A journey into the shaken baby syndrome/abusive head trauma controversy(cambridgeblog.org)
cambridgeblog.org
A journey into the shaken baby syndrome/abusive head trauma controversy
https://www.cambridgeblog.org/2023/05/a-journey-into-the-shaken-baby-syndrome-abusive-head-trauma-controversy/
638 comments
> was asked to live the room while he was questioned
Is that even legal ?
Anyone trying to get between my kids and I is going to have a very bad day.
Is that even legal ?
Anyone trying to get between my kids and I is going to have a very bad day.
Your plan when suspected of abuse is to become belligerent? That should convince them their concerns are unfounded.
It might be a bad idea persoannly to become angry in such a situation if the local social service is authoritarian.
But as an altruistic move for the greater good it is good.
But as an altruistic move for the greater good it is good.
>But as an altruistic move for the greater good it is good.
That's only the case if overall children taken away from their parents end up with better outcomes than in societies where children aren't taken away from their parents, have you seen any data showing this is the case? Children in foster care tend to have horrifically bad outcomes, statistically speaking.
That's only the case if overall children taken away from their parents end up with better outcomes than in societies where children aren't taken away from their parents, have you seen any data showing this is the case? Children in foster care tend to have horrifically bad outcomes, statistically speaking.
Children in foster care start off in a much worse situation than average. Or at least that is the normal case, there are exceptions like the article.
Many parents of 'mentally disabled' kids put the kids in foster care because the parents need a break from the constant care of a kid who isn't normal. Many other kids end up in foster care because they have been abused. Both of those will make the kids much worse than normal and thus much harder to care for.
Kids that are close to normal but end up in foster care often end up adopted fairly quick - there are plenty of families who want a kid but not their own (I personally know several people with genetics they don't want to pass on - there are other good reasons to not want someone else's kids) - but they will try to select a kid who is going to be easy to raise thus kids who will end up normal don't spend much time in foster care.
Many parents of 'mentally disabled' kids put the kids in foster care because the parents need a break from the constant care of a kid who isn't normal. Many other kids end up in foster care because they have been abused. Both of those will make the kids much worse than normal and thus much harder to care for.
Kids that are close to normal but end up in foster care often end up adopted fairly quick - there are plenty of families who want a kid but not their own (I personally know several people with genetics they don't want to pass on - there are other good reasons to not want someone else's kids) - but they will try to select a kid who is going to be easy to raise thus kids who will end up normal don't spend much time in foster care.
I meant that protesting the bad process, increasing risk of having your child taken away, is good for everyone else except you and your child. I.e. altruistic.
Sorry, you think in a case where the doctor suspects abuse, they should have to ask the kid while the potential abuser stands there next to her?
Underage kids can't consult to really anything legally on their own. You cannot have a system where in certain cases they're treated as adults. I get what you're saying but I cannot believe that any good parent thinks this is ok.
This country has weird culture that's started happening in the last decade where the parents take a back seat and the government/institutions are taking their place. Suddenly, you're hearing schools, doctor's, etc. telling kids they should come to them and not trust their parents. It's terrifying as a parent. Parents should never have to give up their rights in the name of "safety".
This country has weird culture that's started happening in the last decade where the parents take a back seat and the government/institutions are taking their place. Suddenly, you're hearing schools, doctor's, etc. telling kids they should come to them and not trust their parents. It's terrifying as a parent. Parents should never have to give up their rights in the name of "safety".
>Parents should never have to give up their rights in the name of "safety".
You can be forgiven with this opinion if you have not met or spent time around the types of parents whose children genuinely need to be taken away: neglectful, abusive, and extremely harmful to their kids.
You can be forgiven with this opinion if you have not met or spent time around the types of parents whose children genuinely need to be taken away: neglectful, abusive, and extremely harmful to their kids.
This is like agreeing with a judicial that treats people as guilty until they're proven innocent.
Bad things happening in some cases is not justification for treating everyone as a criminal. That's how totalitarianism starts.
Bad things happening in some cases is not justification for treating everyone as a criminal. That's how totalitarianism starts.
You're always arrested before being proven guilty in court, this is the same situation.
If they don't have a good reason to suspect abuse, yes. If the medical system assumes an adversarial position with parents, then reasonable people might rightfully avoid taking their kids to the doctor.
Police for example is not allowed to talk to a minor without a parent / guardian being present, I don't see how a medical professional would have that right. If there's a serious suspicion they should just get the courts involved and get a legal mandate.
Not saying I wouldn't be cooperative. If I doc wants to ask a few friendly questions that's fine without me being present, I don't consider that "getting between" me and my kids.
Not saying I wouldn't be cooperative. If I doc wants to ask a few friendly questions that's fine without me being present, I don't consider that "getting between" me and my kids.
I am thinking it's even mandated from the medical personnel
The scary thing in such situations is that if the doctor asks "did your daddy hit you?" the child might randomly say yes.
Shane koyczan has a fantastic poem about a cute thing between him and his grandmother that turned into an abuse investigation. And then he was bullied because of it!
https://genius.com/Shane-koyczan-to-this-day-annotated
https://genius.com/Shane-koyczan-to-this-day-annotated
I came to realize that there was a long-standing scientific controversy in the field, and I felt that I had no choice but to get to the bottom of things myself. Although I am not a medical doctor, I hold a PhD in neuroscience and am familiar with critically reading scientific literature. I decided that I would invest as much time as necessary to learn everything I possibly could on the subject. At that point, there was nothing in my life more important than finding out what had really happened to my son.
drt5b7j(2)
I think that speaks more towards the author than higher education.
Definitely a tangent, but attributing that attitude to higher education is like someone attributing a doctor saving their life to an act of god. Like yeah if you squint I guess that’s true.
My experience with higher education has been that of administrators taking advantage of my naivety for profit, elitism towards those not in academia, and dismissal of any ideas that wouldn’t directly result in a grant or a good headline.
I wouldn’t really say that the author’s “mettle” is a result of the same environment.
Definitely a tangent, but attributing that attitude to higher education is like someone attributing a doctor saving their life to an act of god. Like yeah if you squint I guess that’s true.
My experience with higher education has been that of administrators taking advantage of my naivety for profit, elitism towards those not in academia, and dismissal of any ideas that wouldn’t directly result in a grant or a good headline.
I wouldn’t really say that the author’s “mettle” is a result of the same environment.
Yeah I dunno... I mean, a lot of these things are true, and they all are big problems, but also, in my experience, academics (at least in the sciences) do actually know how to read and understand research, which is an extremely difficult and useful skill.
Yeah, I think "mettle" here is like a sword and shield and the ability to use them (read and understand scientific literature, and able to do so, self-directed, for years).
But whether a person does use them, and for what, is entirely due to the person themselves.
But whether a person does use them, and for what, is entirely due to the person themselves.
Isn't that just what PhD do? I meant going through piles of papers - most of them bring more new questions than answers - and stay sane
Yep. That's exactly what I'm saying. This is like the primary skill that people learn to get a PhD. It's true that people can learn it without getting a PhD, but hardly anyone does, because it kind of sucks and if you're doing it you may as well do it with the guidance of an advisor and get a credential at the end.
That’s okay, I know.
Anyone with the wherewithal can learn to “read and understand research” it’s not a magical power bestowed upon the few who receive recognition from some long standing bloated institution.
Attributing the drive and work of an individual to such an institution is weird and elitist.
I should note that if said institution paid for, assembled the team, and provided resources, then that institution obviously deserves credit.
Anyone with the wherewithal can learn to “read and understand research” it’s not a magical power bestowed upon the few who receive recognition from some long standing bloated institution.
Attributing the drive and work of an individual to such an institution is weird and elitist.
I should note that if said institution paid for, assembled the team, and provided resources, then that institution obviously deserves credit.
I think this is a misunderstanding of how stuff works. I agree that anyone (or at least a large percentage of people) can learn to do it and it isn't a magical power.
But it's far more common for academics to be able to do it because that's what academics learn to do. It's a large focus of the training.
It isn't elitist to say "car mechanics are good at reading and acting on the information in car engine manuals", that's just what car mechanics are trained to do and get consistent practice at doing.
But it's far more common for academics to be able to do it because that's what academics learn to do. It's a large focus of the training.
It isn't elitist to say "car mechanics are good at reading and acting on the information in car engine manuals", that's just what car mechanics are trained to do and get consistent practice at doing.
I don’t think there’s any misunderstanding. Your comment seems in line with what I said and what I believe.
One can teach themselves how to be a mechanic and pass the ASE. Most go through some course to learn the trade, of course. It’s more structured that way and many find it easier.
I’ve never had my auto repair shop attribute their mechanic’s skill to where they learned to be a mechanic. I never turned down a mechanic bc they didn’t go to the brown or Harvard of car repair.
On the other hand I’m an expert in my field, but I’ve been turned down from at least 1 job specifically because I didn’t graduate from Brown university. (It was a backend job for the now-defunct Delivery Dudes)
OP attributed the mettle of the author to higher education and academia, which I think is weird and elitist.
Attributing success or ability to an institution fosters that kind of weird elitism.
One can teach themselves how to be a mechanic and pass the ASE. Most go through some course to learn the trade, of course. It’s more structured that way and many find it easier.
I’ve never had my auto repair shop attribute their mechanic’s skill to where they learned to be a mechanic. I never turned down a mechanic bc they didn’t go to the brown or Harvard of car repair.
On the other hand I’m an expert in my field, but I’ve been turned down from at least 1 job specifically because I didn’t graduate from Brown university. (It was a backend job for the now-defunct Delivery Dudes)
OP attributed the mettle of the author to higher education and academia, which I think is weird and elitist.
Attributing success or ability to an institution fosters that kind of weird elitism.
Fair enough.
Many academics have these skills; whether the higher education system is effective at teaching them and delivers an experience worth the significant cost to students (or here in Australia, also the publics).
I would argue that it's clearly the most effective system at training people to do this. It's fine to imagine (and try to create) alternative systems that would work better. But there isn't one now.
Constructive criticism is good. But what I mostly see (and often do myself) is just grousing.
Constructive criticism is good. But what I mostly see (and often do myself) is just grousing.
Yeah you’re not wrong at all. I’m not saying “down with academia” or anything like that.
Just that attributing the work and work ethic of an individual to the institution of academia is weird and fosters and propagates elitism.
Just that attributing the work and work ethic of an individual to the institution of academia is weird and fosters and propagates elitism.
Lots of other parents driven to look for answers about what happened to their child, but being far less educated on how to read and understand academic papers, ended up "doing their own research" and became antivaxxers. There's a lot to be said for having an education that enables you to evaluate scientific literature effectively.
I was in a private discussion group during the pandemic that "did their own research"
First off, this was genuinely valuable during the first few months. Gigantic medical institutions were moving at a glacial pace and were making proclamations literally months behind the state of the research. In order to conserve masks, propaganda was put out that masks were only effective if you were a medical professional, and the most common way I saw this rationalised was that the general public was simply too stupid to wear a mask in a sanitary way. So I proceeded to wear a mask in a sanitary way. Then after a few months mask stocks started to pile up so propagandists THEN pronounced that more science was conducted and masks were actually effective for everybody!
That positive outcome aside, what other people saw was that the younger people got, the lower the risks of COVID, and the higher the risks of getting vaccinated. In fact, it seemed from the numbers (This is for the earlier strains of COVID), that for certain populations (young people who lived like hermits, in other words, hacker news readers) it could be on a selfish individual basis, be irrational to get the COVID vaccine. The risk from myocarditis could actually outweigh the risk of COVID itself. It was however, always in the collective interest for as many people to get vaccinated as possible, to reduce the transmission of COVID, and reduce the consequent strain on medical resources and the direct/indirect deaths this caused. Public health institutions did not get into this nuance, because it wasn't in the collective interest, so they just told everybody the vaccine was good for you. I proceeded to get vaccinated, and the main person I held discussions with did not, after both drawing the exact same scientific conclusion. Not every anti-vaccer was stupid, some of them were just massive civil libertarians.
What I saw from people who DIDN'T do their own research is that they were UNIFORMLY misinformed because they tended to either believe institutions who would lie to them whenever it served their purposes (2 weeks to flatten the curve!), or believed whatever podcaster told them about Ivermectin.
First off, this was genuinely valuable during the first few months. Gigantic medical institutions were moving at a glacial pace and were making proclamations literally months behind the state of the research. In order to conserve masks, propaganda was put out that masks were only effective if you were a medical professional, and the most common way I saw this rationalised was that the general public was simply too stupid to wear a mask in a sanitary way. So I proceeded to wear a mask in a sanitary way. Then after a few months mask stocks started to pile up so propagandists THEN pronounced that more science was conducted and masks were actually effective for everybody!
That positive outcome aside, what other people saw was that the younger people got, the lower the risks of COVID, and the higher the risks of getting vaccinated. In fact, it seemed from the numbers (This is for the earlier strains of COVID), that for certain populations (young people who lived like hermits, in other words, hacker news readers) it could be on a selfish individual basis, be irrational to get the COVID vaccine. The risk from myocarditis could actually outweigh the risk of COVID itself. It was however, always in the collective interest for as many people to get vaccinated as possible, to reduce the transmission of COVID, and reduce the consequent strain on medical resources and the direct/indirect deaths this caused. Public health institutions did not get into this nuance, because it wasn't in the collective interest, so they just told everybody the vaccine was good for you. I proceeded to get vaccinated, and the main person I held discussions with did not, after both drawing the exact same scientific conclusion. Not every anti-vaccer was stupid, some of them were just massive civil libertarians.
What I saw from people who DIDN'T do their own research is that they were UNIFORMLY misinformed because they tended to either believe institutions who would lie to them whenever it served their purposes (2 weeks to flatten the curve!), or believed whatever podcaster told them about Ivermectin.
We know now that the CDC and the manufacturers (and the media) lied about efficacy regarding preventing transmission/infection. In fact, the trials didn't even attempt to measure transmission or infection, and were not ever authorized for such. The only thing they were authorized for was reducing the severity.
Do not perpetuate the myth that the vaccines slowed the spread.
Do not perpetuate the myth that the vaccines slowed the spread.
No, I think I will stand by my position that the vaccines did in fact slow the spread, especially early on. I think there is LOTS of evidence about the vaccines effects on transmission which points to them being effective.
Also think back to before we had good evidence on transmissibility/infection. Myocarditis hit the young, who were the last to be vaccinated, and consequently among the last to be researched. So the evidence of the vaccinations effects on transmissibility/infection led the evidence about myocarditis. Before either of those bits of evidence came out, the vaccines were nevertheless VERY effective at reducing hospitalisations from COVID-19 caused by early strains in those initial trials. I've also only really heard of the Pfizer trial's being severely criticised after the fact.
So there was good cause to get vaccinated the entire time, although the value of vaccination kept dropping as new strains kept cropping up which were seemingly less impaired by vaccination, and after omicron I saw a huge amount of people start to skip vaccination.
Also think back to before we had good evidence on transmissibility/infection. Myocarditis hit the young, who were the last to be vaccinated, and consequently among the last to be researched. So the evidence of the vaccinations effects on transmissibility/infection led the evidence about myocarditis. Before either of those bits of evidence came out, the vaccines were nevertheless VERY effective at reducing hospitalisations from COVID-19 caused by early strains in those initial trials. I've also only really heard of the Pfizer trial's being severely criticised after the fact.
So there was good cause to get vaccinated the entire time, although the value of vaccination kept dropping as new strains kept cropping up which were seemingly less impaired by vaccination, and after omicron I saw a huge amount of people start to skip vaccination.
> I think there is LOTS of evidence about the vaccines effects on transmission which points to them being effective.
Can you point to some canonical sources on this? Preferably things that were published in the last year or so.
My understanding is that effects on infection and transmission were overstated and very short lived anyway. Didn't everybody get covid eventually, multiple times even?
Can you point to some canonical sources on this? Preferably things that were published in the last year or so.
My understanding is that effects on infection and transmission were overstated and very short lived anyway. Didn't everybody get covid eventually, multiple times even?
Everyone getting covid and slowing transmission aren't incompatible. In the no lockdown, no vaccine world, everyone gets covid in ~100 days. With vaccines that period is a lot longer (roughly a year?) even though omicron has roughly twice as high a transmission rate. The simplest proof that vaccines have an effect on transmission is the number of infected people by vaccine status. There have been dozens of studies of this (see https://covid.cdc.gov/covid-data-tracker/#vaccine-effectiven...) but this really is one where you can just eyeball the effects https://www.nytimes.com/interactive/2021/10/28/us/covid-brea....
While is was not measured directly, we can still look at other data. People who don't get COVID obviously cannot spread it, and so we know vaccines were effective to slow the spread. They were not good enough to stop it, but they did slow it.
You can go ahead and read the trials yourself. They very much found that the vaccines were excellent at preventing Covid-19 entirely (they did not measure if they also prevented SARS-CoV-2 asymptomatic infection).
It just turns out that they had far too little data and that in real-world conditions they weren't anywhere near the 90+% claimed effectiveness.
Even so, the latest population-level research still suggests that the vaccines were 50-60% effective at preventing Covid-19 entirely, at least for some months.
It just turns out that they had far too little data and that in real-world conditions they weren't anywhere near the 90+% claimed effectiveness.
Even so, the latest population-level research still suggests that the vaccines were 50-60% effective at preventing Covid-19 entirely, at least for some months.
First, they still haven't released all the trial data. Second, the data the FDA released on their own website for the Pfizer trials proved they didn't even test all of the participants in the trial for COVID, nor did they test all the 'suspected but unverified' cases of COVID.
There simply is no data to prove they ever prevented transmission. The trials were the best place to prove that, and they DIDN'T EVEN BOTHER TO TRY.
There simply is no data to prove they ever prevented transmission. The trials were the best place to prove that, and they DIDN'T EVEN BOTHER TO TRY.
The kind of people who get PhDs can also figure out how to read academic papers on their own. There's a lot of correlation/causation mix up on this thread.
For instance, people who get accepted into Harvard but don't attend have the exact same life outcomes to those who get accepted and do attend. The same is now true for college in general once you account for opportunity costs.
For instance, people who get accepted into Harvard but don't attend have the exact same life outcomes to those who get accepted and do attend. The same is now true for college in general once you account for opportunity costs.
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Yes, I met other parents with higher education/a scientific background (researchers, engineers...) and living the same situation with their child. They naturally question the assertions by healthcare professionals, they make their own research, they ask highly precise and relevant questions to such a point that most doctors are simply unable to answer...
I remember that as I was questioning the diagnosis at the hospital and trying to make sure there wasn't another medical explanation, I was basically threatened by doctors who told me, "Just stop asking questions and accuse your nanny as everyone else, or you'll be the one in trouble". Apparently, it was very unusual for a parent to refrain from accusing the nanny when she was the suspect number 1!
I actually know one case where the parents (with a high education) were "too fast" in exonerating their nanny and tried to find a second medical opinion on their own to find out why their child was sick. Well, the judicial system didn't like it and they ended up being accused themselves. Their child was taken away for 4 months. The trauma was so intense that their family didn't survive and they eventually divorced (that's unfortunately the fate of many, if not most families).
I remember that as I was questioning the diagnosis at the hospital and trying to make sure there wasn't another medical explanation, I was basically threatened by doctors who told me, "Just stop asking questions and accuse your nanny as everyone else, or you'll be the one in trouble". Apparently, it was very unusual for a parent to refrain from accusing the nanny when she was the suspect number 1!
I actually know one case where the parents (with a high education) were "too fast" in exonerating their nanny and tried to find a second medical opinion on their own to find out why their child was sick. Well, the judicial system didn't like it and they ended up being accused themselves. Their child was taken away for 4 months. The trauma was so intense that their family didn't survive and they eventually divorced (that's unfortunately the fate of many, if not most families).
ls612(1)
Wow, makes me wanna get a ph.d.
whoof. what an ugly trip!
i’ve interacted with the author, who wrote a very nice spike sorting package called `phy` that i used several years back (and iirc turned me off using hdf5 as a result), and came away very impressed with what was so obviously a sharp mind. very odd to recognize the name in a totally other context. Not very pleasant to hear about such a rough time either!
i’ve interacted with the author, who wrote a very nice spike sorting package called `phy` that i used several years back (and iirc turned me off using hdf5 as a result), and came away very impressed with what was so obviously a sharp mind. very odd to recognize the name in a totally other context. Not very pleasant to hear about such a rough time either!
And if he hadn’t, that nanny would probably be in jail.
i’m unsurprised by his level of meticulous detail. and mostly horrified by those sorts of repercussions being possible.
the whole thing just gives one the serious heebie jeebies
the whole thing just gives one the serious heebie jeebies
The worst part here is: He spent months researching 500 medical papers to even realize this was a problem. No way in hell will a single defense lawyer get someone to be able to research enough to figure this out. As stated, how many people are in jail or lost their kids due to something that didn't actually happen. And how many people don't know that a minor bump in the head for a baby could be life threatening, but we just mark it as SIDS. And even worse, no medical doctor will go this hard trying to figure out how to defend a person they believe murdered a baby.
It is the perfect combination of crap.
Cyrille Rossant may save a lot of lives, in both parents and children, if this becomes common knowledge.
It is the perfect combination of crap.
Cyrille Rossant may save a lot of lives, in both parents and children, if this becomes common knowledge.
I’ve heard credible rumors that SIDS is the “parent accidentally killed their child but we won’t tell them that” polite fiction.
Who have you heard these rumors from?
How did you determine them to be credible?
My assumption is that any citation to a rumor should be totally dismissed if these questions can’t be answered.
How did you determine them to be credible?
My assumption is that any citation to a rumor should be totally dismissed if these questions can’t be answered.
It seems to me that this rumor is just an alternate framing of the original commenter's assertion that "a minor bump in the head for a baby could be life threatening, but we just mark it as SIDS". I think it's fair to be skeptical of both, but it's worth reflecting on how the same factual assertions can come across as either "science-informed speculation" or "crazy unsubstantiated rumor" depending on how you say them.
Exactly. And imagine you’re a doctor, and you have a dead child in front of you, crying parents, and a form to fill out. No possible way of filling out the form brings the child back to life, and one way makes it as easy as possible for everyone, and another results in potentially up to jail time.
Now do this repeatedly during your long and illustrious career.
Now do this repeatedly during your long and illustrious career.
My wife is a pediatric ER doctor. That’s not how that works. If suspected SIDS case/unexplained death comes in, it would be handed over to the child abuse team and the medical examiner would determine cause of death. The medical examiner is detached from crying parents.
What you’re talking about would require a lot more than just one well meaning doctor.
What you’re talking about would require a lot more than just one well meaning doctor.
> or "crazy unsubstantiated rumor" depending on how you say them.
“How it was said” was literally presented as unsubstantiated rumor. It’s not worth reflecting that when someone says “I heard a rumor that X…” it sounds like an unsubstantiated rumor. It’s just the basic structure of English language.
“How it was said” was literally presented as unsubstantiated rumor. It’s not worth reflecting that when someone says “I heard a rumor that X…” it sounds like an unsubstantiated rumor. It’s just the basic structure of English language.
[deleted]
This article is entirely about debunking rumors and looking at actual scientific evidence to correct people's misconceptions -- misconceptions among doctors and law enforcement that have ruined people's lives.
So please don't bring "rumors" into a discussion here. That's exactly the kind of harmful behavior the article is trying to fight against.
So please don't bring "rumors" into a discussion here. That's exactly the kind of harmful behavior the article is trying to fight against.
Don’t say horrible things like that unless you can really back them up. Think of how a grief stricken parent might feel after reading that.
SIDS most likely does not exist. "Unknown cause of death" should be preferred.[1] If you review the literature, there has been a definite increase in pushback against "SIDS" instead trying to assign causes of death with known mechanisms. I can't find a great reference but there is one out there that proposes with evidence that the most prevalent actual cause of death labeled "SIDS" is accidental suffocation.
It is so emotionally charged though that there is and has been great hesitation to assign this cause of death because of the emotional effect on the parents.
[1] https://pubmed.ncbi.nlm.nih.gov/10571752/
It is so emotionally charged though that there is and has been great hesitation to assign this cause of death because of the emotional effect on the parents.
[1] https://pubmed.ncbi.nlm.nih.gov/10571752/
One of my children had a serious problem right after birth with breathing (central apnea). He'd stop breathing suddenly while sleeping. If this had happened at home he likely would not have made it, but the hospital was very alert to it and after two weeks with many such episodes it suddenly clicked and then it never happened again.
If we had taken him home without knowing about the condition I'm pretty sure a 'SIDS' cause of death would have been one of the possible outcomes regardless of the actual cause (which would have been very hard to determine after the fact).
If we had taken him home without knowing about the condition I'm pretty sure a 'SIDS' cause of death would have been one of the possible outcomes regardless of the actual cause (which would have been very hard to determine after the fact).
Thank god the hospital caught it!
They were really caught out by it themselves if not for an unrelated issue they would have sent us home. So luck played a huge part here. That's also two weeks that aged me a couple of years. But compared to what I saw some of the other parents there deal with we were the lucky ones in more ways than one.
That's the whole point here, isn't it: that 'what you've heard' isn't credible at all. There is no 'polite fiction' here, what there is is people looking for culprits when there are none. Does that meant that all such cases are accidents? No, because we know for a fact that some people really do hurt infants for whatever reason. But the evidence is apparently such that a large fraction of the cases that were thought to be criminal in actuality were not. So don't go on rumors or polite fictions when lives are at stake. Do the legwork before ruining people's lives.
