Monday, February 7, 2011

what was the cause?

http://www.nytimes.com/2011/02/06/magazine/06baby-t.html?nl=todaysheadlines&emc=tha210

"Shaken-baby cases are haunted by the enormous repercussions of getting it wrong — the conviction of innocent adults, on the one hand, and on the other, the danger to children of missing serious abuse."
My friend F—pointed out that this article mentions some experiments that seem very similar to the research that I’ve done in the Injury and Orthopedics lab, albeit, not with live models (though honestly, I think that was in the works – pigs, ferrets). We did model brains using gelatin, and also tested brains of different species and measure acceleration and pressure, as well subjected different kinds of brains to different amounts of indirect pressurized force/TBI.
-It is kind of horrible that 50 rhesus monkeys were severely hurt and used to give evidence that unexplained subdural bleeding in babies could occur without direct impact to the head and with or without a visible neck injury. Infant-sized dummies equipped with sensors to measure acceleration are also used. However, not much acceleration found.. then again, not an actual brain. In general, impact on brain tissue is still hard to model, as I know too.
-It is even more horrible hearing about the extreme detrimental effect shaking has on these infants.. a burden they will carry forever.
-I don’t think there was enough definitive evidence to convict these caretakers.. the infants could have been hurt for a myriad of other reasons. ex. Noah had a thrombosis — a blood clot within a blood vessel. Another possibility is meningitis.
-At the same time, scanning technology has made these convictions /seem/ more certain than before, and they certainly are more accurate. But can medical experts really say “only the caretaker’s violence could’ve caused these symptoms.” ?? --> later research: “observed a child with subdural and retinal bleeding who was lucid for a period between her brain injury and her collapse.”
-Witnesses and motives are often absent in these cases.. it is so hard to persecute these cases! Because the only evidence is medically-related, and that is more open to interpretation than previously thought! Especially with this condition.. there could be no apparent physical evidence, only internal.
-For the jury, it ultimately becomes a question of human nature: how likely is an adult with no history of wrongdoing to do terrible harm to a child by violently shaking it? To pediatricians like Leventhal and Christian, the sad answer, born of experience, is that such a lapse is all too possible. This is the most disturbing part for me, that people can suddenly snap like that!
-But.. people sometimes falsely admit to crimes because of police pressure or the promise of a plea bargain. And.. doctors are aggrandizing themselves and making a lot of money testifying (defense ones do for free often) Some witnesses on prosecution side are also paid! Jury should account for these possibilities.
-A juror found the medical testimony dense and confusing. “I think we needed 12 doctors on that jury,” she said. Should there be? Should it ultimately come down to science? Docs/scientists can be very stubborn and heavily biased.. one of the prosecuting docs admitted to not even knowing the evidence on the other side. Nah, I still think it’s good to have a thoughtful civilian jury.

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