entered her milk and were made to feel like failures for considering not breast feeding. She had to pump milk at five AM before she took any medicine to minimize the exposure to the extremely toxic medicine that would be present in her milk. She didn’t produce enough milk and we were at wits end. The nurses and doctors at the hospital were unhelpful and treated us like abusers. When we went to our local pediatrician he laughed and said entire generations were raised on formula and to stop killing ourselves. It was the best advice we were ever given. Likewise my daughter couldn’t sleep on her back. She wailed every night. I read everything I could find on SIDS and I realized the correlation for back sleeping was very weak - almost statistically irrelevant - and even then the prevalence of SIDS was very low. Yet I knew for 100% my daughter wasn’t sleeping. I knew if I told anyone I would be lectured, and I worried might even be reported. The after nearly a week of not sleeping I flipped her over one night with my heart pounding. She fell asleep immediately. She didn’t die. She’s nine now and an incredible athlete and has a sharp and brilliant mind. None of the doomsday stuff occurred. No autism, no weak immune system, no weight problems, intellectual deficiency, or all the other warnings we were given about c-section, formula, or belly sleeping. Over the years I continued to read the research and there’s basically nothing compelling about any of this advice, at least not at the level of stridency parents experience.
  • Fire-Dragon-DoL 3y ago
    I didn't know that about sids. What a bullshit diagnosis. Our children mostly slept tummy down on mum's chest, skin-to-skin, because that reduced sids chance (and we were terrified). But like yours, they couldn't sleep tummy up
• pcblues 3y ago
  There is a problem with responsibility. Do you want to never let a perp go (i.e. jail innocent people in order to catch every guilty person) versus let some baddies slip through the net while not imprisoning innocent people. My own life found itself on the nexus, where I lost loved ones with a false accusation, but wasn't charged for it from (obvious) lack of evidence. Although the legal system worked somewhat, it was too late for me and my loved ones. The liars got away with it, and mission accomplished in removing me from the family.
  • P_I_Staker 3y ago
    Okay, what happened? You can't leave these half stories here, lol
  • nonethewiser 3y ago
    > Do you want to never let a perp go (i.e. jail innocent people in order to catch every guilty person) versus let some baddies slip through the net while not imprisoning innocent people Isn't the latter the official standard most places? Innocent until proven guilty. It's just not really a dilemma if you ask me. If you have authority to do something based on some event, then you have to prove that event happened.
• Jecintaworld 3y ago
  [flagged]
• boxed 3y ago
  Here in Sweden I had to watch a video warning against baby shaking when my wife was pregnant with my first child. After seeing this horrible video, I waited a few hours to tell my wife that this entire thing was total bunk, and we've known it's been bunk for many years. Here in Sweden this child abduction idiocy is upheld by three doctors who all refer to each other as the experts proving baby shaking is real. It's a disgrace.
  • Sander_Marechal 3y ago
    I've been made to watch a similar video here in The Netherlands. It's not bunk though. Violently shaking a baby will lead to trauma which can cause death. What this book is about is that there are other causes that can lead to the same symptoms. The video is right. Shaking a baby leads to AHT. But the reverse isn't. AHT does not mean that the baby has been shaken. There are many other causes for AHT.
    • Fire-Dragon-DoL 3y ago
      Didn't the article state that is actually unlikely it leads to AHT?
      • eru 3y ago
        I think the article says that shaking a baby will give you lots of different symptoms, including bruises etc. And you can't really get AHT from shaking without also getting bruises etc. That means if you see 'AHT' without bruises (etc) it was probably not actual shaking.
