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.
> 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’!
This is just speculation, but I bet those groups (or their members) aren't always calmly and coolly trying to find the best policies protect the welfare of children. Instead they feel themselves on a kind of righteous moral crusade, and what's more heroic than swooping in to take the child away from the clutches of the villain? The feelings of heroism could obscure understanding the harm the "heroic act" could cause.
There's another factor in this, which makes it hard to change:
For the people in child welfare organizations, for social workers, for doctors, for police, for judges to change their mind about current and future decisions requires them to change their mind about past decisions. The necessary implication is that many of the people they have persecuted in the past were, in fact, innocent. It requires them to admit that they personally have likely caused untold suffering to parents, caretakers, and children.
This is hard for anyone; but if you've lived your life trying to be the hero, feeling good about swooping in and rescuing children from the clutches of evil villains, how can you face the fact that you are the evil villain in so many children's stories?
You might call this the Paradox of Judgment: If you don't say that something is that bad, then lots of people don't think it's a big deal and don't do anything about it. But if you do say that something is really bad, then there develop all these pathologies of denialism around it.
> they feel themselves on a kind of righteous moral crusade
They see a lot of bad stuff which causes them to have a difficult time admitting that sometimes bad stuff just happens on it's own
Reminds me of the police/detectives that "just know he did it" because they don't understand that people grieve differently. I really empathize with the people that don't have a meltdown and cry when they hear some horrific news. I don't think I would either in many cases. I'd want the cops to do their job and go find the perp so I'd talk to them in a calm and concise manner telling them what I knew; even though that's likely highly suspicious behavior.
I work in child welfare in Australia. Not sure how it compares to the models in other countries, but we desperately try not to remove child from their families. There is very little evidence to support it improves outcomes for those children, and the removing itself is highly horrific for everyone involved. Even in the instances we remove children, we actively attempt to work with the parents to address the issue. We are also beholden to the Courts to justify our decision making.
The harm we cause is better explained by systematic reasons (workload, case complexity, red tape, worker burnout and apathy, racism)
This is true, but not for the reasons you might expect. Well, 10% of the time this is the case, but 90% ...
Mostly they are operating on priors. The prior probability of a separation being the right thing to do is very high, because they have a _long list of mitigation before they actually can take a kid away. In the case of a doctor-approved immediate physical danger, they are regulated into acting on behalf of the immediate safety of the child while the investigation is ongoing but even that is considered temporary.
The goal of any foster care situation is to get the kids back with the biological parents, so time is on their side, provided they are not living in a circumstance that disallows the kind of attendance and involvement that the state would require to clear a caseworker to re-unite the family. Sadly, many are.
That is a point - and also, while I'm sure many are just misguided, and I generally don't want to assume malice when ignorance is a more likely cause, it is certainly interesting that some high-profile people on these 'heroic moral crusades' do then seem to get caught up in sexual misconduct scandals of their own surprisingly frequently...
Exactly. I met many people like this. The notion of groupthink comes to mind: "Unquestioned belief in the morality of the group, causing members to ignore the consequences of their actions."
This always seems to happen to activist groups. They start mistaking their intermediate goals for ‘the cause’ and next thing you know, they’re actively fighting against solutions to their alleged issues because those solutions would impact their self-selected KPIs.
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.
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.
My sense is it's important to keep in back-of-mind that there is a massive selection effect involved in terms of which people chose to enter these fields and what sorts of personal life events (trauma, abuse, witnessing of abuse etc) motives choosing to make this a career. These are not well-paid careers (nor are they high-status) so money and status are typically not motivations (in fact a relative of an in-law works in a closely-related field and we talk at Thanksgiving-type family events about work and their employers often seem to me to be exploiting their investment in the field). I think it's why it can be so difficult to discuss it with them, it is deeply personal and they feel the "system" failed in the past and they want it fixed.
Anyway, it's not meant as an ad hom, but it helps to step back and think why people are involved with certain roles.
To be clear: here the author only bothered look with his well-trained eyes because he was sucked in after the law intruded into his life. It's easy to assume that everyone is highly-skilled. But... highly-skilled people don't usually choose to work for peanuts without other reasons. Fields like this are neglected.
It seems like there is still significant disagreement with this guy's argument in "the science", at least as best as any individual child welfare employee would understand it. There are no doubt specialist doctors, general practitioners, etc. telling the child welfare folks that it's as clear cut a diagnosis as you could get.
The fact of the matter is, the article here is a brief overview describing none of the actual scientific literature at a level that should be convincing to a medical practitioner. But you read it and are apparently convinced of the author's point. So, a layperson (I assume, in your case) is presented with some well-written evidence from an authoritative perspective, alongside broad contours of the actual medical evidence but no details, and is convinced that it's true. Is it so hard to believe that a child welfare worker would be equally convinced under the same circumstances when talking to a doctor, neurologist, trauma surgeon, etc. who believes the opposite as this author?
The “passion” goes beyond this specific issue. Child abuse specialist doctors have come to some sketchy conclusions, only to have the system cover for them.
Part of the issue is they exist in several systems simultaneously: medical system, child-welfare system, and criminal justice system.
Are they there to cure disease, ensure the child had a safe home environment, or put an abuser in prison. Answer: all of the above.
There's a bias in favor of action, especially among the social workers that I have known. The worst possible sin is to do nothing at all.
In cases like this, in the moment, it may be impossible to tell what is actually best for the child. Since removing the child is a form of remediation, it can easily seem to be less harmful than leaving them in a situation that might be actively harming them.
> 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!
Everyone cares about kids, so THINK OF THE CHILDREN is an easy way to both create false urgency to cover totalitarianism and also an excellent shame-generator to suppress protest. C.f. "Drag shows"; "digital privacy"
It's part of the contract cult mechanism. Human tribes for a early version of law by forming contract cults aka religions. For that sexual deviants are hearded into a group to which the family is then ritualistically exposed as a sort of hostage situation that upholds basic providing and welfare contracts. The hysteria is a social fitness signal: "I'm reliably retarded and can be used as a social building block". This is pretty cultural universal, though the cultural baggage with the contact cult may produce different outcomes.
This concept of "the science" we've converged on a culture really doesn't make a ton of sense. What does it mean to say "the science" is against a position that many relevant experts hold? To the extent that there is such a thing as "the science", the book the author is advertising (https://shakenbaby.science/) is pretty frank that its goal is to argue against it: there's a traditional medical consensus in favor of SBS/AHT, but it's become more controversial, and if you read this book you too will be convinced that it's wrong.
1. Premise: Organizations always try to stay alive.
2. To stay alive you have to be active and doing things which is rewarded by future money.
3. If your organizational role is "protect children" but who's functional mechanism is to take them away will look for ways to do that.
Similar things happen when policing seems to go awry, if they confuse "protect the public" (goal) with "arrest people for stuff" (doing something)
I have some inside information on how this plays out in Ontario, Canada, at least. One of my family members was a lawyer for the regional Children's Aid, and I worked for him for a few years. Another family member was a child protection social worker for two decades, but retired early because they felt the organization didn't prioritize the welfare of children (as is their mandate) but rather the needs of the organization or (perhaps more realistically) the needs of their own careers.
MANY social workers feel this way. They got into the field out of a genuine concern for the well-being of the most vulnerable members of our society, and instead found themselves dealing with politics (both real and office).
I'm not sure how it is in other countries, but in my region, they actually appoint a lawyer for the child. This is great, but it also tells you a lot about what everyone else's priorities are that children need their own lawyers:
(1) Parents want their kids back, of course. Not all parents are fit to get them back. But their lawyers fight for the return of their kids regardless of circumstances or reasons for their removal.
(2) Child protection agencies are under constant attack, so at the executive level, they lose sight of the individual kids and are instead worried about the needs of the organization and public relations.
(3) The social workers themselves are handcuffed to do anything about it and have to follow procedure, even if they can see it plainly that the procedure is not in the best interests of the child.
(4) Police want nothing to do with any of it and are quick to wash their hands of these situations.
(5) The children's lawyer somehow has to represent the needs of the child, which may place them at odds with their own clients (the kids).
(6) Activist groups will generally support the parents blindly, because by law, for the privacy of the children, the only parties listed above who can publicly speak about any given case are the parents themselves. So you can only ever hear one side of the argument. That's right: If a father, for example, sexually abuses his kids and as a result has them removed, he's free to say just about anything he likes about the matter, without ever acknowledging that he's a child molester. The other parties can't say a thing about this.
As a result, it's impossible, as a member of the public, to ever know whether it was appropriate or not that the children were removed from the care of their parents. I happen to know, from first-hand experience, that it's a mixed bag: Some parents shouldn't be allowed anywhere near any child ever, much less their own. Others are victims of a system gone haywire. And we, the concerned public, can't have an informed discussion about any of it.
All in all, it transforms child protection into a game of who-has-the-best-lawyers rather than trying to do what's right for the kids. Is it any wonder so many kids end up traumatized by this system?
>I really do wonder if it’s cultural or some kind of innate psychological irrarionality that seems stronger in some than others.
CPS is a human organization. There are no algorithms and the guidelines rarely perfectly fit the situation a case worker is given. Keep this in mind. CPS is horrifically under funded meaning that intelligent and competent staff readily leave the field for better paying gigs.
The biggest problem I see with foster care at large is the rampant classism, sexism, racism, and other isms. The providers tend to be solidly middle class degree bearing people who have no personal connection to primary instigating factors of foster care involvement. Namely and typically presenting cross generationally: poverty, crimes of despair or desperation, and trauma whether that be internal or external to the family unit or community such as neighborhood violence, caregiver assault, or tragic loss.
It easy for providers to casually profile incoming children and their families as poor uneducated violent predacious drug dealing junkies. Providers are given extreme control over the entire family and their extended relations and use this power to coerce whatever behavior they desire out of the people. If the provider dislikes the family they have a lot of tools to inflict suffering on them and oppositely they have a lot of tools to assist families and keep them together.
Honestly, the entire system is such a god damn mess that it should be rebuilt with the same level of distrust of staff that they can exercise against families.
Perhaps the most pressing single metric to focus may be the foster to prison pipeline.
Sorry for the meandering post, bookcases could be filled with anecdotes and descriptions of the flaws in these systems. In general, I think the failure of child protection agencies reflects the decay in America at large. I could point to stuff like broken family units or loss of religions community but I’m not dog whistling here. Stable healthy nurturing familial units of any relation are obviously better but man in the house rules and other racist/classist measures caused more harm. I’m also vehemently opposed to all major organized religions that are regularly used to justify war and protect child sex predators. Perhaps the collapse of American industry and slow erosion of social safety nets has hastened the social collapse. Perhaps the internet had instigated the collapse of communal organizations. Perhaps winner take all government enforced monopoly capitalism is the cause. Perhaps it was the theft of 50,000,000,000.00 from the bottom 99 by the 1% that lead to this. Regardless, the solution is not going to be found in rebuilding foster care when our social fabric is rotten.
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.
The ironic thing here is that these sorts of innocuous bumps and minor traumas regularly lead to severe medical complications and deaths in older children & adults, too. The only difference here is that babies & toddlers are too young to be able to verbalize and advocate for themselves in ways that most adults recognize & respect.
Since having a kid and reading a lot I've been bothered by how clearly a lot of what is labeled as "SIDS" is pretty clearly accidental suffocation. The conclusion is impossible to escape when you begin reading about measures that have "reduced SIDS." Yet I also wonder if continuing to observe this social fiction is just a way of keeping overzealous prosecutors and other crusaders from locking up and treating as depraved murderers grieving families for accidental deaths.
Not an expert but it seems to me you'd be making the same kind of error that the article denounces: attaching equal value to direct evidence on the one hand and inference to the best explanation on the other. If a physician does not observe tell-tale signs of suffocation in an infant, then it is not their role to say "Well, statistically speaking, or logically speaking, pretty good chance it's accidental suffocation isn't it? I'll jot this down as Accidental Suffocation Syndrome" or alternatively "I know in my heart that this is accidental suffocation but let's just call it SIDS for the benefit of the parents" but rather they should simply conclude "there's not enough evidence, therefore this death remains unexplained".
I wish, unfortunately I'm not a criminal defense lawyer nor a medical doctor! And I don't intend to be one anytime soon. ;)
I think the most productive thing I can at least try to do is to raise awareness among lawyers, doctors, and all professionals involved. No one has the time to dig into it as much as I did, but perhaps I can organize and present our current knowledge as clearly as possible. The book is one little step in this direction.
