Showing posts with label diagnosis. Show all posts
Showing posts with label diagnosis. Show all posts

Sunday, January 16, 2011

WHAT DOES AN IMPROVED OUTCOME LOOK LIKE? / Part 421 / For Love and For Justice / Zabeth and Paul Bayne

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Yesterday I wrote two posts and in the first entry I said that we need a model of casework that ensures consistent practices which support improved outcomes for children, youth and families. I am going to give MCFD an example of what a good outcome looks like. I will use the Paul and Zabeth Bayne and their three children as an example because even this difficult case could have been addressed with an improved outcome provision.

There is no question that this has been a complicated case. It is complicated by the nature of their youngest child's injuries, by the initial medical diagnosis of those injuries using a term that immediately insinuates parental liability, by the controversy in the medical sciences arena about the legitimacy of the shaken baby syndrome diagnosis, by the early and continued denial by the parents of any harm done by them to their child, by the early RCMP arrest and charges against the parents prior to an investigation and then the subsequent release and dropping of charges for lack of evidence, by the immediate apprehension of the two older syblings, by the failure of MCFD to follow prescribed time-line guidelines within its own authorizing ACT, by the MCFD refusal to accept the Bayne explanation of accidental injury, by the MCFD refusal to give credence or even read the hundreds of letters of support for the Baynes, by the unjustified retention of the two boys without cause and against their own counsel's advice, by the adversarial treatment MCFD administered to the Baynes at every level including intensely rigid instruction about visitation, by the financial losses of the family in properties to pay legal fees, by the unduly long three years that MCFD has withheld the children from their parents, by the publicity that has been garnered by public protests, by online blogs and news media venues suggesting MCFD blundering, and by the lengthy court case in which the bulk of the time was spent by MCFD counsel. That is complicated!

If an improved outcome had been the focus of MCFD for the Bayne family, the Director and his team would have considered that in spite of a suspicious injury and a medical opinion, there was no verifiable specific evidence. It would have understood the significance of the RCMP dropping of charges. It would have viewed the medical diagnosis as an opinion rather than a verdict. It would have dug deeply enough to recognize even three years ago the controversy revolving around the SBS diagnosis. It may still not have believed the Baynes' story of accidental injury or believe that either one of them was innocent of wrongdoing. However, MCFD would have acknowledged that it did not have proof against the Baynes. It merely had suspicion of them and MCFD would have understood the significant difference between evidence and suspicion. MCFD would have viewed this now as an opportunity – an opportunity to help this family. It would have recognized that the best interests of the children was unquestionably to be with their parents and it would have considered how that can best be effected. It would have provided to the Baynes a compassionate plan whereby the parents were not made to feel like criminals always under suspicion but rather as clients being helped by a caring social agency, whereby the well-being of the children in the family home could be monitored each week for a specified time period, whereby the parents could have attended any agreed upon course for parents of small children to improve understanding, coping skills and patience and whereby the concerns of MCFD could be met and the dignity of two respected people could be retained.

Please send this to news media people you know with a courteous two sentence intro inviting them to read this link. Example: "Please read today's GPS blog post. The Bayne Family will hear Judge Crabtree's ruling by January 19th. Thank you. The Link is: GPS"

This Blog has been advocating the return of three children to their biological parents, Paul and Zabeth Bayne, for which a ruling is expected from Judge Crabtree by January 19th. Three days. Stay posted.

Friday, October 8, 2010

A GRIEF OBSERVED / Part 332 / For Love and For Justice / Zabeth and Paul Bayne

A Grandmother and a grandfather sat helplessly. Yesterday I described the small court room in which Mr. Jensen delivered the final hours of his Summation. The judge's bench and the clerk's desk and the table and chairs of the legal staff and defendants comprised most of the space. Of the nine remaining chairs, two were occupied by these grandparents. Zabeth's parents they are. I paid attention to them because I too am a grandparent, proud of it, loving the relationships with little people that it provides to me. I am special because those grandchildren are extraordinary. I, however, have unfettered access to my grandchildren. These two people do not.