        • rossant 3y ago
          Yeah, it's hard to say for sure what kind of injuries you'll get from violent shaking, as we obviously can't reproduce it on actual babies, and there are so few well-described cases. Studies have been made on animal models, showing a constellation of traumatic injuries, but no clear, obvious, and reproducible pattern so far. Strikingly, the isolated "triad" of subdural and retinal hemorrhage with brain edema hasn't really been reproduced in any animal model so far [1]. Anyway, we don't need this level of scientific detail and knowledge to say that no one should ever shake a baby. All brutal gestures are obviously harmful and dangerous. [1] https://link.springer.com/article/10.1007/s00381-022-05577-6 https://link.springer.com/article/10.1007/s00381-022-05577-6
• Fire-Dragon-DoL 3y ago
  When I was getting ready to turn dad for the first time, I read a few books on pregnancy, children and parenting. My trust on medicine dropped substantially when I discovered that doctors have poor notion of statistics, so they take for granted improper studies results. I remember one classic one is the "no coffee when pregnant", the study says this causes problems, the test was performed on rats and by feeding them coffee in the amount of 3/4 of their body weight. We can agree that with this amount, it's reasonable it could cause problems. Very different from one cup of coffee though. The other study that was done is about Amniocentesis, this one is more interesting the chance of miscarriage is considered 0.1% but this was before the operation was performed with a live ultrasound to look at the needle while performing it, which (probably) makes a big difference. Before, doctors performed an ultrasound and then went in blind. There was also a serious bias towards a certain type of population. But of course doctors don't bring this up at all. Last thing is sids, it's a terrible type of diagnosis that pushes parents against the instinct of sleeping with their children, even though this is commonly done in non-western cultures and can save a lot of pain to the parents and give a lot of security to the child. Do your research though, medical community reports risks and I'm no doctor, just a dad who read a few books. Glad my children are healthy. Every time I read about some illness for children I feel an incredible weight on my heart
  • deleted 3y ago
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  • cjrp 3y ago
    Has SIDS been linked to co-sleeping? I thought the risks of co-sleeping were more around accidentally rolling on or suffocating the baby.
    • lqet 3y ago
      That is also what we were told after birth. My personal opinion is that the advantages of co-sleeping far outweigh the risks. It is much less stressful for both the parents and the baby. My wife simply slept topless, turned (half-sleeping) to our baby whenever it was crying, and immediately fell back asleep.
• concordDance 3y ago
  [flagged]
  • jacquesm 3y ago
    You've got to be kidding. This takes victim blaming to a whole new level.
    • concordDance 3y ago
      Uh, why would I be kidding and how on earth is that victim blaming? There's a range of reasons people don't tend to make the full case for the opposite of the thing they're passionate about. Those who can actually do so are vanishingly rare.
      • praash 3y ago
        This is a valid point! People might feel they must put 100% on arguing for their case when fighting a consensus, because everyone else is already doing the opposite. Steel-manning the opposing perspective could yield stronger insight in favor of their passion. This would convince people to change their minds more effectively, because most are obsessed in the case of "true SBS" with physical abuse. I think your original comment just had a ring of "he's selling a book, don't trust his intentions"
• e40 3y ago
  No mention of the Texas death row inmate’s fate to be decided by SCOTUS in mere days. https://www.theguardian.com/world/2023/sep/24/texas-death-row-robert-roberson-supreme-court-shaken-baby-syndrome https://www.theguardian.com/world/2023/sep/24/texas-death-ro...
• RektBoy 3y ago
  "Shake it baby"
• guynamedloren 3y ago
  Content aside (which is both thought provoking and incredibly alarming) I’m fascinated by the author’s commitment to deeply understanding a system and the factors at play within that system. There’s something inspiring about relentless truth seeking, to the point of obsession, with some extraordinary level of meticulousness. Particularly when it challenges conventional wisdom. This is a slippery slope as it can quickly nosedive into junk science and contrarianism, despite best intentions, but when it’s done well, it’s really something. Probably a faux pas here these days, but reminds me of Elon Musk’s First Principles.
  • tboyd47 3y ago
    When you are a parent it comes naturally. Because your child becomes your #1 time and energy investment, all other investments of time and energy seem trivial. Many parents of autistic children have made similar intellectual commitments. I'd go so far to say that it's commonplace in that community. All the more reason children should not be separated from their parents for flimsy scientific assertions by experts.
• Llamamoe 3y ago
  > has been taught as though it was a proven fact to generations of physicians all over the world. Welcome to healthcare. For many conditions having a medical degree is straight up deleterious to a doctor's ability to accurately diagnose and treat a condition.