> No way in hell will a single defense lawyer get someone to be able to research enough to figure this out.
Why would we have to? We can just hire M. Rossant.
Why would we have to? We can just hire M. Rossant.
I wish, unfortunately I'm not a criminal defense lawyer nor a medical doctor! And I don't intend to be one anytime soon. ;)
I think the most productive thing I can at least try to do is to raise awareness among lawyers, doctors, and all professionals involved. No one has the time to dig into it as much as I did, but perhaps I can organize and present our current knowledge as clearly as possible. The book is one little step in this direction.
I think the most productive thing I can at least try to do is to raise awareness among lawyers, doctors, and all professionals involved. No one has the time to dig into it as much as I did, but perhaps I can organize and present our current knowledge as clearly as possible. The book is one little step in this direction.
First: I'm very sad about your son and also about your experiences afterward.
If you have the requisite "knowledge, skill, experience, training, or education" you can testify as an expert. No need to be a lawyer, don't need to be a doctor.
You gave yourself that knowledge and your knowledge exceeds that of the typical "they shook the baby" expert. I'd go with you any day.
If you have the requisite "knowledge, skill, experience, training, or education" you can testify as an expert. No need to be a lawyer, don't need to be a doctor.
You gave yourself that knowledge and your knowledge exceeds that of the typical "they shook the baby" expert. I'd go with you any day.
It seems highly likely that you and your co authors are the some of the most expert people on the planet about this subject.
Similar case in Denmark/Romania where a baby was taken from his romanian parents because of the shaken baby syndrome, parents spent time in jail, but the hemorage continued over time so they had to concede it wasn't the shaken baby syndromd.
The trouble is: shaken baby syndrome is real and well documented. Because the crime is so abhorrent, people strongly want to believe the diagnostic tools to be much more sensitive and accurate than they really seem to be.
It's the classic "N guilty men" problem, aka Blackstone's ratio: if you risk putting one innocent person in jail, how many guilty people you need to catch to make it morally justifiable? 5, 10? 100?
You have to pick a number, or else no kind of criminal justice can exist.
It's the classic "N guilty men" problem, aka Blackstone's ratio: if you risk putting one innocent person in jail, how many guilty people you need to catch to make it morally justifiable? 5, 10? 100?
You have to pick a number, or else no kind of criminal justice can exist.
In the article it clearly states that shaking does not cause the hemorrhage that's currently considered "shaken baby syndrome". It literally says there aren't documented cases where the shaking was captured on tape/testified and the symptoms present at the same time.
It's more likely that a fall (or being thrown) would cause the symptoms.
It's more likely that a fall (or being thrown) would cause the symptoms.
I read it as no cases where shaking caused ONLY the retinal/subdural haemorrhage, without any other trauma.
That's indeed what I said, but I was cautious. I'd have to dig into the latest literature to be sure, but I don't remember seeing even 1 case where shaking with no impact was independently witnessed or videotaped, and was shown to cause retinal/subdural haemorrhage, with or without any other form of trauma.
In any case, these situations are extremely rare, much more than those involving any kind of head impact.
In any case, these situations are extremely rare, much more than those involving any kind of head impact.
You need to work on your comprehension
Please don't cross into personal attack. You can make your substantive points without that.
https://news.ycombinator.com/newsguidelines.html
https://news.ycombinator.com/newsguidelines.html
The better way to think of what you said is:
If toyota cars unintentionally accelerate and kill people, but sometimes people mistakenly accelerate and kill people. If I am driving a toyota and accelerate and kill a person, if 100% of all cops/investigators believe the first case doesn't exist, and the second case is the only possible answer, I will be thrown in jail without a second thought; my life is destroyed, and it wasn't even my fault.
But more than that, we don't even know what the ratios are, is it 90% / 10%? is it 10% / 90%? is it 50/50? Because everyone believes it is 0%/100% we can't make the "N guilty men" decision at all, so we need a hard stop, evidence, and re-start.
I know you were downvoted, but I think your thoughts are exactly the problem I am trying to point out. So thank you for commenting on it.
If toyota cars unintentionally accelerate and kill people, but sometimes people mistakenly accelerate and kill people. If I am driving a toyota and accelerate and kill a person, if 100% of all cops/investigators believe the first case doesn't exist, and the second case is the only possible answer, I will be thrown in jail without a second thought; my life is destroyed, and it wasn't even my fault.
But more than that, we don't even know what the ratios are, is it 90% / 10%? is it 10% / 90%? is it 50/50? Because everyone believes it is 0%/100% we can't make the "N guilty men" decision at all, so we need a hard stop, evidence, and re-start.
I know you were downvoted, but I think your thoughts are exactly the problem I am trying to point out. So thank you for commenting on it.
Even if the kids hemorrhaging continued, it was brought to the ER initially with fractures in the right side of the skull.
I did not know this detail, I know the Danish state offered apologies, the charges were dropped and the child was returned to the parents.
Yeah, nobody know the exact parts of the case. As its semi-secret (to protect the child and parents I guess). While the parents were cleared, this case is definitely not appropriate to this discussion as it was definitely not only hemorrhaging that started it. If a hospital gets a toddler with fractures on their skull, society should damn well figure out how it got them and stop it from happening again.
> If a hospital gets a toddler with fractures on their skull, society should damn well figure out how it got them and stop it from happening again.
What a leap (the kind the article is calling out by the way). Do you really think all causes for toddler skull fractures are a societal problem?
What a leap (the kind the article is calling out by the way). Do you really think all causes for toddler skull fractures are a societal problem?
I do.
If a child has a serious injury the circumstances should be examined, as it should be quite rare for children to have serious injuries.
That's why places have Child Death and Serious Injury Review Committees.
If a child has a serious injury the circumstances should be examined, as it should be quite rare for children to have serious injuries.
That's why places have Child Death and Serious Injury Review Committees.
So in order to form an informed opinion we have to figure out the relative costs and benefits of various options. Lets start by examining assumptions. Here we have
Fractures among children: incidence and impact on daily activities
https://injuryprevention.bmj.com/content/4/3/194
wherein we discover that kids 0-12 break bones at an incidence of 128 per 10,000. Over 12 years that's more like 1536 or about 15% of kids if injuries were evenly distributed, although they probably aren't. Still in the right ballpark.
So serious injuries among kids are incredibly common.
If we launch investigations and get it right 95% of the time we will none the less fuck up millions of kids lives. We would probably be better off selectively investigating when there is at least some reason to believe something is afoot instead of every injury.
Fractures among children: incidence and impact on daily activities
https://injuryprevention.bmj.com/content/4/3/194
wherein we discover that kids 0-12 break bones at an incidence of 128 per 10,000. Over 12 years that's more like 1536 or about 15% of kids if injuries were evenly distributed, although they probably aren't. Still in the right ballpark.
So serious injuries among kids are incredibly common.
If we launch investigations and get it right 95% of the time we will none the less fuck up millions of kids lives. We would probably be better off selectively investigating when there is at least some reason to believe something is afoot instead of every injury.
First things first - 85% of the fractures you're talking about are arm and leg fractures. Skull fractures, which was what I was talking about, are a significantly smaller number.
But yes, we should investigate why the child broke their arm. Does that need to be an in-depth investigation? Not usually. But it's important to understand why these things happen; that's where the data for the study you cited comes from.
But yes, we should investigate why the child broke their arm. Does that need to be an in-depth investigation? Not usually. But it's important to understand why these things happen; that's where the data for the study you cited comes from.
As a toddler, my daughter fell out of her bed from a height of less than 18 inches and broke her collar-bone. It seems plausible to me that if she had landed on her head rather than her shoulder, she could have fractured her skull. I'm not sure that society needs to be in the business of preventing all falls from such a small height!
I fully understand where you are coming from, but have you had a toddler?
> it was brought to the ER initially with fractures in the right side of the skull.
Just to defuse this a bit. My #4 used to collect skull fractures. He'd slip away in a nanosecond and would be 50' above us two heartbeats later. We put him in a padded helmet for a year or so. It stayed on sometimes.
As an adult he can still disappear in an empty room.
Just to defuse this a bit. My #4 used to collect skull fractures. He'd slip away in a nanosecond and would be 50' above us two heartbeats later. We put him in a padded helmet for a year or so. It stayed on sometimes.
As an adult he can still disappear in an empty room.
The ironic thing here is that these sorts of innocuous bumps and minor traumas regularly lead to severe medical complications and deaths in older children & adults, too. The only difference here is that babies & toddlers are too young to be able to verbalize and advocate for themselves in ways that most adults recognize & respect.
Since having a kid and reading a lot I've been bothered by how clearly a lot of what is labeled as "SIDS" is pretty clearly accidental suffocation. The conclusion is impossible to escape when you begin reading about measures that have "reduced SIDS." Yet I also wonder if continuing to observe this social fiction is just a way of keeping overzealous prosecutors and other crusaders from locking up and treating as depraved murderers grieving families for accidental deaths.
Not an expert but it seems to me you'd be making the same kind of error that the article denounces: attaching equal value to direct evidence on the one hand and inference to the best explanation on the other. If a physician does not observe tell-tale signs of suffocation in an infant, then it is not their role to say "Well, statistically speaking, or logically speaking, pretty good chance it's accidental suffocation isn't it? I'll jot this down as Accidental Suffocation Syndrome" or alternatively "I know in my heart that this is accidental suffocation but let's just call it SIDS for the benefit of the parents" but rather they should simply conclude "there's not enough evidence, therefore this death remains unexplained".
Some measures that reportedly reduce “SIDS” include assembling the crib properly and not putting soft objects that could smother the baby in the crib. Risk factors include lower parental educational attainment. You tell me if I’m being unreasonable attributing a death from the crib collapsing to suffocation and not a mysterious, poorly understood disease. When a baby dies in the crib it is rare for much investigation to be done that would conclusively suggest suffocation and it is usually just labeled SIDS.
I mean, I don't mind, you can attribute whatever to whatever and yeah, a crib full of plush toys doesn't seem like such a smart idea... but the question is what a doctor should do, how we want them to behave in the face of limited evidence.
SIDS is intended as a diagnosis of last resort but is often used with little digging so it's not really any different than the case this article discusses, except with the opposite result. I never demanded that doctors start doing something different but I think it's pretty obvious we're just collectively leaving some stones unturned here.
A tiny selection of the relevant literature:
[1] https://onlinelibrary.wiley.com/doi/abs/10.1002/(SICI)1099-0...
[2] https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1440-1754....
[3] https://link.springer.com/article/10.1007/s12024-014-9600-5
[4] https://publications.aap.org/pediatrics/article/143/5/e20183...
[1] https://onlinelibrary.wiley.com/doi/abs/10.1002/(SICI)1099-0...
[2] https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1440-1754....
[3] https://link.springer.com/article/10.1007/s12024-014-9600-5
[4] https://publications.aap.org/pediatrics/article/143/5/e20183...
These do bolster my point but it becomes more striking in resources intended for parents where one minute they’re telling you the mechanism of SIDS is poorly understood and the next they’re giving you advice that is clearly about removing suffocation risks from the sleeping environment. Though there is similarly strange advice about “preventing shaken baby syndrome” which turns out to be just anger management tips. I guess the sensitive nature of the topic makes frank discussion difficult.
My oldest son has special needs. He's 2e -- gifted and learning disabled -- and has a serious medical condition associated with being very underweight.
I put him in preschool to get him to talk. He could use sentences but wasn't.
At the start of kindergarten, first, second and third grade, I spoke with the teacher, explained he was difficult, let them know I welcomed communication on any issue. They were thrilled and relieved. Parents are often part of the problem.
By fourth grade, my son was no longer obviously "the weird kid." That teacher reported me to the social worker for letting him know up front my child was difficult and please don't hesitate to discuss things with me.
The social worker called me, we talked for a bit. She knew both my kids. Laughed it off as a silly misunderstanding. Months later, his teacher let me know he did eventually get the memo that my child had quirky interpretations of social things.
After my son finally got a proper diagnosis for his medical issue, he gained twenty pounds in one year and this did wonders for his social skills. Then he lost five pounds.
He still felt better than he ever had and neither of us were concerned. His medical team implied I was in danger of being reported to children's services as an abusive mother.
Because his condition predisposes people to being very underweight, pediatric clinics for the condition routinely include a dietitian and yet the standard recommended diet is "junk food" because it's high salt, high fat, high calorie and cheap.
I had not been feeding him junk food, but I dutifully put a big bowl of snacks in the middle of the coffee table. He regained 2.5 pounds, they decided that was adequate and didn't need more follow up visits.
We got home and, with no longer being under threat of being turned in as a neglectful or abusive parent, the first thing he did was hand me the bowl and tell me "We are never doing this again. I feel terrible!"
We resumed feeding him a high quality diet in line with the high fat, high salt, high calorie recommendations.
It's awful to be so protective of your children and be accused of abusing them based on no real evidence. I wish this project well.
I put him in preschool to get him to talk. He could use sentences but wasn't.
At the start of kindergarten, first, second and third grade, I spoke with the teacher, explained he was difficult, let them know I welcomed communication on any issue. They were thrilled and relieved. Parents are often part of the problem.
By fourth grade, my son was no longer obviously "the weird kid." That teacher reported me to the social worker for letting him know up front my child was difficult and please don't hesitate to discuss things with me.
The social worker called me, we talked for a bit. She knew both my kids. Laughed it off as a silly misunderstanding. Months later, his teacher let me know he did eventually get the memo that my child had quirky interpretations of social things.
After my son finally got a proper diagnosis for his medical issue, he gained twenty pounds in one year and this did wonders for his social skills. Then he lost five pounds.
He still felt better than he ever had and neither of us were concerned. His medical team implied I was in danger of being reported to children's services as an abusive mother.
Because his condition predisposes people to being very underweight, pediatric clinics for the condition routinely include a dietitian and yet the standard recommended diet is "junk food" because it's high salt, high fat, high calorie and cheap.
I had not been feeding him junk food, but I dutifully put a big bowl of snacks in the middle of the coffee table. He regained 2.5 pounds, they decided that was adequate and didn't need more follow up visits.
We got home and, with no longer being under threat of being turned in as a neglectful or abusive parent, the first thing he did was hand me the bowl and tell me "We are never doing this again. I feel terrible!"
We resumed feeding him a high quality diet in line with the high fat, high salt, high calorie recommendations.
It's awful to be so protective of your children and be accused of abusing them based on no real evidence. I wish this project well.
> Then he lost five pounds. He still felt better than he ever had and neither of us were concerned. His medical team implied I was in danger of being reported to children's services as an abusive mother.
But wasn't that valid cause for concern, especially for someone who should be a growing boy? If being underweight was a serious medical concern for him, losing 5 pounds seems like a big flashing red warning that something could be going wrong.
Maybe I'm misunderstanding your story, but from what you've written, it sounds to me like their intervention successfully ensured he was eating enough when he wasn't before?
But wasn't that valid cause for concern, especially for someone who should be a growing boy? If being underweight was a serious medical concern for him, losing 5 pounds seems like a big flashing red warning that something could be going wrong.
Maybe I'm misunderstanding your story, but from what you've written, it sounds to me like their intervention successfully ensured he was eating enough when he wasn't before?
You are missing the part where I harmed his health to comply with their expectations. He was fine and does better on a high quality diet than on a junk food diet.
Weight isn't the only metric that matters.
Weight isn't the only metric that matters.
What do you consider a high quality diet? What would meals for a day look like to you?
If you haven’t already: find the accusation in your comment.
It’s a very simple question - one that my kid’s pediatrician asks during almost every visit. Weird that you take it as an accusation.
What's weird is that you apparently don't understand the difference between being asked that question by your child's pediatrician vs a random stranger on the internet.
The question is not weird in the context of telling the story on a messageboard.
If we were applying the default "random stranger" rules, the story never would have been shared in the first place.
If we were applying the default "random stranger" rules, the story never would have been shared in the first place.
The answer can make the story wildly different.
I think there is a class of internet bully that clusters around stories like this, not unlike the "think of the children crowd" mentioned in the article.
Harmed his health by what metric?
The problem is that the phrase "a valid concern" would lead me to think "something doctors and parents should consult on (also with the child themself!) and determine if there is cause for alarm, and if so decide collaboratively what the proper course of action is." Sure! Of course! That's what you do with valid health concerns, right?
What it actually means is "something for which social workers will decide whether to take your child away from you for". That's a pretty big escalation from a "valid concern", but one that happens if "the system" decides you are a target. "A valid concern" is in that case a code word for "credible presumptive evidence of child abuse". A child being underweight is a valid thing to be concerned about, it is not on it's own credible presumptive evidence of abusive parenting, no.
What it actually means is "something for which social workers will decide whether to take your child away from you for". That's a pretty big escalation from a "valid concern", but one that happens if "the system" decides you are a target. "A valid concern" is in that case a code word for "credible presumptive evidence of child abuse". A child being underweight is a valid thing to be concerned about, it is not on it's own credible presumptive evidence of abusive parenting, no.
Abusers sometimes take their victims elsewhere - new doc, new town, new state - when people start getting suspicious. The victim may also be retaliated against; accused of trying to get help. There’s a risk to consulting someone you suspect might be the perpetrator.
I doubt the proper answer to this risk is to assume abuse. I don’t mean to say the answer is easy but the described behavior towards this person for how they try to help their child is sickening.
Any approach here will have bad results on a population-level; there's no perfect answer. I'm very glad I'm not personally responsible for decisions that could destroy families or doom kids to torture if the wrong judgement call is made.
If the parent is abusive, trying to get their cooperation in fixing the problem may be an effective means to out them.
They had absolutely no reason to believe I was abusing him. Most likely, they were just trying to cover their own butts and err in that direction rather than in the direction of "what's best for this child?"
That's without getting into larger concerns of "What on earth is wrong with the world that a junk food diet is the medically recommended diet for a serious medical condition?"
They had absolutely no reason to believe I was abusing him. Most likely, they were just trying to cover their own butts and err in that direction rather than in the direction of "what's best for this child?"
That's without getting into larger concerns of "What on earth is wrong with the world that a junk food diet is the medically recommended diet for a serious medical condition?"
I’m not questioning anything about your story. I’m just curious: what types of “junk food” were they recommending?
They routinely recommend pro inflammatory foods like peanut butter. It's an inflammatory condition.
They recommend sugary foods. It's a condition that puts one at high risk of diabetes.
They recommend ice cream as a high fat, high calorie food. It's a condition that predisposes people to having trouble tolerating milk and milk products, especially from cows.
They recommend sugary foods. It's a condition that puts one at high risk of diabetes.
They recommend ice cream as a high fat, high calorie food. It's a condition that predisposes people to having trouble tolerating milk and milk products, especially from cows.
Thank you for the additional details.
I’m speaking more generally than your specific case.
I know. I'm trying to engage you in good faith.
I was molested as a child. I know a fair amount about abuse.
There isn't always a clear bright line between ignorance and abuse. Assuming the worst can make the problem worse.
People tend to not be paragons of virtue who have all the answers for everything they run into. Some people can be helped to become better parents.
I thought long and hard about that while sending care packages to a couple of welfare moms. Declaring them unfit moms and having their kids taken and placed in foster care wasn't some magic solution that guaranteed a fabulous outcome, so I chose to try to help them succeed to whatever degree I could, on a limited budget and from a distance.
I was molested as a child. I know a fair amount about abuse.
There isn't always a clear bright line between ignorance and abuse. Assuming the worst can make the problem worse.
People tend to not be paragons of virtue who have all the answers for everything they run into. Some people can be helped to become better parents.
I thought long and hard about that while sending care packages to a couple of welfare moms. Declaring them unfit moms and having their kids taken and placed in foster care wasn't some magic solution that guaranteed a fabulous outcome, so I chose to try to help them succeed to whatever degree I could, on a limited budget and from a distance.
There's also a pretty big risk to assuming abuse when it isn't present, removing a child from their parents is an action causing great trauma to the child. Even just putting the family through an adversarial process where removal is threatened can be very traumatic to all involved. If there is a challenging health issue going on too, adding all that on top is actually adding barriers to addressing the challenging health issue, and is harmful.
The solution to reducing risk and harm is not to always err on the side of assuming abuse and making families prove otherwise.
The solution to reducing risk and harm is not to always err on the side of assuming abuse and making families prove otherwise.
There's no perfect answer; there will always be judgement calls that turn out to be wrong, even when made in good faith. You're correct that false accusations of abuse can be devastating to families; missing real abuse is similiarly devastating.
As I've said elsewhere in this thread, I'm glad I don't have to make these calls.
As I've said elsewhere in this thread, I'm glad I don't have to make these calls.
What was the medical issue for your child being underweight, if you could please share that?
He has a form of cystic fibrosis.
12345hn6789(1)
> As a precautionary measure, the hospital followed mandatory reporting statutes and my wife and I temporarily lost custody of David. Thanks to our incredibly effective defense lawyer, we were cleared of all charges within two months, during which we stayed at the hospital 24/7 with David until we sorted out the legal procedures.
Holy shit. Parents bring baby to ER ... results reveal that baby was shaken (article later confirms this was not the case) ... parents lose custody for 2 months. Horror story.
Holy shit. Parents bring baby to ER ... results reveal that baby was shaken (article later confirms this was not the case) ... parents lose custody for 2 months. Horror story.
And:
> [O]ur nanny was eventually cleared of all charges, but it took four years for the court to recognize my son’s medical condition (a rare occurrence in France, as I later discovered) during which we were forbidden to speak to her and she was forbidden to approach children, thus losing her means of livelihood.
> [O]ur nanny was eventually cleared of all charges, but it took four years for the court to recognize my son’s medical condition (a rare occurrence in France, as I later discovered) during which we were forbidden to speak to her and she was forbidden to approach children, thus losing her means of livelihood.
Not surprised it happened in France, they are much more of a nanny state (in good and bad ways) when it comes to parenting. Like the fact that paternity tests are banned unless you have a court order, etc.
Can’t you just get a paternity test online? Otherwise that’s an insane situation, do they expect a dad to raise a kid that is not his?
It's not insane. Genetic lineage is the least important factor in whether or not a given kid is "yours".
> Can’t you just get a paternity test online?
You can, but it's a crime, much like buying banned drugs etc.
> do they expect a dad to raise a kid that is not his?
Yes.
You can, but it's a crime, much like buying banned drugs etc.
> do they expect a dad to raise a kid that is not his?
Yes.
> do they expect a dad to raise a kid that is not his?
You just need a court order to do a paternity test, they're not banned but regulated by law.
You just need a court order to do a paternity test, they're not banned but regulated by law.
reason.com has an entire long-running series of stories like this happening in the U.S. I've heard quite a few stories from the Netherlands. It probably happens in other countries as well.
It's an issue in many Western countries, where we've seemingly become risk-averse to the point where it's causing more harm than good.
It's an issue in many Western countries, where we've seemingly become risk-averse to the point where it's causing more harm than good.
Here in Norway the child protection services have been found guilty[1] of being too quick to remove children from their parents, and not letting the parents see them.
This seems to have led to the pendulum swinging too much in the opposite direction, where they now seemingly force foster kids to meet their biological parents against the kid's will[2]...
[1]: https://rett24.no/articles/norge-felt-i-ni-nye-barnevernsake...
[2]: https://www.nrk.no/norge/mener-fosterbarn-presses-til-skadel...
This seems to have led to the pendulum swinging too much in the opposite direction, where they now seemingly force foster kids to meet their biological parents against the kid's will[2]...
[1]: https://rett24.no/articles/norge-felt-i-ni-nye-barnevernsake...
[2]: https://www.nrk.no/norge/mener-fosterbarn-presses-til-skadel...
>parents lose custody for 2 months. Horror story.
If you read the rest of the article, you will realize that this was the absolute happy path in that kind of situation. That's the real horror story: that the default path involves stuff like losing custody forever, incarceration, suicide, divorce etc.
If you read the rest of the article, you will realize that this was the absolute happy path in that kind of situation. That's the real horror story: that the default path involves stuff like losing custody forever, incarceration, suicide, divorce etc.
Yes, after discovering hundreds of families living much worse situations, I consider myself as one of the lucky few. I'm grateful for that and this is why I can spend so much energy ensuring it doesn't affect too many other families in the future.
I'm happy for you -- the parents -- and your son. Thank you for your dedication. Wish you the best.
Watch the Netflix documentary Taking Care of Maya for a sobering and ongoing look into this.
What's the outcome for the kid? Can the system even do much to help with the child's medical condition? If not, it's irrational for people to take their children in for examination; there's no benefit and you risk being accused.
He underwent surgery to remove the excess of fluid around the brain, and his condition progressively improved. It could have worsened without the operation, we'll never know. Now, at almost 8, he's doing great.
I've seen cases where parents call the ER after a collapse of their child, only to see their child wake up just fine a few minutes later. The EMT tells them it's not necessary to bring their child to the hospital given the child has recovered, but the parents insist. At the hospital, sometimes they have to insist too for a CT scan to be performed. This is where doctors find subdural bleeding and the parents end up accused, the child is removed for months, etc. Yet, the child gets no particular medical treatment. None of this would have occurred if the parents hadn't insisted!
