Shaken Baby Syndrome Decision in Sweden

Score one for sanity, logic, reason, and science.

There has been a recent decision (October, 2014) by the Swedish Supreme Court that calls into question the scientific validity of the classic “triad” SBS diagnosis. According to the triad diagnosis, the symptoms of retinal hemorrhage, subdural hematoma, and diffuse edema of the brain are pathognomonic (exclusively indicative) of violent shaking or abusive head trauma.  The “triad” has been the mainstay of SBS prosecutions for decades, but in recent years, has come under increasingly critical scrutiny.

These quotes from the testimony of experts before the Swedish court:

It can be concluded that, in general terms, the scientific evidence for the diagnosis of violent shaking has turned out to be uncertain.”

The controversy is not about whether it is harmful to shake a child violently. The issue under discussion is with what scientific certainty it can be established how various injuries found in a child have arisen. The claim that the occurrence of the triad is strong evidence that violent shaking has occurred goes back to the late 1960s; however, the medical evidence for it was relatively thin. But the claim became generally accepted and grew into medical truth over several decades, even though the situation in terms of evidence did not change. It is known that a very large share of fundus haemorrhages are not linked to violence and arise in another way. Nor has it been shown that nerve fibers are torn, and that the brain therefore begins to swell, in connection with violent shaking. It can also be asked whether violent shaking can occur without neck injuries arising… To sum up, it can be said that the scientific support for the diagnosis of violent shaking is uncertain.

Sue Luttner, who edits the blog OnSBS, has done an excellent job of summarizing this decision and the case it involves, and has posted it on her blog here.

 

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