• firesteelrain 3y ago
  “ Let there be no misunderstanding on the point that shaking is an absolutely real and dramatic form of child abuse. Inflicted head trauma is a devastating condition and a definite cause of traumatic brain injuries, including intracranial hemorrhage. Many medical determinations of SBS/AHT are made on children who have effectively been victims of violent intentional trauma. Prevention efforts against all forms of child abuse are totally warranted.” A lot of the comments here are missing this key statement. While there can be medical explanations for things that look like SBS, it’s exceedingly rare
  • laurent_du 3y ago
    I missed this part. Where does the author mention that other medical explanations (other than SBS) are exceedingly rare compared to the baby having indeed been shaken?
    • firesteelrain 3y ago
      I said that blaming medical reasons for SBS is exceedingly rare. As indicated, trauma due to shaking is usually the case. Medical reasons can't be ruled out. That's the crux of the issue.
  • ClarityJones 3y ago
    You're assuming that medical science is capable of providing an explanation in every case, when the whole point of this article is to say that these symptoms are insufficient to diagnose SBS. The author is saying if we have no alternative medical explanations, then we have no medical explanation at all. In order to diagnose SBS, the author suggests that you need additional evidence suggesting trauma such as bruising, broken bones, etc. Indeed, that seems to be what the SBS lobby is now saying as well, they just haven't communicated that to front-line providers.
    • firesteelrain 3y ago
      "You're assuming that medical science is capable of providing an explanation in every case, when the whole point of this article is to say that these symptoms are insufficient to diagnose SBS" I do not disagree with you. I just caution as does the author that you can't rule out criminality either.
• tru1ock 3y ago
  This made me think of Handmaid's Tale. Scary to know how easily we will trade away liberty to an illusion of safety for the sake of the children.
  • nonethewiser 3y ago
    I would say it's for the sake of safety. Children may be the topic here, but it applies much more widely to safety in general.
• zapdrive 3y ago
  Imagine your child taken away from you just on the basis of some assumptions. This makes my blood boil. I have never had murderous thoughts even when I have been wronged really bad. I just forget and move on with life. But I don't think I can do that if my child is taken from me for something I didn't do. I'll definitely go postal. Land of "Freedom".
  • slackfan 3y ago
    Not just a US thing. Europe is even more prevalent.
• stevev 3y ago
  There are additional factors to take into account beyond simply labeling it as a rare condition. This includes the food or baby formula itself and the quality of water used. Given the frequency of formula recalls, there's a potential risk of obtaining a defective batch that could harm the baby.
• sandworm101 3y ago
  >> how many people are in jail or lost their kids due to something that didn't actually happen. Thousands upon thousands. By some estimates upwards of 10% of incarcerated individuals. The situation is just accepted. The general consensus is always that locking up too many people is better than than too few. It is on defense attorneys to check on the system.
  • lqet 3y ago
    Are you saying that 10% of incarcerated individuals are innocent (which I do not find an unrealistic number), or are you saying that 10% of incarcerated individuals are wrongly in prison for crimes against their children?
    • sandworm101 3y ago
      10% of people are innocent of the crimes for which they have been convicted. Whole innocence is another thing. But yes, there are a huge number of people wrongfully convicted. Things like DNA evidence is showing us that a great many mistakes are made. For those crimes convicted without things like DNA evidence, one must presume an equal rate of wrongful convictions. Courts are not FAA crash investigations, or any other sort of investigation. They are not about truth. They are about rights and laws. There is no right to a truthful outcome, only a lawful one.
      • lqet 3y ago
        I agree, but I think OP referred to crimes involving violence against their own children.