I've seen cases where parents call the ER after a collapse of their child, only to see their child wake up just fine a few minutes later. The EMT tells them it's not necessary to bring their child to the hospital given the child has recovered, but the parents insist. At the hospital, sometimes they have to insist too for a CT scan to be performed. This is where doctors find subdural bleeding and the parents end up accused, the child is removed for months, etc. Yet, the child gets no particular medical treatment. None of this would have occurred if the parents hadn't insisted!
Parents only know symptoms, which could be anything. Those same symptoms (or small variations) can lead to a very different diagnosis which is easily treatable.
Something similar happened recently in Massachusetts with a doctor seeing an injury the parents couldn't explain and the kid being taken away for a while. Injury turned out to probably have been done by the grandparents who never told the parents because the kid didn't fuss, but the kids were taken away in the middle of the night.
https://www.nbcboston.com/investigations/massachusetts-dcf-e...
https://www.nbcboston.com/investigations/massachusetts-dcf-e...
My first inclination here is to blame the doctor. Per the Hippocratic Oath, doctors need to understand the implications of making reports like this and only do so in cases where there isn't reasonable doubt or plausible explanations other than abuse. Separating children from parents and making accusations like this is extremely traumatic in itself, so the evidence bar needs to be very high.
Even if the rules tell doctors that they need to make a report in a given scenario, they should not be following the rules when they know the bureaucracies that handle these reports are dysfunctional and prone to separating children without conclusive evidence. Imo they are responsible for protecting their patients from the system in these cases.
Even if the rules tell doctors that they need to make a report in a given scenario, they should not be following the rules when they know the bureaucracies that handle these reports are dysfunctional and prone to separating children without conclusive evidence. Imo they are responsible for protecting their patients from the system in these cases.
I'm not sure if it's federal, but in my state a doctor is required to report anything they feel is unusual. Mandated reporter, it's called.
There's a federal act (CAPTA) that requires states to adopt mandatory reporting rules, but the rules vary from state-to-state. Some states, simply by being in a particular profession you are required to report (even when not on the job); in other states it's specifically when evidence is uncovered while performing your duties; in some states, all people are required to report.
I've never encountered a state in which a medical doctor encountering evidence of abuse while seeing a patient is not required to report it, with the exception of some states exempting mental-health professionals told things in confidence (so a psychiatrist, which is also an MD, might not be required to report it depending on the state).
I've never encountered a state in which a medical doctor encountering evidence of abuse while seeing a patient is not required to report it, with the exception of some states exempting mental-health professionals told things in confidence (so a psychiatrist, which is also an MD, might not be required to report it depending on the state).
So you err on the 'some children are abused and die' side of things, and other people err on the 'some parents get separated from their children' side.
I don't think the line is at doctors reporting, and I'll tell you why.
There are many cases of MD's having patients where they know the whole family and can't believe that abuse would be going on, so they don't report things like spiral fractures and pattern bruising in a five year old. Those are markers of serious domestic violence and abuse, but since the doc knows the parent, and the parent has a sorta reasonable explanation, fine.
No. The doctor reports, then the parents get investigated. Sorry it sucks, but the point to fix is the people interacting with the family at the point of investigation, not the report by an MD, because unfortunately the MD is going to lean towards not reporting until it is too late.
I don't think the line is at doctors reporting, and I'll tell you why.
There are many cases of MD's having patients where they know the whole family and can't believe that abuse would be going on, so they don't report things like spiral fractures and pattern bruising in a five year old. Those are markers of serious domestic violence and abuse, but since the doc knows the parent, and the parent has a sorta reasonable explanation, fine.
No. The doctor reports, then the parents get investigated. Sorry it sucks, but the point to fix is the people interacting with the family at the point of investigation, not the report by an MD, because unfortunately the MD is going to lean towards not reporting until it is too late.
That would be fine if the investigations were fair and followed basic principles of jurisprudence like "innocent until proven guilty", but it's plain to see that kids are being separated based on very flimsy evidence.
In my book, a doctor doesn't get to absolve themselves of responsibility by saying "just following orders" and that it's the investigative system that needs to be fixed. If they know the system is broken, it's both immoral and a deep betrayal of trust for them to report people without strong evidence.
Almost any injury can be framed as possible evidence of abuse. Parents shouldn't have to be afraid that taking their kids to the hospital after an injury will get them taken away. The vast majority of injuries are not from abuse, so a system with a low bar for evidence is going to end up with more false positives than cases of abuse. This is exacerbated by the fact that abusers, for obvious reasons, are often going to avoid getting medical care for the kids they abuse.
If your reasoning were applied more broadly, we'd put anyone accused of a crime, or of even planning a crime, in prison immediately, since otherwise crimes will occur (with people hurt/killed) that could have been prevented. There's a reason the legal system doesn't work this way.
In my book, a doctor doesn't get to absolve themselves of responsibility by saying "just following orders" and that it's the investigative system that needs to be fixed. If they know the system is broken, it's both immoral and a deep betrayal of trust for them to report people without strong evidence.
Almost any injury can be framed as possible evidence of abuse. Parents shouldn't have to be afraid that taking their kids to the hospital after an injury will get them taken away. The vast majority of injuries are not from abuse, so a system with a low bar for evidence is going to end up with more false positives than cases of abuse. This is exacerbated by the fact that abusers, for obvious reasons, are often going to avoid getting medical care for the kids they abuse.
If your reasoning were applied more broadly, we'd put anyone accused of a crime, or of even planning a crime, in prison immediately, since otherwise crimes will occur (with people hurt/killed) that could have been prevented. There's a reason the legal system doesn't work this way.
I think the point is that the blame lies with DCF, not the doctors. Doctors should report, and DCF should competently investigate. In this scenario, the doctor did their job and DCF did not.
With something as serious as child abduction, there's plenty of blame to distribute among all involved parties.
In most dysfunctional systems its functionally impossible for individual actors to fix any part of the overarching system and MUST necessarily choose between dysfunctional options with an eye on least bad outcomes.
My first inclination is to blame DCF workers.
> These people are working in the shadows, in darkness," Lamanna said. "They can show up at your house in the middle of the night with no paperwork, no court order whatsoever, and say we’re removing under the B, we’ve decided an emergency exists."
> According to DCF’s 2022 quarterly report, about 60% of parents are reunited with their kids within a year after being removed by DCF.
Anyone who feels justified in stealing kids from parents in the middle of the night, without any due process, WITH A 60% MISS RATE, is completely and truly evil.
Seriously, more often than not DCF realizes they made a mistake and the kid goes back home. Insane.
> These people are working in the shadows, in darkness," Lamanna said. "They can show up at your house in the middle of the night with no paperwork, no court order whatsoever, and say we’re removing under the B, we’ve decided an emergency exists."
> According to DCF’s 2022 quarterly report, about 60% of parents are reunited with their kids within a year after being removed by DCF.
Anyone who feels justified in stealing kids from parents in the middle of the night, without any due process, WITH A 60% MISS RATE, is completely and truly evil.
Seriously, more often than not DCF realizes they made a mistake and the kid goes back home. Insane.
Who gave DCF the power to take away kids in the middle of the night without due process?
Until we vote out of office the elected representatives who passed the laws that give government agencies such draconian powers, and insist on those laws being changed, we won't fix this problem.
Until we vote out of office the elected representatives who passed the laws that give government agencies such draconian powers, and insist on those laws being changed, we won't fix this problem.
>we won't fix this problem.
I agree.
I agree.
Reuniting within a year is not intrinsically evidence that it was a bad removal - a parent can change a lot in less than a year. Most obviously, one abusive parent can be jailed or kicked out and the children go home to live with the remaining parent, who may have been abused themselves. Rehab, counseling, parenting classes, diagnosis and treatment for mental illness, moving out of an unsafe hoarding home, etc, can all be done in that time.
The ones you want to really examine are the kids who go home in less than a week. At one point I think I read that New Mexico had about 25% of children who entered care returning home within days. Those are very likely to be children who were not at risk of harm in the first place.
The ones you want to really examine are the kids who go home in less than a week. At one point I think I read that New Mexico had about 25% of children who entered care returning home within days. Those are very likely to be children who were not at risk of harm in the first place.
In my state, all doctors are required to report any evidence of child abuse, even if they don’t believe abuse has occurred.
That’s the law.
At the same time, reporting doesn’t guarantee or even suggest any outcome. Most reports end up as entries in a database and nothing more.
That’s the law.
At the same time, reporting doesn’t guarantee or even suggest any outcome. Most reports end up as entries in a database and nothing more.
I can't help but think that incidents like this might make parents less likely to take their baby to the ER out of fear.
This is timely as the life of Robert Roberson is currently being decided based on this syndrome:
https://news.ycombinator.com/item?id=37632122
https://www.themarshallproject.org/2023/09/15/texas-shaken-b...
https://news.ycombinator.com/item?id=37632122
https://www.themarshallproject.org/2023/09/15/texas-shaken-b...
Yes and the current submission is a result of this subthreaed from there:
https://news.ycombinator.com/item?id=37635094
https://news.ycombinator.com/item?id=37635094
[deleted]
From a related article on the case [1]:
> Evans said the syndrome remains a fair medical diagnosis and also notes in the report that SBS was not the sole cause of child's death.
There ought to be a law where lawyers deal with legal interpretations and advice and medical doctors deal with medical interpretation and advice.
In a sane world, she'd be taken off the bench until she completes some remedial legal coursework and several dozen hours of medical talks from this century.
> Evans said the syndrome remains a fair medical diagnosis and also notes in the report that SBS was not the sole cause of child's death.
There ought to be a law where lawyers deal with legal interpretations and advice and medical doctors deal with medical interpretation and advice.
In a sane world, she'd be taken off the bench until she completes some remedial legal coursework and several dozen hours of medical talks from this century.
[1] https://www.cbs19.tv/article/news/local/judge-denies-recommending-east-texas-death-row-inmates-appeal-exoneration-new-trial/501-39bfdd8e-b687-4065-9b34-25b60c320e6ctrully unbelievable, i lose faith in thr justice system day by day
The justice system does the best it can with the information it has. It is far from perfect. It makes horrible mistakes all the time. The problem, of course, is improving it without knock-on effects making it worse.
There are huge swaths of people doing the work required to make it better, every day. It's not as easy as turning a dial from "bad" to "good"
There are huge swaths of people doing the work required to make it better, every day. It's not as easy as turning a dial from "bad" to "good"
and none as effective as this one person
too many cooks in the kitchen
too many cooks in the kitchen
No. When it comes to evaluating forensic evidence lawyers are, by training, too process oriented to solve the problems.
Ask a prosecutor what the error rate is for fingerprints or DNA evidence and you’ll get a blank stare. They don’t even try to measure it.
You're telling me no defense lawyer thinks about arguing the evidence is unreliable or are you just saying the prosecution throws everything they can find at their side of the case? The former seems extremely hard to believe (lest you're about to become the greatest defense lawmaker of all time due to wisdom shared in a short HN comment) and the latter seems to be evidence of the system working both well and as designed, not evidence it's badly faulty.
> latter seems to be evidence of the system working both well and as designed
Prosecutors in America have one goal: close the case. At any cost, close the case. They are not interested in justice. They are not interested in finding the one who actually committed the crime. They are interested in closing the case. If that is “working as designed”, then we need to change the design.
Prosecutors in America have one goal: close the case. At any cost, close the case. They are not interested in justice. They are not interested in finding the one who actually committed the crime. They are interested in closing the case. If that is “working as designed”, then we need to change the design.
Sure, but the accused should have a lawyer who is screaming about anything that is unreliable.
Have you seen the caseloads of public defenders?
There’s no practical way for a defense lawyer to find out what the error rate is for, say, a state lab. Occasionally organizations can do this, for example the innocence project figured out that the FBI’s hair analysis was bogus for decades (https://www.fbi.gov/news/press-releases/fbi-testimony-on-mic...).
And the opposite is true of the defense. The result is a 3rd party gets to hear all of the evidence either side could come up with and weight the outcome based on all of that instead of 2 interested parties trying to figure it out themselves.
There are of course ways to improve the legal system, more equal access to quality representation is my preferred improvement regardless of system, but you can't just look at one element of the system in isolation and declare the whole concept bad. That's "The CPU produces waste heat so we need to remove it completely" type logic where you find one thing that sounds unambiguously bad and ignore that it could be a symptom of great net positive function of that thing. Doesn't mean it's perfect either, just means it needs more than a shallow dismissal.
There are of course ways to improve the legal system, more equal access to quality representation is my preferred improvement regardless of system, but you can't just look at one element of the system in isolation and declare the whole concept bad. That's "The CPU produces waste heat so we need to remove it completely" type logic where you find one thing that sounds unambiguously bad and ignore that it could be a symptom of great net positive function of that thing. Doesn't mean it's perfect either, just means it needs more than a shallow dismissal.
A lot of doctors are process oriented as well. Which is fine most of the time. But I was similarly disturbed when a specialist had zero clue what the approx half life of one of the primary drugs they use was. There was a situation that didn’t fit the book and i just looked it up for them on the spot. They didn’t like me.
If the current functioning is it doing "the best it can", the whole thing should be burnt to the ground.
to be replaced with what? i'm all for making changes that are an improvement, but just burning it to the ground for the sake of it with no end game is not an improvement
At this point, I would not be surprised if having two judges per case, randomly selected from the community, from parents who have successfully had at least three children leave the nest while still remaining on speaking terms, was a more reliable method of justice.
isn't an even number of judges ripe for uselessness?
A system that does not incarcerate anyone for any reason would be much preferable to the atrocities that are the current criminal justice systems in most of the global west (and especially of course the United States).
Interesting and unusual perspective - we have the one person in this thread who supports wildly expanding the death penalty.
Unless the person above is, of course, an anarchist who has no answer for what to do about Richard Ramirez, Ted Bundy, Jeffrey Dahmer, Phillip Garrido, or Brian Mitchell. I would say that as imperfect and heavily flawed as our system is, "Perfect is the enemy of good."
Unless the person above is, of course, an anarchist who has no answer for what to do about Richard Ramirez, Ted Bundy, Jeffrey Dahmer, Phillip Garrido, or Brian Mitchell. I would say that as imperfect and heavily flawed as our system is, "Perfect is the enemy of good."
> what to do about Richard Ramirez, Ted Bundy, Jeffrey Dahmer, Phillip Garrido, or Brian Mitchell
Nothing. Those people are one-in-a-million anomalies. If it weren't for the media hype surrounding them, their impact on society would be comparable to the impact of deaths from lightning strikes. What do we do about people being struck by lightning? Nothing.
Nothing. Those people are one-in-a-million anomalies. If it weren't for the media hype surrounding them, their impact on society would be comparable to the impact of deaths from lightning strikes. What do we do about people being struck by lightning? Nothing.
That's not true. We have things in place to protect people and objects from lightning strikes. For example, lightning protection systems on tall buildings.
That’s nuts. Even if you were correct about that, and I’m not admitting any such thing, it isn’t how people work. If the state doesn’t provide justice, then the mob will.
"Justice" is an incredibly malleable idea that is largely shaped by what people are told. Until very, very recently, nobody gave a fuck about serial killers, or even knew they existed. If the hype stopped, there wouldn't be any mobs to worry about.
Define recently. There is plenty of historical hysteria around them. Ever heard of Jack the Ripper?
Have you thought about moving to Somalia?
> A system that does not incarcerate anyone for any reason would be much preferable
surely you don't actually believe that? I don't think the result of this is just 0 false positives. The result of that is a lot more crime, and a lot more injustice.
surely you don't actually believe that? I don't think the result of this is just 0 false positives. The result of that is a lot more crime, and a lot more injustice.
I think you (as is very common) vastly overestimate the effect of the threat of incarceration on crime.
Forget the threat. Serial muggers/armed robbers/thugs need to be off the street. This "nobody should be in prison" rhetoric is painfully naïve. Wait till you've had elderly/defenseless parents or friends violently mugged and beaten, you'll change your tune.
I think incarceration is very bad at deterring future crimes, but it very good at delaying them. Someone in jail for 10 years is at the very least not going to commit a crime for 10 years. There is some merit to that until we have a better system.
If you burnt to the ground everything doing the best it can probably 75% of the public and every instution would spontaneously combust.
There are also huge swaths of people actively trying to make it worse, that's what the FBI did (does?) for years when it knowingly pushed junk forensics.
Or what basically every prosecution does, when it knows that the science behind some things isn't airtight but still presents it in the best possible light to get a conviction.
Or what basically every prosecution does, when it knows that the science behind some things isn't airtight but still presents it in the best possible light to get a conviction.
> junk forensics
Fiber analysis (e.g. carpets)
Fiber analysis (e.g. carpets)
It's not a justice system, it's a Law and Order system: It's not designed to deliver justice, it's designed to resolve disputes relatively cheaply, while allowing for spending more money to get better results.
Nothing shook my faith in the medical system more than having kids.
Holy cow is modern medicine still as smugly wrong as it’s always been. Every generation laughs at all the stupid stuff the previous generations believed, and then acts so confident that they’ve got it right this time.
And as a result you get unworthy nurses making moms feel intense shame for not “trying hard enough” to somehow magically produce milk.
Holy cow is modern medicine still as smugly wrong as it’s always been. Every generation laughs at all the stupid stuff the previous generations believed, and then acts so confident that they’ve got it right this time.
And as a result you get unworthy nurses making moms feel intense shame for not “trying hard enough” to somehow magically produce milk.
My sister wouldn't sleep. The doctor constantly gave the "sigh, you're an idiot, you just do X and Y and they sleep" talk to my mother because nothing came up on their screening, even though my mother almost wanted to scream that something was clearly wrong and abnormal. Turns out, different doctor, serious vitamin deficiency.
And medical incompetence by staff, not doctors, is also awful. My brother hated reading. He got glasses, still hated reading, my mother wondered why he could be so disobedient in that regard. They said, well, the prescription is right, he can clearly see fine. Turns out two years later that the lenses were installed on opposite sides. Right lens on left eye, left lens on right eye. A simple mistake, but the consequences...
And medical incompetence by staff, not doctors, is also awful. My brother hated reading. He got glasses, still hated reading, my mother wondered why he could be so disobedient in that regard. They said, well, the prescription is right, he can clearly see fine. Turns out two years later that the lenses were installed on opposite sides. Right lens on left eye, left lens on right eye. A simple mistake, but the consequences...
I do find it bizarre they don't verify you can see with your actual glasses.
How would one have tested it instead?
They can verify the prescription. Also in principle they could use the same machine that finds the prescription, to verify that your net correction is zero with your glasses on.
I once proved that my wife got the wrong prescription by just holding her old and new glasses up at arms length and seeing that things looked way different through them. The glasses place agreed.
I once proved that my wife got the wrong prescription by just holding her old and new glasses up at arms length and seeing that things looked way different through them. The glasses place agreed.
Ask you to read letters again... with your actual new glasses on so you can verify how good you can see.
When you get a car engine rebuilt, do they just diagnose, replace parts and then never start the engine themselves to verify it actually works?
When you get a car engine rebuilt, do they just diagnose, replace parts and then never start the engine themselves to verify it actually works?
It’s especially a problem with women and minorities. Doctors just don’t believe them. I’m neither of those and I had to convince my doctor that I had Lyme disease. I had the bullseye right where the tick had bit me. It was clearly Lyme disease. He assumed it couldn’t be because it took 8 weeks for the bullseye to show up (it’s usually a matter of days in America). He did not know that European Lyme disease takes much longer for the bullseye to appear. He at least had the tact to call me later and apologize after he did more research
[deleted]
After 5 kids in 10 years, you come to realize that the standards aren't agreed upon, and best practices/recommendations change YEAR TO YEAR without fail.
Breastfeeding is one of the worst things hoisted upon mothers who are told "you must try no matter what" - seemingly ignoring the mental and physical health of the mother and the father all the while.
Breastfeeding is one of the worst things hoisted upon mothers who are told "you must try no matter what" - seemingly ignoring the mental and physical health of the mother and the father all the while.
There are a lot of really good benefits to breastfeeding but it's not going to work for everybody or in every situation. I wouldn't fault a doctor for recommending it, but they shouldn't make someone feel bad if it isn't working out.
I want recommendations and best practices to change as our understanding of things improve though. The alternative would mean that either no more research is being done, or doctors are just ignoring anything they didn't learn while in school.
I want recommendations and best practices to change as our understanding of things improve though. The alternative would mean that either no more research is being done, or doctors are just ignoring anything they didn't learn while in school.
Our doctor was fine with it. The nurse called formula poison.
> The nurse called formula poison.
An absolutely gross and ridiculous position.
My partner is a GP who has been doing early childhood screening. One thing she learnt after doing a special training is that advice on proper breastfeeding is very difficult to find. She found that with many mothers that had problems, some small adjustments could often make a huge difference (often causing a kind of hallelujah moment for the mothers). The issue is much of the advice given at the hospital is wrong or insufficient.
The training the she did is the possums program from Australia, if somebody wants to look it up I think some resources are available for free.
The training the she did is the possums program from Australia, if somebody wants to look it up I think some resources are available for free.
Completely agree. Half the lactation consultants have never breastfed themselves. The advice my wife got from the nurses versus what she got from her own mother and my grandmother were completely at odds. Both of those women told her to just keep doing it and to ignore the nurses while the professionals were single mindedly focused on a few days of weight loss. The milk came in (as all the older women expected) and my daughter breastfed for many years after.
Really the advice given is simply ridiculous. I honestly think most men who's children have nursed can give better advice than the lactation consultants. One that always makes me roll my eyes is the idea that a breastfed child should eat for a few minutes and then be full for an hour or two. That is simply... Not how it works. Babies like eating and being with mom. Breastfeeding mothers should expect to be with their newborn all the time. We are lucky to know many breastfeeding mothers and I don't know any family where the baby is satiated after ten minutes. And yet... The professionals are convinced this is how it works
Really the advice given is simply ridiculous. I honestly think most men who's children have nursed can give better advice than the lactation consultants. One that always makes me roll my eyes is the idea that a breastfed child should eat for a few minutes and then be full for an hour or two. That is simply... Not how it works. Babies like eating and being with mom. Breastfeeding mothers should expect to be with their newborn all the time. We are lucky to know many breastfeeding mothers and I don't know any family where the baby is satiated after ten minutes. And yet... The professionals are convinced this is how it works
[deleted]
Same experience. The medical system is a reflection of pop parenting culture or vice versa. Everyone was so gung ho on breastfeeding, but when the milk didn’t come in and our son wasn’t interested in a dry breast the only advice given was “keep trying”. Then the shock and surprise when baby is losing weight. We had to demand formula, which was given grudgingly, and left the hospital a day later. If we have another we will do breast plus formula from the get go.
> We had to demand formula
I don’t understand. You can’t just go to the store and buy infant formula?
I don’t understand. You can’t just go to the store and buy infant formula?
In the US (not sure about other countries), new parents often stay at the hospital where the baby was delivered for a few days after the birth. During this time, the hospital often provides them all their food and childcare supplies: diapers, swaddles, diaper cream, wipes, etc. To get formula, you have to ask the hospital for it, but if your nurse doesn’t want to give it to you because they think you should try harder at breastfeeding, you get stuck. You could sneak out and buy some, but you’re pretty exhausted, and your partner is still stuck with a screaming, hungry baby until you’re back.
(I realize after writing this out that being at the mercy of your hospital sounds draconian, but it can be really really great if you have a good nurse or midwife. They teach you how to bathe and swaddle the baby, how to nurse, how to rock them to sleep, etc. All skills you’ll need once you leave)
(I realize after writing this out that being at the mercy of your hospital sounds draconian, but it can be really really great if you have a good nurse or midwife. They teach you how to bathe and swaddle the baby, how to nurse, how to rock them to sleep, etc. All skills you’ll need once you leave)
In the Netherlands, for the 8 days after you give birth, someone comes to your house for some number of hours per day (in our case 8) to teach you these things, maybe do some tidying and cooking but most importantly, take the baby so you can sleep! This is called kraamzorg.
It also has some similar pitfalls, as they are not necessarily specialists and it's still hard to disagree or do something else even if in your own home in the face of the supposed expert.
It also has some similar pitfalls, as they are not necessarily specialists and it's still hard to disagree or do something else even if in your own home in the face of the supposed expert.
It’s not that easy to just know how parenting is going to work the first time around. You can be lactating prior to delivery and then dry up for no reason. Even worse, your baby can decide not to latch or be tongue-tied. If your husband isn’t on hand to run to the store from the hospital, things can get challenging.
We had to worry about my wife dying because they wouldn’t suggest a C-section and we didn’t think to ask for one (her induction didn’t take for several days). We’re quite confident they’d have let her die before suggesting one. Thankfully, we thought better in time.
We had to worry about my wife dying because they wouldn’t suggest a C-section and we didn’t think to ask for one (her induction didn’t take for several days). We’re quite confident they’d have let her die before suggesting one. Thankfully, we thought better in time.
Not so easy when you are in a hospital recovering from birth. They generally won't allow things from offsight into the hospital either, so even if you (dad) goes to get some you have to get it in without getting caught.