So I watched them as the Jensen words cut them deeply. They sat motionless, staring ahead, no longer shocked by what they were hearing because they have grown accustomed to their savage sound. They were grieving I thought, hardly bearing the insinuations against their daughter or her husband, perhaps imagining the worst possible outcome of this hearing.

Jensen pointedly directed Judge Crabtree that (1) his honour must find that there is need for protection, and that (2) he must therefore order the Continuing Care of the children. With such intense statement of objective, I found it interesting that Jensen then mentioned that contrary to what some people were saying, there are more than two possible rulings from which Judge Crabtree may select his verdict. In fact he said there is a host of alternative rulings beside either a CCO or giving the children back to the parents. Among these he suggested that Judge Crabtree might issue a Temporary Care Order, or a Period of Supervision, or place them in temporary care while the parents take further steps to satisfy the Ministry that they are indeed risk-free as it were. These were proffered to the Judge it appeared, as considerations should the judge come to the conclusion that the risk is still there but that the CCO is too final for this particular case. Who knows the precise motivation other than Jensen? But he did underscore that there should be no misunderstanding, that the Director's desired and appropriate ruling is a CCO. Yet Jensen implied that these other options might be considered. The Judge asked for some guidance on a Last Chance Order and that definition was discussed for a few moments.

Now all of this was at the conclusion of the first couple of hours during which Jensen reestablished Dr. Jane Gardner's paediatric ophthalmology qualifications and revisited her testimony concerning how she arrived at her diagnosis of the injuries, her opinion about extent of force needed to produce these injuries, her reactions to the hypotheses of the Baynes' experts. Then he focused upon Dr. Alexander's credentials and testimony, the foundation for his opinions being clinical records rather than information from Dr. Colbourne Jensen said. Alexander had disagreed with any theories that a short fall and particular that of a toddler upon the reclining infant could produce the extent of injuries Baby B sustained. Those injuries included subdural hemorrhages on both sides of the brain, retinal bleeding, a skull fracture and a chip off the long bone of the left femur. His testimony was that this was only due to a blunt force impact together with acceleration and deceleration. He even said that this force was the equivalent of that experienced in a car crash or a large fall from a great height, or child abuse. Well that's mighty frightening if it is to be believed. But that is precisely the obstacle. It does not have to be believed because it is still one man's theory against how many was it? Ten experts. Whose expertise Jensen discounted for numerous reasons stated in court. And that is his job. And the Judge's responsibility will be to conclude what and who is believable. What can be viewed as definitive?
Oh, I know, I know, Jensen would quickly respond to that. I will share again more of the Jensen summation tomorrow although I feel I have given him far too much air time or blog space. The transcript of these several days of Jensen are being prepared now.  

Wednesday, August 25, 2010

FORMULAIC LEGAL REPRESENTATION / Part 291 / For Love and For Justice / Zabeth and Paul Bayne/

Mr. Finn Jensen sought to convincingly present to the Court the Ministry's case that one parent is or both parents are a continuing risk to their children for which reason, they should not be awarded custody of those children. Jensen's presentation was based upon the Director's affidavit that expressly based its case on Dr. Colbourne's medical diagnosis. As I interpret the court case development, when the shaken child insinuation became shaky because the diagnosis itself is controversial and the evidence against either Bayne is non existent, Jensen employed other approaches.

Zabeth, under cross-examination by Jensen was squeezed to extract information that might be construed as admission that Paul had alone time with his several week old infant and he might have hurt her. Zabeth gave Jensen nothing. Then, of course, Jensen did the unthinkable. What was a loving confidence between husband and wife and shared with only a few others, her new pregnancy, mistakenly disclosed or clandestinely pirated to Jensen became for him a cruel instrument. He knew the effect it could have. The method is formulaic. When a counsel can make a witness come unglued or display behaviour that casts doubt upon emotional control and stability, it is easier to assert incapacity to care for children. He posed questions that evoked from her, what else, truthful responses. Yes, she and Paul have always loved children. Yes they wanted a large family. Yes they had considered enlarging their family. And then, “Are you pregnant now?” “Yes,” she said. She cried. A young woman, happily pregnant, had been made to feel soiled, guilty. Caught in the act of being with child.