      • rossant 3y ago
        Yes. I suggest everyone to look into the fantastic work done by the Innocence Project [1] and the Innocence Network [2]. Also, the Innocence Files is a must-watch on Netflix [3]. [1] https://innocenceproject.org/ https://innocenceproject.org/ [2] https://innocencenetwork.org/ https://innocencenetwork.org/ [3] https://www.netflix.com/title/80214563 https://www.netflix.com/title/80214563
• fusslo 3y ago
  since everyone else is sharing an anecdote: When I was 14 or so I fell off my dirt bike and broke my arm, both bones in my forearm. Went to the hospital. About 5 people asked me how it happened taking about an hour, while I was WRITHING in pain. Finally, I complained to the right nurse and she got me something for the pain. It was just enough to stop crying, not enough to stop feeling it. I later found out that the intake nurse was concerned about abuse. I was dressed head to toe in dirtbike gear. I was a 150lb 14 yr old. my mother was 110 lbs. They delayed treatment so multiple people, nurses, doctors, and hospital staff could all ask me what happened and compare if I told them the same thing.
  • bell-cot 3y ago
    THIS. It very often seems as if the medical/social system has "barricaded itself" inside it own ideological/psychiatric obsessions with the idea of child abuse, and is blind to reality. Let alone the actual welfare of the child.
  • aidenn0 3y ago
    They may delay treatment for reasons other than just asking; my son was in the ER for 4 hours with a significant laceration (it resulted in two layers of over 2 dozen sutures each) before he was given anything as the nurses were not allowed to administer an analgesic (much less pain killers) until a doctor had examined him, and it took 4 hours for the doctor to get to him. At no point was there any sign of the staff acting like there might be abuse or neglect involved.
  • volkl48 3y ago
    While I certainly don't agree with delaying your treatment....your size/weight vs your mother's is irrelevant - just because she's who brought you in doesn't mean that she's the only person who could have abused you. For all they know you've got a father or uncle or whoever that's huge and has anger problems who broke it. One abusive family member and a partner who's covering for/trying to make up for their behavior (and may be being abused themselves) is a pretty common type of abusive situation.
• losthobbies 3y ago
  There was a infamous case in the UK around SBS: https://3dc.org.uk/press-release-preliminary-study-of-uk-shaken-baby-syndrome-cases-raises-serious-concerns/ https://3dc.org.uk/press-release-preliminary-study-of-uk-sha... Louise Woodward was the nanny involved and the court case was televised. Was huge at the time I remember.
  • rossant 3y ago
    Yes, Innocence Project cofounder Barry Scheck was the defense attorney in the Woodward case and he wrote a long foreword to our book about it. It starts like this: "After a Quarter of a Century, Have Any Lessons Been Learned from the Trial of Louise Woodward? Twenty-five years ago, the Louise Woodward trial in Boston (the ‘nanny murder case’) thrust shaken baby syndrome (SBS) into headlines across the globe, raising worldwide consciousness about the hypothesis that infants and toddlers could be seriously brain injured, even killed, by violent shaking. Although the case was tried in the early days of SBS prosecutions, the underlying science was fiercely disputed and litigated at trial. A quarter of a century later, although science has advanced, the issues remain just as hotly disputed and poorly understood, and yet parents and caregivers continue to be prosecuted and families torn apart based on the hypothesis."
• Dove 3y ago
  > What happened is that during my literature review, I disturbingly realized that what I had been told at the hospital ... was an assertion based on very weak scientific foundations. And yet ... has been taught as though it was a proven fact to generations of physicians all over the world. This exact thing has happened to me so many times, on so many different medical topics, that it is now my going in assumption that if I review the literature, this is what I'll find. The most flabberghasting case was one in which I was able to determine the standard of care the doctors insisted on was in flat contradiction to the established science in the course of an afternoon. As a mathematician by training, I am used to checking the reasoning behind everything I believe for myself. I can understand not having taken months and months to delve into a deeply technical topic, but when the state of affairs can be determined in an afternoon? I cannot fathom spending a career giving people advice and never having looked that far. My favorite example of obvious, silly unscientific behavior is the basic set of practices and beliefs surrounding blood pressure. Blood pressure varies a lot, second to second, minute to minute, hour to hour, and day to day, with an astonishing range, for a very long list of reasons both benign and concerning. It is an obvious fact, well known and easy to establish by anyone with a measuring device and a little statistical curiosity. The literature, the instruction books shipped with measuring devices, the procedures followed by doctors and nurses, the procedures they say they should be following, bear all the hallmarks of the behavior of the statistically unsophisticated seeking patterns and meaning in randomness. But my very favorite behavior is the sheer cognitive dissonance. I have had nurses take my blood pressure while varying the circumstance - sitting, lying, this arm, that arm - until they got the answer they wanted, reported it to a doctor, who compared it to a chart with great authority and made a claim about my health over a span of months and years. I have had a five