Similar case in Denmark/Romania where a baby was taken from his romanian parents because of the shaken baby syndrome, parents spent time in jail, but the hemorage continued over time so they had to concede it wasn't the shaken baby syndromd.
The trouble is: shaken baby syndrome is real and well documented. Because the crime is so abhorrent, people strongly want to believe the diagnostic tools to be much more sensitive and accurate than they really seem to be.
It's the classic "N guilty men" problem, aka Blackstone's ratio: if you risk putting one innocent person in jail, how many guilty people you need to catch to make it morally justifiable? 5, 10? 100?
You have to pick a number, or else no kind of criminal justice can exist.
That's the whole point here, isn't it: that 'what you've heard' isn't credible at all. There is no 'polite fiction' here, what there is is people looking for culprits when there are none. Does that meant that all such cases are accidents? No, because we know for a fact that some people really do hurt infants for whatever reason. But the evidence is apparently such that a large fraction of the cases that were thought to be criminal in actuality were not. So don't go on rumors or polite fictions when lives are at stake. Do the legwork before ruining people's lives.
This article is entirely about debunking rumors and looking at actual scientific evidence to correct people's misconceptions -- misconceptions among doctors and law enforcement that have ruined people's lives.
So please don't bring "rumors" into a discussion here. That's exactly the kind of harmful behavior the article is trying to fight against.
> 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.
> [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.
If you read the rest of the article, you will realize that this was the absolute happy path in that kind of situation. That's the real horror story: that the default path involves stuff like losing custody forever, incarceration, suicide, divorce etc.
Yes, after discovering hundreds of families living much worse situations, I consider myself as one of the lucky few. I'm grateful for that and this is why I can spend so much energy ensuring it doesn't affect too many other families in the future.
Something similar happened recently in Massachusetts with a doctor seeing an injury the parents couldn't explain and the kid being taken away for a while. Injury turned out to probably have been done by the grandparents who never told the parents because the kid didn't fuss, but the kids were taken away in the middle of the night.
My first inclination here is to blame the doctor. Per the Hippocratic Oath, doctors need to understand the implications of making reports like this and only do so in cases where there isn't reasonable doubt or plausible explanations other than abuse. Separating children from parents and making accusations like this is extremely traumatic in itself, so the evidence bar needs to be very high.
Even if the rules tell doctors that they need to make a report in a given scenario, they should not be following the rules when they know the bureaucracies that handle these reports are dysfunctional and prone to separating children without conclusive evidence. Imo they are responsible for protecting their patients from the system in these cases.
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.
reason.com has an entire long-running series of stories like this happening in the U.S. I've heard quite a few stories from the Netherlands. It probably happens in other countries as well.
It's an issue in many Western countries, where we've seemingly become risk-averse to the point where it's causing more harm than good.
What's the outcome for the kid? Can the system even do much to help with the child's medical condition? If not, it's irrational for people to take their children in for examination; there's no benefit and you risk being accused.
He underwent surgery to remove the excess of fluid around the brain, and his condition progressively improved. It could have worsened without the operation, we'll never know. Now, at almost 8, he's doing great.
I've seen cases where parents call the ER after a collapse of their child, only to see their child wake up just fine a few minutes later. The EMT tells them it's not necessary to bring their child to the hospital given the child has recovered, but the parents insist. At the hospital, sometimes they have to insist too for a CT scan to be performed. This is where doctors find subdural bleeding and the parents end up accused, the child is removed for months, etc. Yet, the child gets no particular medical treatment. None of this would have occurred if the parents hadn't insisted!
Parents only know symptoms, which could be anything. Those same symptoms (or small variations) can lead to a very different diagnosis which is easily treatable.
> 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.
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.
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.
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.
I'm starting to see AI studies on the medical detection of child abuse, which unfortunately reproduce the same biases as the low-quality clinical data they are based on. An AI that would detect subdural and retinal hemorrhage without external signs of trauma with 99% accuracy would detect "child abuse with 99% accuracy" and would impress law enforcement and courts. However, it wouldn't be more reliable than an expert witness confidently asserting that these signs are almost always due to child abuse.
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
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".
(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.
Current AI is deeply rooted in probability and statistics, so it would actually increase the use of statistics.
I'm not saying a false positive or a false negative cannot happen. I am saying that we would have better estimates of both, according to probability theory.
Also: false positives and false negatives are basically impossible to prevent, for a sufficient small margin of error. And that's science.
> Basically, you want to replace statistics ("large enough samples will average out variation") with AI
No. This is misunderstanding due to my lack of clarity. Apologizes.
The biggest problems with Medical data is that 1) incredibly small scale data is collected to make assertions, 2) the data is horrendously de-normalized
In Radiology, a common validation approach is have radiologists review cases on the order of 250 studies to make assessments about a radiology product. This is considered the gold standard for FDA. Look into it more, vaccines, treatments. The sample sizes are fucking tiny.
The statistical assertion is that these relatively small samples capture the variation sufficiently to demonstrate efficacy across devices, treatments. These are then extrapolated to the US and wider populations. Do you believe that this is rigorously true?
The rationale underpinning this is simply practicality. You cannot get thousands (or hundreds of thousands) of patients/doctors/etc to get a strong signal and confidence. For drugs, it's super hard, but for devices and software interventions, it way easier to get data.
That brings us to the second big problem: the data structure is completely highly varied and denormalized.
1) From a pure structure point of view, it's basically free text fields that doctors sporadically fill.
2) From a underlying truth point of view, each hospital across the world has different protocols for care delivery. A histopathological FNA procedure might have a completely different meaning in CA, NY, or EU. This might simply be because of workflow, timeline, or just people using the words wrong.
What I mean with AI+Sensors:
AI doesn't need to solve the problem of intuition around medical problems. The biggest impact will likely come from the relatively mundane task of simply structuring and normalizing the data. Sensors simply help to generate more data
To be more concrete, you don't want (and shouldn't trust) this:
Prompt: "Please diagnose this person"
You want this:
Prompt: "Here is 100 TB of data from 100 different hospitals each with different workflows and patients for histopathology. For each patient, synthesize a CSV with the following schema "AnonPatientID, AnonCaseID, Pathology Result, Pathology stage, Incidenctal findings, ..."
Then I can do the analysis myself.
Hope this makes more sense.
(I work in healthtech and med device and I promise you: Demoralization at the state of medicine is a rite of passage after which you can begin to address practical problems)
Your narrative reverses the roles a bit. The lawyers appear as the heroes in this particular story and the villains are all associated with the hospital -- either in the form of people or bureaucratic red tape, depending on how generous you want to be in your analysis.
> The doctors at the hospital were absolutely, unconditionally 100% certain that no other cause than violent shaking could ever explain blood around the brain and at the back of the eyes.
> As a precautionary measure, the hospital followed mandatory reporting statutes and my wife and I temporarily lost custody of David.
> 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.
> 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.
> Every case requires years of intense, dedicated efforts by an entire team of specialized lawyers and medical experts, but there are tens of thousands of cases and few experts willing to defend them.
Hospitals are definitely the weak link in this system. Just looking at the way the story is laid out, the solution is more lawyers and fewer, less expansive hospitals.
> - 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.
Well, this wouldn't even be that bad, if sample size were actually large enough.
No I think the point that was being made is that the "average person" idea is not that great if you have huge variance. If I have a uniform distribution from 0 to 1, average is '0.5', but its just as likely to get 0. or 1.
That's part of it. The sample size is usually super small.
Furthermore, there's the opportunity. With large amounts of data (from software, medical devices, sensors) we can actually tackle this problem at scale.
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.
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.
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.
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.
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.
Shane koyczan has a fantastic poem about a cute thing between him and his grandmother that turned into an abuse investigation. And then he was bullied because of it!
> 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.
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.
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.
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
AIUI tummy down on a (wakeful) person is generally not a concern nor what the "back is best" crowd is referring to
Obviously a parent who is spending nearly all their time with a newborn knows them best and is likely able to make the best judgement about what works for the child, but the purpose of the advice is to avoid a class of scenario that occur most often. due to issues that are very difficult to detect and often go completely undiagnosed, as they pertain to early development and often improve naturally over time.
The technical report by AAP the other year does an excellent job of presenting the current evidence in an as objective way as possible, I highly recommend it:
You will note that efforts are being made to disentangle diagnoses from the broad SIDS label and that while SIDS cases are trending downwards, it's likely due to both proper classification and education.
The point of preventative measures is to avoid the issue entirely. Sure, tummy sleeping might not be a problem for you (or maybe it was and you just got lucky!) but by generally recommending back sleeping, a class of issues is avoided.
So all in all, I really don't see this as bullshit at all. Caveat that you gotta do what you gotta do, but I'd rather this advice persist than not. We should hope that no one ever has to endure the loss of a child.
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.
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'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.
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.
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!
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.
> 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?
The problem is that the phrase "a valid concern" would lead me to think "something doctors and parents should consult on (also with the child themself!) and determine if there is cause for alarm, and if so decide collaboratively what the proper course of action is." Sure! Of course! That's what you do with valid health concerns, right?
What it actually means is "something for which social workers will decide whether to take your child away from you for". That's a pretty big escalation from a "valid concern", but one that happens if "the system" decides you are a target. "A valid concern" is in that case a code word for "credible presumptive evidence of child abuse". A child being underweight is a valid thing to be concerned about, it is not on it's own credible presumptive evidence of abusive parenting, no.
You are missing the part where I harmed his health to comply with their expectations. He was fine and does better on a high quality diet than on a junk food diet.
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?
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.
My kids love it when they come running toward me and I pick them up and in one swoop throw them on to my (big) bed. I'm always holding back because I see their head snap back to land on the mattress, it's that "violent" head-moving-back thing that gives me the fear, so I stopped.
A) No, but no one can tell that you’re a dog on the internet. Further, dogs do not dispense reliable medical advice. The op is a press release for a textbook covering this topic in what looks like excruciating detail from a wide variety of angles. I doubt a superior citation exists.
B) Beyond that, my understanding is that once a child is past the infant phase where they cannot support their own head, they’re fine. Humans are not all that delicate. Bumps and falls are inevitable, I don’t see how we would have seen success as a species if the risk were outsized. And I guess we’ve been around for a while by now.
C) TFA does mention this a little but it is split across a wide gap and is not the focus. I pulled the two quotes I think are relevant below.
> And yet, although subdural and retinal hemorrhage may be caused by non-accidental trauma, especially when impact is involved, they simply are not specific for it: indeed, it has been demonstrated that a wide range of accidental events and medical conditions are plausible alternative causes. Particularly fragile infants may sustain severe head injuries following minor household falls. Others may suffer from genetic conditions, metabolic disorders, blood clotting abnormalities, or infections.
> On the other hand, there exist dozens of documented cases of witness reports of shaking, videotaped shakings, and spontaneous admissions of shaking, but without subdural and retinal hemorrhage. In fact, there is virtually no known case of a reliably-documented event of violent shaking without impact of a healthy baby resulting in isolated subdural and retinal hemorrhage (additional markers of trauma would be expected in such cases). In contrast, there have been numerous cases of videotaped or witnessed short falls resulting in these very medical findings, considered “impossible” by the shaking hypothesis.
So it’s like they say: it’s not the fall that gets you, it’s when you land.
I don't think you should worry too much. Abusive shaking really involves extreme forces. "Routine shaking" occurring during play is not expected to be harmful to healthy children. Games should be adapted to the age of children according to common sense.
The takeaway of biomechanics studies is basically that you should be much more careful about accidental head impacts on hard surfaces.
The article as I interpreted says that there is no recorded case where you can get shaken baby syndrome and the sharking was recorded on tape or declared in front of the police, that being said, if your child has some pathology, they might be at risk with even a minor fall
re: the bouncy houses and such. Other than kids banging into each other, this never seemed like much of a head or brain injury risk. But watch out for knees! Trampolines with more than one person on them are incredibly dangerous, and bouncy houses seem likely to be pretty dangerous with occupants of widely varying sizes. The specific issue is that the floor may move abruptly and unexpectedly when someone is trying to land, causing a potentially severe knee injury.
If you’re in a bouncy house with kids, consider avoiding any bouncing yourself.
