50 U. Mich. J.L. Reform 749 (2016-2017)
Can a Sign or Occult Finding Predict a Causal Relationship: How to Reason about Possible Child Abuse

handle is hein.journals/umijlr50 and id is 773 raw text is: 




KEYNOTE ADDRESS: CAN A SIGN OR OCCULT FINDING
PREDICT A CAUSAL RELATIONSHIP?: HOW TO REASON
ABOUT POSSIBLE CHILD ABUSE

Dr. Peter Aspelin*


   This is only the second time I'm talking about child abuse. The
first time was a few months ago for the Swedish Supreme  Court.' I
then explained  that I can't testify on an individual case because I'm
not a specialist who diagnoses-in spite of my profession as a radiol-
ogist-child  abuse.  But  I  explained  that I'm  experienced  in
evidence-based medicine.  So I had the opportunity to testify in the
Supreme   Court and I contributed to change the verdict of the case.
That ruling created some  turbulence in Sweden  about how  to han-
dle child abuse and Shaken  Baby Syndrome  (SBS) in the future. So
I think that was why I was invited here. I will tell you about how I
was reasoning when  I came into the child abuse field just four years
ago.
   I have a disclosure. I have a son who was accused of shaking his
son, my  grandson Johan,  and I will talk a little about that in rela-
tionship to the topic of today, and that will be referred to asJohan's
case.2 After more than  three years, the charges were dismissed. I
first want to emphasize that I personally believe that violent shaking
may  seriously injure a child. I heard Patrick Barnes say the same
thing. I believe that some of the cases that I have been presented
with  over the years had  involved  violent shaking. Pediatricians
should look for signs of child abuse. So let's make sure that these
facts are never forgotten.
   I have served in several different roles to analyze and evaluate
science, especially the seven years when I was Chairman of the Sci-
entific Board   of  the Swedish   Board   of Health   Technology
Assessment,  whose  main  purpose  is to promote   evidence-based
medicine.  So, in summary, I'm not  a specialist in diagnosing SBS,
but  I'm well-educated in  evaluating research and  especially evi-
dence-based  medicine.

  *   Professor of Medical Radiology, Karolinska Institutet and Karolinska University
Hospital, Stockholm, Sweden.
  1.  See generally H6gsta Domstolen [HD] [Supreme Court] 2014-10-16 B 3438-12
(Swed.), http://rffr.se/wp-content/uploads/2014/12/Swedish-supremeCourt_20141016.
pdf.
  2.  Joseph Shapiro, Dismissed Case Raises Questions on Shaken Baby Syndrome. NAT'L PUB.
RADio (Dec. 21, 2012), http://www.npr.org/2012/12/21/167719033/dismissed-case-raises-
questions-on-shaken-baby-diagnosis.


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