The other side is nursing is hard, and so it is easy to cheat and use formula when you could with a little effort nurse the baby just fine. (Nursing is generally slightly better for the baby, but the difference is tiny. Nursing is generally a lot better for the wallet though)
The other side is nursing is hard, and so it is easy to cheat and use formula when you could with a little effort nurse the baby just fine. (Nursing is generally slightly better for the baby, but the difference is tiny. Nursing is generally a lot better for the wallet though)
> The medical system is a reflection of pop parenting culture
Indeed. And not just in relation to parenting. The average doctor is constantly trying to emulate TV doctors, just like the average police detective is influenced by what they see on CSI, and every archaeologist wants to be Indiana Jones or Lara Croft. It would be hilarious, if it didn't have such disastrous consequences for regular people every day.
Indeed. And not just in relation to parenting. The average doctor is constantly trying to emulate TV doctors, just like the average police detective is influenced by what they see on CSI, and every archaeologist wants to be Indiana Jones or Lara Croft. It would be hilarious, if it didn't have such disastrous consequences for regular people every day.
Huh? Doctors don't base their decisions on House episodes. Not even ER episodes.
No, but they base their behavior and expectations on such shows. Life imitates art.
Older nurses are the best. They've seen it all.
The worst encounters I have had with nurses have been with older ones filtering information and using out of date practices because they think they have seen it all and now know best.
> Every generation laughs at all the stupid stuff the previous generations believed, and then acts so confident that they’ve got it right this time.
Voltaire (1694-1778) wrote a satirical account of a medieval university's oral examination on medicine: the examiner asks why morphine puts people to sleep, and the student confidently replies that morphine has a "dormative essence". This is a bit like saying that things with an essence of gravity fall towards the earth, whereas things with an essence of levity float towards the sky. The examiner proudly accepts that answer and bestows upon the student the title of doctor.
This was very funny to anyone educated in the time Voltaire was writing, since they would have known that morphine puts people to sleep because... it has round molecules with no sharp edges...
Edit: correction below, thank you thaumasiotes.
Voltaire (1694-1778) wrote a satirical account of a medieval university's oral examination on medicine: the examiner asks why morphine puts people to sleep, and the student confidently replies that morphine has a "dormative essence". This is a bit like saying that things with an essence of gravity fall towards the earth, whereas things with an essence of levity float towards the sky. The examiner proudly accepts that answer and bestows upon the student the title of doctor.
This was very funny to anyone educated in the time Voltaire was writing, since they would have known that morphine puts people to sleep because... it has round molecules with no sharp edges...
Edit: correction below, thank you thaumasiotes.
> Voltaire (1694-1778) wrote a satirical account of a medieval university's oral examination on medicine: the examiner asks why morphine puts people to sleep, and the student confidently replies that morphine has a "dormative essence".
It was Molière (<1622 - 1673), who wrote a play that featured an apothecary (explaining the functioning of opium to laymen), but no examinations.
https://en.wikipedia.org/wiki/The_Imaginary_Invalid
It was Molière (<1622 - 1673), who wrote a play that featured an apothecary (explaining the functioning of opium to laymen), but no examinations.
https://en.wikipedia.org/wiki/The_Imaginary_Invalid
I used to enjoy this blog written by a person who hated US medical school:
https://web.archive.org/web/20101218031844/http://www.medsch...
People will probably find it offensive but it does explain a lot about why the stuff being taught is almost always not questioned.
This post in particular:
https://web.archive.org/web/20101211180021/http://www.medsch...
https://web.archive.org/web/20101218031844/http://www.medsch...
People will probably find it offensive but it does explain a lot about why the stuff being taught is almost always not questioned.
This post in particular:
https://web.archive.org/web/20101211180021/http://www.medsch...
> unworthy nurses making moms feel intense shame for not “trying hard enough” to somehow magically produce milk.
Stay away from mommy blogs/forums. Those are the most toxic cesspools I've ever witnessed. Things are changing, some of the newer ones are not nearly as bad, but man the judgement is super real.
Nurses are one thing, but personally, the worst is family members who think they know better and don't understand the data and that times have changed.
FORMULA IS PERFECTLY FINE.
Stay away from mommy blogs/forums. Those are the most toxic cesspools I've ever witnessed. Things are changing, some of the newer ones are not nearly as bad, but man the judgement is super real.
Nurses are one thing, but personally, the worst is family members who think they know better and don't understand the data and that times have changed.
FORMULA IS PERFECTLY FINE.
What are some good mom blogs?
Not a "mom blog," but covers pregnancy and childbirth from a scientific viewpoint plus some parenting topics - The Skeptical OB - https://www.skepticalob.com/ the author was a practicing obstetrician, professor at Harvard Medical School, and mom of 4.
Maternal milk is better than formula in every possible way and there is a perfect scientific consensus around this. Formula is the least worst substitute to maternal milk but going around and screaming that formula is perfectly fine, as if it was as good (or even better!) than maternal milk is denying some very well-established piece of science for likely ideological reasons.
Milk is better than formula, but formula is better than starvation.
There are way too many instances of infants "failing to thrive" because their mothers are bullied into relying on breast milk which they simply aren't producing enough of.
There are way too many instances of infants "failing to thrive" because their mothers are bullied into relying on breast milk which they simply aren't producing enough of.
> Maternal milk is better than formula in every possible way and there is a perfect scientific consensus around this.
I have not seen result like this obtained in a randomized, controlled trial, and it is almost certainly false as stated: you're almost certainly exaggerating for effect, but doing that in scientific context is bad intellectual hygiene.
All results of this sort that I have seen have been purely correlational, and as such suffer from selection bias. This might be true, but the evidence is far from conclusive, and if such consensus exists among medical professionals, it only shows how susceptible they are to groupthink and parroting the stuff they heard from the cathedra.
I have not seen result like this obtained in a randomized, controlled trial, and it is almost certainly false as stated: you're almost certainly exaggerating for effect, but doing that in scientific context is bad intellectual hygiene.
All results of this sort that I have seen have been purely correlational, and as such suffer from selection bias. This might be true, but the evidence is far from conclusive, and if such consensus exists among medical professionals, it only shows how susceptible they are to groupthink and parroting the stuff they heard from the cathedra.
It’s like saying that you should only eat organic food. Sure, there is lots of science backing it up, but that’s besides the point. It’s not always possible or easy for everyone to get organic food. Any food is better than no food.
And this is what I'm talking about - Clearly, you've never been a mother who can't produce milk for her child.
I've been there with my wife and I'm only the husband.
Everything you say is true, but by saying this and in this manner, you lack empathy. You sound just like the mommy blogs and their followers that I'm speaking against who spout facts with no room for life's situations. My wife sincerely believed she was less of a mother because of people like this.
I say it again: Formula is _perfectly_ fine. Use it a little or as a total replacement. You're not a lesser mother/parent for it.
I've been there with my wife and I'm only the husband.
Everything you say is true, but by saying this and in this manner, you lack empathy. You sound just like the mommy blogs and their followers that I'm speaking against who spout facts with no room for life's situations. My wife sincerely believed she was less of a mother because of people like this.
I say it again: Formula is _perfectly_ fine. Use it a little or as a total replacement. You're not a lesser mother/parent for it.
When you say more empathy is required, do you mean the same thing should be phrased differently, or do you mean it should not be said at all?
Probably something that says while breast milk is ideal, formula is a great alternative if it's not available.
Acknowledging that formula is a safe alternative and that you don't need to stress.
Acknowledging that formula is a safe alternative and that you don't need to stress.
Formula is adequate as far as macronutrients go, but it lacks sugars present (at varying levels-about 20% of the population are FUT2 non-secretors and cannot produce the α1,2-fucosyltransferase enzyme that is used to make human milk oligosaccharides), stem cells and bacteria present in breast milk. Women in the US are often deficient in the strain that can metabolize the human milk oligosaccharides, b. infantis, and it's not clear afaik to what extent bacteria gets passed vertically in breastmilk. The microRNA present in breastmilk can modulate gene expression, but the extent and effects are unclear.
B. infantis and human milk oligosaccharides create a feedback loop that encourages the formation of a robust immune system during a critical period [1]. Some formulas contain b. infantis, and some contain 2'FL, the HMO present in breastmilk. The most robust strain is EVC001, which has been shown to be present at a year after 21 days of supplementation. In an observational study, it reduced the diagnosis of necrotizing enterocolitis in very low birth rate infants by 73% [2].
I wish this was common knowledge, but most formulas do not contain these (often they contain other pre and probiotics) and babies are missing out on the specific sugars and bacteria that we know impact the development of the immune system.
1. https://www.cell.com/cell/fulltext/S0092-8674(21)00660-7 2. https://pubmed.ncbi.nlm.nih.gov/35032555/
B. infantis and human milk oligosaccharides create a feedback loop that encourages the formation of a robust immune system during a critical period [1]. Some formulas contain b. infantis, and some contain 2'FL, the HMO present in breastmilk. The most robust strain is EVC001, which has been shown to be present at a year after 21 days of supplementation. In an observational study, it reduced the diagnosis of necrotizing enterocolitis in very low birth rate infants by 73% [2].
I wish this was common knowledge, but most formulas do not contain these (often they contain other pre and probiotics) and babies are missing out on the specific sugars and bacteria that we know impact the development of the immune system.
1. https://www.cell.com/cell/fulltext/S0092-8674(21)00660-7 2. https://pubmed.ncbi.nlm.nih.gov/35032555/
At least this one doesn't sound as bad as the other post, but it's still in the same vein - you've never been a mother who can't produce milk for her child.
I've been as the husband there and are all your facts don't allow for people's situations.
Formula is perfectly fine.
I've been as the husband there and are all your facts don't allow for people's situations.
Formula is perfectly fine.
> you've never been a mother who can't produce milk for her child
That's your assumption.
You're missing the point, which is that you can supplement formula with both 2'FL and b. infantis and get immune system outcomes that are more similar to those that occur while breastfeeding [1]. The fact that milk typically faciliates a cascade of changes that lay the foundation for a healthy immune system is not at odds with formula feeding. Formula is adequate macronutrition, but if we cannot be honest about the ways in which it is not on par with breastmilk, we will never close the gaps.
1. https://www.nutraingredients.com/Article/2023/05/18/Abbott-s...
That's your assumption.
You're missing the point, which is that you can supplement formula with both 2'FL and b. infantis and get immune system outcomes that are more similar to those that occur while breastfeeding [1]. The fact that milk typically faciliates a cascade of changes that lay the foundation for a healthy immune system is not at odds with formula feeding. Formula is adequate macronutrition, but if we cannot be honest about the ways in which it is not on par with breastmilk, we will never close the gaps.
1. https://www.nutraingredients.com/Article/2023/05/18/Abbott-s...
> That's your assumption.
Oh do correct me if I'm wrong. I'd love to hear your personal experience. Anyway...
How can you close the gaps when the mother isn't producing milk?
I'm actually confused because you keep telling me it's better, with links and everything, but... It's simply non existent for a lot of mothers. Non producing or a bad latch is enough to put a newborn baby at risk after one week.
It's like you don't believe it's possible.
That's why you're just like the mommy blogs. "You must feed 'em breast milk. It's soooooo important"
Oh do correct me if I'm wrong. I'd love to hear your personal experience. Anyway...
How can you close the gaps when the mother isn't producing milk?
I'm actually confused because you keep telling me it's better, with links and everything, but... It's simply non existent for a lot of mothers. Non producing or a bad latch is enough to put a newborn baby at risk after one week.
It's like you don't believe it's possible.
That's why you're just like the mommy blogs. "You must feed 'em breast milk. It's soooooo important"
I've breastfed multiple children with ups and downs of it being easy and hard, suffered through the struggle of learning to do it the first time as postpartum mother after major surgery, through teething, latch issues, biting, pure physical exhaustion, and the transition of going back to work that leads to decreased supply. I've watched close friends that have struggled with production with underweight, premature babies pump like crazy and feel stressed out trying to get their supply up but ultimately transition to formula on the advice of doctors. My own anxiety around combination feeding and not feeling like I had a clear understanding of differences in the microbiome with a surgical birth or formula use lead to me reading everything I could find to gain a better understanding of the differences in outcomes for exclusive breastfeeding, combination and formula feeding.
We can close the gaps by subsidizing Evivo's EVC001 b. infantis and making it a standard that every formula contains 2'FL. Individuals can choose these formulas and purchase b. infantis already. If we were to make it so that all babies, not just NICU babies at hospitals aware of the research, get these two things, public health outcomes (especially those related to autoimmune conditions) should be better than if we continue allowing formula that is not as analogous with breastmilk. We can have better lactation support that is current and evidence based (such as that from ABM contributor Katrina Mitchell https://physicianguidetobreastfeeding.org).
Another reason mom blogs are toxic is because people read past others points when issues are really emotionally charged for them. Really sorry your wife struggled. Formula is fine, but there are reasons breastmilk is pushed, especially since milk is supply and demand and it's hard to identify those with true low supply and those whose bodies just haven't ramped up production yet. Hopefully as a model of immune system response and the impact of b. infantis and HMOs gains more awareness, there will be less pressure since we are assured babies are getting many of the same benefits.
We can close the gaps by subsidizing Evivo's EVC001 b. infantis and making it a standard that every formula contains 2'FL. Individuals can choose these formulas and purchase b. infantis already. If we were to make it so that all babies, not just NICU babies at hospitals aware of the research, get these two things, public health outcomes (especially those related to autoimmune conditions) should be better than if we continue allowing formula that is not as analogous with breastmilk. We can have better lactation support that is current and evidence based (such as that from ABM contributor Katrina Mitchell https://physicianguidetobreastfeeding.org).
Another reason mom blogs are toxic is because people read past others points when issues are really emotionally charged for them. Really sorry your wife struggled. Formula is fine, but there are reasons breastmilk is pushed, especially since milk is supply and demand and it's hard to identify those with true low supply and those whose bodies just haven't ramped up production yet. Hopefully as a model of immune system response and the impact of b. infantis and HMOs gains more awareness, there will be less pressure since we are assured babies are getting many of the same benefits.
Apologies and Thanks for sharing your story.
Our twins were put into my wife's arms, and we were wheeled into a room to stay for 48 hrs, being woken up every 2 hours by a nurse, which would wake up our kids, making the whole thing a living nightmare. I have no idea how I drove home.
They had no care for my wife's ability to heal, rest, or anything, just subjecting us to the worst kind of institutionalized checklist torture. The medical system cares for nothing other than preventing lawsuits and providing a place for doctors to do their 1 hr of work on their 18 patients a day.
They had no care for my wife's ability to heal, rest, or anything, just subjecting us to the worst kind of institutionalized checklist torture. The medical system cares for nothing other than preventing lawsuits and providing a place for doctors to do their 1 hr of work on their 18 patients a day.
The justice system is doing what the doctors tell them. Broadly speaking If a medical professional testifies that this is the only way, what qualifications does a DA have to question him? Medicine is a profession; thus the professional body ought to be addressing this and, if the guidance changes, be advocating and lobbying to Congress that people start being released.
> If a medical professional testifies that this is the only way, what qualifications does a DA have to question him?
Questioning witnesses is literally the DA's job. That doesn't magically stop being the case just because the witness is an expert. The DA is indeed qualified for this. You could even say it's one of the main reasons the DA exists.
Questioning witnesses is literally the DA's job. That doesn't magically stop being the case just because the witness is an expert. The DA is indeed qualified for this. You could even say it's one of the main reasons the DA exists.
Got it. So the DA is supposed to not only be an expert in the law, but enough of an expert in medicine such that he can flaunt widely acknowledged medical standards while cross-examining expert witnesses on why they're wrong.
The author of this post admitted that it took him countless hours to discover that medicine basically has this issue wrong and only after being particularly motivated to do so. If the DA has so much medical expertise that they know better than the doctors, then what exactly is he doing being a DA?
The idea that the main purpose of the DA is to know better than doctors is ludicrous.
The author of this post admitted that it took him countless hours to discover that medicine basically has this issue wrong and only after being particularly motivated to do so. If the DA has so much medical expertise that they know better than the doctors, then what exactly is he doing being a DA?
The idea that the main purpose of the DA is to know better than doctors is ludicrous.
The DA's job is to question the credibility of witnesses. If credentials conferred credibility, it wouldn't be possible to ever convict an expert of anything.
So to be plain: No, DA's don't (and aren't supposed to) just take experts by their word. They ask clarifying questions, and often bring additional experts offering contradicting testimony.
Do you seriously think courts operate by "the doctor said so, case closed"? We wouldn't need courts if that were the case.
So to be plain: No, DA's don't (and aren't supposed to) just take experts by their word. They ask clarifying questions, and often bring additional experts offering contradicting testimony.
Do you seriously think courts operate by "the doctor said so, case closed"? We wouldn't need courts if that were the case.
So the defense attorney (since it wouldn't be the da anyway) is going to convince the jury that not just the witness but the entire medical profession is suspect because of its heretofore unanimous belief that shaken baby syndrome is the only explanation of these phenomenon.
> Do you seriously think courts operate by "the doctor said so, case closed"? We wouldn't need courts if that were the case.
For certain things.. yes. If a doctor tells a jury that these injuries could only be sustained via shaking trauma, most juries will believe them over a rogue doctor or a non doctor. Doctors have some of the highest trust ratings of all professions. Attorneys have some of the lowest. That means convincing the jury the doctors are wrong.
The blame should lay at the feet of the medical professional bodies.
> Do you seriously think courts operate by "the doctor said so, case closed"? We wouldn't need courts if that were the case.
For certain things.. yes. If a doctor tells a jury that these injuries could only be sustained via shaking trauma, most juries will believe them over a rogue doctor or a non doctor. Doctors have some of the highest trust ratings of all professions. Attorneys have some of the lowest. That means convincing the jury the doctors are wrong.
The blame should lay at the feet of the medical professional bodies.
TLDR:
There are issues with the way/how quickly we diagnose shaken baby syndrome without exploring other potential diagnoses, and with how severely/quickly we take kids away from their parents once we "think" we have a shaken baby
There are issues with the way/how quickly we diagnose shaken baby syndrome without exploring other potential diagnoses, and with how severely/quickly we take kids away from their parents once we "think" we have a shaken baby
This doesn't do it justice. The damn name of the diagnosis makes it sound like a crime was committed. Guy runs an educational foundation on the issue that gets over 200 people a year asking for help in France alone.
> we diagnose shaken baby syndrome without exploring other potential diagnoses
It's more that 'shaken baby syndrome' is caused by more things than just a shaken baby (and evidence that shaking does not cause it even.)
> the more neutral and objective term of “retino-dural hemorrhage of infancy” (RDHI).
It's more that 'shaken baby syndrome' is caused by more things than just a shaken baby (and evidence that shaking does not cause it even.)
> the more neutral and objective term of “retino-dural hemorrhage of infancy” (RDHI).
It's much worse. There's no evidence of any baby shaking. At all.
Well, I was very surprised to discover that shaking appears to be a highly common and widespread form of child abuse in the world [1]. It may affect 2-3% of all babies in the US and other developed countries, and the rate may be 10x or more higher in other countries.
I think it's reasonable to say that billions of babies may have been shaken in the past, yet the vast majority (of the order of 99.9% or even much more? [2]) are not diagnosed with shaken baby syndrome, since this diagnosis has an incidence of ~1/3,000 among children < 12 months in developed countries. In the countries where the incidence of shaking appears to be >50%, it is striking to note that the SBS diagnosis actually does not exist, i.e. doctors are not trained to diagnose it.
On the other hand, actual cases of severe inflicted head injuries probably affect < 1/10,000 children < 12 months, and I think most of them involve external evidence of trauma. Those that do not probably involve extreme forms of shaking far beyond what most of the billions of "shaken babies" sustain.
In other words, I've come to the likely conclusion that the intersection of babies who are effectively shaken, and babies who are labelled with "shaken baby syndrome", is an abysmal proportion of the first set, and a small proportion of the second.
[1] https://www.sciencedirect.com/science/article/pii/S074937970...
[2] Excerpt from the paper above: "the ratio of children hospitalized or dying from inflicted neurotrauma compared to the numbers of reported shaken children may be estimated at 1 to 152."
I think it's reasonable to say that billions of babies may have been shaken in the past, yet the vast majority (of the order of 99.9% or even much more? [2]) are not diagnosed with shaken baby syndrome, since this diagnosis has an incidence of ~1/3,000 among children < 12 months in developed countries. In the countries where the incidence of shaking appears to be >50%, it is striking to note that the SBS diagnosis actually does not exist, i.e. doctors are not trained to diagnose it.
On the other hand, actual cases of severe inflicted head injuries probably affect < 1/10,000 children < 12 months, and I think most of them involve external evidence of trauma. Those that do not probably involve extreme forms of shaking far beyond what most of the billions of "shaken babies" sustain.
In other words, I've come to the likely conclusion that the intersection of babies who are effectively shaken, and babies who are labelled with "shaken baby syndrome", is an abysmal proportion of the first set, and a small proportion of the second.
[1] https://www.sciencedirect.com/science/article/pii/S074937970...
[2] Excerpt from the paper above: "the ratio of children hospitalized or dying from inflicted neurotrauma compared to the numbers of reported shaken children may be estimated at 1 to 152."
> I couldn’t live with this uncertainty any longer. But first, I had to get my son back. As a precautionary measure, the hospital followed mandatory reporting statutes and my wife and I temporarily lost custody of David. Thanks to our incredibly effective defense lawyer, we were cleared of all charges within two months, during which we stayed at the hospital 24/7 with David until we sorted out the legal procedures. I would discover much later that we actually had been lucky to be allowed to do this, as most parents are abruptly separated from their babies for months after reporting takes place.
This sounds very much like presumed guilt rather than presumed innocence.
This sounds very much like presumed guilt rather than presumed innocence.
Is the criminal justice system in France based on a presumption of innonce?
Is that a serious question? Yes, the French justice system is based on a presumption of innocence, just like any other functioning democratic nation. It is a basic human right under the UN charter after all.
You say that, but this doesn't seem like presumption of innocence. A country with a presumption of innocence doesn't take your child away from you without trial.
I'm willing to bet that almost all countries have a different standard of proof for taking a child away than for criminal trial, and none will wait for the outcome of a trial to do this.
I don't deny that many other countries may also be missing elements of the presumption of innocence.
A presumption of innocence doesn't mean that a trial is needed before (what are supposed to be) basic safety measures.
Judges can issue preliminary injunctions before trial in all places in the world. A justice system that can't take any coercive action until the end of a trial would simply not function.
In particular though, cases like this aren't even related to the presumption of innocence. The state believes that the child has suffered harm, so a judge takes them in protective custody. Who is harming the child remains to be determined, but taking the child into custody is supposed to protect the child immediately.
Of course, this can be, like in this case, wrongly applied to disastrous effects. But it has also saved many children from abusive parents, where leaving them without state protection for years while the trial advances would have scarred them permanently or killed them.
Judges can issue preliminary injunctions before trial in all places in the world. A justice system that can't take any coercive action until the end of a trial would simply not function.
In particular though, cases like this aren't even related to the presumption of innocence. The state believes that the child has suffered harm, so a judge takes them in protective custody. Who is harming the child remains to be determined, but taking the child into custody is supposed to protect the child immediately.
Of course, this can be, like in this case, wrongly applied to disastrous effects. But it has also saved many children from abusive parents, where leaving them without state protection for years while the trial advances would have scarred them permanently or killed them.
> Of course, this can be, like in this case, wrongly applied to disastrous effects. But it has also saved many children from abusive parents
So what is the relative frequency of these two outcomes? You can't ignore the wrong applications; if they outnumber the proper ones, then the system is doing more harm than good.
So what is the relative frequency of these two outcomes? You can't ignore the wrong applications; if they outnumber the proper ones, then the system is doing more harm than good.
I don't know, but this particular case is actually quite uncommon. I forgot to mention this, but apart from everything else, this is a case where the justice system actually followed the opinions and recommendations of actual experts - except that those experts seem to be very wrong on this topic.
So, in this particular case, I would say that the justice system did it's job quite well, and it's a massive failure of the medical system that shaken baby syndrome is still identified as a real thing by real, board-certified doctors.
So, in this particular case, I would say that the justice system did it's job quite well, and it's a massive failure of the medical system that shaken baby syndrome is still identified as a real thing by real, board-certified doctors.
"The system" is not just the justice system. If the justice system is relying on wrong evaluations by experts, that's still the system doing harm instead of good. And if it is known that so-called "experts" in a field can get things this wrong, the justice system should not be relying on their confident assertions.
Pre-trial detention is a thing pretty much everywhere despite literally locking innocent people up before a trial.
Tough to see how else you would do it - a hypothetical murderer in broad daylight with a ton of reliable witnesses and video evidence would still have to wait for a trial, I don't think anyone would seriously say that this hypothetical person should be free until the trial happens.
I don't think so either https://www.itv.com/news/london/2023-09-21/met-police-office...
There are complications when immediate danger needs to be avoided. E.g., the system prefers to take away children preventively in serious cases rather than leaving them in a dangerous environment. Which is sometimes justified, and sometimes not. The idea in this case is that it is easier to correct a mistake by restoring custody than by reviving a dead child.
A bit like temporary restraining orders pending trial in the US.
A bit like temporary restraining orders pending trial in the US.
Yes, as others have said. However, this is a legitimate question, because in these specific cases, the burden of proof tends to be on the side of the defendant who needs to prove they didn't harm their child. That's obviously impossible, and probably unconstitutional.
