Shaken Baby Syndrome, Abusive Head Trauma, and Actual Innocence: Getting It Right

Keith A. Findley

University of Wisconsin Law School

Patrick David Barnes

Stanford University - School of Medicine

David A. Moran

University of Michigan at Ann Arbor - The University of Michigan Law School

Waney Squier

John Radcliffe Hospital

April 30, 2012

Houston Journal of Health Law and Policy, Forthcoming
Univ. of Wisconsin Legal Studies Research Paper No. 1195

Abstract:     
In the past decade, the existence of shaken baby syndrome (SBS) has been called into serious question by biomechanical studies, the medical and legal literature, and the media. As a result of these questions, SBS has been renamed abusive head trauma (AHT). This is, however, primarily a terminological shift: like SBS, AHT refers to the two-part hypothesis that one can reliably diagnose shaking or abuse from three internal findings (subdural hemorrhage, retinal hemorrhage and encephalopathy) and that one can identify the perpetrator based on the onset of symptoms. Over the past decade, we have learned that this hypothesis fits poorly with the anatomy and physiology of the infant brain, that there are many natural and accidental causes for these findings, and that the onset of symptoms does not reliably indicate timing. In the last issue of this journal, Dr. Sandeep Narang marshaled the arguments and evidence that he believes support the diagnostic specificity of the medical signs that are used to diagnose SBS/AHT. Dr. Narang does not dispute the alternative diagnoses but nonetheless argues that, in the absence of a proven alternative, the SBS/AHT hypothesis is sufficiently reliable to support criminal convictions. The cited studies do not, however, support this position since they assume the validity of the hypothesis without examining it and classify cases accordingly, often without considering alternative diagnoses. To address this problem, Dr. Narang argues that, in diagnosing SBS/AHT, we should rely on the judgment of child abuse pediatricians and other clinicians who endorse the hypothesis. Reliance on groups that endorse a particular hypothesis is, however, antithetical to evidence-based medicine and Daubert, which require an objective assessment of the scientific evidence. In the past decades, thousands of parents and caretakers have been accused "and many convicted" of abusing children based on a hypothesis that is not scientifically supported. While we must do everything in our power to protect children, we must refrain from invoking abuse as a default diagnosis for medical findings that are complex, poorly understood and have a wide range of causes, some doubtlessly yet unknown. To this end, we are calling for collaboration between the medical and legal communities for the sole purpose of "getting it right."

Number of Pages in PDF File: 80
Keywords: SBS, Shaken Baby Syndrome, AHT, Abusive Head Trauma, Daubert, innocence, wrongful conviction, medical evidence
Accepted Paper Series Download This Paper

Date posted: April 30, 2012  

Suggested Citation

Findley, Keith A., Barnes, Patrick David, Moran, David A. and Squier, Waney, Shaken Baby Syndrome, Abusive Head Trauma, and Actual Innocence: Getting It Right (April 30, 2012). Houston Journal of Health Law and Policy, Forthcoming; Univ. of Wisconsin Legal Studies Research Paper No. 1195. Available at SSRN: http://ssrn.com/abstract=2048374

Contact Information

Keith A. Findley (Contact Author) University of Wisconsin Law School ( email ) 975 Bascom Mall Madison, WI 53706 United States 608-262-4763 (Phone) 608-263-3380 (Fax) HOME PAGE: http://www.law.wisc.edu/facstaff/biog.php?iID=269
Patrick David Barnes Stanford University - School of Medicine ( email ) Stanford, CA 94305 United States
David A. Moran University of Michigan at Ann Arbor - The University of Michigan Law School ( email ) 625 South State Street Ann Arbor, MI 48109-1215 United States
Waney Squier John Radcliffe Hospital ( email ) Oxford, Oxfordshire, England United Kingdom