minute conversation with a doctor about the statistical variation of the number and the fact that best practices involve taking many measurements and he opined that it wasn't really valid unless you measured it over twenty four hours... and then said, "anyway..." and proceeded in the next sentence to diagnose me and argue strenuously for a prescription based on a single measurement and no context. One of the things I find cynically, darkly entertaining is how often the standard advice is, not just random, not just useless, but exactly wrong. The diet they insist on to manage gallstones is known to cause gallstones. The treatment traditionally insisted on for diabetes is known to kill you faster the more exactly you comply. The saline typically used in hospitals, compared to an electrolyte balanced solution, is known to kill patients. They institutionally get saline wrong! The absolute theatrics and bureaucracy required historically to institute handwashing in hospitals indicates a cultural problem, and the current state of affairs suggests to me that it remains. I am not talking about advancing scientific knowledge here - I am talking about accounting for things that are well known and can be checked with little effort so long as one is not intimidated by basic science. The prospect of professional mathematicians behaving this way is laughable. Everyone knows the discredited results and no one would dream of using them. The prospect of cybersecurity professionals taking years to apply a patch after a security flaw is discovered beggars belief. Yet here are the doctors, insisting with great pomp and authority on easily checkable wrong things, and they have apparently been doing so in many domains, for a very long time. I know there is value in medical advice, and in many situations I seek it, but it is enough to make one want to throw in the towel and consult the aromatherapists and their healing crystals - at least they won't insist on something destructive! The words "scientific medicine" clearly do not mean what I would think they should mean.
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• jurgenaut23 3y ago
  Thank you so much for investigating this matter so thoroughly and fighting for justice so eagerly. As the father of a 4-month-old baby, I couldn't imagine anything more devastating than having him taken away by the authorities for something neither my wife nor I have done. I can only imagine the despair of the families to whom this happens, let alone the impact on the poor kids themselves.
• londons_explore 3y ago
  I do wonder how many cases of 'shaken babies' are because the baby has stopped responding for some other reason, and a desperate mother tries to revive them by shaking? I'm pretty sure I have seen such things in nature documentaries, where a mother shakes a stillborn/dead child as a last ditch attempt to bring them back to life. If that really was what happened, I would struggle to convict the mother for murder if I was on the the jury...
  • rossant 3y ago
    That's a very interesting and relevant comment. Maybe that happens in a few cases. However, the reality in my experience is much more complex (and interesting). This is basically an instance of a coerced internalized false confession, according to the classification by Saul Kassin [1]. Let's imagine a mother seeing her baby who suddenly stops breathing. Panicked, she gently takes her baby under the armpits: "Please wake up!". The baby is brought to the hospital, doctors find subdural and retinal hemorrhage, she is accused of shaking her baby. At the police station, investigators are told by doctors that SBS is 100% certain, that the baby was shaken just before collapsing. They keep pressuring the mother, who swears there was no shaking, no trauma, no accident, no short fall, absolutely nothing. The baby just collapsed with no triggering event. This is a story that is repeated again and again by most parents and caregivers who are living this situation. This is such a dramatic and emotional situation for parents and caregivers that many will actually doubt their own memory (that actually happened to me, briefly, and yet I never went through a tough police interrogation in custody). Anyway, innocent and sincere persons will actually try to find rational explanations. They will retrospectively try to find any sort of mild movement of the baby's head that could resemble shaking. Police officers will say what they're told (which is actually true): mild shaking will not cause this, only extremely violent ones will. At one point during the interrogation, the idea will be brought up that, perhaps, the mother accidentally shook the baby after the collapse as a resuscitation attempt. In the end, it may well be the only rational explanation? The mother may even end up believing that she involuntarily harmed her own child while trying to save him, and that will be the charge brought by the prosecution that leads the mother to trial. In reality, this gesture was likely to be far too mild to do any serious injury to the child. However, in this particular context, it may well be the only explanation that could be accepted by both the investigators and the defendant. In these cases, it's more likely that the child collapsed due to some undetected medical condition leading to a respiratory arrest (akin to what happens in SIDS). I've seen this pattern over and over again. It has actually be well studied by psychologists in slightly more general contexts. The book contains 2 chapters (by Keith Findley, Richard Leo, Deborah Davis) on the extremely important issue of SBS confessions, as this is basically the main evidence of the diagnosis today. [1] https://en.wikipedia.org/wiki/False_confession#Coerced_internalized_confessions https://en.wikipedia.org/wiki/False_confession#Coerced_inter...