This is the adversarial nature of the Court Room. The weapon was dulled at the moment of impact by the unified abhorrence of a full court room.  So Jensen's propositions continued. Whether Zabeth agreed or not, Jensen expressed questions to the Court that inferred that after three years without children in her home, and with the significant demands of a newborn, she and Paul would surely not be able to adequately care for these children. If he thought that his sails filled just then with a desirable breeze, Zabeth closed her trial by shredding the sails with her valiant and forceful final words.

Saturday, June 5, 2010

Munchausen Syndrome / Part 210 / For Love and For Justice / Zabeth and Paul Bayne/

Munchausen syndrome is named after Baron von Munchausen who was in the German military and is noted for his extensive travels during which he told fantastic tales about his imaginary exploits. In 1951 Richard Asher applied the Baron's name to people who reported into hospitals fabricating histories or symptoms of illnesses. His name now has become synonymous with a disorder in which a person intentionally fakes, simulates, worsens, or self-induces an injury or illness for the main purpose of being treated like a medical patient. A related condition, called Munchausen by proxy syndrome, refers to a caregiver who fakes symptoms by causing injury to someone else, often a child, and then wants to be with that person in a hospital or similar medical setting. It is the latter syndrome that was associated with Zabeth by someone who called in a report of concern to the MCFD. That person could have remained anonymous but didn't and in fact was identified in court when he gave testimony. He testified that during his professional training he had become acquainted with the term and its signs and in observing both Zabeth and her children, although unqualified professionally to make a definitive assessment, concluded Zabeth may be suffering this disorder. The timing of that call to MCFD approximate to the time of the Bayne infant's admission to and examination in Children's Hospital in Vancouver fueled the MCFD persuasion that the children needed protection. That combination of factors has led the Bayne family to the point today that the fate of their family rests with a provincial judge who will decide whether evidence presented by the Ministry lawyer proves that Paul and Zabeth are unfit parents who should never have custody of their children again in this life, or whether they should receive those children back immediately because the Ministry file folder containing three years of data on the Baynes is filled with subjective and biased hearsay rather than conclusive evidence.

Did Zabeth actually do what the syndrome scenario suggests? For one moment do you think that when her small daughter vomited, didn't eat, didn't poop, couldn't breath, didn't respond to stimuli and she took the child to hospitals and clinics in Hope, Chilliwack and Abbotsford over a period of days because no one was making an accurate diagnosis, that she was actually trying to gain attention for herself? Was she so needy that she inflicted injury to her child so that she would have reason to go the hospital and make a scene? No, Munchausen doesn't relate to her daughter's life in even the remotest sense. MCFD has never attested that it accepts the Munchausen possibility but it has not needed to because a medical diagnosis at Children's Hospital assessed the daughter's condition and speculated that it derived from non accidental trauma, that is an inflicted wounding. So regardless of the motivation, the implication is that mom did it, or dad did it. If the diagnosis of these symptoms was as conclusive as Children's Hospital or MCFD have maintained for almost three years, Paul and Zabeth would not have a hope. However, the ministry case in court has been paper thin. The Ministry lawyer's problem is that shaking a baby, as horrific an act as it is, is not the only probable cause for what the baby suffered in 2007 and has since then. That is why August 9-13 is so important as the Baynes present the alternative medical expert opinions that controvert the SBS diagnosis and which MCFD should have been diligent to pursue if quality investigation is a Ministry commitment.

It has been and it is an uphill battle for this mom to establish credibility which she lost involuntarily. She didn't need attention. She received it naturally and deservedly as a concert pianist and a music instructor. She is not now personally thriving on the media attention by which she hopes to regain her children, but rather is wilting under the discourtesies of insinuations and allegations. She is compelled to be a parent by proxy. She would much prefer to slip quietly away in the embrace of her three children, never to be heard from again.

See M.A.M.A.