When medical experts claim they're 100% confident that this child was violently shaken at this specific time, and that you were the only person with the child at that time, how can you defend yourself when you haven't done anything? There's nothing you could ever do to convince courts that your word has more value than the confidence of highly reputable experts with decades of experience.
This is an instance where the prosecution's case relies on the confidence in medical authorities, and where it is extremely hard to challenge it as the subject is so difficult on a scientific and technical level. In the US and other adversarial jurisdictions, you see an incredible level of technicality during oral debates, with extensive and long-running discussions around extremely obscure points related to the anatomy, physiology, and pathology of the infant nervous system in highly specific pathological situations, where infants frequently suffer from multiple rare medical conditions or risk factors. Few people in the world have the required expertise, and even fewer accept to testify in courts! There's also an obvious financial imbalance between the State and the defendant.
In inquisitorial jurisdictions like France, this is even worse as there's basically no system in place to challenge the views of the State's experts.
So, yes, litigating these cases is extraordinarily challenging because the only way to prove the defendant's innocence is to challenge the opinion of overly assertive medical experts by digging into highly difficult (and multidisciplinary) science.
When medical experts claim they're 100% confident that this child was violently shaken at this specific time, and that you were the only person with the child at that time, how can you defend yourself when you haven't done anything? There's nothing you could ever do to convince courts that your word has more value than the confidence of highly reputable experts with decades of experience.
This is an instance where the prosecution's case relies on the confidence in medical authorities, and where it is extremely hard to challenge it as the subject is so difficult on a scientific and technical level. In the US and other adversarial jurisdictions, you see an incredible level of technicality during oral debates, with extensive and long-running discussions around extremely obscure points related to the anatomy, physiology, and pathology of the infant nervous system in highly specific pathological situations, where infants frequently suffer from multiple rare medical conditions or risk factors. Few people in the world have the required expertise, and even fewer accept to testify in courts! There's also an obvious financial imbalance between the State and the defendant.
In inquisitorial jurisdictions like France, this is even worse as there's basically no system in place to challenge the views of the State's experts.
So, yes, litigating these cases is extraordinarily challenging because the only way to prove the defendant's innocence is to challenge the opinion of overly assertive medical experts by digging into highly difficult (and multidisciplinary) science.
> Very often, abuse is diagnosed “by default”, because no known alternative explanation was found (or even actively sought). This is extremely dangerous, as it seems to indicate that no further medical discovery need ever be made in the future.
Well, "dangerous" for who? For a lot of people involved in "child abuse" – from medical professionals to child services to the police – a false positive carries basically no consequences: you report it, or follow up, or do whatever your task is, "to be sure", and that's it.
But a false negative can have a lot more consequences, including losing your job, lawsuits, becoming the centre of a media circus, becoming the target of an investigation yourself, etc. etc.
Also see: most Amber Alerts should not have been sent, and are just simple cases of runaways, miscommunications, or family drama. But the official "pushing the button" to send out an alert has the same incentives as above.
The incentives are pretty obvious.
Well, "dangerous" for who? For a lot of people involved in "child abuse" – from medical professionals to child services to the police – a false positive carries basically no consequences: you report it, or follow up, or do whatever your task is, "to be sure", and that's it.
But a false negative can have a lot more consequences, including losing your job, lawsuits, becoming the centre of a media circus, becoming the target of an investigation yourself, etc. etc.
Also see: most Amber Alerts should not have been sent, and are just simple cases of runaways, miscommunications, or family drama. But the official "pushing the button" to send out an alert has the same incentives as above.
The incentives are pretty obvious.
It would be dangerous for the children. In the most extreme imaginable case we could discover a preventative measure for the brain bleed.
Infants are routinely given vitamin K and vitamin D to prevent bleeding and to prevent bone development issues. Imagine if there was something else that could be given to prevent brain bleeds. That would save a lot of children.
Infants are routinely given vitamin K and vitamin D to prevent bleeding and to prevent bone development issues. Imagine if there was something else that could be given to prevent brain bleeds. That would save a lot of children.
Indeed, it's especially problematic in the public sector. Since there's generally no reward for successful risk management, yet severe consequences for misjudgments, it fosters a culture of risk aversion. Another example is at the FDA, where an overemphasis on caution can inadvertently lead to more harm than good by delaying or preventing the approval of beneficial treatments.
Oh. And I thought that reddit outrage over the video of a father throwing his son in the air was just your standard modern hyperprotectiveness. Actually, the father risked lawsuit as it stands. The lack of common sense (and knowledge of physics) is off-putting.
Did you read the article? The article claims the reverse. That this is not a real problem.
> . As a precautionary measure, the hospital followed mandatory reporting statutes and my wife and I temporarily lost custody of David. Thanks to our incredibly effective defense lawyer, we were cleared of all charges within two months, during which we stayed at the hospital 24/7 with David until we sorted out the legal procedures.
Woah
Woah
Amazing that bit about child welfare organisations fighting against the science, when clearly taking children away based on false accusations is clearly far worse for the child’s welfare, not to mention the parents’!
It’s just incredible the injustice that can be done in the name of protecting children. I really do wonder if it’s cultural or some kind of innate psychological irrarionality that seems stronger in some than others. I love kids and care deeply about their welfare, but people sometimes try to make me feel bad or that I’m the weird one for being able to think (I believe) fairly rationally about the risks and dangers that they face, instead of massively over-exaggerating!
Or of course the opposite, keeping an appropriate eye on relations and acquaintances when people assume they’re totally safe but it’s actually somebody with that level of relation who’s likely to be a danger than a stranger.
It’s just incredible the injustice that can be done in the name of protecting children. I really do wonder if it’s cultural or some kind of innate psychological irrarionality that seems stronger in some than others. I love kids and care deeply about their welfare, but people sometimes try to make me feel bad or that I’m the weird one for being able to think (I believe) fairly rationally about the risks and dangers that they face, instead of massively over-exaggerating!
Or of course the opposite, keeping an appropriate eye on relations and acquaintances when people assume they’re totally safe but it’s actually somebody with that level of relation who’s likely to be a danger than a stranger.
My theory is that emotionally charged issues seem like a haven for people not thinking clearly and cover for hand waving or opposing any thoughtful analysis.
I think there are people drawn to the absolutes. I can maybe see how it can be comforting to have a black and white issue to try to solve / help. A good side to be a part of in a world that to some seems very bad or confusing.
Some old friends of mine are very much into these kinds of children’s issues. But when they talk to you about it it’s all emotion, it’s not even clear to me that they know much at all other than a sense that the bad guys are out there, maybe some strange legislation they support and so on. They’re not interested in justice, just this absolute sorta cause.
I think there are people drawn to the absolutes. I can maybe see how it can be comforting to have a black and white issue to try to solve / help. A good side to be a part of in a world that to some seems very bad or confusing.
Some old friends of mine are very much into these kinds of children’s issues. But when they talk to you about it it’s all emotion, it’s not even clear to me that they know much at all other than a sense that the bad guys are out there, maybe some strange legislation they support and so on. They’re not interested in justice, just this absolute sorta cause.
Yes, this happens because most of us are unconsciously repeating our own histories.
I agree. This is clearly visible in trials where emotion plays a big part. An innocent childminder being charged with murder can't really compete with the extraordinarily charged testimony of grieving, devastated and sincere parents who have been made to believe in the strongest way possible that she killed their baby.
> Amazing that bit about child welfare organisations fighting against the science, when clearly taking children away based on false accusations is clearly far worse for the child’s welfare, not to mention the parents’!
This is just speculation, but I bet those groups (or their members) aren't always calmly and coolly trying to find the best policies protect the welfare of children. Instead they feel themselves on a kind of righteous moral crusade, and what's more heroic than swooping in to take the child away from the clutches of the villain? The feelings of heroism could obscure understanding the harm the "heroic act" could cause.
This is just speculation, but I bet those groups (or their members) aren't always calmly and coolly trying to find the best policies protect the welfare of children. Instead they feel themselves on a kind of righteous moral crusade, and what's more heroic than swooping in to take the child away from the clutches of the villain? The feelings of heroism could obscure understanding the harm the "heroic act" could cause.
> and what's more heroic than swooping in to take the child away from the clutches of the villain?
In a (somewhat) post-scarcity society attention from others is hard currency and narcissism is at an all time high.
In a (somewhat) post-scarcity society attention from others is hard currency and narcissism is at an all time high.
I suspect that was the motivation for Apple's iPhone client-side scanning and reporting of CSAM feature and the subsequent hard push for it.
> they feel themselves on a kind of righteous moral crusade
They see a lot of bad stuff which causes them to have a difficult time admitting that sometimes bad stuff just happens on it's own
Reminds me of the police/detectives that "just know he did it" because they don't understand that people grieve differently. I really empathize with the people that don't have a meltdown and cry when they hear some horrific news. I don't think I would either in many cases. I'd want the cops to do their job and go find the perp so I'd talk to them in a calm and concise manner telling them what I knew; even though that's likely highly suspicious behavior.
They see a lot of bad stuff which causes them to have a difficult time admitting that sometimes bad stuff just happens on it's own
Reminds me of the police/detectives that "just know he did it" because they don't understand that people grieve differently. I really empathize with the people that don't have a meltdown and cry when they hear some horrific news. I don't think I would either in many cases. I'd want the cops to do their job and go find the perp so I'd talk to them in a calm and concise manner telling them what I knew; even though that's likely highly suspicious behavior.
That actually happened to me, not with the police though, but with social workers. I explained the situation in a very calm, concise, and perhaps emotionally detached manner because this is just my personality. They wrote in their report that they found it strange that "I almost did not cry during the interview", which they said was the main reason they would recommend to put David in foster care. The guilt of knowing that I, with my personality, was responsible for losing his care, was devastating.
I also found this argument absurd: I was suspected of losing my temper on my child, and it's my calmness that was interpreted as a sign of danger!
It reminds me the Robert Roberson Texas death penalty case that John Grisham recently wrote about [1]: "He told hospital staff that she had fallen out of bed, but they didn’t believe him. They didn’t know he was autistic and decided he didn’t show the proper emotions given the dire situation."
[1] https://www.wsj.com/articles/texas-may-execute-a-man-based-o...
I also found this argument absurd: I was suspected of losing my temper on my child, and it's my calmness that was interpreted as a sign of danger!
It reminds me the Robert Roberson Texas death penalty case that John Grisham recently wrote about [1]: "He told hospital staff that she had fallen out of bed, but they didn’t believe him. They didn’t know he was autistic and decided he didn’t show the proper emotions given the dire situation."
[1] https://www.wsj.com/articles/texas-may-execute-a-man-based-o...
It's especially bizarre because even apart from things like autism, even for more neurotypical people disassociation (which as I understand in mild forms can appear as emotional detachment which could come off as being calm) is a well known symptom of acute stress responses (i.e. psychological shock). As unreproducible as a lot of psychology is, putting any merit in 'they didn't respond how I think they "should" have' seems like just utterly extraordinary nonsense...
I’m rather neurotypical but I worked in high trauma environments during my college years; ER, OR, ICU, various life and death situations on daily basis in a healthcare environment. I pretty much saw it all.
That was 20+ years ago, my career was not there so I left clinical work but the ability to function during high stress and deal with the present mentally stuck with me. I also could mostly leave it at the door and it didn’t weigh on me outside work (I think most healthcare workers can do this, it all just becomes normal.
Since then, I’m the one that springs into action instead of paralyzed by shock/surprise. Saved someone choking in a restaurant, pulled a pregnant woman from a burning car after an accident, just a few weeks ago someone had a stroke at a park and I had to figure out best way to help - all these had many other bystanders just watching it happen and they all just were frozen until I came over and took charge barking order about call an ambulance or telling them exactly how to help. I’ve also learned that when something really bad happens in my life, like bad diagnoses/death of loved ones, my immediate response is to help and support what ever immediate actions are needed, talk about what needs to be done, help others experiencing immediate and usually uncontrollable grief. My grief usually starts a day or two later once all the immediate concerns are addressed.
That was 20+ years ago, my career was not there so I left clinical work but the ability to function during high stress and deal with the present mentally stuck with me. I also could mostly leave it at the door and it didn’t weigh on me outside work (I think most healthcare workers can do this, it all just becomes normal.
Since then, I’m the one that springs into action instead of paralyzed by shock/surprise. Saved someone choking in a restaurant, pulled a pregnant woman from a burning car after an accident, just a few weeks ago someone had a stroke at a park and I had to figure out best way to help - all these had many other bystanders just watching it happen and they all just were frozen until I came over and took charge barking order about call an ambulance or telling them exactly how to help. I’ve also learned that when something really bad happens in my life, like bad diagnoses/death of loved ones, my immediate response is to help and support what ever immediate actions are needed, talk about what needs to be done, help others experiencing immediate and usually uncontrollable grief. My grief usually starts a day or two later once all the immediate concerns are addressed.
When I was young my youngest brother walked across a large firepit barefoot (no one realized it was still hot, the neighbor had been burning wood and the like outside).
He experienced 3rd degree burns on his feet and my mother rushed him to the hospital. My stepfather at the time was basically freaking out, my mother was very calm. After it was over the thing she told us is that panicking in an emergency helps no one.
It's a lesson I've kept with me my entire life. Most of the time, for me to truly process things, I need to be alone. I have no doubt I would come across as detached and not caring if something tramautic were to happen to me.
OTOH, I had to put a pet down once and I was crying like a baby so maybe not. I've never been in a situation where I haven't had time to process before really speaking about it to others so I really am not sure what my response would be.
He experienced 3rd degree burns on his feet and my mother rushed him to the hospital. My stepfather at the time was basically freaking out, my mother was very calm. After it was over the thing she told us is that panicking in an emergency helps no one.
It's a lesson I've kept with me my entire life. Most of the time, for me to truly process things, I need to be alone. I have no doubt I would come across as detached and not caring if something tramautic were to happen to me.
OTOH, I had to put a pet down once and I was crying like a baby so maybe not. I've never been in a situation where I haven't had time to process before really speaking about it to others so I really am not sure what my response would be.
> I had to put a pet down once and I was crying like a baby so maybe not
I relate with much of your comment but this was something I actually considered writing before. The most drastic emotional response I've ever experienced was putting a pet down. I knew it was the right choice, planned it out, to be done at home in the back yard, his favorite place and final resting place, and even made time for one last outing to his favorite lake a little while before.
But with all the planning and forethought, it's like I started grieving before the event happened. So when it did happen, I just cried and cried. Like, sobbing on the floor for an hour type thing. Also, the fact he was mentally still 100% but his body was failing made it a wrenching decision that I was questioning even though I felt like it was the humane choice.
I was really in a funk for about a year after. The first couple months, I'd just randomly cry as some old memory would pop in my head. I was really close to this dog though, was like a child to me and it hit really hard. I got him in my early 20s, then later married but hadn't had kids yet. For some reason, the saddest thought in my head was "he'll never get to meet my kids". I've had 2 dogs since, that have been more like pets than children and I have real children too which changes the dynamic entirely.
I relate with much of your comment but this was something I actually considered writing before. The most drastic emotional response I've ever experienced was putting a pet down. I knew it was the right choice, planned it out, to be done at home in the back yard, his favorite place and final resting place, and even made time for one last outing to his favorite lake a little while before.
But with all the planning and forethought, it's like I started grieving before the event happened. So when it did happen, I just cried and cried. Like, sobbing on the floor for an hour type thing. Also, the fact he was mentally still 100% but his body was failing made it a wrenching decision that I was questioning even though I felt like it was the humane choice.
I was really in a funk for about a year after. The first couple months, I'd just randomly cry as some old memory would pop in my head. I was really close to this dog though, was like a child to me and it hit really hard. I got him in my early 20s, then later married but hadn't had kids yet. For some reason, the saddest thought in my head was "he'll never get to meet my kids". I've had 2 dogs since, that have been more like pets than children and I have real children too which changes the dynamic entirely.
For me it was unexpected, through a series of very unfortunate events my inside cat got into my neighbors yard and the dog attacked it.
I took her to emergency surgery, spent about $2k until the vet basically told me there was no point. They put me in a room, wrapped her in a towel, and brought her in for me to spend time with before we put her to sleep. I just remember after they put her in my arms she looked up at me and started purring and I couldn't have stopped the tears if I had wanted to. I'm not a fan of anthropomorphizing animals, but I like to think she felt safe in that last moment.
Even just thinking about it now gets me upset. What makes it worse is that the actions of my neighbor contributed to her death. I had to chalk it up to stupidity, the alternative would be an impotent rage that would do none of us any good.
That was probably 8 years ago, and even now if I talk much about her my girlfriend will start crying. They're just pets, and yet...
I took her to emergency surgery, spent about $2k until the vet basically told me there was no point. They put me in a room, wrapped her in a towel, and brought her in for me to spend time with before we put her to sleep. I just remember after they put her in my arms she looked up at me and started purring and I couldn't have stopped the tears if I had wanted to. I'm not a fan of anthropomorphizing animals, but I like to think she felt safe in that last moment.
Even just thinking about it now gets me upset. What makes it worse is that the actions of my neighbor contributed to her death. I had to chalk it up to stupidity, the alternative would be an impotent rage that would do none of us any good.
That was probably 8 years ago, and even now if I talk much about her my girlfriend will start crying. They're just pets, and yet...
Thanks for sharing. I too get teary-eyed thinking too much about it too much, but find as time passes it's much more filled with happy thoughts as you remember back on your time together. Nothing too additive to say but just wanted to acknowledge and voice respect for sharing in your experience, it's crazy how deep those relationships can be. I actually do believe they're pretty damn smart and that final eye gaze had a lot of love embedded. I have same, and it felt like he was saying "it's time, I'm ready" which is probably in my mind but that's the reality I choose for myself lol
Sounds a lot like the terrible case of Lindy Chamberlain "A Dingo Ate My Baby" https://www.youtube.com/watch?v=quC4cbpJeaU
It gets really obvious when this becomes not just a matter of personal experience but culture. Had the fortune to watch the news about an airplane crash without survivors on a TV channel in Asia. They had a video of grieving relatives from Western Europe who looked utterly gutted and in pain. But since they werent crying and screaming the news anchor had to explain that this was cultural differences.
That is a point - and also, while I'm sure many are just misguided, and I generally don't want to assume malice when ignorance is a more likely cause, it is certainly interesting that some high-profile people on these 'heroic moral crusades' do then seem to get caught up in sexual misconduct scandals of their own surprisingly frequently...
It is easy to think bad things of others that you know to be true of yourself.
Another example is that a lot of anti-gay crusaders turned out to be closet gays who hated themselves.
Another example is that a lot of anti-gay crusaders turned out to be closet gays who hated themselves.
Exactly. I met many people like this. The notion of groupthink comes to mind: "Unquestioned belief in the morality of the group, causing members to ignore the consequences of their actions."
See https://en.m.wikipedia.org/wiki/Groupthink
See https://en.m.wikipedia.org/wiki/Groupthink
Do you ( or anyone else ) have an idea about how to deal with that? Not just on a group level but also on an individual one?
The willful ignorance of the dissonance between proclaimed intention and consequences is one of the scariest phenomenons i have experienced and its among proper mob mentality turning in a charged violence prone environment.
Being a bit of a smartass (OFCOURSE just as a teen :) i prodded a bit when some family friend got into some superficial moral signaling about the evils of child labor. I asked how exactly the alternative looks without social safety nets in the relevant regions. Being convinced of having the moral high ground an emotional fever set in and it went as far as a "Well maybe then they should all starve!". Pretty sure i saw the realization of what i just goaded out and if hateful stares could kill i would have been a goner. It has been almost two decades now and the relationship has never recovered. I know some seriously scary people but this is up there.
edit: Sorry for the late edits, was hard to read.
The willful ignorance of the dissonance between proclaimed intention and consequences is one of the scariest phenomenons i have experienced and its among proper mob mentality turning in a charged violence prone environment.
Being a bit of a smartass (OFCOURSE just as a teen :) i prodded a bit when some family friend got into some superficial moral signaling about the evils of child labor. I asked how exactly the alternative looks without social safety nets in the relevant regions. Being convinced of having the moral high ground an emotional fever set in and it went as far as a "Well maybe then they should all starve!". Pretty sure i saw the realization of what i just goaded out and if hateful stares could kill i would have been a goner. It has been almost two decades now and the relationship has never recovered. I know some seriously scary people but this is up there.
edit: Sorry for the late edits, was hard to read.
There's another factor in this, which makes it hard to change:
For the people in child welfare organizations, for social workers, for doctors, for police, for judges to change their mind about current and future decisions requires them to change their mind about past decisions. The necessary implication is that many of the people they have persecuted in the past were, in fact, innocent. It requires them to admit that they personally have likely caused untold suffering to parents, caretakers, and children.
This is hard for anyone; but if you've lived your life trying to be the hero, feeling good about swooping in and rescuing children from the clutches of evil villains, how can you face the fact that you are the evil villain in so many children's stories?
You might call this the Paradox of Judgment: If you don't say that something is that bad, then lots of people don't think it's a big deal and don't do anything about it. But if you do say that something is really bad, then there develop all these pathologies of denialism around it.
For the people in child welfare organizations, for social workers, for doctors, for police, for judges to change their mind about current and future decisions requires them to change their mind about past decisions. The necessary implication is that many of the people they have persecuted in the past were, in fact, innocent. It requires them to admit that they personally have likely caused untold suffering to parents, caretakers, and children.
This is hard for anyone; but if you've lived your life trying to be the hero, feeling good about swooping in and rescuing children from the clutches of evil villains, how can you face the fact that you are the evil villain in so many children's stories?
You might call this the Paradox of Judgment: If you don't say that something is that bad, then lots of people don't think it's a big deal and don't do anything about it. But if you do say that something is really bad, then there develop all these pathologies of denialism around it.
This is spot on. This psychological barrier is probably the number one obstacle to a wider recognition of the existence and extent of this problem.
People like me who challenge the science behind the diagnoses of SBS face an absolutely unprecedented and unreasonable pushback, like I've never seen in any other area. Basically everyone who has worked on this side has faced threats, insults, personal attacks, cancellations, boycotts, and so on. The "cognitive bias" you mention (does it have a name? perhaps cognitive dissonance?) is a likely reason for this amount of antagonism.
People like me who challenge the science behind the diagnoses of SBS face an absolutely unprecedented and unreasonable pushback, like I've never seen in any other area. Basically everyone who has worked on this side has faced threats, insults, personal attacks, cancellations, boycotts, and so on. The "cognitive bias" you mention (does it have a name? perhaps cognitive dissonance?) is a likely reason for this amount of antagonism.
Closest name I can think of is "commitment and consistency". People tend to behave as they have behaved in the past, doing so is both a cognitive shortcut and a source of positive emotion. We go to great lengths to maintain consistency (see also: confirmation bias), and being consistent even in the face of conflicting evidence feels better than being inconsistent but right.
From Cialdini: "Once we have made a choice or taken a stand, we will encounter personal and interpersonal pressures to behave consistently with that commitment. Those pressures will cause us to respond in ways that justify our earlier decision."
From Cialdini: "Once we have made a choice or taken a stand, we will encounter personal and interpersonal pressures to behave consistently with that commitment. Those pressures will cause us to respond in ways that justify our earlier decision."
In my head -- and I'm no doctor, believe you me! -- I call this "emotional inertia", which is a phrase I've borrowed from one of the many doctors who has treated me for depression.
It certainly would be a form of cognitive dissonance, but that's much more general; I experienced cognitive dissonance hearing the word "nicht" pronounced by a native German speaker yesterday evening, because it wasn't at all like what I expected it to sound like.
"Confirmation bias", where you tend to see what you expect to see, is narrower; but still I think doesn't capture what we're talking about. We're specifically talking about resistance to accepting the idea because accepting it would mean reclassifying actions you yourself had taken from "very good" to "very bad". It's kind of weird that it doesn't have a name -- I'm convinced it plays a pretty big part of human behavior, much more than is commonly acknowledged.
"Confirmation bias", where you tend to see what you expect to see, is narrower; but still I think doesn't capture what we're talking about. We're specifically talking about resistance to accepting the idea because accepting it would mean reclassifying actions you yourself had taken from "very good" to "very bad". It's kind of weird that it doesn't have a name -- I'm convinced it plays a pretty big part of human behavior, much more than is commonly acknowledged.
> We're specifically talking about resistance to accepting the idea because accepting it would mean reclassifying actions you yourself had taken from "very good" to "very bad".
That's exactly it. I'd love to discover scientific literature about this phenomenon, and I'd also be surprised if it doesn't already have a name and an extensive literature. But if that's the case: I think there are research carriers in psychology to make here...
Edit: ChatGPT found "belief perseverance" [1] but, again, that's not exactly what we're talking about, which also relates to a personal sense of morality and "being one of the good guys".
[1] https://en.wikipedia.org/wiki/Belief_perseverance
That's exactly it. I'd love to discover scientific literature about this phenomenon, and I'd also be surprised if it doesn't already have a name and an extensive literature. But if that's the case: I think there are research carriers in psychology to make here...
Edit: ChatGPT found "belief perseverance" [1] but, again, that's not exactly what we're talking about, which also relates to a personal sense of morality and "being one of the good guys".
[1] https://en.wikipedia.org/wiki/Belief_perseverance
You could call it "moral self-image maintenance bias": A bias towards maintaining your self-image as an upright, moral person.
