Defense Witnesses Using Flawed Theories to Cast Doubt in Courtrooms

05 October 2017

John Leventhal, MD, Yale School of Medicine, and George Edwards, MD, University of Texas, recently published an article in the Journal of American Medical Association (JAMA) titled Flawed Theories to Explain Child Physical Abuse : What Are the Medical-Legal Consequences? The article states that "there is no significant controversy about the diagnosis of physical abuse and abusive head trauma in clinical medicine" and claims that defense witnesses in Abusive Head Trauma (AHT) cases often use "scientifically unsupported theories to explain abuse."

"When defense witnesses have decided to cite opinions that are not real diagnoses, or when they cherry pick information by looking at half a child's findings and ignoring the other half, it's upsetting," said Dr. Leventhal. ""This is not how physicians work. We try to understand symptoms, look at physical findings, do laboratory tests, and come up with a specific scientific diagnosis."

Diagnosing abuse is a difficult task that requires a team of professionals. James Metz, MD, Seattle Children's Hospital, uses a multitiered approach to gather facts before a diagnosis of abuse can be reached. This approach involves consulting with radiology, lab work, patient examinations and gathering history from family members. The science behind the Shaken Baby Syndrome (SBS)/AHT diagnosis is sound. Dr. Metz compares the debate over the SBS diagnosis with the one on climate change. "A large majority of the scientific community has an overwhelming opinion about the science, while a very few loud people object, raising doubts in people's minds." Dr. Metz agrees that a thoughtful debate that pushes science ahead is helpful, "but when the science is irrefutable, or well documented, the debate does it an injustice," he said.

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