It is pretty hard for such injuries to occur with the level of movement you're taking about, especially with a child old enough to support their own head. I don't think you need to worry.
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.
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.
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.
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.
I mean.. sure. But if you shoot a baby it will also harmed. Or stomp on it, or set fire to it.
So, why is this video specifically about shaking? Because of this very specific and narrow conspiracy theory that takes children away from their parents.
“ 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
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.
"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.
> 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.
> 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
The article seems to be dedicated to precisely the opposite conclusion. The author's contention would seem to be that in cases of shaking there is other trauma that doesn't fit the "shaken baby syndrome" theory.
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?
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.
You must have skimmed the article because it said over and over that it was basically impossible to definitively identify that a baby was shaken. It's a diagnosis they use when they're not sure.
> 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.
Yes, as others have said. However, this is a legitimate question, because in these specific cases, the burden of proof tends to be on the side of the defendant who needs to prove they didn't harm their child. That's obviously impossible, and probably unconstitutional.
When medical experts claim they're 100% confident that this child was violently shaken at this specific time, and that you were the only person with the child at that time, how can you defend yourself when you haven't done anything? There's nothing you could ever do to convince courts that your word has more value than the confidence of highly reputable experts with decades of experience.
This is an instance where the prosecution's case relies on the confidence in medical authorities, and where it is extremely hard to challenge it as the subject is so difficult on a scientific and technical level. In the US and other adversarial jurisdictions, you see an incredible level of technicality during oral debates, with extensive and long-running discussions around extremely obscure points related to the anatomy, physiology, and pathology of the infant nervous system in highly specific pathological situations, where infants frequently suffer from multiple rare medical conditions or risk factors. Few people in the world have the required expertise, and even fewer accept to testify in courts! There's also an obvious financial imbalance between the State and the defendant.
In inquisitorial jurisdictions like France, this is even worse as there's basically no system in place to challenge the views of the State's experts.
So, yes, litigating these cases is extraordinarily challenging because the only way to prove the defendant's innocence is to challenge the opinion of overly assertive medical experts by digging into highly difficult (and multidisciplinary) science.
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.
There are complications when immediate danger needs to be avoided. E.g., the system prefers to take away children preventively in serious cases rather than leaving them in a dangerous environment. Which is sometimes justified, and sometimes not. The idea in this case is that it is easier to correct a mistake by restoring custody than by reviving a dead child.
A bit like temporary restraining orders pending trial in the US.
> 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.
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.
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.
> . 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.
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
I think it's both funny and sad that you're doing the exact same thing as the "bad" doctors in TFA and then are on here commenting about it. A quick search on Google Scholar for "caffeine pregnancy" reveals a number of studies that show a non-trivial link in humans to increased miscarriage chances, at levels of consumption that realistically occur with heavy coffee drinkers. I.e. your conclusion is not so clear-cut and is based on one (admittedly bad science) thing you read. Example [1][2]
I don't think that's fair toward me: the bad doctors never told me "do your research, form your opinion". They were always clear cut, they looked up on us for sleeping with our children and they "checked" the breastfeeding checkmark at the hospital even if my wife lamented pain during it and turned out my daughter had a really bad lip/tongue tie that took a month to be solved (with surgery).
Notice that medical personnel even told her "you have to endure it, it's normal", as her breasts were cracking and she couldn't breastfeed anymore (had to pump).
I explicitly said, do your research at the end of the message.
P. S.
The book might have been one of the following, I can't remember:
Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong--and What You Really Need to Know (The ParentData Series Book 1) from Emily Oyster
What to expect when you are expecting
I think it's the first one. I read many at the same time, so it's hard to remember which one had the information.
The problem that became very salient to me dealing with miscarriage is that women who have healthy pregnancies are also more likely to have problems with morning sickness, and are more likely to avoid things like coffee that are likely to make them feel even more nauseous. Women who have troubled pregnancies that are more likely to end in miscarriage are less likely to feel nauseous and therefore continue to drink and eat things as before.
So it's possible caffeine consumption is a sign of a troubled pregnancy rather than a cause of it. I'm sure there's a point where caffeine becomes problematic but that could be said of a lot of things.
There's a paper in NEJM or JAMA that pointed to this as a likely explanation but it's been a few years and don't have time to look for it now. I think they were looking at timing of caffeine consumption and nausea symptoms?
>The results of this literature review suggest that heavy caffeine use (≥ 300 mg per day) during pregnancy is associated with small reductions in infant birth weight that may be especially detrimental to premature or low-birth-weight infants. Some researchers also document an increased risk of spontaneous abortion associated with caffeine consumption prior to and during pregnancy. However, overwhelming evidence indicates that caffeine is not a human teratogen, and that caffeine appears to have no effect on preterm labor and delivery.
> 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.
Honestly I don't know which study you're talking about, and I'm not trying to question what you're saying (such studies indeed often use exaggerated amounts because it's more likely to show effects, but it can skew the results of course) but I just found it interesting that depending on what "feeding them coffee in the amount of 3/4 of their body weight" means, well over a pregnancy it's easy to consume 3/4 of one's body weight in coffee.
It means about 150 mL coffee per day for a woman weighing 55 kg, over 9 months.
About SIDS and sleeping with the children in the same bed, if I remember correctly (it's been some time since I had to read about this) the very large majority of cases happened with parents who either smoke or are obese. I think I couldn't find precise stats just for non-smoking, non-obese parents but it seems like SIDS basically didn't happen in this case when co-sleeping. It also almost never happens with immigrant parents for some reason (even though they are statistically more likely to practice co-sleeping, here in Europe).
I'm a light sleeper and I feel like I have an awareness of everything nearby when I'm asleep (like I used to fall asleep with an open laptop in bed during college without knocking into it). I have a feeling co-sleeping wouldn't be an issue for me, but with all the dire warnings I'm afraid to risk it.
You should see how the second hand smoke studies upon which all other second hand smoke studies were based were done - very similar methodology - cotton swabs were saturated with combustion residues from hundreds of cigarettes, making them into tarry masses, which were then applied to 100% of the bodies of infant rats, every day for several weeks - and they were then observed for developmental abnormalities. The discussion then explicitly states that this should not be taken as a human analogue, as the rats were seen to lick the residue off their bodies, thus consuming all of it, and that further research would be needed.
Further research was of course done - on rats - with much the same methodology.
Medicine is really prone to falling for this sort of thing - and it’s honestly no great shock, recalling the calibre of people at school who went on to become doctors. I studied physics, for Christ’s sake, and knew more about metabolic pathways than third year med students who I would help cram.
When my wife was pregnant 15 years ago, I did a lot of similar reading about various things. One was home vs hospital birth, and at that time at least, there was a strong vibe of "home birth is best birth" going around. Many people linked to a study (which I can no longer find!) in Norway maybe? It was a big study that "showed" that home birth was safer than hospital birth. However, if you dug into the study, you'd find one particular interesting nugget: if any of the home birth participants experience any negative medical event, even during delivery, they were removed from the study. It was preposterous. In the end, all the study said was, "home births that happened without incident were safer than hospital births", or, in other words, "safe births are safer than non-safe births".
The home birth obsession makes me so angry. My wife had a really bad postpartum hemorrhage when our daughter was born. Thankfully, we were in the hospital, so the obstetrics team was able to stop the bleeding and get her stabilized. She'd have likely died if it was a home birth.
What's even crazier is that in most of the US, midwives only need a high school diploma and a midwifery certificate - or in many states, no education is required at all as the title "midwife" is not protected. The vast majority of the rest of the developed world requires midwives to either be professional nurses with additional training in midwifery, or to have a special four year midwifery degree (eg: here in Canada, midwifery is a bachelor's degree). Many parents in the US who opt for a home birth are likely unaware of how underqualified many American midwives are compared to their international counterparts to respond to an obstetric emergency.
I'm glad we were given an option but only based on comfort level, not because of better safety. We wanted the hospital, in case you need a rushed c section.
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.
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.
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".
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".
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...). 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.
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.
> 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.
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...
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.
"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.
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."
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.
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.
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.
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.
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.
> 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.
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.
> 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.
One particularly aggravating manifestation of the medical industry's inability to be wrong is its tendency to blame patients. It is famous for doing so in the area of obesity. But one rather entertaining incident happened to me: I was in the hospital under observation and (for medical reasons) fasting. They had me on IV saline which, apart from the medication I was getting, was all I took in. After a day or so, I was informed I had developed a potassium deficiency, and given a supplement with the air of someone who needed to fix a bad diet.
My potassium had been just fine when I came into the hospital. At this point, I stood up and read the content of the saline bag, considered how many times I'd seen it changed, did a little noodling about sodium potassium balance, and dramatically downgraded my opinion of the experts in charge of my care.
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
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.
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.
Lots of other parents driven to look for answers about what happened to their child, but being far less educated on how to read and understand academic papers, ended up "doing their own research" and became antivaxxers. There's a lot to be said for having an education that enables you to evaluate scientific literature effectively.
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).
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.
"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.
> 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.
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.
If they are experts. The problem lies in distinguishing those who actually do have expertise in the field in question from those who merely think that they do and can persuade others that they do.
In many medical contexts there is no such thing as an expert because the data simply doesn't exist, they are sometimes simply more capable than the general public.
Actual experts I talked too can tell you easily why the opinion they have are true and the evidence it is based on. They are also very good at vulgarization.
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.
> the assumption that this is plain malice designed to let the state rob a few more individuals of their freedom makes much more sense.
Of course it makes much more sense that there was a massive conspiracy across the medical, legal, prison industry, and press to put more people in prison. Rather than some doctors and legal professionals assuming SIDs was a simple explanation for a not very well understood medical phenomenon probably with many causes.
>Of course it makes much more sense that there was a massive conspiracy across the medical, legal, prison industry, and press to put more people in prison.
Not like it hasn't happened before. And you're overestimating the required massiveness of the conspiracy IMO.
In a world where people are incarcerated on a scale unprecedented in all of human history,
This is only true, because prior to these times, people were killed instead. Or beaten to within an inch of their lives. Local "justice", lynching, mob action, used to be far, far more common.
And of course, many people used to be worked to death. Or sold into slavery. Or die from horrid conditions in jail. Or forced into the foreign legion.
While I agree that something may be wrong in the US, there are many regions in the world where the above still happens.
> This is only true, because prior to these times, people were killed instead. Or beaten to within an inch of their lives. Local "justice", lynching, mob action, used to be far, far more common.
Hm, sounds like an assertion that ought to be checked by a historian, possibly ACoUP's blog? (Yes, the one who writes about Rome, he is sometimes featured in HN). He specializes in demolishing misconceptions people/Hollywood have about history.
For example, many historians have been writing, recently, about how medieval society was far less brutish and cruel than portrayed in pop culture. There were laws, rights the monarch gave their subjects, culture, etc. Lots of what we "know" about the middle ages from Hollywood is simply wrong.
Their source could be your source, which you seem to be very seriously misreading.
> As the global population grew 21 per cent, between 2000 and 2019, the number of prisoners worldwide jumped by more than 25 per cent, according to the UNODC data.
So, worldwide trend is upward.
> While Northern America, Sub-Saharan Africa and Eastern Europe have experienced a long-term decrease in imprisonment rates of up to 27 per cent, other regions and countries, such as Latin America, Australia and New Zealand, have seen up to 68 per cent growth over the last two decades, the study revealed.
So apparently your definition of “western countries” includes sub-Saharan Africa but excludes most of Europe and all of Australia and New Zealand?
Overall your own source supports their point and contradicts your own.
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.
>designed to let the state rob a few more individuals of their freedom
"The state" doesn't benefit in any way from locking people up. In fact, it costs them money (both directly and in lost taxes from the lost salaries and wages of those incarcerated).
An argument could be made that prosecutors benefit from higher incarceration rates through the incentives you described. And an argument could definitely be made that private corporations paying well-below-market rates for prison labour benefit.
You think states don't benefit from spending more money? They're just like other organizations who try to expand their budgets year over year.
Except they can force people to pay them more, all they need is plausible justification (like combating crime, or terrorists, or drugs, or viruses, or whatever the current societal scare happens to be about).
Also, keep in mind, it costs the taxpayers money, not the people running the criminal justice system. They're motivated by climbing the ladder and scorekeeping.