I think it's probably just a kind of "avoidance" or "denial."
https://en.wikipedia.org/wiki/Experiential_avoidance
https://en.wikipedia.org/wiki/Denial_(Freud)
HN and software engineers have bias to over-focus on the cognitive, but I think the key experience here is emotional distress.
https://en.wikipedia.org/wiki/Experiential_avoidance
https://en.wikipedia.org/wiki/Denial_(Freud)
HN and software engineers have bias to over-focus on the cognitive, but I think the key experience here is emotional distress.
I agree. It's kind of ironic you mention "denial". It turns out this is one of the favorite attacks by "SBS proponents" against those who challenge the scientific reliability of the diagnosis. We are called "denialists" and we're accused of "denying the existence of child abuse" (?). Parents in my organization (Adikia) who face false allegations of abuse are said to be in "denial" of their own abusive behavior. This story line appears to be quite credible and powerful within the medical and judicial communities.
Here's one among thousands of examples, from a really terrible paper by one such powerful SBS proponent here in France [1] (another of his papers was actually retracted this year [2]).
"Fake news 11: the caretakers’ denial is sincere
Clinicians and defenders can become intoxicated by the denials of parents suffering the agony of having their child in dire condition, and at the same time being grilled for their possible responsibility. The mental mechanisms of self-denial are well-known to psychiatrists. A perpetrator, after a violent burst, and faced with its terrible consequences, can experience a dissociation mechanism similar to witnesses of catastrophes, dissociation being understood as “a break between the memory, the perception, the consciousness and the identity…when faced with unbearable feelings”. Sincere denial easily elicits compassion from the medical staff as well as defenders, a natural response which is enhanced by professional training. Some authors have documented with functional imaging the sincerity of denial in a case of convicted child abuse and concluded that the sincerity of denial is not a criterion for innocence."
[1] https://link.springer.com/article/10.1007/s00381-021-05357-8
[2] https://link.springer.com/article/10.1007/s00381-023-05889-1
Here's one among thousands of examples, from a really terrible paper by one such powerful SBS proponent here in France [1] (another of his papers was actually retracted this year [2]).
"Fake news 11: the caretakers’ denial is sincere
Clinicians and defenders can become intoxicated by the denials of parents suffering the agony of having their child in dire condition, and at the same time being grilled for their possible responsibility. The mental mechanisms of self-denial are well-known to psychiatrists. A perpetrator, after a violent burst, and faced with its terrible consequences, can experience a dissociation mechanism similar to witnesses of catastrophes, dissociation being understood as “a break between the memory, the perception, the consciousness and the identity…when faced with unbearable feelings”. Sincere denial easily elicits compassion from the medical staff as well as defenders, a natural response which is enhanced by professional training. Some authors have documented with functional imaging the sincerity of denial in a case of convicted child abuse and concluded that the sincerity of denial is not a criterion for innocence."
[1] https://link.springer.com/article/10.1007/s00381-021-05357-8
[2] https://link.springer.com/article/10.1007/s00381-023-05889-1
You obviously have more experience than I do; but two phrases I'd be tempted to try out in these discussions are, "If you were wrong, would you want to know?" And at some point later "How would you know if you were wrong?"
That could only happen if such discussions could actually take place. So far, the controversy has been so polarized that there has been almost no communication between the two "sides".
Norman Guthkelch himself (the first to hypothesize a causal link between shaking and subdural/retinal hemorrhage) wrote in 2012 [1]:
"While controversy is a normal and necessary part of scientific discourse, there has arisen a level of emotion and divisiveness on shaken baby syndrome/abusive head trauma that has interfered with our commitment to pursue the truth."
A French neuropediatrician wrote a medical book in French a few years ago about this issue. When interrogated by a lawyer in a symposium a couple of years ago, the author of the papers linked in my comment above said: "I haven't read this book because I absolutely can't agree with it, since it's written by one of the leaders of a denialist and revisionist school of thought".
How can you even start a discussion in a context where a Godwin point is reached with the very term they use to call you?
[1] https://law.uh.edu/hjhlp/volumes/Vol_12_2/Guthkelch.pdf
Norman Guthkelch himself (the first to hypothesize a causal link between shaking and subdural/retinal hemorrhage) wrote in 2012 [1]:
"While controversy is a normal and necessary part of scientific discourse, there has arisen a level of emotion and divisiveness on shaken baby syndrome/abusive head trauma that has interfered with our commitment to pursue the truth."
A French neuropediatrician wrote a medical book in French a few years ago about this issue. When interrogated by a lawyer in a symposium a couple of years ago, the author of the papers linked in my comment above said: "I haven't read this book because I absolutely can't agree with it, since it's written by one of the leaders of a denialist and revisionist school of thought".
How can you even start a discussion in a context where a Godwin point is reached with the very term they use to call you?
[1] https://law.uh.edu/hjhlp/volumes/Vol_12_2/Guthkelch.pdf
Right, so if I had to guess how such a person might change their mind, I would say they would have to go through four stages:
1. These anti-SBS people are evil sophists trying to help child abusers
2. These views of these anti-SBS people irrational; but they're not evil, just misguided and/or misled.
3. The views of these anti-SBS people are wrong, but they are actually reasonable views for someone to hold, given the evidence they have available to hem.
4. The views of these anti-SBS people are correct.
You're never going to jump from 1->4 directly; you need to start with going 1->2.
So if you're serious about it, then I guess I would start with actually trying to get face-time with some people. Look at the various people in this community, and find someone who seems either more reasonable, or more friendly / sociable: someone who is unlikely to turn down an invitation to coffee / lunch, and unlikely to hate a decent person right in front of them. If there's someone who's has a lot of influence, or is in the "core", that's best; but anyone within one or two steps of the "core" could be a good start.
My goals going into the meeting would be:
* Establish a human connection; see them as a person, help them see you as a person
* Make sure they feel heard and understood. Try to understand how they got into the work they're doing now; and not only the evidence they've seen, but also the personal experiences they've had. Try to mostly listen; and if possible repeat back to them what you've heard them say.
* Share your story, and some of the key stories you've seen or heard. If you can, stick to your observations and opinions; i.e., don't say "my nanny was innocent", but rather, "it didn't really seem possible that the nanny did it; it would have been really out of character" (and explain more about the nanny's character).
I'd call it by ear whether to ask "would you want to know if you were wrong" and "how would you know if you were wrong".
Remember the goal for the first meeting is to get them from 1 to 2: That maybe you're way off base and misguided, but that you're not evil. Getting to 3 would be a bonus if it goes well, but don't count on it; and there's no way 4 will happen over the course of lunch.
That's a lot of work, but you seem pretty motivated. Whatever you end up doing, good luck!
1. These anti-SBS people are evil sophists trying to help child abusers
2. These views of these anti-SBS people irrational; but they're not evil, just misguided and/or misled.
3. The views of these anti-SBS people are wrong, but they are actually reasonable views for someone to hold, given the evidence they have available to hem.
4. The views of these anti-SBS people are correct.
You're never going to jump from 1->4 directly; you need to start with going 1->2.
So if you're serious about it, then I guess I would start with actually trying to get face-time with some people. Look at the various people in this community, and find someone who seems either more reasonable, or more friendly / sociable: someone who is unlikely to turn down an invitation to coffee / lunch, and unlikely to hate a decent person right in front of them. If there's someone who's has a lot of influence, or is in the "core", that's best; but anyone within one or two steps of the "core" could be a good start.
My goals going into the meeting would be:
* Establish a human connection; see them as a person, help them see you as a person
* Make sure they feel heard and understood. Try to understand how they got into the work they're doing now; and not only the evidence they've seen, but also the personal experiences they've had. Try to mostly listen; and if possible repeat back to them what you've heard them say.
* Share your story, and some of the key stories you've seen or heard. If you can, stick to your observations and opinions; i.e., don't say "my nanny was innocent", but rather, "it didn't really seem possible that the nanny did it; it would have been really out of character" (and explain more about the nanny's character).
I'd call it by ear whether to ask "would you want to know if you were wrong" and "how would you know if you were wrong".
Remember the goal for the first meeting is to get them from 1 to 2: That maybe you're way off base and misguided, but that you're not evil. Getting to 3 would be a bonus if it goes well, but don't count on it; and there's no way 4 will happen over the course of lunch.
That's a lot of work, but you seem pretty motivated. Whatever you end up doing, good luck!
I've always called this "cognitive dissonance", but it is the same thing that http://www.paulgraham.com/identity.html talks about. Once something becomes associated with your identity, you take threats to it as an existential attack on you. And immediately rationality goes out of the window. But we're not AWARE of ourselves being irrational - everything that we say seems obvious, natural, and right.
Our inability to judge extends to others.
It certainly deserves a better name.
Our inability to judge extends to others.
It certainly deserves a better name.
I phrased it that way because I think this kind of influence on our judgement is pervasive: we all have our "thumbs on the scale" when evaluating our own behavior. That's bias. But at some point it's not a "thumb on the scale" anymore -- you've just thrown the scale away; that's denial.
Still, there are different types and sources of denial, just as there are different sources of emotional bias. "Self-image maintenance bias" and "self-image maintenance denial" can both be about general ways in which we try to maintain our self image (as strong, talented, attractive, whatever). "Moral self-image maintenance bias" or "moral self-image maintenance denial" can be about ways in which we try to maintain our self-image as good, decent people.
Still, there are different types and sources of denial, just as there are different sources of emotional bias. "Self-image maintenance bias" and "self-image maintenance denial" can both be about general ways in which we try to maintain our self image (as strong, talented, attractive, whatever). "Moral self-image maintenance bias" or "moral self-image maintenance denial" can be about ways in which we try to maintain our self-image as good, decent people.
It's the sunk cost fallacy.
This is why Max Planch (German physicist) has quipped that science advances one funeral at a time.
This is why Max Planch (German physicist) has quipped that science advances one funeral at a time.
I think the related term, the escalation of commitment, suits this better.
Interestingly enough, no bigger offender then the psychiatric and mental health community. There's a very sophisticated system for shutting down criticism and lashing out at patients that have civil rights concerns.
They do a lot of mental gymnastics trying to run from the idea that their main function is to imprison and take away peoples rights, often without due process.
Medical industry is rife with abuse. They routinely kill people out of spite, torture dying people and their families, and want to be shielded from any criticism... so fuck all the patients and look for reasons they're "not righteous", etc, so you can dismiss them.
It's quite interesting (and disturbing) to see how much culture evolves around deflecting blame and victim blaming.
They do a lot of mental gymnastics trying to run from the idea that their main function is to imprison and take away peoples rights, often without due process.
Medical industry is rife with abuse. They routinely kill people out of spite, torture dying people and their families, and want to be shielded from any criticism... so fuck all the patients and look for reasons they're "not righteous", etc, so you can dismiss them.
It's quite interesting (and disturbing) to see how much culture evolves around deflecting blame and victim blaming.
Your comment reminds me of the Rosenhan Experiment[1]. "The first part involved the use of healthy associates or "pseudopatients" (three women and six men, including Rosenhan himself) who briefly feigned auditory hallucinations in an attempt to gain admission to 12 psychiatric hospitals in five states in the United States. All were admitted and diagnosed with psychiatric disorders. ... The second part of his study involved a hospital administration challenging Rosenhan to send pseudopatients to its facility, whose staff asserted that they would be able to detect the pseudopatients. Rosenhan agreed, and in the following weeks 41 out of 193 new patients were identified as potential pseudopatients, with 19 of these receiving suspicion from at least one psychiatrist and one other staff member. Rosenhan sent no pseudopatients to the hospital."
1: https://en.wikipedia.org/wiki/Rosenhan_experiment
1: https://en.wikipedia.org/wiki/Rosenhan_experiment
My favorite control experiment! Tell somebody you did something and ask them what the results were, but don't actually do the something.
"Honey, I doubled the salt in the pasta this time, how does it taste?" "Oh, it's really salty". "Ha-HA! I didn't actually add ANY salt!"
(do not actually do this to people you like or who like you)
"Honey, I doubled the salt in the pasta this time, how does it taste?" "Oh, it's really salty". "Ha-HA! I didn't actually add ANY salt!"
(do not actually do this to people you like or who like you)
In fairness, psychiatry is totally different today than in 1973. The obvious change is that a huge reduction in the number of inpatient beds, combined with increasing demand, have created huge pressures to admit only the most obviously unwell patients and discharge them as quickly as possible. Most psychiatric inpatient stays are just a few days - just enough to get a patient through a crisis, revise their medication and (hopefully, but not always) arrange for appropriate outpatient care and support. The downtown of most US cities is a testament to the fact that, in 2023, under-treatment of severe mental illness is a far greater concern than over-treatment.
On an ontological level, psychiatry made a huge leap forward in 1980 with the publication of the DSM-III. One of the core goals of the DSM-III was to address the concerns raised in the Rosenhan experiment, making diagnostic criteria more robust and reliable. While there are still many controversies and shortcomings - most prominently regarding the over-diagnosis of less severe conditions - we now have a suite of reliable, validated diagnostic instruments for most serious conditions. For the most part, we aren't diagnosing or treating patients based on the gut instinct of an individual practitioner; we're using objective criteria with proven inter-relater reliability, guided by the over-arching principle that, regardless of symptomatology, no-one is mentally ill unless a) they're experiencing distress and/or b) they're causing significant harm to others. There are many shortcomings in how psychiatric medicine is practised today, but the era of locking people up just because they behave strangely is definitively over.
On an ontological level, psychiatry made a huge leap forward in 1980 with the publication of the DSM-III. One of the core goals of the DSM-III was to address the concerns raised in the Rosenhan experiment, making diagnostic criteria more robust and reliable. While there are still many controversies and shortcomings - most prominently regarding the over-diagnosis of less severe conditions - we now have a suite of reliable, validated diagnostic instruments for most serious conditions. For the most part, we aren't diagnosing or treating patients based on the gut instinct of an individual practitioner; we're using objective criteria with proven inter-relater reliability, guided by the over-arching principle that, regardless of symptomatology, no-one is mentally ill unless a) they're experiencing distress and/or b) they're causing significant harm to others. There are many shortcomings in how psychiatric medicine is practised today, but the era of locking people up just because they behave strangely is definitively over.
There's also the normalization of seeing and hearing awful things. After a while of being exposed to the wretches of humanity you begin to see the signals for the wretches everywhere.
As the warrior poet Maslow put it, "if the only tool you ever have is a hammer, you tend to see every problem as a nail."
As the warrior poet Maslow put it, "if the only tool you ever have is a hammer, you tend to see every problem as a nail."
I actually strongly suspect that this is a major issue with cops. Even the most well-meaning new hire is likely to become jaded and paranoid after years of interacting primarily with criminals. They are probably more likely to assume the worst of a given stranger, even in contexts where there is no reason to suspect that stranger.
Totally, child abuse pediatricians, forensic pediatric pathologists etc. are exposed on a daily basis to the very worse things imaginable in the world (autopsies of babies beaten to death and so on), and yet they need to keep a calm and rational stance by analyzing facts objectively. This is hard and they don't always succeed. Some are led to see the worse in everyone and they see potential child abusers in every parent and caregiver.
This can go quite far, with some experts stating that the histories reported by parents and caregivers bringing a child to the hospital with some injuries are always falsified. This can surely happen, but a foundational tenet of medicine is to listen to the patient/parents.
I've seen experts concluding to abuse in 100% of their cases, including those where children hah obvious, DNA-proven genetic conditions causing the observed injuries. Fortunately, some judges remain reasonable and act as "gatekeepers" by exculpating parents and caregivers despite affirmative opinions by reputable experts. But many don't.
This can go quite far, with some experts stating that the histories reported by parents and caregivers bringing a child to the hospital with some injuries are always falsified. This can surely happen, but a foundational tenet of medicine is to listen to the patient/parents.
I've seen experts concluding to abuse in 100% of their cases, including those where children hah obvious, DNA-proven genetic conditions causing the observed injuries. Fortunately, some judges remain reasonable and act as "gatekeepers" by exculpating parents and caregivers despite affirmative opinions by reputable experts. But many don't.
It's hard to understand something if your salary depends on it being false.
It's much, much harder again to understand something if it makes your life's work ignoble.
It's much, much harder again to understand something if it makes your life's work ignoble.
It's hard to understand something if your salary depends on your misunderstanding.
It's even harder to understand something if your self-conception as honorable depends on your mistunderstanding?
It's even harder to understand something if your self-conception as honorable depends on your mistunderstanding?
Thanks for this insight, I'd never thought about it this way.
"We need to take away your kid because um.. DEUS VULT."
I work in child welfare in Australia. Not sure how it compares to the models in other countries, but we desperately try not to remove child from their families. There is very little evidence to support it improves outcomes for those children, and the removing itself is highly horrific for everyone involved. Even in the instances we remove children, we actively attempt to work with the parents to address the issue. We are also beholden to the Courts to justify our decision making.
The harm we cause is better explained by systematic reasons (workload, case complexity, red tape, worker burnout and apathy, racism)
The harm we cause is better explained by systematic reasons (workload, case complexity, red tape, worker burnout and apathy, racism)
Yeah in my dealings with child welfare workers (in America at least), they are the first to understand how "the system", and they as a key component, can cause harm.
What happens if the cops are called, rather than child services?
This is how I ended up in foster care over a false accusation against my parents (in the US). I'm told that if the accuser had called child services directly, they would have done their investigation first and only taken me if they determined I was in danger (which I was not).
But because the accuser called the cops instead, the cops took me without investigating first and handed me over to child services. Thus I spent the entire investigation period in foster care, until a judge ordered me to be sent back to my family. Even though they failed to produce any evidence of abuse, it still took many months.
It was an extremely traumatizing and harrowing experience (honestly even harder on me and my parents than when my brother got sick and died) and remains the worst thing I have ever experienced. But I find it hard to even talk about because people tend to assume that if a child is seized from a home, the parents must have been abusive. (My parents are extremely not abusive, not even in the mildest sense of the word.)
What's fucked is that I actually know two other families who went through this exact same experience: false accuser calls the cops, the cops give the kid to child services, child services puts the kid in foster care while investigating, the investigation turns up no evidence of abuse, the court forces child services to send the kid home, and the kid finally returns home with lifelong trauma.
This is how I ended up in foster care over a false accusation against my parents (in the US). I'm told that if the accuser had called child services directly, they would have done their investigation first and only taken me if they determined I was in danger (which I was not).
But because the accuser called the cops instead, the cops took me without investigating first and handed me over to child services. Thus I spent the entire investigation period in foster care, until a judge ordered me to be sent back to my family. Even though they failed to produce any evidence of abuse, it still took many months.
It was an extremely traumatizing and harrowing experience (honestly even harder on me and my parents than when my brother got sick and died) and remains the worst thing I have ever experienced. But I find it hard to even talk about because people tend to assume that if a child is seized from a home, the parents must have been abusive. (My parents are extremely not abusive, not even in the mildest sense of the word.)
What's fucked is that I actually know two other families who went through this exact same experience: false accuser calls the cops, the cops give the kid to child services, child services puts the kid in foster care while investigating, the investigation turns up no evidence of abuse, the court forces child services to send the kid home, and the kid finally returns home with lifelong trauma.
How does this play out in Aboriginal communities?
In the US we have strict laws regarding how social services interact with native populations.
In the US we have strict laws regarding how social services interact with native populations.
Some statistics from New Zealand: https://www.theguardian.com/world/2018/mar/08/study-one-in-f...
In America the system is split between people who say we should do everything we can to keep children safe in their own home, and people who think it is wokeness gone mad that a parent can test positive for drugs and not have the kids immediately removed. It is, as you’d expect, a calm and reasonable debate filled with claims that “I’m the only one who is thinking about the best interest of the kids!” and “you hate foster care so much you prefer babies to DIE instead of going to a safe foster home!” (As a foster parent, I have unfortunately found that this kind of idiocy is all too common among foster parents.)
This is true, but not for the reasons you might expect. Well, 10% of the time this is the case, but 90% ...
Mostly they are operating on priors. The prior probability of a separation being the right thing to do is very high, because they have a _long list of mitigation before they actually can take a kid away. In the case of a doctor-approved immediate physical danger, they are regulated into acting on behalf of the immediate safety of the child while the investigation is ongoing but even that is considered temporary.
The goal of any foster care situation is to get the kids back with the biological parents, so time is on their side, provided they are not living in a circumstance that disallows the kind of attendance and involvement that the state would require to clear a caseworker to re-unite the family. Sadly, many are.
Source: Foster parent.
Mostly they are operating on priors. The prior probability of a separation being the right thing to do is very high, because they have a _long list of mitigation before they actually can take a kid away. In the case of a doctor-approved immediate physical danger, they are regulated into acting on behalf of the immediate safety of the child while the investigation is ongoing but even that is considered temporary.
The goal of any foster care situation is to get the kids back with the biological parents, so time is on their side, provided they are not living in a circumstance that disallows the kind of attendance and involvement that the state would require to clear a caseworker to re-unite the family. Sadly, many are.
Source: Foster parent.
Priors should never, ever factor into it like this.
I was a foster child who was taken from my parents wrongly. A third party (not connected to child services) made a false accusation to the cops, who took me and turned me over to child services without any investigation. Even though I insisted nothing had happened and even though child services failed to produce any evidence (beyond aforesaid hearsay) over the course of their investigation, child services nonetheless fought extremely hard against letting me go home to my family.
In the end, a judge had to order them to return me to my family because they refused to accept that the accusation had been a lie.
In the meantime, I went through three different foster homes. I was a very difficult kid to foster (I cried and screamed a lot, demanding to go home) and so I unfortunately experienced abuse and neglect in two of the three homes. (My first foster home was particularly severe, which was strange because they were otherwise great parents to their biological kids. At least the other abusive home treated their real children equally poorly.)
I was a foster child who was taken from my parents wrongly. A third party (not connected to child services) made a false accusation to the cops, who took me and turned me over to child services without any investigation. Even though I insisted nothing had happened and even though child services failed to produce any evidence (beyond aforesaid hearsay) over the course of their investigation, child services nonetheless fought extremely hard against letting me go home to my family.
In the end, a judge had to order them to return me to my family because they refused to accept that the accusation had been a lie.
In the meantime, I went through three different foster homes. I was a very difficult kid to foster (I cried and screamed a lot, demanding to go home) and so I unfortunately experienced abuse and neglect in two of the three homes. (My first foster home was particularly severe, which was strange because they were otherwise great parents to their biological kids. At least the other abusive home treated their real children equally poorly.)
Have you considered suing the third party that made a false accusation? It seems that they’ve caused suffering and irreparable long term harm. This sounds like something that may have a standing. Perhaps you can sue them and either get some material compensation (if they are well to do) put them through a few rounds of trials in another state or something (if they are poor, this will be a good punishment in itself).
[Not a lawyer, this maybe a bad idea. But what you’re describing should have consequences for the party that had caused harm.]
[Not a lawyer, this maybe a bad idea. But what you’re describing should have consequences for the party that had caused harm.]
Also not a lawyer, but there is a significant motivation for protection when an incorrect accusation is made in good faith, because a lot of correct reports of child abuse are based on circumstantial evidence and suspicion - so you would need very clear strong evidence that the reporter knew the information was false and was intentionally misleading CPS, or you’d be thrown out of court immediately. In some places you wouldn’t even be given the identity of the reporter.
Duh. It is pretty wrong that the accuser could stay anonymous.
Why not?
But on the same note, I would also consider suing child services for failing to act according to their own principles and mainly for ignoring evidence.
But on the same note, I would also consider suing child services for failing to act according to their own principles and mainly for ignoring evidence.
Yes, it seems that there’s nothing that opposes child services to protect parents and children from a zealous and righteous institution.
But we do have an example of another righteous institution misbehaving - churches are now paying back for years of children abuse (Catholic priests abusing children). I don’t see why cases like the one above that forcefully separating children can’t go the same way.
It doesn’t really matter that “most reports are good faith”. Most priests are also good faith…
But we do have an example of another righteous institution misbehaving - churches are now paying back for years of children abuse (Catholic priests abusing children). I don’t see why cases like the one above that forcefully separating children can’t go the same way.
It doesn’t really matter that “most reports are good faith”. Most priests are also good faith…
We never found out who did it. It was an anonymous accusation. It could have been a stranger on the street, for all we know.
We don't even know if it was an intentional lie or if they genuinely thought I had been hurt. We never found out what they told the cops.
We don't even know if it was an intentional lie or if they genuinely thought I had been hurt. We never found out what they told the cops.
:(
Anonymous accusations really should have no place in this.
Anonymous accusations really should have no place in this.
This always seems to happen to activist groups. They start mistaking their intermediate goals for ‘the cause’ and next thing you know, they’re actively fighting against solutions to their alleged issues because those solutions would impact their self-selected KPIs.
> It’s just incredible the injustice that can be done in the name of protecting children
Whatever it is:
- If it's in the name of protecting the children, odds are it is not justice.
- If it is not justice, at some point the excuse will be to protect the children
Whatever it is:
- If it's in the name of protecting the children, odds are it is not justice.
- If it is not justice, at some point the excuse will be to protect the children
> - If it is not justice, at some point the excuse will be to protect the children
I don't think this is a very solid maxim. It seems to imply things other than justice can only occur if protecting children is a claimed motive.
I don't think this is a very solid maxim. It seems to imply things other than justice can only occur if protecting children is a claimed motive.
