Shaken Baby Syndrome Dr Waney Squier
This shaken baby syndrome case is a dark day for science – and for justice
A leading doctor faces being struck off for challenging the theory about the infant condition. It’s like Galileo all over again
‘Shaken baby syndrome is almost unique among medical diagnoses in that it is not focused on treating the child.’ Photograph: Moodboard/Alamy
Monday 14 March 2016 09.30 GMTLast modified on Monday 14 March 201612.05 GMT
On Friday, I witnessed something akin to a reenactment of the trial of Galileo, precisely four centuries after the original. Dr Waney Squier faces being struck off by the General Medical Council (GMC) for having the temerity to challenge the mainstream theory on shaken baby syndrome (SBS).
For years, the medical profession has boldly asserted that a particular “triad” of neurological observations is essentially diagnostic of SBS. Since the Nuremberg Code properly prevents human experimentation, this is an unproved hypothesis, and there has been rising doubt as to its validity.
Doctor who doubted shaken baby syndrome misled courts, panel rules
I am convinced that Squier is correct, but one does not have to agree with me to see the ugly side to the GMC prosecution: the moment that we are denied the right to question a scientific theory that is held by the majority, we are not far away from Galileo’s predicament in 1615, as he appeared before the papal inquisition. He dared to suggest that the Bible was an authority on faith and morals, rather than on science, and that 1 Chronicles 16:30 – “the world is firmly established, it cannot be moved” – did not mean that the Earth was rigidly lodged at the epicentre of the universe. It was not until 1982 that Pope John Paul II issued a formal admission that the church had got it wrong.
Shaken baby syndrome is almost unique among medical diagnoses in that it is not focused on treating the child. If an infant has bleeding on the brain (a subdural hematoma), the doctor wants to relieve the pressure – it is of little relevance how the infant came about the injury. SBS is, then, a “diagnosis” of a crime rather than an illness, and when a brain surgeon comes into the courtroom and “diagnoses” guilt, the defendant, mostly a parent, is likely to go to prison – or worse.
I have defended a number of emotionally charged capital cases where doctors have opined that a child had to have been shaken by an angry parent because it was “impossible” for the triad of neurological sequelae to result from an accident – it “had” to be caused by shaking. Many American doctors adhere to a bizarre notion that an infant cannot suffer a fatal head injury from a fall of less than three storeys. While we cannot drop a series of infants on their heads to test this, it would appear to be plain folly. The velocity of a five-foot fall means a child’s head can hit the ground at roughly 15mph, which is faster than most people – short of Usain Bolt - can sprint. I invited a series of neurosurgeons to run headlong into a hardwood wall in one courtroom, so we could see what happened to them. They politely declined, and stuck to their silly theory.
What other doctor will be prepared to question the prosecution theory if it means the end of a career?
Squier has now been branded a “liar” by the panel, and found “guilty” of paying insufficient respect to her peers. Dr Michael Powers, perhaps the eminent QC in the area of medico-legal practice in the UK, believes that the GMC tribunal – made up of a retired wing commander, a retired policeman and a retired geriatric psychiatrist – was not qualified to understand the complex pathology of the developing brain. “It is therefore sad, but not surprising, that they have reached the wrong conclusion,” he said. “The proper forum for debating these issues is the international neuroscience community.”
Powers has a point: Michele Codd, the chair of the panel, was a general duties officer in the RAF for 32 years. One might doubt whether Stephen Marr, a retired Merseyside police officer, would hold up a constable’s hand to a prosecution theory that has sent so many people to prison.
Nisreen Booya was the sole person with any meaningful medical qualifications on the panel, but in a rather different area: she is a retired psychiatrist specialising in geriatric issues such as Alzheimer’s, an illness that, like infant head trauma, is “poorly understood”. She is quoted as saying that she “made a career of trying to provide innovative services” in her field – and yet she condemns Squier for thinking outside her own rigid box. All three are doubtless honourable people, but they are simply wrong to hold SBS up as the fifth gospel.
At the risk of being diagnosed with “I told you so” syndrome, I wrote an article 20 years ago questioning whether forensic hair analysis was really science. I was pleased therefore when, in 2015, the FBI admitted that they had got it wrong for decades – but this came after thousands of men, women and children had been convicted on the basis of latter-day snake oil, and scores had been sent to death row.
Those deemed to be blasphemers often suffer a gruesome fate. Although Squier may be struck off, at least she will not be burned at the stake. But the impact on medical science will be immense, because what other doctor will be prepared to question the prosecution theory if it means the end of a career? This is a very dark day for science, as it is for justice.