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Hullabaloo


Wednesday, January 22, 2014

 
The perils of pathology

by digby

I think that in this age of CSI and Law and Order we think that science has advanced to the point at which it can answer all of our questions about how a crime may have been perpetrated and by whom. Not so fast:
Pediatric neurosurgeon Dr. Norman Guthkelch had wondered about a medical mystery reported for decades — some babies bleeding atop their brains, despite little outside evidence of head trauma.

When a colleague suffered similar bleeding after riding a roller coaster, Guthkelch suggested whiplash-type injuries were to blame. He published a paper in 1971, warning parents about the dangers of shaking their children.

In the years that followed, shaken-baby syndrome became widely accepted in the medical community, diagnosed through a triad of symptoms: subdural bleeding (blood collecting between the brain and the skull), retinal bleeding (bleeding in the back of the eye) and brain swelling.

Courts recognized the syndrome, and the triad became proof of fatal abuse — "a medical diagnosis for murder," said Deborah Tuerkheimer, author of the new book, "Flawed Convictions: 'Shaken Baby Syndrome' and the Inertia of Injustice."

In 1987, public questions began to arise when biochemical engineers from Penn State University found shaking alone failed to cause the blood vessels in the brain to rupture. It was only when the head made impact that researchers observed bleeding in the brain.

Despite the findings, shaken-baby syndrome continued to be diagnosed and used to prosecute.

In 1995, prosecutors in Wisconsin charged caregiver Audrey Edmunds with murder, concluding she had shaken 7-month-old Natalie Beard to death — despite no witnesses and no outside evidence of trauma.

The jury convicted Edmunds, who insisted on her innocence, but had no explanation for the injuries. The judge sentenced her to 18 years in prison.

In the years since, medical belief that the shaken-baby syndrome's triad of symptoms provided ironclad proof of homicide has begun to crumble with several studies raising doubts. Some biomechanical studies suggest shaking a baby to death would be impossible without also injuring the child's neck or spine

In 2008, the Wisconsin Supreme Court granted Edmunds a new trial. The emergence of a "significant dispute within the medical community as to the cause of those injuries … constitutes newly discovered evidence," the court concluded.

Her previous trial and hearing lacked "fierce debate," justices wrote. "Now, a jury would be faced with competing credible medical opinions in determining whether there is a reasonable doubt as to (her) guilt."

After the Wisconsin court's decision, prosecutors dismissed the charges against Edmunds, and the mother of three walked free after 11 years in prison.

Mississippi Democratic state Rep. Kevin Horan said he would like to see a review of the cases in this state that have relied on shaken-baby syndrome.

Horan, a former prosecutor who handled the appeal of a man convicted in a shaken-baby case, said, "Most of the shaken-baby cases are legitimate. They're not really shaken baby, but blunt force trauma."

As for Guthkelch, the pioneer of the shaken-baby syndrome, he now has doubts about the way his theory is being used.

He told the Medill Justice Center that he regrets writing his 1971 paper "because people are in jail on the basis of what they claim is my paper, when in fact it is nothing like it."

As it turns out, what we were told was "shaken baby syndrome" --- the consequence of irrational anger at a helpless infant --- is far more likely to have been caused by trauma. That could be the result of irrational anger at an infant, but it can also be the result of an accidental short fall or bump on the head, something for which there is no intent to hurt or cause harm and could easily happen to anyone. A tragedy, not a crime.

There are a bunch of people in jail, some of them like the one discussed in the article who are facing the death penalty. Some prosecutors will, as usual, never give up the idea that they've caught an evil person doing an evil thing and will defend their convictions to the end. But every one of those cases should be revisited and convictions overturned if they were based on this faulty scientific theory. That's what science calls for and it's certainly what justice calls for.

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