It seems like there is still significant disagreement with this guy's argument in "the science", at least as best as any individual child welfare employee would understand it. There are no doubt specialist doctors, general practitioners, etc. telling the child welfare folks that it's as clear cut a diagnosis as you could get.
The fact of the matter is, the article here is a brief overview describing none of the actual scientific literature at a level that should be convincing to a medical practitioner. But you read it and are apparently convinced of the author's point. So, a layperson (I assume, in your case) is presented with some well-written evidence from an authoritative perspective, alongside broad contours of the actual medical evidence but no details, and is convinced that it's true. Is it so hard to believe that a child welfare worker would be equally convinced under the same circumstances when talking to a doctor, neurologist, trauma surgeon, etc. who believes the opposite as this author?
The fact of the matter is, the article here is a brief overview describing none of the actual scientific literature at a level that should be convincing to a medical practitioner. But you read it and are apparently convinced of the author's point. So, a layperson (I assume, in your case) is presented with some well-written evidence from an authoritative perspective, alongside broad contours of the actual medical evidence but no details, and is convinced that it's true. Is it so hard to believe that a child welfare worker would be equally convinced under the same circumstances when talking to a doctor, neurologist, trauma surgeon, etc. who believes the opposite as this author?
My sense is it's important to keep in back-of-mind that there is a massive selection effect involved in terms of which people chose to enter these fields and what sorts of personal life events (trauma, abuse, witnessing of abuse etc) motives choosing to make this a career. These are not well-paid careers (nor are they high-status) so money and status are typically not motivations (in fact a relative of an in-law works in a closely-related field and we talk at Thanksgiving-type family events about work and their employers often seem to me to be exploiting their investment in the field). I think it's why it can be so difficult to discuss it with them, it is deeply personal and they feel the "system" failed in the past and they want it fixed.
Anyway, it's not meant as an ad hom, but it helps to step back and think why people are involved with certain roles.
To be clear: here the author only bothered look with his well-trained eyes because he was sucked in after the law intruded into his life. It's easy to assume that everyone is highly-skilled. But... highly-skilled people don't usually choose to work for peanuts without other reasons. Fields like this are neglected.
Anyway, it's not meant as an ad hom, but it helps to step back and think why people are involved with certain roles.
To be clear: here the author only bothered look with his well-trained eyes because he was sucked in after the law intruded into his life. It's easy to assume that everyone is highly-skilled. But... highly-skilled people don't usually choose to work for peanuts without other reasons. Fields like this are neglected.
>I really do wonder if it’s cultural or some kind of innate psychological irrarionality that seems stronger in some than others.
CPS is a human organization. There are no algorithms and the guidelines rarely perfectly fit the situation a case worker is given. Keep this in mind. CPS is horrifically under funded meaning that intelligent and competent staff readily leave the field for better paying gigs.
The biggest problem I see with foster care at large is the rampant classism, sexism, racism, and other isms. The providers tend to be solidly middle class degree bearing people who have no personal connection to primary instigating factors of foster care involvement. Namely and typically presenting cross generationally: poverty, crimes of despair or desperation, and trauma whether that be internal or external to the family unit or community such as neighborhood violence, caregiver assault, or tragic loss.
It easy for providers to casually profile incoming children and their families as poor uneducated violent predacious drug dealing junkies. Providers are given extreme control over the entire family and their extended relations and use this power to coerce whatever behavior they desire out of the people. If the provider dislikes the family they have a lot of tools to inflict suffering on them and oppositely they have a lot of tools to assist families and keep them together.
Honestly, the entire system is such a god damn mess that it should be rebuilt with the same level of distrust of staff that they can exercise against families.
Perhaps the most pressing single metric to focus may be the foster to prison pipeline.
Sorry for the meandering post, bookcases could be filled with anecdotes and descriptions of the flaws in these systems. In general, I think the failure of child protection agencies reflects the decay in America at large. I could point to stuff like broken family units or loss of religions community but I’m not dog whistling here. Stable healthy nurturing familial units of any relation are obviously better but man in the house rules and other racist/classist measures caused more harm. I’m also vehemently opposed to all major organized religions that are regularly used to justify war and protect child sex predators. Perhaps the collapse of American industry and slow erosion of social safety nets has hastened the social collapse. Perhaps the internet had instigated the collapse of communal organizations. Perhaps winner take all government enforced monopoly capitalism is the cause. Perhaps it was the theft of 50,000,000,000.00 from the bottom 99 by the 1% that lead to this. Regardless, the solution is not going to be found in rebuilding foster care when our social fabric is rotten.
0. https://srcd.onlinelibrary.wiley.com/doi/10.1002/sop2.10
1. https://www.crimlawpractitioner.org/post/the-foster-care-to-....
3. https://nlihc.org/resource/study-examines-man-house-rules-vo...
4. https://time.com/5888024/50-trillion-income-inequality-ameri...
CPS is a human organization. There are no algorithms and the guidelines rarely perfectly fit the situation a case worker is given. Keep this in mind. CPS is horrifically under funded meaning that intelligent and competent staff readily leave the field for better paying gigs.
The biggest problem I see with foster care at large is the rampant classism, sexism, racism, and other isms. The providers tend to be solidly middle class degree bearing people who have no personal connection to primary instigating factors of foster care involvement. Namely and typically presenting cross generationally: poverty, crimes of despair or desperation, and trauma whether that be internal or external to the family unit or community such as neighborhood violence, caregiver assault, or tragic loss.
It easy for providers to casually profile incoming children and their families as poor uneducated violent predacious drug dealing junkies. Providers are given extreme control over the entire family and their extended relations and use this power to coerce whatever behavior they desire out of the people. If the provider dislikes the family they have a lot of tools to inflict suffering on them and oppositely they have a lot of tools to assist families and keep them together.
Honestly, the entire system is such a god damn mess that it should be rebuilt with the same level of distrust of staff that they can exercise against families.
Perhaps the most pressing single metric to focus may be the foster to prison pipeline.
Sorry for the meandering post, bookcases could be filled with anecdotes and descriptions of the flaws in these systems. In general, I think the failure of child protection agencies reflects the decay in America at large. I could point to stuff like broken family units or loss of religions community but I’m not dog whistling here. Stable healthy nurturing familial units of any relation are obviously better but man in the house rules and other racist/classist measures caused more harm. I’m also vehemently opposed to all major organized religions that are regularly used to justify war and protect child sex predators. Perhaps the collapse of American industry and slow erosion of social safety nets has hastened the social collapse. Perhaps the internet had instigated the collapse of communal organizations. Perhaps winner take all government enforced monopoly capitalism is the cause. Perhaps it was the theft of 50,000,000,000.00 from the bottom 99 by the 1% that lead to this. Regardless, the solution is not going to be found in rebuilding foster care when our social fabric is rotten.
0. https://srcd.onlinelibrary.wiley.com/doi/10.1002/sop2.10
1. https://www.crimlawpractitioner.org/post/the-foster-care-to-....
3. https://nlihc.org/resource/study-examines-man-house-rules-vo...
4. https://time.com/5888024/50-trillion-income-inequality-ameri...
There's a bias in favor of action, especially among the social workers that I have known. The worst possible sin is to do nothing at all.
In cases like this, in the moment, it may be impossible to tell what is actually best for the child. Since removing the child is a form of remediation, it can easily seem to be less harmful than leaving them in a situation that might be actively harming them.
In cases like this, in the moment, it may be impossible to tell what is actually best for the child. Since removing the child is a form of remediation, it can easily seem to be less harmful than leaving them in a situation that might be actively harming them.
Baby-stealing is a deep drive.
I have some inside information on how this plays out in Ontario, Canada, at least. One of my family members was a lawyer for the regional Children's Aid, and I worked for him for a few years. Another family member was a child protection social worker for two decades, but retired early because they felt the organization didn't prioritize the welfare of children (as is their mandate) but rather the needs of the organization or (perhaps more realistically) the needs of their own careers.
MANY social workers feel this way. They got into the field out of a genuine concern for the well-being of the most vulnerable members of our society, and instead found themselves dealing with politics (both real and office).
I'm not sure how it is in other countries, but in my region, they actually appoint a lawyer for the child. This is great, but it also tells you a lot about what everyone else's priorities are that children need their own lawyers:
(1) Parents want their kids back, of course. Not all parents are fit to get them back. But their lawyers fight for the return of their kids regardless of circumstances or reasons for their removal.
(2) Child protection agencies are under constant attack, so at the executive level, they lose sight of the individual kids and are instead worried about the needs of the organization and public relations.
(3) The social workers themselves are handcuffed to do anything about it and have to follow procedure, even if they can see it plainly that the procedure is not in the best interests of the child.
(4) Police want nothing to do with any of it and are quick to wash their hands of these situations.
(5) The children's lawyer somehow has to represent the needs of the child, which may place them at odds with their own clients (the kids).
(6) Activist groups will generally support the parents blindly, because by law, for the privacy of the children, the only parties listed above who can publicly speak about any given case are the parents themselves. So you can only ever hear one side of the argument. That's right: If a father, for example, sexually abuses his kids and as a result has them removed, he's free to say just about anything he likes about the matter, without ever acknowledging that he's a child molester. The other parties can't say a thing about this.
As a result, it's impossible, as a member of the public, to ever know whether it was appropriate or not that the children were removed from the care of their parents. I happen to know, from first-hand experience, that it's a mixed bag: Some parents shouldn't be allowed anywhere near any child ever, much less their own. Others are victims of a system gone haywire. And we, the concerned public, can't have an informed discussion about any of it.
All in all, it transforms child protection into a game of who-has-the-best-lawyers rather than trying to do what's right for the kids. Is it any wonder so many kids end up traumatized by this system?
MANY social workers feel this way. They got into the field out of a genuine concern for the well-being of the most vulnerable members of our society, and instead found themselves dealing with politics (both real and office).
I'm not sure how it is in other countries, but in my region, they actually appoint a lawyer for the child. This is great, but it also tells you a lot about what everyone else's priorities are that children need their own lawyers:
(1) Parents want their kids back, of course. Not all parents are fit to get them back. But their lawyers fight for the return of their kids regardless of circumstances or reasons for their removal.
(2) Child protection agencies are under constant attack, so at the executive level, they lose sight of the individual kids and are instead worried about the needs of the organization and public relations.
(3) The social workers themselves are handcuffed to do anything about it and have to follow procedure, even if they can see it plainly that the procedure is not in the best interests of the child.
(4) Police want nothing to do with any of it and are quick to wash their hands of these situations.
(5) The children's lawyer somehow has to represent the needs of the child, which may place them at odds with their own clients (the kids).
(6) Activist groups will generally support the parents blindly, because by law, for the privacy of the children, the only parties listed above who can publicly speak about any given case are the parents themselves. So you can only ever hear one side of the argument. That's right: If a father, for example, sexually abuses his kids and as a result has them removed, he's free to say just about anything he likes about the matter, without ever acknowledging that he's a child molester. The other parties can't say a thing about this.
As a result, it's impossible, as a member of the public, to ever know whether it was appropriate or not that the children were removed from the care of their parents. I happen to know, from first-hand experience, that it's a mixed bag: Some parents shouldn't be allowed anywhere near any child ever, much less their own. Others are victims of a system gone haywire. And we, the concerned public, can't have an informed discussion about any of it.
All in all, it transforms child protection into a game of who-has-the-best-lawyers rather than trying to do what's right for the kids. Is it any wonder so many kids end up traumatized by this system?
The “passion” goes beyond this specific issue. Child abuse specialist doctors have come to some sketchy conclusions, only to have the system cover for them.
Part of the issue is they exist in several systems simultaneously: medical system, child-welfare system, and criminal justice system.
Are they there to cure disease, ensure the child had a safe home environment, or put an abuser in prison. Answer: all of the above.
Here’s a good example:
https://wisconsinwatch.org/2022/01/alaska-couple-loses-custo...
Part of the issue is they exist in several systems simultaneously: medical system, child-welfare system, and criminal justice system.
Are they there to cure disease, ensure the child had a safe home environment, or put an abuser in prison. Answer: all of the above.
Here’s a good example:
https://wisconsinwatch.org/2022/01/alaska-couple-loses-custo...
It's part of the contract cult mechanism. Human tribes for a early version of law by forming contract cults aka religions. For that sexual deviants are hearded into a group to which the family is then ritualistically exposed as a sort of hostage situation that upholds basic providing and welfare contracts. The hysteria is a social fitness signal: "I'm reliably retarded and can be used as a social building block". This is pretty cultural universal, though the cultural baggage with the contact cult may produce different outcomes.
My hunch would be:
1. Premise: Organizations always try to stay alive. 2. To stay alive you have to be active and doing things which is rewarded by future money. 3. If your organizational role is "protect children" but who's functional mechanism is to take them away will look for ways to do that.
Similar things happen when policing seems to go awry, if they confuse "protect the public" (goal) with "arrest people for stuff" (doing something)
1. Premise: Organizations always try to stay alive. 2. To stay alive you have to be active and doing things which is rewarded by future money. 3. If your organizational role is "protect children" but who's functional mechanism is to take them away will look for ways to do that.
Similar things happen when policing seems to go awry, if they confuse "protect the public" (goal) with "arrest people for stuff" (doing something)
> It’s just incredible the injustice that can be done in the name of protecting children. I really do wonder if it’s cultural or some kind of innate psychological irrarionality that seems stronger in some than others. I love kids and care deeply about their welfare, but people sometimes try to make me feel bad or that I’m the weird one for being able to think (I believe) fairly rationally about the risks and dangers that they face, instead of massively over-exaggerating!
Everyone cares about kids, so THINK OF THE CHILDREN is an easy way to both create false urgency to cover totalitarianism and also an excellent shame-generator to suppress protest. C.f. "Drag shows"; "digital privacy"
Everyone cares about kids, so THINK OF THE CHILDREN is an easy way to both create false urgency to cover totalitarianism and also an excellent shame-generator to suppress protest. C.f. "Drag shows"; "digital privacy"
This concept of "the science" we've converged on a culture really doesn't make a ton of sense. What does it mean to say "the science" is against a position that many relevant experts hold? To the extent that there is such a thing as "the science", the book the author is advertising (https://shakenbaby.science/) is pretty frank that its goal is to argue against it: there's a traditional medical consensus in favor of SBS/AHT, but it's become more controversial, and if you read this book you too will be convinced that it's wrong.
"What happened is that during my literature review, I disturbingly realized that what I had been told at the hospital, namely that subdural and retinal hemorrhage in infants are almost always caused by violent shaking even in the absence of external evidence of trauma, was an assertion based on very weak scientific foundations. And yet, this “shaking hypothesis” (sometimes referred to as the theory of the “triad”, since encephalopathy is frequently associated with the other two signs, subdural and retinal hemorrhage) has been taught as though it was a proven fact to generations of physicians all over the world. Every year, thousands of children are removed from their parents, and thousands are prosecuted, convicted, and even incarcerated, on the basis of this assertion. Law professor Deborah Tuerkheimer qualifies SBS/AHT as a “medical diagnosis of murder”. The very least we should expect for an assertion this powerful is that it should be based on reliable scientific foundations."
This is why using experts for advice is great but everyone should still be encouraged to do their own research.
This is why using experts for advice is great but everyone should still be encouraged to do their own research.
We need so much more than some combination of (1) trusting experts and (2) doing your own research.
The first is practically necessary but unsatisfying given well-known concerns about scientific replication, knowledge dissemination, and industry incentives.
The second isn't practical for most people.
I don't have detailed interventions to suggest right now, but it seems clear that we need better _systems_ that result in less dogmatic behavior among experts and legal systems.
The first is practically necessary but unsatisfying given well-known concerns about scientific replication, knowledge dissemination, and industry incentives.
The second isn't practical for most people.
I don't have detailed interventions to suggest right now, but it seems clear that we need better _systems_ that result in less dogmatic behavior among experts and legal systems.
How would doing your own research prevent the state from taking your child away and putting you in prison for murder?
> This is why using experts for advice is great but everyone should still be encouraged to do their own research.
Not everyone is equipped to do this kind of literature review (that’s not research), or have access to all these papers. Everyone needs to be critical and skeptical to a reasonable extent, but this kind of “do your own research” attitude is damaging. People just end up trusting dodgy but authoritative-sounding YouTube videos and blog posts because they cannot read scientific articles.
Not everyone is equipped to do this kind of literature review (that’s not research), or have access to all these papers. Everyone needs to be critical and skeptical to a reasonable extent, but this kind of “do your own research” attitude is damaging. People just end up trusting dodgy but authoritative-sounding YouTube videos and blog posts because they cannot read scientific articles.
YouTube videos are just letting other people do research ;)
> using experts for advice is great
If they are experts. The problem lies in distinguishing those who actually do have expertise in the field in question from those who merely think that they do and can persuade others that they do.
In many medical contexts there is no such thing as an expert because the data simply doesn't exist, they are sometimes simply more capable than the general public.
If they are experts. The problem lies in distinguishing those who actually do have expertise in the field in question from those who merely think that they do and can persuade others that they do.
In many medical contexts there is no such thing as an expert because the data simply doesn't exist, they are sometimes simply more capable than the general public.
Actual experts I talked too can tell you easily why the opinion they have are true and the evidence it is based on. They are also very good at vulgarization.
> It is the perfect combination of crap.
I think that's being way too charitable.
In a world where people are incarcerated on a scale unprecedented in all of human history, and where prosecutorial success is measured by number of scalps taken, the assumption that this is plain malice designed to let the state rob a few more individuals of their freedom makes much more sense than it all being just a big pile of incompetence and misunderstandings.
I think that's being way too charitable.
In a world where people are incarcerated on a scale unprecedented in all of human history, and where prosecutorial success is measured by number of scalps taken, the assumption that this is plain malice designed to let the state rob a few more individuals of their freedom makes much more sense than it all being just a big pile of incompetence and misunderstandings.
Source? Incarceration rate seems to be going down in western countries: https://news.un.org/en/story/2021/07/1096042
The scale of incarceration is still unprecedented. A reduction by 27 percent doesn't change that. Imprisonment was an extremely rare phenomenon for much of history (as was police, for that matter). Today's incarceration rates would have to be reduced by 99+% in order to reach pre-modern levels, where large cities often had only a handful of cells in total, and rural areas had none at all.
> Imprisonment was an extremely rare phenomenon for much of history (as was police, for that matter).
And crimes weren't solved, people not prosecuted, criminals not punished
For much of history life didn't even exist, that's not an argument for or against anything
And crimes weren't solved, people not prosecuted, criminals not punished
For much of history life didn't even exist, that's not an argument for or against anything
Murder clearance rates went DOWN last decades in USA. Less of major crime is solved.
Plus majority of it never went through tria, because trial is just too much risk. So, there are not all that many actual checks and balances
Plus majority of it never went through tria, because trial is just too much risk. So, there are not all that many actual checks and balances
That's a multi faceted problem. Murder rates also were halves since the 80s in the US, it's not necessarily the same type of criminality
In other countries the clearance rates are as high as ever. The US is an exception in many aspects in the West, closer to third world countries depending on what metric you look at
> overall, findings showed that the clearance rate in Finland and Switzerland in the years of analysis was very high, in some years of the analysis even reaching 100 percent. Internationally, these rates are extraordinary high, even in comparison with other European countries such as Italy (67 percent and, later, 78 percent) , Estonia (80 percent), England & Wales (85 percent) and France (80 percent)
https://journals.sagepub.com/doi/full/10.1177/14773708187648...
In other countries the clearance rates are as high as ever. The US is an exception in many aspects in the West, closer to third world countries depending on what metric you look at
> overall, findings showed that the clearance rate in Finland and Switzerland in the years of analysis was very high, in some years of the analysis even reaching 100 percent. Internationally, these rates are extraordinary high, even in comparison with other European countries such as Italy (67 percent and, later, 78 percent) , Estonia (80 percent), England & Wales (85 percent) and France (80 percent)
https://journals.sagepub.com/doi/full/10.1177/14773708187648...
Mob justice existed too. And execution for minor crime, with king's justice.
Modern western police forces, with all their foibles, are far, far, far better than mob justice.
Are people even aware of history, and how absolutely bloody it was, with an immense lack of personal rights?
Fixing what's broken now is good. Trying to pretend it is worse than what was before, is absolutely absurd and laughable.
Modern western police forces, with all their foibles, are far, far, far better than mob justice.
Are people even aware of history, and how absolutely bloody it was, with an immense lack of personal rights?
Fixing what's broken now is good. Trying to pretend it is worse than what was before, is absolutely absurd and laughable.
It's not so clear cut. At least admit that a lot of thought has been given to this, none the least by Foucalt's famous essay on this topic, Discipline and Punish.
Foucalt has his critics, but it's not immediately obvious that the massive incarceration problem in some Western nations is better than public execution at the whim of monarchs. And some forms of torture, Foucalt argued, have changed from the theatrical and public to the more subdued torture of everyday lives of prison inmates.
Foucalt has his critics, but it's not immediately obvious that the massive incarceration problem in some Western nations is better than public execution at the whim of monarchs. And some forms of torture, Foucalt argued, have changed from the theatrical and public to the more subdued torture of everyday lives of prison inmates.
Remove the US from the list of western countries and it must be better today, yes?
well, you were beaten or killed for a lot of crimes- some only perceived.
So, one may perceive incarceration as an improvement.
So, one may perceive incarceration as an improvement.
To be fair, for much of history there weren't enough resources for everyone, much less for keeping people fed for free in a prison for decades. For serious crimes you just got executed as soon as possible.
We also no longer have exile as a punishment.
Their source could be your source, which you seem to be very seriously misreading.
> As the global population grew 21 per cent, between 2000 and 2019, the number of prisoners worldwide jumped by more than 25 per cent, according to the UNODC data.
So, worldwide trend is upward.
> While Northern America, Sub-Saharan Africa and Eastern Europe have experienced a long-term decrease in imprisonment rates of up to 27 per cent, other regions and countries, such as Latin America, Australia and New Zealand, have seen up to 68 per cent growth over the last two decades, the study revealed.
So apparently your definition of “western countries” includes sub-Saharan Africa but excludes most of Europe and all of Australia and New Zealand?
Overall your own source supports their point and contradicts your own.
> As the global population grew 21 per cent, between 2000 and 2019, the number of prisoners worldwide jumped by more than 25 per cent, according to the UNODC data.
So, worldwide trend is upward.
> While Northern America, Sub-Saharan Africa and Eastern Europe have experienced a long-term decrease in imprisonment rates of up to 27 per cent, other regions and countries, such as Latin America, Australia and New Zealand, have seen up to 68 per cent growth over the last two decades, the study revealed.
So apparently your definition of “western countries” includes sub-Saharan Africa but excludes most of Europe and all of Australia and New Zealand?
Overall your own source supports their point and contradicts your own.
> So apparently your definition of “western countries” includes sub-Saharan Africa but excludes most of Europe and all of Australia and New Zealand?
To be honest the text you are quoting doesn't talk about Western Europe at all, and I think if you exclude Western Europe, then "Northern America + Eastern Europe" is most of what remains of "western countries". Australia and New Zealand, while part of western countries, are so small that they are basically insignificant for statistics.
The data in the source[0], though, says the number of prisoners in Europe as a whole (as well as Northern America) has decreased (Figures 10, 12, and 13) confirming what GP said. Eastern Europe is quoted specifically because the decrease has been much more important (basically, the numbers are becoming similar to Western Europe).
There's no question that the trend in the West has been a decrease in incarceration rate, with Australia and New Zealand clear outliers.
[0]https://www.unodc.org/documents/data-and-analysis/statistics...
To be honest the text you are quoting doesn't talk about Western Europe at all, and I think if you exclude Western Europe, then "Northern America + Eastern Europe" is most of what remains of "western countries". Australia and New Zealand, while part of western countries, are so small that they are basically insignificant for statistics.
The data in the source[0], though, says the number of prisoners in Europe as a whole (as well as Northern America) has decreased (Figures 10, 12, and 13) confirming what GP said. Eastern Europe is quoted specifically because the decrease has been much more important (basically, the numbers are becoming similar to Western Europe).
There's no question that the trend in the West has been a decrease in incarceration rate, with Australia and New Zealand clear outliers.
[0]https://www.unodc.org/documents/data-and-analysis/statistics...
If you exclude Western Europe and simply ignore Australia and New Zealand you’ve abandoned any reasonable conception of “the West” altogether.
Regardless, cherry-picking even such an incredibly gerrymandered “West” ignores the entire point of the source: the human population in prison has risen faster than the human population itself… pointing to minor improvements in the world’s largest prison state and what remains of the ex-Soviet gulag system states while ignoring considerably larger regressions in, for example, a nation colonized specifically to be a prison does nothing to contradict that fact.
Regardless, cherry-picking even such an incredibly gerrymandered “West” ignores the entire point of the source: the human population in prison has risen faster than the human population itself… pointing to minor improvements in the world’s largest prison state and what remains of the ex-Soviet gulag system states while ignoring considerably larger regressions in, for example, a nation colonized specifically to be a prison does nothing to contradict that fact.
The data (linked in my comment) shows that incarceration rates have decreased in all of Europe as well as all of Northern America and increased in Australia and New Zealand.
If you consider "the West" to be (as is commonly admitted) Europe, Northern America, Australia and New Zealand (with maybe Japan included) then incarceration rates have decreased in the West. Even if they have increased in minor countries (AU + NZ).
