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.
[iii] Dr.
Margaret Colbourne, Director, Child Protection Service Unit, Child
and Family Clinic, B.C. Children’s Hospital, Via email: mcolbourne@cw.bc.ca
Ron; one correction. I do not know whether or not the BC medical establishment supports SBS or not. What I wrote was that the British medical establishment does not support it. St Thomas Hospital in London sends out teams of doctors to train lawyers in how to defend against SBS accusations.
ReplyDeleteIt has been corrected Ray.
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ReplyDeleteThis is a good assessment of SBS as a flawed diagnosis, and good observations on the increasing danger of biased embedded child abuse doctors who "specialize" in declaring parents guilty of abuse, so that child protection workers have "no choice" but to strip parents of custody. There is no recourse for parents if removals turn out to be wrong, because erring on the side of caution is accepted by the courts.
ReplyDeleteI watched Colbourne testify in Chilliwack. The "new" term used even back then was "Non-accidental injury" or "unexplained injury", and this, my guess is merely an attempt by the proponents of SBS to distance themselves from the now-damaged marketability of the term SBS. The press still find this a popular term to use, the courts less so.
In the Bayne case in 2010/11, you will recall the appearance of Dr. Alexander, the individual that MCFD flew from Florida at enormous (wasted) taxpayer expense to bolster their offence agains the Bayne's family, and to take the heat off the very much unqualified Dr. Colbourne, because she was outgunned by the many volunteer defence experts.
It is beyond me how a paediatric doctor can proclaim herself as an expert in a clearly biomechanic injury, and categorically eliminate all other possible explanations for injury except their "abuse" theory. It is mind boggling.
JUDGE CRABTREE writes in his ruling in the Bayne case in 2011:
[154] Dr. Alexander was unwilling to examine alternative hypotheses for the cause of the injury or injuries. He was somewhat dismissive of the other experts called to express an opinion, on the basis that they were not experts in the area of child abuse.
[155] His initial views were based on the review of a limited number of the clinical records, primarily the consultation report of Dr. Colbourne and a letter of Dr. Gardiner, as well as some records obtained from the Children’s Hospital. He had no opportunity to review any of the images or the balance of the clinical records from the various hospitals and health care providers that the child attended prior to her admission to Children’s Hospital.
[156] For the foregoing reasons, I place little weight on the opinions expressed by Dr. Alexander in this case.
The Bayne case can be found on Canlii at 2011 BCPC 72
http://bit.ly/Bayne-Canlii
The many conferences the Baynes hosted brought together several experts at the EBMSI (Evidence Based Medical and Social Investigation) helped debunk the validity of SBS diagnosis'. Hospitals are increasing funding to continue to attribute guilt to parents abusing their child without due process. This has to be concerning. Parents often face a triple whammy of losing custody of their kids, civil, and criminal proceedings.
The point needs to be made that there is a growing investment in embedded medical child abuse teams inside hospitals. Medical Kidnap is the term used to describe parental termination of custody owing to a medical diagnosis. Guilt first, and the onus is on parents to prove they did not abuse their offspring. It is a terrible trend.
The Innocence Project in the U.S. is freeing more and more parents from jail after wrongful SBS convictions. Meanwhile, the medical community continues to investigate new ways to use child protection to their advantage.
PapaBC blogger, yours is an insightful piece, thanks for putting this here. I will comment with you privately about using it further.
DeleteI too remember the days of the Bayne hearing and the testimonies of Colbourne and Alexander. How could we who were so integrally invested in the truth and the facts ignore the nonsense that passed as expertise; the enslavement to a bureaucracy and a face saving and job saving effort by government employees. It was glaring and appalling.
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