Ray Ferris is a retired child-protection worker and the author of The Art of Child Protection, and an occasional contributor here.
When I say that Dr. Colbourne is on the warpath again, most of you will not know what I mean. So let me explain about the shaken baby syndrome.
Doctors who believe in the shaken baby syndrome hypothesis claim that when three medical symptoms are present, they can only be explained by a shaken baby opinion. They claim that when these injuries occur to an infant that they can tell the cause of injury. They claim, they could only happen because the baby has been shaken. Hence the acronym of SBS syndrome. The reason why such an allegation is especially damaging is that it is an automatic allegation that an injury has been deliberately inflicted and is thus criminal and proof that the parent is unfit. Well you can see for yourselves that if the hypothesis is incorrect, that it can result in horrible wrongs being done to parents and other caregivers.
So how valid is this theory? To start with, you need to understand that the SBS hypothesis is just an unproven hypothesis and it has fallen increasingly into disrepute. Do not imagine for one minute that all medical practices are based on sound research that can pass the test of reliability and repeatability. The history of medicine is full of popular ideas that tumbled into disrespect. Numerous forensic medical experts[ii] are convinced that the SBS syndrome has no basis in quality research and that it should be abandoned. Among these experts are bio-mechanical experts who have done a great deal of impact testing and they are convinced that one could not damage a child’s brain by shaking without breaking the neck first. Apparently neck injuries are not common among alleged shaken baby cases, which takes a lot of explaining away.
SBS doctors commit two serious medical transgressions. They frequently fail to do a differential diagnosis and fail to consider a whole range of possible causes of a brain injury. They claim that they can tell the cause of an injury from symptoms alone, which is not accepted in medicine. Good doctors do not guess. Another bad practice is to fail to consider profile. Is this the sort of family where it would be highly unlikely that they would inflict an injury? Do they seem to be responsible citizens with good standards or do they parents have a history of violence or alcoholism? This is an important consideration for any injury within the home.
In addition to all the expert opinions we have a most important judgement. There was an Inquiry into the SBS by an Ontario Supreme Court judge, resulting in what is known as the Goudge Report. One can access it in any search engine, the judge said that it was impossible to determine the cause of injury from medical symptoms alone and that the determination of the cause of injury was a judicial matter and not a medical one. He put paid to all the convictions obtained by testimony from pathologist Charles Smith. He effectively put an end to the use of the SBS hypothesis in Ontario and a number of wrongfully convicted people were released from prison.
Strangely what is the truth in Ontario does not seem to be the truth in British (UK) and cases are still being conducted in this province. The police no longer appear to prosecute such cases because they do get some training in evidence, but child protection cases do crop up from time to time. As far as I know the British Columbian medical establishment rejects the SBS hypothesis and one major hospital campaigned vigorously against it. Chief provincial court judge Thomas Crabtree ruled in one case that the cause of the injuries could not be determined from the symptoms alone as claimed by Dr. Colbourne.
So who is Doctor Colbourne and why do I say she is on the warpath? Dr. Colbourne[iii] is a paediatrician at the Vancouver Children’s Hospital and a firm believer in the SBS hypothesis. She appears to be completely untroubled by any self doubt and does not hesitate to testify for the prosecution. Principally she testifies in child protection cases. The parents she claims have injured their child seem to have completely the wrong profile and this does not suggest any likelihood of violence.
That Good Samaritan, Zabeth Bayne is helping all she can with defense medical experts and so on. We just hope their lawyer knows how to use all the help she is offering. From the legal point of view it hinges on evidence. An expert medical opinion is only opinion evidence and has some serious weaknesses. It is much lower on the list of evidentiary value than factual and eyewitness evidence. Equally qualified experts often disagree with each other. As soon as one expert disagrees, the evidence becomes unreliable and no grounds for serious consequences.
Unfortunately social workers do not know enough to question the word of a doctor and usually act quickly if a doctor makes an allegation. So the warpath continues.
I have finished with this topic, but I would like to add a PS to the Bob Plecas topic. Writing previously, I said that many children who die in care would have died anyway due to years of neglect and abuse at home and entrenched addictions. A couple of readers responded somewhat indignantly about my comments and I blame myself for not being clearer. Of course I did not mean that we should just give up on these kids. We should always do our best to support them and help them with a leg up. But understand that some will respond, but in spite of our best efforts some will still die because their lifestyle is so risky. Do your best and rejoice at the kids that get ahead, but do not beat yourself up about the kids that do not make it. You are not all-powerful and nobody can control all the factors that go into despair. Also there are grey areas. A number of young people will die of drug overdoses, whether in or out of ministry care. Who can tell whether some of these are deliberate or not? Same goes for adults. It is good to know that people are reading the blog and thinking and not afraid to put me in my place!
A Differential Diagnosis of Justice - an exhaustive study of North American cases where the SBS has been improperly diagnosed and criminal cases were mistaken.Dr. Margaret Colbourne Opinions and an outdated 1962 Publication
[ii] Shaken Baby Syndrome, Abusive Head Trauma and Actual Innocence: Getting it Right - an outstanding research and a 103 page statement by A Keith A. Findley, Patrick D. Barnes, David A. Moran, and Waney Squier, that establishes that the SBS hypothesis fits poorly with the anatomy and physiology of the infant brain, and that there are many natural and accidental causes for these findings, and that the onset of symptoms does not reliably indicate timing.