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.
749](ViewImageLocal?handle=hein.journals/umijlr50&div=28&collection=&method=preview&ext=.png&size=3)
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Can a Sign or Occult Finding Predict a Causal Relationship: How to Reason about Possible Child Abuse
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