I hate to break it to you, but the prison system has been the premiere, essential job-creation program for these United States ever since Appomattox 1865.
Power is not a meagre result. For those people who live by it, it is the ultimate goal, and they will use any means to obtain and expand it, no matter the cost to others.
>> 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.
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?
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.
There is a skin condition called Mongolian (Blue) Spot (wikipedia: https://en.wikipedia.org/wiki/Mongolian_spot ) that doctors can mistake for an infant being beaten or otherwise abused. It has led to a lot of cases of false accusations and children being forcibly removed from their parents who were then charged with child abuse.
According to Wikipedia, as to the distribution of this condition,
> The birthmark is prevalent among East, South, Southeast, North and Central Asian peoples, Indigenous Oceanians (chiefly Micronesians and Polynesians), certain populations in Africa, Amerindians, non-European Latin Americans and Caribbeans of mixed-race descent.
So you can see how, in a Western European nation, even if no-one is being biased in the sense of "hating foreigners", the false accusations would cluster in "non-indigenous" populations, for want of a better word (I originally had "immigrants" then realised that isn't the correct split I'm looking for.). Personally I believe there is no defense for doctors, courts and social workers not knowing about this and checking for it before making any accusations.
This doesn't seem to apply to Romanians / Eastern Europeans specifically, unless they have partly Asian ancestry, but it does show that there are conditions that can be mistaken for abuse that appear in some cultures more than others.
Damn that hits home. I’ve got a blue spot birthmark that was seen at elementary school which then led to child services showing up at home. This happened in the US and everyone involved was “non Indigenous.”
> Oh the good old, violent Easter European bias mixed into crap science.
Honest question, trying to parse your statement (and bear in mind I don't live in Europe, so I'm surely missing the obvious): do you mean that in Denmark there is a bias against Eastern Europeans, such as Romanians?
Edit: excellent, got a downvote for asking an honest question and clarifying why I wrote it. Is this an example of the fine discourse we are supposed to have here? This is an honest question, I'm neither European nor a native English speaker and I have difficulty parsing the sentence I quoted. How on earth does this warrant downvotes?
It’s not just in Denmark, most Europeans have a negative bias towards Romanian immigrants (mostly because they’re too ignorant to even know Romanians are not Roma).
I could not say I ever experienced it, but I have school-aged relatives that moved to Germany and received all sorts of crap from their peers explicitly for being romanians. Not a race thing because they're whiter than most germans( blonde, white, blue eyes).
Yes. Romanians probably get the worst of it from the association with Roma in general who are generally discriminated against, but there is generally a base level of anti eastern-european discrimination among western Europe (and especially the UK). Not that all or most western Europeans do this, but it's a significant enough minority that does that it's unavoidable.
For your edit: 'honest questions' (which are in fact anything but: the person asking has no interest in the answer, and the question itself is often leading) are a common disruptive tactic used by people (normally pushing extreme right-wing ideologies) to derail a conversation.
I'm sure that you're not doing that here, but unfortunately people with genuinely honest questions have become collateral damage caused by disingenuous actors, especially among people with itchy downvote-trigger-fingers.
It could be, but communication issues could also be at play, plus overeager doctors/social workers.
In Romania they go at great lengths not to pull children out of family environments, in Denmark and other more developed countries it could be the opposite.
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.
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.
Wait, are there Europeans who don't acknowledge that this bias exists? In my experience with European colleagues and those who've traveled a lot there it's so universally-acknowledged that this would surprise me.
Seen complaints/protests like this in my country. Then the adult children of the lady leading these protests spoke out against her and pointed out she was just doing it to get a house and embezzling a load of GoFundMe money.
This wasn't SBS though, she just kept adopting out her kids to devote more time to her drug habits.
Nothing shook my faith in the medical system more than having kids.
Holy cow is modern medicine still as smugly wrong as it’s always been. Every generation laughs at all the stupid stuff the previous generations believed, and then acts so confident that they’ve got it right this time.
And as a result you get unworthy nurses making moms feel intense shame for not “trying hard enough” to somehow magically produce milk.
> Every generation laughs at all the stupid stuff the previous generations believed, and then acts so confident that they’ve got it right this time.
Voltaire (1694-1778) wrote a satirical account of a medieval university's oral examination on medicine: the examiner asks why morphine puts people to sleep, and the student confidently replies that morphine has a "dormative essence". This is a bit like saying that things with an essence of gravity fall towards the earth, whereas things with an essence of levity float towards the sky. The examiner proudly accepts that answer and bestows upon the student the title of doctor.
This was very funny to anyone educated in the time Voltaire was writing, since they would have known that morphine puts people to sleep because... it has round molecules with no sharp edges...
My sister wouldn't sleep. The doctor constantly gave the "sigh, you're an idiot, you just do X and Y and they sleep" talk to my mother because nothing came up on their screening, even though my mother almost wanted to scream that something was clearly wrong and abnormal. Turns out, different doctor, serious vitamin deficiency.
And medical incompetence by staff, not doctors, is also awful. My brother hated reading. He got glasses, still hated reading, my mother wondered why he could be so disobedient in that regard. They said, well, the prescription is right, he can clearly see fine. Turns out two years later that the lenses were installed on opposite sides. Right lens on left eye, left lens on right eye. A simple mistake, but the consequences...
> unworthy nurses making moms feel intense shame for not “trying hard enough” to somehow magically produce milk.
Stay away from mommy blogs/forums. Those are the most toxic cesspools I've ever witnessed. Things are changing, some of the newer ones are not nearly as bad, but man the judgement is super real.
Nurses are one thing, but personally, the worst is family members who think they know better and don't understand the data and that times have changed.
Our twins were put into my wife's arms, and we were wheeled into a room to stay for 48 hrs, being woken up every 2 hours by a nurse, which would wake up our kids, making the whole thing a living nightmare. I have no idea how I drove home.
They had no care for my wife's ability to heal, rest, or anything, just subjecting us to the worst kind of institutionalized checklist torture. The medical system cares for nothing other than preventing lawsuits and providing a place for doctors to do their 1 hr of work on their 18 patients a day.
Same experience. The medical system is a reflection of pop parenting culture or vice versa. Everyone was so gung ho on breastfeeding, but when the milk didn’t come in and our son wasn’t interested in a dry breast the only advice given was “keep trying”. Then the shock and surprise when baby is losing weight. We had to demand formula, which was given grudgingly, and left the hospital a day later. If we have another we will do breast plus formula from the get go.
After 5 kids in 10 years, you come to realize that the standards aren't agreed upon, and best practices/recommendations change YEAR TO YEAR without fail.
Breastfeeding is one of the worst things hoisted upon mothers who are told "you must try no matter what" - seemingly ignoring the mental and physical health of the mother and the father all the while.
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"
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.
There are also huge swaths of people actively trying to make it worse, that's what the FBI did (does?) for years when it knowingly pushed junk forensics.
Or what basically every prosecution does, when it knows that the science behind some things isn't airtight but still presents it in the best possible light to get a conviction.
It's not a justice system, it's a Law and Order system: It's not designed to deliver justice, it's designed to resolve disputes relatively cheaply, while allowing for spending more money to get better results.
The justice system is doing what the doctors tell them. Broadly speaking If a medical professional testifies that this is the only way, what qualifications does a DA have to question him? Medicine is a profession; thus the professional body ought to be addressing this and, if the guidance changes, be advocating and lobbying to Congress that people start being released.
> If a medical professional testifies that this is the only way, what qualifications does a DA have to question him?
Questioning witnesses is literally the DA's job. That doesn't magically stop being the case just because the witness is an expert. The DA is indeed qualified for this. You could even say it's one of the main reasons the DA exists.
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
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.
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.
[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."
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.
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?
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.
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.
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.
> 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’!
This is just speculation, but I bet those groups (or their members) aren't always calmly and coolly trying to find the best policies protect the welfare of children. Instead they feel themselves on a kind of righteous moral crusade, and what's more heroic than swooping in to take the child away from the clutches of the villain? The feelings of heroism could obscure understanding the harm the "heroic act" could cause.
There's another factor in this, which makes it hard to change:
For the people in child welfare organizations, for social workers, for doctors, for police, for judges to change their mind about current and future decisions requires them to change their mind about past decisions. The necessary implication is that many of the people they have persecuted in the past were, in fact, innocent. It requires them to admit that they personally have likely caused untold suffering to parents, caretakers, and children.
This is hard for anyone; but if you've lived your life trying to be the hero, feeling good about swooping in and rescuing children from the clutches of evil villains, how can you face the fact that you are the evil villain in so many children's stories?
You might call this the Paradox of Judgment: If you don't say that something is that bad, then lots of people don't think it's a big deal and don't do anything about it. But if you do say that something is really bad, then there develop all these pathologies of denialism around it.
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> they feel themselves on a kind of righteous moral crusade
They see a lot of bad stuff which causes them to have a difficult time admitting that sometimes bad stuff just happens on it's own
Reminds me of the police/detectives that "just know he did it" because they don't understand that people grieve differently. I really empathize with the people that don't have a meltdown and cry when they hear some horrific news. I don't think I would either in many cases. I'd want the cops to do their job and go find the perp so I'd talk to them in a calm and concise manner telling them what I knew; even though that's likely highly suspicious behavior.
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I work in child welfare in Australia. Not sure how it compares to the models in other countries, but we desperately try not to remove child from their families. There is very little evidence to support it improves outcomes for those children, and the removing itself is highly horrific for everyone involved. Even in the instances we remove children, we actively attempt to work with the parents to address the issue. We are also beholden to the Courts to justify our decision making.
The harm we cause is better explained by systematic reasons (workload, case complexity, red tape, worker burnout and apathy, racism)
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> and what's more heroic than swooping in to take the child away from the clutches of the villain?
In a (somewhat) post-scarcity society attention from others is hard currency and narcissism is at an all time high.
This is true, but not for the reasons you might expect. Well, 10% of the time this is the case, but 90% ...
Mostly they are operating on priors. The prior probability of a separation being the right thing to do is very high, because they have a _long list of mitigation before they actually can take a kid away. In the case of a doctor-approved immediate physical danger, they are regulated into acting on behalf of the immediate safety of the child while the investigation is ongoing but even that is considered temporary.
The goal of any foster care situation is to get the kids back with the biological parents, so time is on their side, provided they are not living in a circumstance that disallows the kind of attendance and involvement that the state would require to clear a caseworker to re-unite the family. Sadly, many are.
Source: Foster parent.
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I suspect that was the motivation for Apple's iPhone client-side scanning and reporting of CSAM feature and the subsequent hard push for it.
That is a point - and also, while I'm sure many are just misguided, and I generally don't want to assume malice when ignorance is a more likely cause, it is certainly interesting that some high-profile people on these 'heroic moral crusades' do then seem to get caught up in sexual misconduct scandals of their own surprisingly frequently...
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Exactly. I met many people like this. The notion of groupthink comes to mind: "Unquestioned belief in the morality of the group, causing members to ignore the consequences of their actions."
See https://en.m.wikipedia.org/wiki/Groupthink
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This always seems to happen to activist groups. They start mistaking their intermediate goals for ‘the cause’ and next thing you know, they’re actively fighting against solutions to their alleged issues because those solutions would impact their self-selected KPIs.
"We need to take away your kid because um.. DEUS VULT."
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.
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.
Yes, this happens because most of us are unconsciously repeating our own histories.
My sense is it's important to keep in back-of-mind that there is a massive selection effect involved in terms of which people chose to enter these fields and what sorts of personal life events (trauma, abuse, witnessing of abuse etc) motives choosing to make this a career. These are not well-paid careers (nor are they high-status) so money and status are typically not motivations (in fact a relative of an in-law works in a closely-related field and we talk at Thanksgiving-type family events about work and their employers often seem to me to be exploiting their investment in the field). I think it's why it can be so difficult to discuss it with them, it is deeply personal and they feel the "system" failed in the past and they want it fixed.
Anyway, it's not meant as an ad hom, but it helps to step back and think why people are involved with certain roles.
To be clear: here the author only bothered look with his well-trained eyes because he was sucked in after the law intruded into his life. It's easy to assume that everyone is highly-skilled. But... highly-skilled people don't usually choose to work for peanuts without other reasons. Fields like this are neglected.