• pmarreck 3y ago
  As a new parent of a son, this is horrifying. Why is the default, to accuse the caretakers with phantom (unfounded) certainty, absent any other good evidence?
• mcguire 3y ago
  "But in practice, extremely few medical conditions are checked for and “excluded” before concluding a diagnosis ... – the great majority are not checked for at all. Very often, ... is diagnosed “by default”, because no known alternative explanation was found (or even actively sought)." From anecdotes I hear, that is one of the major problems with the medical system in a nutshell.
• noobermin 3y ago
  In the anglosphere (or may be just america) "think of the children" has lead to a lot of these sorts of issues. Child abuse is the worst thing anyone could imagine, and so, how could anyone over-react? How can any action be enough? May be some figures or entities take advantage of this, but there is some sincere motivation in these drives too. And now, we have issues like this article, children not being allowed unattended in most public places, children unallowed to walk on their own without adult supervision, and it goes on and on. The thing is there is no needed ill intent, all parents can be sincere, and yet create a society and culture that stunts their very childrens' growth and lives. In the article, as the author said, how many thousands of parents have been separated from their child, and the infant, now parent-less, will be shuffled from foster home to foster home, all in the name of ending abuse based on filmsy evidence and poor science? It's depressing. The very desire to protect and love leads to hurting those we intend to help.
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  • sacnoradhq 3y ago
    This was a sensational news trope on MSM nightly news and news magazines in the 90's in the US.
  • emodendroket 3y ago
    The story is set in France if you were thinking this is a uniquely Anglo issue.
• didibus 3y ago
  As a parent, I can only imagine one thing worst than someone causing such head injury to my child, it is for me to be falsely convicted of such abuse and losing access to my own child.
  • qez2 3y ago
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• juanani 3y ago
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• emodendroket 3y ago
  While his experience is nightmarish enough it's hard not to suspect that being a well-educated professional had a lot to do with some of the special privileges he was afforded compared to other parents.
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• skjoldr 3y ago
  So what I got from this article is that it's a good idea to have a 24/7 CCTV coverage of all areas where a baby might be in case there might be a need to defend oneself from fradulent accusations by government agents. Oh well.
  • rossant 3y ago
    It's actually a fairly good idea, we think about it a lot. My highest hope is that technology soon reaches a point where it's cheap and convenient and not totally socially awkward to videotape the life of a baby 24/7. I feel like we're not totally there yet. The new Ray-Ban Meta can apparently record 60 seconds of video. What we need is 24/7 continuous videotaping to ensure that the exact moment when a baby collapses (and the hours before), and the caregiver calls the ER, is filmed. A single case where we a video would prove that there was no shaking at this exact moment might help convince many doctors (not all, unfortunately). Relatedly, this recent medical article [1] reports a case of an alleged short fall resulting in subdural and retinal hemorrhage. As usual, doctors did not believe in the story of the short fall (they assume a short fall can almost never cause them) and they concluded that the short fall was a cover-up for unadmitted abuse. The police was called and, surprise, the whole thing was filmed by CCTV. The videotape proved that the story of the short fall was entirely correct and the caregiver was exculpated. Interestingly, the doctors did not conclude that their belief was wrong (short falls almost never cause subdural and retinal hemorrhage), but that it was an "outlier". [1] https://www.sciencedirect.com/science/article/abs/pii/S1091853123001179 https://www.sciencedirect.com/science/article/abs/pii/S10918...