Social Issues
The Need for Accurate Diagnosis in Cases of Abusive Head Trauma
Opinion:
Accusations are often levelled at those who challenge the science behind Shaken Baby Syndrome (now known as Abusive Head Trauma). Those seeking to silence anyone who questions this orthodoxy often go well beyond name-calling including publication censorship, and legal and professional registration challenges.
I am compelled to take that risk, because thousands of innocent parents and caregivers throughout the world have been accused of abusing children, convicted and given long jail sentences or even sentenced to death, and thousands more have had their children removed from their care. This is based on the testimony of highly credentialled medical expert witnesses who believe in the Abusive Head Trauma (AHT) orthodoxy, but lack a scientific foundation for those beliefs. With the best of intentions, paediatricians have wrongly equated physical findings as evidence of child abuse, with devastating consequences.
Challenging the Scientific Validity of Abusive Head Trauma
An important new book, Shaken Baby Syndrome: Investigating the Abusive Head Trauma Controversy, seriously challenges the scientific validity of SBS. It reports that contrary to prevailing beliefs, the ‘triad’ of brain swelling, subdural haemorrhage, and retinal haemorrhage (often defined as AHT) is not diagnostic of child abuse, but results from hypoxia (lack of oxygen) in the brain.
A long and growing list of natural conditions such as various convulsive states – certain haemorrhagic diseases, infectious diseases, metabolic disorders, immunological diseases, skeletal diseases and vascular malformations – can all result in these hypoxic findings. So can non-abusive accidental factors such as short falls from a couch or bed.
Vigorous shaking should first cause damage to the neck or spine, but no neck injury is seen in cases defined as AHT. There are no documented, independently witnessed shaking events that have resulted in the findings associated with AHT either, and witnessed shaking events have never led to AHT-associated findings.
Scientific studies all report that shaking a baby generates biomechanical forces well below those considered necessary to cause the purported AHT injuries, and detailed microscopic studies of the brains of infants diagnosed with non-accidental injury find that the majority do not have torn nerve fibres (the assumed mechanism of brain damage in AHT cases), but predominantly have hypoxia – a failure of oxygen supply.
The Importance of Sustainable Development Goals (SDGs)
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Shaken Baby Syndrome provides careful, evidence-based analyses by 50 world-leading professionals from 16 different medical, scientific and legal disciplines from over 20 countries globally. It aims to pursue that truth, and challenge the orthodoxy. The book acknowledges that child abuse is a pervasive societal issue that has only recently received the consideration it deserves, and effective child protection systems are essential to detect and protect abused children.
Sometimes parents and caregivers do inflict intentional head trauma on infants and cause severe injuries. This book does not present the claim that violently shaking or abusing a child is safe. Abusive behaviours are dangerous and must be prevented, and perpetrators must be criminally prosecuted. However, Shaken Baby Syndrome should help courts make the best informed decisions in each case, by understanding the real state of current scientific knowledge regarding AHT and its limitations.
A Better Approach to Intervention in Cases of Suspected Child Abuse
I was invited to contribute a chapter on mandatory reporting of child maltreatment – that is, professionals working in health, educational, or social settings being mandated to report to authorities whenever they encounter a child they suspect may be abused or neglected. There is a call for mandatory reporting in New Zealand. However, in effect this is already in place as Te Whatu Ora has a Memorandum of Understanding with Oranga Tamariki and the police to report all children and young people admitted to hospital with suspected child abuse or neglect or both.
We could, and I would recommend, take a better approach to the way we intervene in cases of suspected child abuse. Nordic and northern European countries have family support-oriented child welfare systems. If child maltreatment is suspected, an investigation is not to determine whether an allegation is correct, but to examine family functioning, including parent-child interactions, and offer support to address issues rather than impose intrusive state intervention.
Social workers assess in relation to what might be expected to be a “good-enough” childhood or family life, rather than against gold-standard parenting. Open-care measures are prioritised, with provision of a wide range of psychosocial, financial, and practical supportive services. These flexible services are often embedded within, and normalised by, broad child welfare and public health services. Removal of children from their families is a last resort and mainly on a voluntary basis.
In contrast, New Zealand has a stand-alone, adversarial child protection-oriented service, demanding children are protected from harm that might be inflicted by parents and other relatives. Removal of children from their homes is seen to be warranted, as it is ‘better to be safe than sorry’. The implications of this are of particular concern where authorities too often leap to the conclusion that the presence of retinal and subdural haemorrhage and brain swelling is diagnostic of AHT.