It seems like there is still significant disagreement with this guy's argument in "the science", at least as best as any individual child welfare employee would understand it. There are no doubt specialist doctors, general practitioners, etc. telling the child welfare folks that it's as clear cut a diagnosis as you could get.
The fact of the matter is, the article here is a brief overview describing none of the actual scientific literature at a level that should be convincing to a medical practitioner. But you read it and are apparently convinced of the author's point. So, a layperson (I assume, in your case) is presented with some well-written evidence from an authoritative perspective, alongside broad contours of the actual medical evidence but no details, and is convinced that it's true. Is it so hard to believe that a child welfare worker would be equally convinced under the same circumstances when talking to a doctor, neurologist, trauma surgeon, etc. who believes the opposite as this author?
The “passion” goes beyond this specific issue. Child abuse specialist doctors have come to some sketchy conclusions, only to have the system cover for them.
Part of the issue is they exist in several systems simultaneously: medical system, child-welfare system, and criminal justice system.
Are they there to cure disease, ensure the child had a safe home environment, or put an abuser in prison. Answer: all of the above.
Here’s a good example:
https://wisconsinwatch.org/2022/01/alaska-couple-loses-custo...
There's a bias in favor of action, especially among the social workers that I have known. The worst possible sin is to do nothing at all.
In cases like this, in the moment, it may be impossible to tell what is actually best for the child. Since removing the child is a form of remediation, it can easily seem to be less harmful than leaving them in a situation that might be actively harming them.
> 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!
Everyone cares about kids, so THINK OF THE CHILDREN is an easy way to both create false urgency to cover totalitarianism and also an excellent shame-generator to suppress protest. C.f. "Drag shows"; "digital privacy"
It's part of the contract cult mechanism. Human tribes for a early version of law by forming contract cults aka religions. For that sexual deviants are hearded into a group to which the family is then ritualistically exposed as a sort of hostage situation that upholds basic providing and welfare contracts. The hysteria is a social fitness signal: "I'm reliably retarded and can be used as a social building block". This is pretty cultural universal, though the cultural baggage with the contact cult may produce different outcomes.
This concept of "the science" we've converged on a culture really doesn't make a ton of sense. What does it mean to say "the science" is against a position that many relevant experts hold? To the extent that there is such a thing as "the science", the book the author is advertising (https://shakenbaby.science/) is pretty frank that its goal is to argue against it: there's a traditional medical consensus in favor of SBS/AHT, but it's become more controversial, and if you read this book you too will be convinced that it's wrong.
> It’s just incredible the injustice that can be done in the name of protecting children
Whatever it is:
- If it's in the name of protecting the children, odds are it is not justice.
- If it is not justice, at some point the excuse will be to protect the children
> - If it is not justice, at some point the excuse will be to protect the children
I don't think this is a very solid maxim. It seems to imply things other than justice can only occur if protecting children is a claimed motive.
My hunch would be:
1. Premise: Organizations always try to stay alive. 2. To stay alive you have to be active and doing things which is rewarded by future money. 3. If your organizational role is "protect children" but who's functional mechanism is to take them away will look for ways to do that.
Similar things happen when policing seems to go awry, if they confuse "protect the public" (goal) with "arrest people for stuff" (doing something)
I have some inside information on how this plays out in Ontario, Canada, at least. One of my family members was a lawyer for the regional Children's Aid, and I worked for him for a few years. Another family member was a child protection social worker for two decades, but retired early because they felt the organization didn't prioritize the welfare of children (as is their mandate) but rather the needs of the organization or (perhaps more realistically) the needs of their own careers.
MANY social workers feel this way. They got into the field out of a genuine concern for the well-being of the most vulnerable members of our society, and instead found themselves dealing with politics (both real and office).
I'm not sure how it is in other countries, but in my region, they actually appoint a lawyer for the child. This is great, but it also tells you a lot about what everyone else's priorities are that children need their own lawyers:
(1) Parents want their kids back, of course. Not all parents are fit to get them back. But their lawyers fight for the return of their kids regardless of circumstances or reasons for their removal.
(2) Child protection agencies are under constant attack, so at the executive level, they lose sight of the individual kids and are instead worried about the needs of the organization and public relations.
(3) The social workers themselves are handcuffed to do anything about it and have to follow procedure, even if they can see it plainly that the procedure is not in the best interests of the child.
(4) Police want nothing to do with any of it and are quick to wash their hands of these situations.
(5) The children's lawyer somehow has to represent the needs of the child, which may place them at odds with their own clients (the kids).
(6) Activist groups will generally support the parents blindly, because by law, for the privacy of the children, the only parties listed above who can publicly speak about any given case are the parents themselves. So you can only ever hear one side of the argument. That's right: If a father, for example, sexually abuses his kids and as a result has them removed, he's free to say just about anything he likes about the matter, without ever acknowledging that he's a child molester. The other parties can't say a thing about this.
As a result, it's impossible, as a member of the public, to ever know whether it was appropriate or not that the children were removed from the care of their parents. I happen to know, from first-hand experience, that it's a mixed bag: Some parents shouldn't be allowed anywhere near any child ever, much less their own. Others are victims of a system gone haywire. And we, the concerned public, can't have an informed discussion about any of it.
All in all, it transforms child protection into a game of who-has-the-best-lawyers rather than trying to do what's right for the kids. Is it any wonder so many kids end up traumatized by this system?
Baby-stealing is a deep drive.
>I really do wonder if it’s cultural or some kind of innate psychological irrarionality that seems stronger in some than others.
CPS is a human organization. There are no algorithms and the guidelines rarely perfectly fit the situation a case worker is given. Keep this in mind. CPS is horrifically under funded meaning that intelligent and competent staff readily leave the field for better paying gigs.
The biggest problem I see with foster care at large is the rampant classism, sexism, racism, and other isms. The providers tend to be solidly middle class degree bearing people who have no personal connection to primary instigating factors of foster care involvement. Namely and typically presenting cross generationally: poverty, crimes of despair or desperation, and trauma whether that be internal or external to the family unit or community such as neighborhood violence, caregiver assault, or tragic loss.
It easy for providers to casually profile incoming children and their families as poor uneducated violent predacious drug dealing junkies. Providers are given extreme control over the entire family and their extended relations and use this power to coerce whatever behavior they desire out of the people. If the provider dislikes the family they have a lot of tools to inflict suffering on them and oppositely they have a lot of tools to assist families and keep them together.
Honestly, the entire system is such a god damn mess that it should be rebuilt with the same level of distrust of staff that they can exercise against families.
Perhaps the most pressing single metric to focus may be the foster to prison pipeline.
Sorry for the meandering post, bookcases could be filled with anecdotes and descriptions of the flaws in these systems. In general, I think the failure of child protection agencies reflects the decay in America at large. I could point to stuff like broken family units or loss of religions community but I’m not dog whistling here. Stable healthy nurturing familial units of any relation are obviously better but man in the house rules and other racist/classist measures caused more harm. I’m also vehemently opposed to all major organized religions that are regularly used to justify war and protect child sex predators. Perhaps the collapse of American industry and slow erosion of social safety nets has hastened the social collapse. Perhaps the internet had instigated the collapse of communal organizations. Perhaps winner take all government enforced monopoly capitalism is the cause. Perhaps it was the theft of 50,000,000,000.00 from the bottom 99 by the 1% that lead to this. Regardless, the solution is not going to be found in rebuilding foster care when our social fabric is rotten.
0. https://srcd.onlinelibrary.wiley.com/doi/10.1002/sop2.10
1. https://www.crimlawpractitioner.org/post/the-foster-care-to-....
3. https://nlihc.org/resource/study-examines-man-house-rules-vo...
4. https://time.com/5888024/50-trillion-income-inequality-ameri...
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.
The ironic thing here is that these sorts of innocuous bumps and minor traumas regularly lead to severe medical complications and deaths in older children & adults, too. The only difference here is that babies & toddlers are too young to be able to verbalize and advocate for themselves in ways that most adults recognize & respect.
Since having a kid and reading a lot I've been bothered by how clearly a lot of what is labeled as "SIDS" is pretty clearly accidental suffocation. The conclusion is impossible to escape when you begin reading about measures that have "reduced SIDS." Yet I also wonder if continuing to observe this social fiction is just a way of keeping overzealous prosecutors and other crusaders from locking up and treating as depraved murderers grieving families for accidental deaths.
A tiny selection of the relevant literature:
[1] https://onlinelibrary.wiley.com/doi/abs/10.1002/(SICI)1099-0...
[2] https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1440-1754....
[3] https://link.springer.com/article/10.1007/s12024-014-9600-5
[4] https://publications.aap.org/pediatrics/article/143/5/e20183...
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Not an expert but it seems to me you'd be making the same kind of error that the article denounces: attaching equal value to direct evidence on the one hand and inference to the best explanation on the other. If a physician does not observe tell-tale signs of suffocation in an infant, then it is not their role to say "Well, statistically speaking, or logically speaking, pretty good chance it's accidental suffocation isn't it? I'll jot this down as Accidental Suffocation Syndrome" or alternatively "I know in my heart that this is accidental suffocation but let's just call it SIDS for the benefit of the parents" but rather they should simply conclude "there's not enough evidence, therefore this death remains unexplained".
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> No way in hell will a single defense lawyer get someone to be able to research enough to figure this out.
Why would we have to? We can just hire M. Rossant.
I wish, unfortunately I'm not a criminal defense lawyer nor a medical doctor! And I don't intend to be one anytime soon. ;)
I think the most productive thing I can at least try to do is to raise awareness among lawyers, doctors, and all professionals involved. No one has the time to dig into it as much as I did, but perhaps I can organize and present our current knowledge as clearly as possible. The book is one little step in this direction.
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Try that in a court which doesn’t recognise the reliability of evidence provided by an “expert” witness.
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Similar case in Denmark/Romania where a baby was taken from his romanian parents because of the shaken baby syndrome, parents spent time in jail, but the hemorage continued over time so they had to concede it wasn't the shaken baby syndromd.
Even if the kids hemorrhaging continued, it was brought to the ER initially with fractures in the right side of the skull.
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The trouble is: shaken baby syndrome is real and well documented. Because the crime is so abhorrent, people strongly want to believe the diagnostic tools to be much more sensitive and accurate than they really seem to be.
It's the classic "N guilty men" problem, aka Blackstone's ratio: if you risk putting one innocent person in jail, how many guilty people you need to catch to make it morally justifiable? 5, 10? 100?
You have to pick a number, or else no kind of criminal justice can exist.
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I’ve heard credible rumors that SIDS is the “parent accidentally killed their child but we won’t tell them that” polite fiction.
That's the whole point here, isn't it: that 'what you've heard' isn't credible at all. There is no 'polite fiction' here, what there is is people looking for culprits when there are none. Does that meant that all such cases are accidents? No, because we know for a fact that some people really do hurt infants for whatever reason. But the evidence is apparently such that a large fraction of the cases that were thought to be criminal in actuality were not. So don't go on rumors or polite fictions when lives are at stake. Do the legwork before ruining people's lives.
This article is entirely about debunking rumors and looking at actual scientific evidence to correct people's misconceptions -- misconceptions among doctors and law enforcement that have ruined people's lives.
So please don't bring "rumors" into a discussion here. That's exactly the kind of harmful behavior the article is trying to fight against.
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.
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Don’t say horrible things like that unless you can really back them up. Think of how a grief stricken parent might feel after reading that.
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> 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.
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.
>parents lose custody for 2 months. Horror story.
If you read the rest of the article, you will realize that this was the absolute happy path in that kind of situation. That's the real horror story: that the default path involves stuff like losing custody forever, incarceration, suicide, divorce etc.
Yes, after discovering hundreds of families living much worse situations, I consider myself as one of the lucky few. I'm grateful for that and this is why I can spend so much energy ensuring it doesn't affect too many other families in the future.
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Watch the Netflix documentary Taking Care of Maya for a sobering and ongoing look into this.
Something similar happened recently in Massachusetts with a doctor seeing an injury the parents couldn't explain and the kid being taken away for a while. Injury turned out to probably have been done by the grandparents who never told the parents because the kid didn't fuss, but the kids were taken away in the middle of the night.
https://www.nbcboston.com/investigations/massachusetts-dcf-e...
My first inclination here is to blame the doctor. Per the Hippocratic Oath, doctors need to understand the implications of making reports like this and only do so in cases where there isn't reasonable doubt or plausible explanations other than abuse. Separating children from parents and making accusations like this is extremely traumatic in itself, so the evidence bar needs to be very high.
