Comment by firesteelrain
2 years ago
“ 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.
I think that is a reasonable gloss on the following:
> 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.
> But in practice, extremely few medical conditions are checked for and “excluded” before concluding a diagnosis of abuse – the great majority are not checked for at all. 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.
> Overall, the clinical literature supporting the shaking hypothesis suffers from a number of severe methodological shortcomings. The main issue is circular reasoning. It is only in a small minority of “shaken baby” cases that actual shaking has been observed by independent witnesses, videotaped, or spontaneously confessed before police interrogation. Far more often, shaking is “inferred” after the observation of subdural and retinal hemorrhage in infants who are brought to the hospital by parents or caregivers. Physicians interpret these types of bleeding as markers of violent trauma. When asked about these findings, parents and caregivers generally do not provide “acceptable explanations” – but the only “acceptable explanations” today apart from shaking are multistory falls and high speed motor vehicle accidents. This being so, it is considered that parents and caregivers must be lying when they report non-traumatic events such as a sudden collapse, an unexplained respiratory arrest, or a minor fall – even though this happens in case after case