The fact the parents deny the occurrence of any traumatic event is interpreted as giving a false history, and this is too often assumed as evidence that they cannot be trusted with the care of their children. Their denial means they present an ongoing risk, and removing children justified as a way
SDGs, Targets, and Indicators Analysis
1. Which SDGs are addressed or connected to the issues highlighted in the article?
- SDG 3: Good Health and Well-being
- SDG 5: Gender Equality
- SDG 10: Reduced Inequalities
- SDG 16: Peace, Justice, and Strong Institutions
The article discusses the issue of Abusive Head Trauma (Shaken Baby Syndrome) and its impact on innocent parents and caregivers who have been wrongly accused of child abuse. This issue is connected to SDG 3 as it addresses the need for good health and well-being, specifically in terms of ensuring accurate medical diagnoses and preventing false accusations. It is also connected to SDG 5 as it highlights the importance of gender equality in addressing child abuse cases. Additionally, SDG 10 is relevant as it emphasizes the need to reduce inequalities in accessing justice and protecting the rights of individuals. Finally, SDG 16 is connected as it focuses on promoting peace, justice, and strong institutions, which includes ensuring fair and evidence-based legal processes.
2. What specific targets under those SDGs can be identified based on the article’s content?
- Target 3.8: Achieve universal health coverage, including access to quality essential healthcare services
- Target 5.2: Eliminate all forms of violence against all women and girls in public and private spheres
- Target 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion, or economic or other status
- Target 16.3: Promote the rule of law at the national and international levels and ensure equal access to justice for all
Based on the article’s content, the following targets can be identified. Target 3.8 is relevant as it emphasizes the need for universal health coverage and access to quality healthcare services, which includes accurate medical diagnoses. Target 5.2 is applicable as it aims to eliminate all forms of violence against women and girls, including addressing false accusations of child abuse. Target 10.2 is relevant as it focuses on promoting social, economic, and political inclusion for all individuals, regardless of their status, which includes protecting innocent parents and caregivers from false accusations. Target 16.3 is connected as it highlights the importance of promoting the rule of law and ensuring equal access to justice for all individuals involved in child abuse cases.
3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?
- Indicator: Number of cases where medical diagnoses are based on scientific evidence rather than assumptions
- Indicator: Number of false accusations of child abuse reported and resolved
- Indicator: Proportion of innocent parents and caregivers who have access to legal support and fair legal processes
- Indicator: Number of cases where alternative explanations for brain swelling and other symptoms are thoroughly investigated
The article does not explicitly mention specific indicators, but based on the issues discussed, the following indicators can be used to measure progress towards the identified targets. The first indicator measures the number of cases where medical diagnoses are based on scientific evidence rather than assumptions, ensuring accurate diagnoses and preventing false accusations. The second indicator measures the number of false accusations of child abuse reported and resolved, indicating progress in addressing this issue. The third indicator measures the proportion of innocent parents and caregivers who have access to legal support and fair legal processes, ensuring equal access to justice. The fourth indicator measures the number of cases where alternative explanations for brain swelling and other symptoms are thoroughly investigated, promoting a comprehensive understanding of the causes of these symptoms.
4. Table: SDGs, Targets, and Indicators
| SDGs | Targets | Indicators |
|---|---|---|
| SDG 3: Good Health and Well-being | Target 3.8: Achieve universal health coverage, including access to quality essential healthcare services | Indicator: Number of cases where medical diagnoses are based on scientific evidence rather than assumptions |
| SDG 5: Gender Equality | Target 5.2: Eliminate all forms of violence against all women and girls in public and private spheres | Indicator: Number of false accusations of child abuse reported and resolved |
| SDG 10: Reduced Inequalities | Target 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion, or economic or other status | Indicator: Proportion of innocent parents and caregivers who have access to legal support and fair legal processes |
| SDG 16: Peace, Justice, and Strong Institutions | Target 16.3: Promote the rule of law at the national and international levels and ensure equal access to justice for all | Indicator: Number of cases where alternative explanations for brain swelling and other symptoms are thoroughly investigated |
Behold! This splendid article springs forth from the wellspring of knowledge, shaped by a wondrous proprietary AI technology that delved into a vast ocean of data, illuminating the path towards the Sustainable Development Goals. Remember that all rights are reserved by SDG Investors LLC, empowering us to champion progress together.
Source: newsroom.co.nz
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