Even if the rules tell doctors that they need to make a report in a given scenario, they should not be following the rules when they know the bureaucracies that handle these reports are dysfunctional and prone to separating children without conclusive evidence. Imo they are responsible for protecting their patients from the system in these cases.
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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.
reason.com has an entire long-running series of stories like this happening in the U.S. I've heard quite a few stories from the Netherlands. It probably happens in other countries as well.
It's an issue in many Western countries, where we've seemingly become risk-averse to the point where it's causing more harm than good.
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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?
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What's the outcome for the kid? Can the system even do much to help with the child's medical condition? If not, it's irrational for people to take their children in for examination; there's no benefit and you risk being accused.
He underwent surgery to remove the excess of fluid around the brain, and his condition progressively improved. It could have worsened without the operation, we'll never know. Now, at almost 8, he's doing great.
I've seen cases where parents call the ER after a collapse of their child, only to see their child wake up just fine a few minutes later. The EMT tells them it's not necessary to bring their child to the hospital given the child has recovered, but the parents insist. At the hospital, sometimes they have to insist too for a CT scan to be performed. This is where doctors find subdural bleeding and the parents end up accused, the child is removed for months, etc. Yet, the child gets no particular medical treatment. None of this would have occurred if the parents hadn't insisted!
Parents only know symptoms, which could be anything. Those same symptoms (or small variations) can lead to a very different diagnosis which is easily treatable.
I can't help but think that incidents like this might make parents less likely to take their baby to the ER out of fear.
> 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.
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.
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.
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.
I'm starting to see AI studies on the medical detection of child abuse, which unfortunately reproduce the same biases as the low-quality clinical data they are based on. An AI that would detect subdural and retinal hemorrhage without external signs of trauma with 99% accuracy would detect "child abuse with 99% accuracy" and would impress law enforcement and courts. However, it wouldn't be more reliable than an expert witness confidently asserting that these signs are almost always due to child abuse.
Reminds me of the bias towards long sleeves and stethoscopes for detecting doctors in photos.
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
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".
(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.
Current AI is deeply rooted in probability and statistics, so it would actually increase the use of statistics.
I'm not saying a false positive or a false negative cannot happen. I am saying that we would have better estimates of both, according to probability theory.
Also: false positives and false negatives are basically impossible to prevent, for a sufficient small margin of error. And that's science.
> Basically, you want to replace statistics ("large enough samples will average out variation") with AI
No. This is misunderstanding due to my lack of clarity. Apologizes.
The biggest problems with Medical data is that 1) incredibly small scale data is collected to make assertions, 2) the data is horrendously de-normalized
In Radiology, a common validation approach is have radiologists review cases on the order of 250 studies to make assessments about a radiology product. This is considered the gold standard for FDA. Look into it more, vaccines, treatments. The sample sizes are fucking tiny.
The statistical assertion is that these relatively small samples capture the variation sufficiently to demonstrate efficacy across devices, treatments. These are then extrapolated to the US and wider populations. Do you believe that this is rigorously true?
The rationale underpinning this is simply practicality. You cannot get thousands (or hundreds of thousands) of patients/doctors/etc to get a strong signal and confidence. For drugs, it's super hard, but for devices and software interventions, it way easier to get data.
That brings us to the second big problem: the data structure is completely highly varied and denormalized.
1) From a pure structure point of view, it's basically free text fields that doctors sporadically fill.
2) From a underlying truth point of view, each hospital across the world has different protocols for care delivery. A histopathological FNA procedure might have a completely different meaning in CA, NY, or EU. This might simply be because of workflow, timeline, or just people using the words wrong.
What I mean with AI+Sensors:
AI doesn't need to solve the problem of intuition around medical problems. The biggest impact will likely come from the relatively mundane task of simply structuring and normalizing the data. Sensors simply help to generate more data
To be more concrete, you don't want (and shouldn't trust) this:
Prompt: "Please diagnose this person"
You want this:
Prompt: "Here is 100 TB of data from 100 different hospitals each with different workflows and patients for histopathology. For each patient, synthesize a CSV with the following schema "AnonPatientID, AnonCaseID, Pathology Result, Pathology stage, Incidenctal findings, ..."
Then I can do the analysis myself.
Hope this makes more sense.
(I work in healthtech and med device and I promise you: Demoralization at the state of medicine is a rite of passage after which you can begin to address practical problems)
Your narrative reverses the roles a bit. The lawyers appear as the heroes in this particular story and the villains are all associated with the hospital -- either in the form of people or bureaucratic red tape, depending on how generous you want to be in your analysis.
> The doctors at the hospital were absolutely, unconditionally 100% certain that no other cause than violent shaking could ever explain blood around the brain and at the back of the eyes.
> As a precautionary measure, the hospital followed mandatory reporting statutes and my wife and I temporarily lost custody of David.
> 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.
> 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.
> Every case requires years of intense, dedicated efforts by an entire team of specialized lawyers and medical experts, but there are tens of thousands of cases and few experts willing to defend them.
Hospitals are definitely the weak link in this system. Just looking at the way the story is laid out, the solution is more lawyers and fewer, less expansive hospitals.
> - 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.
Well, this wouldn't even be that bad, if sample size were actually large enough.
No I think the point that was being made is that the "average person" idea is not that great if you have huge variance. If I have a uniform distribution from 0 to 1, average is '0.5', but its just as likely to get 0. or 1.
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That's part of it. The sample size is usually super small.
Furthermore, there's the opportunity. With large amounts of data (from software, medical devices, sensors) we can actually tackle this problem at scale.
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.
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.
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.
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.
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.
The scary thing in such situations is that if the doctor asks "did your daddy hit you?" the child might randomly say yes.
Shane koyczan has a fantastic poem about a cute thing between him and his grandmother that turned into an abuse investigation. And then he was bullied because of it!
https://genius.com/Shane-koyczan-to-this-day-annotated
> 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.
Your plan when suspected of abuse is to become belligerent? That should convince them their concerns are unfounded.
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.
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Sorry, you think in a case where the doctor suspects abuse, they should have to ask the kid while the potential abuser stands there next to her?
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I am thinking it's even mandated from the medical personnel
This is timely as the life of Robert Roberson is currently being decided based on this syndrome:
https://www.themarshallproject.org/2023/09/15/texas-shaken-b...
Yes and the current submission is a result of this subthreaed from there:
https://news.ycombinator.com/item?id=37635094
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.
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.
This was a sensational news trope on MSM nightly news and news magazines in the 90's in the US.
The story is set in France if you were thinking this is a uniquely Anglo issue.
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-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.
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
AIUI tummy down on a (wakeful) person is generally not a concern nor what the "back is best" crowd is referring to
Obviously a parent who is spending nearly all their time with a newborn knows them best and is likely able to make the best judgement about what works for the child, but the purpose of the advice is to avoid a class of scenario that occur most often. due to issues that are very difficult to detect and often go completely undiagnosed, as they pertain to early development and often improve naturally over time.
The technical report by AAP the other year does an excellent job of presenting the current evidence in an as objective way as possible, I highly recommend it:
https://publications.aap.org/pediatrics/article/150/1/e20220...
You will note that efforts are being made to disentangle diagnoses from the broad SIDS label and that while SIDS cases are trending downwards, it's likely due to both proper classification and education.
The point of preventative measures is to avoid the issue entirely. Sure, tummy sleeping might not be a problem for you (or maybe it was and you just got lucky!) but by generally recommending back sleeping, a class of issues is avoided.
So all in all, I really don't see this as bullshit at all. Caveat that you gotta do what you gotta do, but I'd rather this advice persist than not. We should hope that no one ever has to endure the loss of a child.
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And people wonder why the fertility rate is falling.
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=10.1...
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.
> 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.
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.
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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!
And if he hadn’t, that nanny would probably be in jail.
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
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.
What was the medical issue for your child being underweight, if you could please share that?
He has a form of cystic fibrosis.
> 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?
The problem is that the phrase "a valid concern" would lead me to think "something doctors and parents should consult on (also with the child themself!) and determine if there is cause for alarm, and if so decide collaboratively what the proper course of action is." Sure! Of course! That's what you do with valid health concerns, right?
What it actually means is "something for which social workers will decide whether to take your child away from you for". That's a pretty big escalation from a "valid concern", but one that happens if "the system" decides you are a target. "A valid concern" is in that case a code word for "credible presumptive evidence of child abuse". A child being underweight is a valid thing to be concerned about, it is not on it's own credible presumptive evidence of abusive parenting, no.
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You are missing the part where I harmed his health to comply with their expectations. He was fine and does better on a high quality diet than on a junk food diet.
Weight isn't the only metric that matters.
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[flagged]
I'm not sure if this is personal attack, trolling, or both, but posting this way will get you banned here, so please don't do it again.
If you'd please review https://news.ycombinator.com/newsguidelines.html and stick to the rules, we'd appreciate it.
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?
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.
My kids love it when they come running toward me and I pick them up and in one swoop throw them on to my (big) bed. I'm always holding back because I see their head snap back to land on the mattress, it's that "violent" head-moving-back thing that gives me the fear, so I stopped.
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A) No, but no one can tell that you’re a dog on the internet. Further, dogs do not dispense reliable medical advice. The op is a press release for a textbook covering this topic in what looks like excruciating detail from a wide variety of angles. I doubt a superior citation exists.
B) Beyond that, my understanding is that once a child is past the infant phase where they cannot support their own head, they’re fine. Humans are not all that delicate. Bumps and falls are inevitable, I don’t see how we would have seen success as a species if the risk were outsized. And I guess we’ve been around for a while by now.
C) TFA does mention this a little but it is split across a wide gap and is not the focus. I pulled the two quotes I think are relevant below.
> And yet, although subdural and retinal hemorrhage may be caused by non-accidental trauma, especially when impact is involved, they simply are not specific for it: indeed, it has been demonstrated that a wide range of accidental events and medical conditions are plausible alternative causes. Particularly fragile infants may sustain severe head injuries following minor household falls. Others may suffer from genetic conditions, metabolic disorders, blood clotting abnormalities, or infections.
> On the other hand, there exist dozens of documented cases of witness reports of shaking, videotaped shakings, and spontaneous admissions of shaking, but without subdural and retinal hemorrhage. In fact, there is virtually no known case of a reliably-documented event of violent shaking without impact of a healthy baby resulting in isolated subdural and retinal hemorrhage (additional markers of trauma would be expected in such cases). In contrast, there have been numerous cases of videotaped or witnessed short falls resulting in these very medical findings, considered “impossible” by the shaking hypothesis.
So it’s like they say: it’s not the fall that gets you, it’s when you land.
I don't think you should worry too much. Abusive shaking really involves extreme forces. "Routine shaking" occurring during play is not expected to be harmful to healthy children. Games should be adapted to the age of children according to common sense.
The takeaway of biomechanics studies is basically that you should be much more careful about accidental head impacts on hard surfaces.
The article as I interpreted says that there is no recorded case where you can get shaken baby syndrome and the sharking was recorded on tape or declared in front of the police, that being said, if your child has some pathology, they might be at risk with even a minor fall
You misread the article. The article states that there aren’t any SBS cases with only “isolated subdural and retinal hemorrhage.”
re: the bouncy houses and such. Other than kids banging into each other, this never seemed like much of a head or brain injury risk. But watch out for knees! Trampolines with more than one person on them are incredibly dangerous, and bouncy houses seem likely to be pretty dangerous with occupants of widely varying sizes. The specific issue is that the floor may move abruptly and unexpectedly when someone is trying to land, causing a potentially severe knee injury.
If you’re in a bouncy house with kids, consider avoiding any bouncing yourself.
It is pretty hard for such injuries to occur with the level of movement you're taking about, especially with a child old enough to support their own head. I don't think you need to worry.
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.
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.
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-ro...
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.
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.
I mean.. sure. But if you shoot a baby it will also harmed. Or stomp on it, or set fire to it.
So, why is this video specifically about shaking? Because of this very specific and narrow conspiracy theory that takes children away from their parents.
Didn't the article state that is actually unlikely it leads to AHT?
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“ 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
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.
"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.
> 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.
That's exactly it.
> 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
The article seems to be dedicated to precisely the opposite conclusion. The author's contention would seem to be that in cases of shaking there is other trauma that doesn't fit the "shaken baby syndrome" theory.
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?
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.
You must have skimmed the article because it said over and over that it was basically impossible to definitively identify that a baby was shaken. It's a diagnosis they use when they're not sure.
It does not say that.
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> 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.
Is the criminal justice system in France based on a presumption of innonce?
Yes, as others have said. However, this is a legitimate question, because in these specific cases, the burden of proof tends to be on the side of the defendant who needs to prove they didn't harm their child. That's obviously impossible, and probably unconstitutional.
When medical experts claim they're 100% confident that this child was violently shaken at this specific time, and that you were the only person with the child at that time, how can you defend yourself when you haven't done anything? There's nothing you could ever do to convince courts that your word has more value than the confidence of highly reputable experts with decades of experience.
This is an instance where the prosecution's case relies on the confidence in medical authorities, and where it is extremely hard to challenge it as the subject is so difficult on a scientific and technical level. In the US and other adversarial jurisdictions, you see an incredible level of technicality during oral debates, with extensive and long-running discussions around extremely obscure points related to the anatomy, physiology, and pathology of the infant nervous system in highly specific pathological situations, where infants frequently suffer from multiple rare medical conditions or risk factors. Few people in the world have the required expertise, and even fewer accept to testify in courts! There's also an obvious financial imbalance between the State and the defendant.
In inquisitorial jurisdictions like France, this is even worse as there's basically no system in place to challenge the views of the State's experts.
So, yes, litigating these cases is extraordinarily challenging because the only way to prove the defendant's innocence is to challenge the opinion of overly assertive medical experts by digging into highly difficult (and multidisciplinary) science.
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.
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There are complications when immediate danger needs to be avoided. E.g., the system prefers to take away children preventively in serious cases rather than leaving them in a dangerous environment. Which is sometimes justified, and sometimes not. The idea in this case is that it is easier to correct a mistake by restoring custody than by reviving a dead child.
A bit like temporary restraining orders pending trial in the US.
> 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.
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_Uni...
[2] https://lawreview.law.ucdavis.edu/issues/50/1/Articles/50-1_...
[3] https://en.wikipedia.org/wiki/Factitious_disorder_imposed_on...
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.
> . 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
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
I think it's both funny and sad that you're doing the exact same thing as the "bad" doctors in TFA and then are on here commenting about it. A quick search on Google Scholar for "caffeine pregnancy" reveals a number of studies that show a non-trivial link in humans to increased miscarriage chances, at levels of consumption that realistically occur with heavy coffee drinkers. I.e. your conclusion is not so clear-cut and is based on one (admittedly bad science) thing you read. Example [1][2]
[1] https://www.sciencedirect.com/science/article/abs/pii/S00029...
[2] https://academic.oup.com/nutritionreviews/article/54/7/203/1...
I don't think that's fair toward me: the bad doctors never told me "do your research, form your opinion". They were always clear cut, they looked up on us for sleeping with our children and they "checked" the breastfeeding checkmark at the hospital even if my wife lamented pain during it and turned out my daughter had a really bad lip/tongue tie that took a month to be solved (with surgery). Notice that medical personnel even told her "you have to endure it, it's normal", as her breasts were cracking and she couldn't breastfeed anymore (had to pump).
I explicitly said, do your research at the end of the message.
P. S. The book might have been one of the following, I can't remember:
Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong--and What You Really Need to Know (The ParentData Series Book 1) from Emily Oyster
What to expect when you are expecting
I think it's the first one. I read many at the same time, so it's hard to remember which one had the information.
The problem that became very salient to me dealing with miscarriage is that women who have healthy pregnancies are also more likely to have problems with morning sickness, and are more likely to avoid things like coffee that are likely to make them feel even more nauseous. Women who have troubled pregnancies that are more likely to end in miscarriage are less likely to feel nauseous and therefore continue to drink and eat things as before.
So it's possible caffeine consumption is a sign of a troubled pregnancy rather than a cause of it. I'm sure there's a point where caffeine becomes problematic but that could be said of a lot of things.
There's a paper in NEJM or JAMA that pointed to this as a likely explanation but it's been a few years and don't have time to look for it now. I think they were looking at timing of caffeine consumption and nausea symptoms?
From your second link:
>The results of this literature review suggest that heavy caffeine use (≥ 300 mg per day) during pregnancy is associated with small reductions in infant birth weight that may be especially detrimental to premature or low-birth-weight infants. Some researchers also document an increased risk of spontaneous abortion associated with caffeine consumption prior to and during pregnancy. However, overwhelming evidence indicates that caffeine is not a human teratogen, and that caffeine appears to have no effect on preterm labor and delivery.
> 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.
Honestly I don't know which study you're talking about, and I'm not trying to question what you're saying (such studies indeed often use exaggerated amounts because it's more likely to show effects, but it can skew the results of course) but I just found it interesting that depending on what "feeding them coffee in the amount of 3/4 of their body weight" means, well over a pregnancy it's easy to consume 3/4 of one's body weight in coffee.
It means about 150 mL coffee per day for a woman weighing 55 kg, over 9 months.
About SIDS and sleeping with the children in the same bed, if I remember correctly (it's been some time since I had to read about this) the very large majority of cases happened with parents who either smoke or are obese. I think I couldn't find precise stats just for non-smoking, non-obese parents but it seems like SIDS basically didn't happen in this case when co-sleeping. It also almost never happens with immigrant parents for some reason (even though they are statistically more likely to practice co-sleeping, here in Europe).
SIDS has all manner of interesting and unexpected demographic correlations. I’m not convinced anyone knows what to make of them.
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I'm a light sleeper and I feel like I have an awareness of everything nearby when I'm asleep (like I used to fall asleep with an open laptop in bed during college without knocking into it). I have a feeling co-sleeping wouldn't be an issue for me, but with all the dire warnings I'm afraid to risk it.
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It was intended in a day, not over the course of the pregnancy
You should see how the second hand smoke studies upon which all other second hand smoke studies were based were done - very similar methodology - cotton swabs were saturated with combustion residues from hundreds of cigarettes, making them into tarry masses, which were then applied to 100% of the bodies of infant rats, every day for several weeks - and they were then observed for developmental abnormalities. The discussion then explicitly states that this should not be taken as a human analogue, as the rats were seen to lick the residue off their bodies, thus consuming all of it, and that further research would be needed.
Further research was of course done - on rats - with much the same methodology.
Medicine is really prone to falling for this sort of thing - and it’s honestly no great shock, recalling the calibre of people at school who went on to become doctors. I studied physics, for Christ’s sake, and knew more about metabolic pathways than third year med students who I would help cram.
When my wife was pregnant 15 years ago, I did a lot of similar reading about various things. One was home vs hospital birth, and at that time at least, there was a strong vibe of "home birth is best birth" going around. Many people linked to a study (which I can no longer find!) in Norway maybe? It was a big study that "showed" that home birth was safer than hospital birth. However, if you dug into the study, you'd find one particular interesting nugget: if any of the home birth participants experience any negative medical event, even during delivery, they were removed from the study. It was preposterous. In the end, all the study said was, "home births that happened without incident were safer than hospital births", or, in other words, "safe births are safer than non-safe births".
The home birth obsession makes me so angry. My wife had a really bad postpartum hemorrhage when our daughter was born. Thankfully, we were in the hospital, so the obstetrics team was able to stop the bleeding and get her stabilized. She'd have likely died if it was a home birth.
What's even crazier is that in most of the US, midwives only need a high school diploma and a midwifery certificate - or in many states, no education is required at all as the title "midwife" is not protected. The vast majority of the rest of the developed world requires midwives to either be professional nurses with additional training in midwifery, or to have a special four year midwifery degree (eg: here in Canada, midwifery is a bachelor's degree). Many parents in the US who opt for a home birth are likely unaware of how underqualified many American midwives are compared to their international counterparts to respond to an obstetric emergency.
I'm glad we were given an option but only based on comfort level, not because of better safety. We wanted the hospital, in case you need a rushed c section.
Has SIDS been linked to co-sleeping? I thought the risks of co-sleeping were more around accidentally rolling on or suffocating the baby.
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.
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Newer research shows a good chunk of SIDS cases actually _are_ likely suffocation from various causes.
That’s why the SIDS reduction measures are mostly ‘sleep on the back, in an empty crib, with nothing soft around’.
But it’s much easier to tell a grieving parent that there’s nothing they could have done, than that their baby got unlucky and suffocated to death.
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The problem is that sids is vague, sometimes is used to protect the parents from murder accusation because overly tired
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.
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/S10918...
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".
Not just a US thing. Europe is even more prevalent.
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...). 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.
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.
> 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.
Okay, what happened? You can't leave these half stories here, lol
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...
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_inter...
"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.
There was a infamous case in the UK around SBS:
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.
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."
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.
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.
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.
Wow, makes me wanna get a ph.d.
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.
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.
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.
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.
> 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.
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.
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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?
> 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.
One particularly aggravating manifestation of the medical industry's inability to be wrong is its tendency to blame patients. It is famous for doing so in the area of obesity. But one rather entertaining incident happened to me: I was in the hospital under observation and (for medical reasons) fasting. They had me on IV saline which, apart from the medication I was getting, was all I took in. After a day or so, I was informed I had developed a potassium deficiency, and given a supplement with the air of someone who needed to fix a bad diet.
My potassium had been just fine when I came into the hospital. At this point, I stood up and read the content of the saline bag, considered how many times I'd seen it changed, did a little noodling about sodium potassium balance, and dramatically downgraded my opinion of the experts in charge of my care.
> The prospect of cybersecurity professionals taking years to apply a patch after a security flaw is discovered beggars belief.
Not just years, but generations in some cases.
This is why higher education (and academic mettle) is amazing
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.
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.
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Lots of other parents driven to look for answers about what happened to their child, but being far less educated on how to read and understand academic papers, ended up "doing their own research" and became antivaxxers. There's a lot to be said for having an education that enables you to evaluate scientific literature effectively.
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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).
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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.
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And that’s solid advice for starting a tech company. (This is a y combinator website)
"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.
> 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.
YouTube videos are just letting other people do research ;)
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.
> using experts for advice is great
If they are experts. The problem lies in distinguishing those who actually do have expertise in the field in question from those who merely think that they do and can persuade others that they do.
In many medical contexts there is no such thing as an expert because the data simply doesn't exist, they are sometimes simply more capable than the general public.
Actual experts I talked too can tell you easily why the opinion they have are true and the evidence it is based on. They are also very good at vulgarization.
How would doing your own research prevent the state from taking your child away and putting you in prison for murder?
> 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.
> the assumption that this is plain malice designed to let the state rob a few more individuals of their freedom makes much more sense.
Of course it makes much more sense that there was a massive conspiracy across the medical, legal, prison industry, and press to put more people in prison. Rather than some doctors and legal professionals assuming SIDs was a simple explanation for a not very well understood medical phenomenon probably with many causes.
>Of course it makes much more sense that there was a massive conspiracy across the medical, legal, prison industry, and press to put more people in prison.
Not like it hasn't happened before. And you're overestimating the required massiveness of the conspiracy IMO.
https://en.wikipedia.org/wiki/Kids_for_cash_scandal
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In a world where people are incarcerated on a scale unprecedented in all of human history,
This is only true, because prior to these times, people were killed instead. Or beaten to within an inch of their lives. Local "justice", lynching, mob action, used to be far, far more common.
And of course, many people used to be worked to death. Or sold into slavery. Or die from horrid conditions in jail. Or forced into the foreign legion.
While I agree that something may be wrong in the US, there are many regions in the world where the above still happens.
> This is only true, because prior to these times, people were killed instead. Or beaten to within an inch of their lives. Local "justice", lynching, mob action, used to be far, far more common.
Hm, sounds like an assertion that ought to be checked by a historian, possibly ACoUP's blog? (Yes, the one who writes about Rome, he is sometimes featured in HN). He specializes in demolishing misconceptions people/Hollywood have about history.
For example, many historians have been writing, recently, about how medieval society was far less brutish and cruel than portrayed in pop culture. There were laws, rights the monarch gave their subjects, culture, etc. Lots of what we "know" about the middle ages from Hollywood is simply wrong.
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If you're interested in how criminal punishment changed from medieval times, Medieval Crime Museum is outstanding. https://www.germany.travel/en/cities-culture/medieval-crime-...
Source? Incarceration rate seems to be going down in western countries: https://news.un.org/en/story/2021/07/1096042
Their source could be your source, which you seem to be very seriously misreading.
> As the global population grew 21 per cent, between 2000 and 2019, the number of prisoners worldwide jumped by more than 25 per cent, according to the UNODC data.
So, worldwide trend is upward.
> While Northern America, Sub-Saharan Africa and Eastern Europe have experienced a long-term decrease in imprisonment rates of up to 27 per cent, other regions and countries, such as Latin America, Australia and New Zealand, have seen up to 68 per cent growth over the last two decades, the study revealed.
So apparently your definition of “western countries” includes sub-Saharan Africa but excludes most of Europe and all of Australia and New Zealand?
Overall your own source supports their point and contradicts your own.
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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.
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Unfortunate. It frankly needs to go up in Western countries to get to half-decent crime rates.
>designed to let the state rob a few more individuals of their freedom
"The state" doesn't benefit in any way from locking people up. In fact, it costs them money (both directly and in lost taxes from the lost salaries and wages of those incarcerated).
An argument could be made that prosecutors benefit from higher incarceration rates through the incentives you described. And an argument could definitely be made that private corporations paying well-below-market rates for prison labour benefit.
Politicians benefit from locking people up because it gives them an easily measurable way to look "tough on crime".
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You think states don't benefit from spending more money? They're just like other organizations who try to expand their budgets year over year.
Except they can force people to pay them more, all they need is plausible justification (like combating crime, or terrorists, or drugs, or viruses, or whatever the current societal scare happens to be about).
Also, keep in mind, it costs the taxpayers money, not the people running the criminal justice system. They're motivated by climbing the ladder and scorekeeping.
I hate to break it to you, but the prison system has been the premiere, essential job-creation program for these United States ever since Appomattox 1865.
https://en.wikipedia.org/wiki/Thirteenth_Amendment_to_the_Un...
https://www.aclu.org/news/human-rights/captive-labor-exploit...
We got 800,000 or so right now. Fight unemployment? Lock more people up.
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We detached this subthread from https://news.ycombinator.com/item?id=37667150.
https://en.wikipedia.org/wiki/Hanlon%27s_razor
"Sufficiently advanced ignorance/apathy is indistinguishable from malice"
> the assumption that this is plain malice designed to let the state rob a few more individuals of their freedom makes much more sense
That's a lot of work, a lot of malice, a lot of hate, from a lot of people, for a very meagre result.
If that's how you view your government you must live a really painful existence
It's just people "doing their jobs" and trying to get ahead.
That's the banality of evil.
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> for a very meagre result
Power is not a meagre result. For those people who live by it, it is the ultimate goal, and they will use any means to obtain and expand it, no matter the cost to others.
>> 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.
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?
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.
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Imagine when it’s not just locking up, but spills over to state homicide: https://amp.theguardian.com/world/2023/sep/24/texas-death-ro...
We detached this subthread from https://news.ycombinator.com/item?id=37667150.
Not everywhere is the US.
This isn’t even true for the US. In the US we believe it’s better to let a criminal run free than deprive an innocent of their liberty.
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Oh the good old, violent Easter European bias mixed into crap science.
We detached this subthread from https://news.ycombinator.com/item?id=37670664.
There is a skin condition called Mongolian (Blue) Spot (wikipedia: https://en.wikipedia.org/wiki/Mongolian_spot ) that doctors can mistake for an infant being beaten or otherwise abused. It has led to a lot of cases of false accusations and children being forcibly removed from their parents who were then charged with child abuse.
According to Wikipedia, as to the distribution of this condition,
> The birthmark is prevalent among East, South, Southeast, North and Central Asian peoples, Indigenous Oceanians (chiefly Micronesians and Polynesians), certain populations in Africa, Amerindians, non-European Latin Americans and Caribbeans of mixed-race descent.
So you can see how, in a Western European nation, even if no-one is being biased in the sense of "hating foreigners", the false accusations would cluster in "non-indigenous" populations, for want of a better word (I originally had "immigrants" then realised that isn't the correct split I'm looking for.). Personally I believe there is no defense for doctors, courts and social workers not knowing about this and checking for it before making any accusations.
This doesn't seem to apply to Romanians / Eastern Europeans specifically, unless they have partly Asian ancestry, but it does show that there are conditions that can be mistaken for abuse that appear in some cultures more than others.
Damn that hits home. I’ve got a blue spot birthmark that was seen at elementary school which then led to child services showing up at home. This happened in the US and everyone involved was “non Indigenous.”
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> Oh the good old, violent Easter European bias mixed into crap science.
Honest question, trying to parse your statement (and bear in mind I don't live in Europe, so I'm surely missing the obvious): do you mean that in Denmark there is a bias against Eastern Europeans, such as Romanians?
Edit: excellent, got a downvote for asking an honest question and clarifying why I wrote it. Is this an example of the fine discourse we are supposed to have here? This is an honest question, I'm neither European nor a native English speaker and I have difficulty parsing the sentence I quoted. How on earth does this warrant downvotes?
It’s not just in Denmark, most Europeans have a negative bias towards Romanian immigrants (mostly because they’re too ignorant to even know Romanians are not Roma).
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I could not say I ever experienced it, but I have school-aged relatives that moved to Germany and received all sorts of crap from their peers explicitly for being romanians. Not a race thing because they're whiter than most germans( blonde, white, blue eyes).
Yes. Romanians probably get the worst of it from the association with Roma in general who are generally discriminated against, but there is generally a base level of anti eastern-european discrimination among western Europe (and especially the UK). Not that all or most western Europeans do this, but it's a significant enough minority that does that it's unavoidable.
Domestic violence is still common in Eastern Europe(i.e Romania) so go figure why there is a bias against Eastern Europeans.
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Yes, that's what GP meant.
For your edit: 'honest questions' (which are in fact anything but: the person asking has no interest in the answer, and the question itself is often leading) are a common disruptive tactic used by people (normally pushing extreme right-wing ideologies) to derail a conversation.
I'm sure that you're not doing that here, but unfortunately people with genuinely honest questions have become collateral damage caused by disingenuous actors, especially among people with itchy downvote-trigger-fingers.
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It could be, but communication issues could also be at play, plus overeager doctors/social workers. In Romania they go at great lengths not to pull children out of family environments, in Denmark and other more developed countries it could be the opposite.
Implying ripping children out of their families willy-nilly is "more developed."
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> in Denmark and other more developed countries it could be the opposite.
Did you mean: richer?
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Seems like the bias is on your part… Which is ironic, given the articles content….
Or do you have _evidence_?
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.
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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.
The username kinda suggests an Eastern European (https://en.wikipedia.org/wiki/Ilya_Muromets) so I read the post as a personal opinion that the bias exists.
Wait, are there Europeans who don't acknowledge that this bias exists? In my experience with European colleagues and those who've traveled a lot there it's so universally-acknowledged that this would surprise me.
It also because north Europe has one of the most toxic social services in the world, kidnapping kids 24/7. That's basically their job.
Whatever core truth you're trying to express, wording it in this way isn't helpful.
This is a difficult question I've been pondering between the UK/USA.
Who has more authority over their children and in which domains?
Medical providers, can they ruin kids' lives in various ways? It's easy to manipulate worried parents.
Schools, do teachers have authority over their classroom, how much? Can they override parents, for example when rescuing them from anti-LGBT?
Nobody trusts churches anymore, so that's not really a problem.
Seen complaints/protests like this in my country. Then the adult children of the lady leading these protests spoke out against her and pointed out she was just doing it to get a house and embezzling a load of GoFundMe money.
This wasn't SBS though, she just kept adopting out her kids to devote more time to her drug habits.
No.
trully unbelievable, i lose faith in thr justice system day by day
Nothing shook my faith in the medical system more than having kids.
Holy cow is modern medicine still as smugly wrong as it’s always been. Every generation laughs at all the stupid stuff the previous generations believed, and then acts so confident that they’ve got it right this time.
And as a result you get unworthy nurses making moms feel intense shame for not “trying hard enough” to somehow magically produce milk.
> Every generation laughs at all the stupid stuff the previous generations believed, and then acts so confident that they’ve got it right this time.
Voltaire (1694-1778) wrote a satirical account of a medieval university's oral examination on medicine: the examiner asks why morphine puts people to sleep, and the student confidently replies that morphine has a "dormative essence". This is a bit like saying that things with an essence of gravity fall towards the earth, whereas things with an essence of levity float towards the sky. The examiner proudly accepts that answer and bestows upon the student the title of doctor.
This was very funny to anyone educated in the time Voltaire was writing, since they would have known that morphine puts people to sleep because... it has round molecules with no sharp edges...
Edit: correction below, thank you thaumasiotes.
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My sister wouldn't sleep. The doctor constantly gave the "sigh, you're an idiot, you just do X and Y and they sleep" talk to my mother because nothing came up on their screening, even though my mother almost wanted to scream that something was clearly wrong and abnormal. Turns out, different doctor, serious vitamin deficiency.
And medical incompetence by staff, not doctors, is also awful. My brother hated reading. He got glasses, still hated reading, my mother wondered why he could be so disobedient in that regard. They said, well, the prescription is right, he can clearly see fine. Turns out two years later that the lenses were installed on opposite sides. Right lens on left eye, left lens on right eye. A simple mistake, but the consequences...
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> unworthy nurses making moms feel intense shame for not “trying hard enough” to somehow magically produce milk.
Stay away from mommy blogs/forums. Those are the most toxic cesspools I've ever witnessed. Things are changing, some of the newer ones are not nearly as bad, but man the judgement is super real.
Nurses are one thing, but personally, the worst is family members who think they know better and don't understand the data and that times have changed.
FORMULA IS PERFECTLY FINE.
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Our twins were put into my wife's arms, and we were wheeled into a room to stay for 48 hrs, being woken up every 2 hours by a nurse, which would wake up our kids, making the whole thing a living nightmare. I have no idea how I drove home.
They had no care for my wife's ability to heal, rest, or anything, just subjecting us to the worst kind of institutionalized checklist torture. The medical system cares for nothing other than preventing lawsuits and providing a place for doctors to do their 1 hr of work on their 18 patients a day.
Same experience. The medical system is a reflection of pop parenting culture or vice versa. Everyone was so gung ho on breastfeeding, but when the milk didn’t come in and our son wasn’t interested in a dry breast the only advice given was “keep trying”. Then the shock and surprise when baby is losing weight. We had to demand formula, which was given grudgingly, and left the hospital a day later. If we have another we will do breast plus formula from the get go.
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After 5 kids in 10 years, you come to realize that the standards aren't agreed upon, and best practices/recommendations change YEAR TO YEAR without fail.
Breastfeeding is one of the worst things hoisted upon mothers who are told "you must try no matter what" - seemingly ignoring the mental and physical health of the mother and the father all the while.
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Older nurses are the best. They've seen it all.
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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"
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.
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There are also huge swaths of people actively trying to make it worse, that's what the FBI did (does?) for years when it knowingly pushed junk forensics.
Or what basically every prosecution does, when it knows that the science behind some things isn't airtight but still presents it in the best possible light to get a conviction.
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It's not a justice system, it's a Law and Order system: It's not designed to deliver justice, it's designed to resolve disputes relatively cheaply, while allowing for spending more money to get better results.
If the current functioning is it doing "the best it can", the whole thing should be burnt to the ground.
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and none as effective as this one person
too many cooks in the kitchen
The justice system is doing what the doctors tell them. Broadly speaking If a medical professional testifies that this is the only way, what qualifications does a DA have to question him? Medicine is a profession; thus the professional body ought to be addressing this and, if the guidance changes, be advocating and lobbying to Congress that people start being released.
> If a medical professional testifies that this is the only way, what qualifications does a DA have to question him?
Questioning witnesses is literally the DA's job. That doesn't magically stop being the case just because the witness is an expert. The DA is indeed qualified for this. You could even say it's one of the main reasons the DA exists.
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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
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.
> 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).
It's much worse. There's no evidence of any baby shaking. At all.
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/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."
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You've got to be kidding. This takes victim blaming to a whole new level.
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.
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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?
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.
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"Shake it baby"
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.
Did you read the article? The article claims the reverse. That this is not a real problem.