You're getting stuck on a sentence of the summary that talks about a subset of the data, but I'm not sure why. I also have no idea what you mean about a "nation colonized to be a prison", but honestly this looks to me as if you're just trying to push some idea without vocalizing it, which is a bit off-putting. If you're talking about the US, then yes it does have a much higher incarceration rate than anywhere else in the West, but it's a clear exception within the West and it is still decreasing.
If you consider "the West" to be (as is commonly admitted) Europe, Northern America, Australia and New Zealand (with maybe Japan included) then incarceration rates have decreased in the West. Even if they have increased in minor countries (AU + NZ).
You're getting stuck on a sentence of the summary that talks about a subset of the data, but I'm not sure why. I also have no idea what you mean about a "nation colonized to be a prison", but honestly this looks to me as if you're just trying to push some idea without vocalizing it, which is a bit off-putting. If you're talking about the US, then yes it does have a much higher incarceration rate than anywhere else in the West, but it's a clear exception within the West and it is still decreasing.
Unfortunate. It frankly needs to go up in Western countries to get to half-decent crime rates.
> the assumption that this is plain malice designed to let the state rob a few more individuals of their freedom makes much more sense
That's a lot of work, a lot of malice, a lot of hate, from a lot of people, for a very meagre result.
If that's how you view your government you must live a really painful existence
That's a lot of work, a lot of malice, a lot of hate, from a lot of people, for a very meagre result.
If that's how you view your government you must live a really painful existence
> for a very meagre result
Power is not a meagre result. For those people who live by it, it is the ultimate goal, and they will use any means to obtain and expand it, no matter the cost to others.
Power is not a meagre result. For those people who live by it, it is the ultimate goal, and they will use any means to obtain and expand it, no matter the cost to others.
It's just people "doing their jobs" and trying to get ahead.
That's the banality of evil.
That's the banality of evil.
Lest we forget the very systems enabling this behavior of banal evil were created and maintained by perhaps the most evil of them all.
[deleted]
The word "lest" is meant to come after something else. It means "for fear that" or "or else" or something similar. So it's not clear what you're trying to say. I don't know what "very systems" built by "the most evil" you mean either. Is it supposed to be obvious what you're referring to?
It's from a poem in 1897.
https://en.wikipedia.org/wiki/Recessional_(poem)
https://en.wikipedia.org/wiki/Recessional_(poem)
>designed to let the state rob a few more individuals of their freedom
"The state" doesn't benefit in any way from locking people up. In fact, it costs them money (both directly and in lost taxes from the lost salaries and wages of those incarcerated).
An argument could be made that prosecutors benefit from higher incarceration rates through the incentives you described. And an argument could definitely be made that private corporations paying well-below-market rates for prison labour benefit.
"The state" doesn't benefit in any way from locking people up. In fact, it costs them money (both directly and in lost taxes from the lost salaries and wages of those incarcerated).
An argument could be made that prosecutors benefit from higher incarceration rates through the incentives you described. And an argument could definitely be made that private corporations paying well-below-market rates for prison labour benefit.
Politicians benefit from locking people up because it gives them an easily measurable way to look "tough on crime".
Good point.
I hate to break it to you, but the prison system has been the premiere, essential job-creation program for these United States ever since Appomattox 1865.
https://en.wikipedia.org/wiki/Thirteenth_Amendment_to_the_Un...
https://www.aclu.org/news/human-rights/captive-labor-exploit...
We got 800,000 or so right now. Fight unemployment? Lock more people up.
https://en.wikipedia.org/wiki/Thirteenth_Amendment_to_the_Un...
https://www.aclu.org/news/human-rights/captive-labor-exploit...
We got 800,000 or so right now. Fight unemployment? Lock more people up.
Yep and there are some specific product that rely heavily on prison labor- license plates come to mind.
Also, keep in mind, it costs the taxpayers money, not the people running the criminal justice system. They're motivated by climbing the ladder and scorekeeping.
You think states don't benefit from spending more money? They're just like other organizations who try to expand their budgets year over year.
Except they can force people to pay them more, all they need is plausible justification (like combating crime, or terrorists, or drugs, or viruses, or whatever the current societal scare happens to be about).
Except they can force people to pay them more, all they need is plausible justification (like combating crime, or terrorists, or drugs, or viruses, or whatever the current societal scare happens to be about).
> the assumption that this is plain malice designed to let the state rob a few more individuals of their freedom makes much more sense.
Of course it makes much more sense that there was a massive conspiracy across the medical, legal, prison industry, and press to put more people in prison. Rather than some doctors and legal professionals assuming SIDs was a simple explanation for a not very well understood medical phenomenon probably with many causes.
Of course it makes much more sense that there was a massive conspiracy across the medical, legal, prison industry, and press to put more people in prison. Rather than some doctors and legal professionals assuming SIDs was a simple explanation for a not very well understood medical phenomenon probably with many causes.
>Of course it makes much more sense that there was a massive conspiracy across the medical, legal, prison industry, and press to put more people in prison.
Not like it hasn't happened before. And you're overestimating the required massiveness of the conspiracy IMO.
https://en.wikipedia.org/wiki/Kids_for_cash_scandal
Not like it hasn't happened before. And you're overestimating the required massiveness of the conspiracy IMO.
https://en.wikipedia.org/wiki/Kids_for_cash_scandal
[deleted]
In a world where people are incarcerated on a scale unprecedented in all of human history,
This is only true, because prior to these times, people were killed instead. Or beaten to within an inch of their lives. Local "justice", lynching, mob action, used to be far, far more common.
And of course, many people used to be worked to death. Or sold into slavery. Or die from horrid conditions in jail. Or forced into the foreign legion.
While I agree that something may be wrong in the US, there are many regions in the world where the above still happens.
This is only true, because prior to these times, people were killed instead. Or beaten to within an inch of their lives. Local "justice", lynching, mob action, used to be far, far more common.
And of course, many people used to be worked to death. Or sold into slavery. Or die from horrid conditions in jail. Or forced into the foreign legion.
While I agree that something may be wrong in the US, there are many regions in the world where the above still happens.
> This is only true, because prior to these times, people were killed instead. Or beaten to within an inch of their lives. Local "justice", lynching, mob action, used to be far, far more common.
Hm, sounds like an assertion that ought to be checked by a historian, possibly ACoUP's blog? (Yes, the one who writes about Rome, he is sometimes featured in HN). He specializes in demolishing misconceptions people/Hollywood have about history.
For example, many historians have been writing, recently, about how medieval society was far less brutish and cruel than portrayed in pop culture. There were laws, rights the monarch gave their subjects, culture, etc. Lots of what we "know" about the middle ages from Hollywood is simply wrong.
Hm, sounds like an assertion that ought to be checked by a historian, possibly ACoUP's blog? (Yes, the one who writes about Rome, he is sometimes featured in HN). He specializes in demolishing misconceptions people/Hollywood have about history.
For example, many historians have been writing, recently, about how medieval society was far less brutish and cruel than portrayed in pop culture. There were laws, rights the monarch gave their subjects, culture, etc. Lots of what we "know" about the middle ages from Hollywood is simply wrong.
Lots of what we "know" about from Hollywood is simply wrong :)
If you're interested in how criminal punishment changed from medieval times, Medieval Crime Museum is outstanding. https://www.germany.travel/en/cities-culture/medieval-crime-...
"Sufficiently advanced ignorance/apathy is indistinguishable from malice"
We detached this subthread from https://news.ycombinator.com/item?id=37667150.
It's interesting the instance cited about authors of a scientific paper being compelled to remove a reference because a peer reviewer alleged that the researcher behind it is "a lousy and dishonest researcher". What's more interesting is that PLOS ONE repeated the allegation. I am curious whether there is a case for defamation for the publication of such an allegation.
https://journals.plos.org/plosone/article/peerReview?id=10.1...
I've certainly had peer reviewers trying to get me to cite their own papers in my articles, however I've never seen an instance where a peer reviewer alleged that an article I've cited was by someone disreputable.
https://journals.plos.org/plosone/article/peerReview?id=10.1...
I've certainly had peer reviewers trying to get me to cite their own papers in my articles, however I've never seen an instance where a peer reviewer alleged that an article I've cited was by someone disreputable.
> I've certainly had peer reviewers trying to get me to cite their own papers in my articles, however I've never seen an instance where a peer reviewer alleged that an article I've cited was by someone disreputable.
I have recommended some citations to be removed as a reviewer. It’s not useful to keep citing discredited articles that should have been retracted. Keeping them in new articles just makes them more likely to be read uncritically and further propagate bullshit.
OTOH, the argument is “the article is rubbish”, not some kind of as hominem attack because I don’t like the main author.
I have recommended some citations to be removed as a reviewer. It’s not useful to keep citing discredited articles that should have been retracted. Keeping them in new articles just makes them more likely to be read uncritically and further propagate bullshit.
OTOH, the argument is “the article is rubbish”, not some kind of as hominem attack because I don’t like the main author.
I can see encouraging authors to remove "zombie citations", but that should be rare nowadays, as many bibliographic databases will automatically flag retracted articles now, thanks to integration with the Retraction Watch database.
Hopefully, yes. But there are a lot of articles that should be retracted, but that won’t be because of editorial policies or the fact that nobody actually cares.
This always scared me because I don't even know what counts as shaking.
Can you accidentally shake a baby? Can my 2 year old daughter get shaken baby syndrome when older children on an inflatable castle with her jump and bounce too wild around her (she can't jump yet but loves the bouncing)? I've also often seen parents throw their children a bit in the air and then catch them. The children like it and laugh.
I'm not even speaking of law and police but medically. Can this seriously hurt my daughter?
Can you accidentally shake a baby? Can my 2 year old daughter get shaken baby syndrome when older children on an inflatable castle with her jump and bounce too wild around her (she can't jump yet but loves the bouncing)? I've also often seen parents throw their children a bit in the air and then catch them. The children like it and laugh.
I'm not even speaking of law and police but medically. Can this seriously hurt my daughter?
To protect against all possible harm against your child, perhaps consider wrapping them in a giant balloon so they are isolated from all possible outside influences.
We either accept the randomness of fate or we live in self-made prisons.
We either accept the randomness of fate or we live in self-made prisons.
I don't think this person is asking to protect against all possible harm. I find it strange that you seem to think it is unreasonable to not want your baby shaken so hard they die, and to want to clearly know how much force that is.
Generally throwing kids around (within reason) is absolutely safe, specially at +2yrs. Rough play is very much part of development for all mammals including us.
Perhaps something to help you cope with this is that our brain although fragile has a lot of redundancy around it.
On a fall or bounce our neck will decelerate our fall/bounce, there is no need to be an athlete, our muscles have a contraction reflex if they are violently streched (myotatic reflex), less so for very young babies with weak neck muscles (think less than 6/9 months).
Then our skull is filled with fluid which has inertia so the force on the skull is not directly transmitted to the brain. You have to slush the liquid around quite a bit before your brain experiences any meaningful force.
Effectively it is only with some extreme force or internal bleeding compressing the brain that brain damage would occur.
Perhaps something to help you cope with this is that our brain although fragile has a lot of redundancy around it.
On a fall or bounce our neck will decelerate our fall/bounce, there is no need to be an athlete, our muscles have a contraction reflex if they are violently streched (myotatic reflex), less so for very young babies with weak neck muscles (think less than 6/9 months).
Then our skull is filled with fluid which has inertia so the force on the skull is not directly transmitted to the brain. You have to slush the liquid around quite a bit before your brain experiences any meaningful force.
Effectively it is only with some extreme force or internal bleeding compressing the brain that brain damage would occur.
My kids love it when they come running toward me and I pick them up and in one swoop throw them on to my (big) bed. I'm always holding back because I see their head snap back to land on the mattress, it's that "violent" head-moving-back thing that gives me the fear, so I stopped.
a core part of my son and i's relationship is me yeeting him on soft pieces of furniture (he's 3)! He is very physical and likes to roughhouse - he injuries himself a lot! Little kids really are made of rubber
I don't think you should worry too much. Abusive shaking really involves extreme forces. "Routine shaking" occurring during play is not expected to be harmful to healthy children. Games should be adapted to the age of children according to common sense.
The takeaway of biomechanics studies is basically that you should be much more careful about accidental head impacts on hard surfaces.
The takeaway of biomechanics studies is basically that you should be much more careful about accidental head impacts on hard surfaces.
A) No, but no one can tell that you’re a dog on the internet. Further, dogs do not dispense reliable medical advice. The op is a press release for a textbook covering this topic in what looks like excruciating detail from a wide variety of angles. I doubt a superior citation exists.
B) Beyond that, my understanding is that once a child is past the infant phase where they cannot support their own head, they’re fine. Humans are not all that delicate. Bumps and falls are inevitable, I don’t see how we would have seen success as a species if the risk were outsized. And I guess we’ve been around for a while by now.
C) TFA does mention this a little but it is split across a wide gap and is not the focus. I pulled the two quotes I think are relevant below.
> And yet, although subdural and retinal hemorrhage may be caused by non-accidental trauma, especially when impact is involved, they simply are not specific for it: indeed, it has been demonstrated that a wide range of accidental events and medical conditions are plausible alternative causes. Particularly fragile infants may sustain severe head injuries following minor household falls. Others may suffer from genetic conditions, metabolic disorders, blood clotting abnormalities, or infections.
> On the other hand, there exist dozens of documented cases of witness reports of shaking, videotaped shakings, and spontaneous admissions of shaking, but without subdural and retinal hemorrhage. In fact, there is virtually no known case of a reliably-documented event of violent shaking without impact of a healthy baby resulting in isolated subdural and retinal hemorrhage (additional markers of trauma would be expected in such cases). In contrast, there have been numerous cases of videotaped or witnessed short falls resulting in these very medical findings, considered “impossible” by the shaking hypothesis.
So it’s like they say: it’s not the fall that gets you, it’s when you land.
B) Beyond that, my understanding is that once a child is past the infant phase where they cannot support their own head, they’re fine. Humans are not all that delicate. Bumps and falls are inevitable, I don’t see how we would have seen success as a species if the risk were outsized. And I guess we’ve been around for a while by now.
C) TFA does mention this a little but it is split across a wide gap and is not the focus. I pulled the two quotes I think are relevant below.
> And yet, although subdural and retinal hemorrhage may be caused by non-accidental trauma, especially when impact is involved, they simply are not specific for it: indeed, it has been demonstrated that a wide range of accidental events and medical conditions are plausible alternative causes. Particularly fragile infants may sustain severe head injuries following minor household falls. Others may suffer from genetic conditions, metabolic disorders, blood clotting abnormalities, or infections.
> On the other hand, there exist dozens of documented cases of witness reports of shaking, videotaped shakings, and spontaneous admissions of shaking, but without subdural and retinal hemorrhage. In fact, there is virtually no known case of a reliably-documented event of violent shaking without impact of a healthy baby resulting in isolated subdural and retinal hemorrhage (additional markers of trauma would be expected in such cases). In contrast, there have been numerous cases of videotaped or witnessed short falls resulting in these very medical findings, considered “impossible” by the shaking hypothesis.
So it’s like they say: it’s not the fall that gets you, it’s when you land.
The article as I interpreted says that there is no recorded case where you can get shaken baby syndrome and the sharking was recorded on tape or declared in front of the police, that being said, if your child has some pathology, they might be at risk with even a minor fall
You misread the article. The article states that there aren’t any SBS cases with only “isolated subdural and retinal hemorrhage.”
re: the bouncy houses and such. Other than kids banging into each other, this never seemed like much of a head or brain injury risk. But watch out for knees! Trampolines with more than one person on them are incredibly dangerous, and bouncy houses seem likely to be pretty dangerous with occupants of widely varying sizes. The specific issue is that the floor may move abruptly and unexpectedly when someone is trying to land, causing a potentially severe knee injury.
If you’re in a bouncy house with kids, consider avoiding any bouncing yourself.
If you’re in a bouncy house with kids, consider avoiding any bouncing yourself.
It is pretty hard for such injuries to occur with the level of movement you're taking about, especially with a child old enough to support their own head. I don't think you need to worry.
> As a precautionary measure, the hospital followed mandatory reporting statutes and my wife and I temporarily lost custody of David.
Are people absolutely nuts? Is this just a thing in France or is this elsewhere in Europe or even the US? You're actively encouraging people to not bring their children to the ER by doing this crazy nonsense.
Are people absolutely nuts? Is this just a thing in France or is this elsewhere in Europe or even the US? You're actively encouraging people to not bring their children to the ER by doing this crazy nonsense.
Definitely a UK thing too. If you take your kid to A&E you can guarantee every person who interacts with you is required to be on the lookout for abuse. You get probing questions by the doctors as veiled accusations and you may get protection services knocking on your door the next day.
This is a thing in most Western countries! Especially in the US. It dates back to the 1960s [1].
Most parents don't realize that anytime they interact with a medical doctor (or another professional), they interact with someone who was trained to detect "signs of abuse", which basically can be anything out of the ordinary. They are required by law to report any suspicion of abuse, and they can be prosecuted if they fail to do so. The incentives are pretty clear. Unfortunately, while this obviously protects some children, there are adverse effects such as an enormous waste of human and financial resources to unsubstantiated reports [2].
To quote Wikipedia (this is more generally about hotline calls but this also affects healthcare professionals):
"There are approximately 3.6 million calls each year nationwide (..) affecting on average 1 out of 10 U.S. families with children under the age of 18 each year (there are 32.2 million such families). (...) Of those substantiated, over half are minor situations and many are situations where the worker thinks something may happen in the future.
Each year, approximately 85% of hotline calls either do not warrant investigation or are not substantiated. Approximately 78% of all investigations are unsubstantiated and approximately 22% are substantiated, with around 9% where "alternative responses" are offered in some states, which have a focus on working with the family to address issues rather than confirming maltreatment."
On this topic, I highly recommend "Take Care of Maya" on Netflix.
[1] https://en.wikipedia.org/wiki/Mandatory_reporting_in_the_Uni...
[2] https://lawreview.law.ucdavis.edu/issues/50/1/Articles/50-1_...
[3] https://en.wikipedia.org/wiki/Factitious_disorder_imposed_on...
Most parents don't realize that anytime they interact with a medical doctor (or another professional), they interact with someone who was trained to detect "signs of abuse", which basically can be anything out of the ordinary. They are required by law to report any suspicion of abuse, and they can be prosecuted if they fail to do so. The incentives are pretty clear. Unfortunately, while this obviously protects some children, there are adverse effects such as an enormous waste of human and financial resources to unsubstantiated reports [2].
To quote Wikipedia (this is more generally about hotline calls but this also affects healthcare professionals):
"There are approximately 3.6 million calls each year nationwide (..) affecting on average 1 out of 10 U.S. families with children under the age of 18 each year (there are 32.2 million such families). (...) Of those substantiated, over half are minor situations and many are situations where the worker thinks something may happen in the future.
Each year, approximately 85% of hotline calls either do not warrant investigation or are not substantiated. Approximately 78% of all investigations are unsubstantiated and approximately 22% are substantiated, with around 9% where "alternative responses" are offered in some states, which have a focus on working with the family to address issues rather than confirming maltreatment."
On this topic, I highly recommend "Take Care of Maya" on Netflix.
[1] https://en.wikipedia.org/wiki/Mandatory_reporting_in_the_Uni...
[2] https://lawreview.law.ucdavis.edu/issues/50/1/Articles/50-1_...
[3] https://en.wikipedia.org/wiki/Factitious_disorder_imposed_on...
This doesn’t surprise me. We have massive systemic issues in medical science and care delivery.
- Medical science handles variation by simply assuming that large enough samples will average out variation. This loses a ton of information as the “average person” is a construct that almost certainly doesn’t exist.
- news media on medical science glosses over all uncertainties in the name of clickbaity sensationalism.
- lawyers are the incentivized by our adversarial legal system to adopt aggressively hyperbolic interpretations of the science to sue people and extract money.
- medical associations then tweak policies to protect against malpractice
Run this loop enough times and lots of noise gets amplified.
My hope is the AI+sensors ushers in the era of truely personalized medicine.
- Medical science handles variation by simply assuming that large enough samples will average out variation. This loses a ton of information as the “average person” is a construct that almost certainly doesn’t exist.
- news media on medical science glosses over all uncertainties in the name of clickbaity sensationalism.
- lawyers are the incentivized by our adversarial legal system to adopt aggressively hyperbolic interpretations of the science to sue people and extract money.
- medical associations then tweak policies to protect against malpractice
Run this loop enough times and lots of noise gets amplified.
My hope is the AI+sensors ushers in the era of truely personalized medicine.
[deleted]
Basically, you want to replace statistics ("large enough samples will average out variation") with AI. I'm afraid that's cargo cult instead of science.
AI can lie. It means a "truely personalized medicine" would sometimes poison its patients. See for instance Donald Knuth experiment with Chat GPT, starting with "Answer #3 is fouled up beautifully!" with some totally wrong AI answers https://www-cs-faculty.stanford.edu/~knuth/chatGPT20.txt
Of course medical science could make a better use of statistics, get help from AI, and discern more profiles (e.g. one US adult out of two is obese, and it's often unclear how to adjust medication to person mass). But that's a long process, with no obvious path, and much distinct from the magic "AI will solve it all".
AI can lie. It means a "truely personalized medicine" would sometimes poison its patients. See for instance Donald Knuth experiment with Chat GPT, starting with "Answer #3 is fouled up beautifully!" with some totally wrong AI answers https://www-cs-faculty.stanford.edu/~knuth/chatGPT20.txt
Of course medical science could make a better use of statistics, get help from AI, and discern more profiles (e.g. one US adult out of two is obese, and it's often unclear how to adjust medication to person mass). But that's a long process, with no obvious path, and much distinct from the magic "AI will solve it all".
(I'll bring a conciliatory bias to this conversation. Under what interpretations might the ^ and ^^ comments be saying mostly the same thing?)
>> My hope is the AI+sensors ushers in the era of truely personalized medicine.
> AI can lie.
The first hope is compatible with the second fact. It is possible that carefully _designed_ AI systems (that have different architectures than 'vanilla' LLMs) can serve a useful purpose here.
There is a lot of interesting conversation to be had in 'the conciliatory zone', leaving plenty of opportunities to disagree when it is warranted.
> Basically, you want to replace statistics ("large enough samples will average out variation") with AI. I'm afraid that's cargo cult instead of science.
There is a whole lot of _assuming_ going on here, followed by a mischaracterization. This is not the paragon of curious conversation.
I don't expect perfection, but I still think we should try. I don't mean to pick on any one person; I do this sometimes as well. I'm just pointing it out because, well, it is right here, right now.
Think about the impact on the system. Seeing the anti-pattern above too often can drive people away. I think it does. Who remains? People who somehow aren't bothered by it? Downselecting in this way is self-defeating.
I'm probably just as frustrated as anyone here (if not more) regarding (i) the state of medicine, (ii) perceptions of what current AI technology can do, and (iii) many other serious problems. But we shouldn't not let this frustration bleed into our personal interactions.
It is both a waste of our time and (worse) damaging to the community ethos when we take an unnecessarily pessimistic view of _each other_. Some online fora are 'good enough' (though flawed) to help us connect and build bridges as _people_. It doesn't help when we fall into the all-too-common pattern of sniping without asking questions first and clarifying meaning.
Again, nothing personal. This is more of a rant and request.
>> My hope is the AI+sensors ushers in the era of truely personalized medicine.
> AI can lie.
The first hope is compatible with the second fact. It is possible that carefully _designed_ AI systems (that have different architectures than 'vanilla' LLMs) can serve a useful purpose here.
There is a lot of interesting conversation to be had in 'the conciliatory zone', leaving plenty of opportunities to disagree when it is warranted.
> Basically, you want to replace statistics ("large enough samples will average out variation") with AI. I'm afraid that's cargo cult instead of science.
There is a whole lot of _assuming_ going on here, followed by a mischaracterization. This is not the paragon of curious conversation.
I don't expect perfection, but I still think we should try. I don't mean to pick on any one person; I do this sometimes as well. I'm just pointing it out because, well, it is right here, right now.
Think about the impact on the system. Seeing the anti-pattern above too often can drive people away. I think it does. Who remains? People who somehow aren't bothered by it? Downselecting in this way is self-defeating.
I'm probably just as frustrated as anyone here (if not more) regarding (i) the state of medicine, (ii) perceptions of what current AI technology can do, and (iii) many other serious problems. But we shouldn't not let this frustration bleed into our personal interactions.
It is both a waste of our time and (worse) damaging to the community ethos when we take an unnecessarily pessimistic view of _each other_. Some online fora are 'good enough' (though flawed) to help us connect and build bridges as _people_. It doesn't help when we fall into the all-too-common pattern of sniping without asking questions first and clarifying meaning.
Again, nothing personal. This is more of a rant and request.
> Basically, you want to replace statistics ("large enough samples will average out variation") with AI
No. This is misunderstanding due to my lack of clarity. Apologizes.
The biggest problems with Medical data is that 1) incredibly small scale data is collected to make assertions, 2) the data is horrendously de-normalized
In Radiology, a common validation approach is have radiologists review cases on the order of 250 studies to make assessments about a radiology product. This is considered the gold standard for FDA. Look into it more, vaccines, treatments. The sample sizes are fucking tiny.
The statistical assertion is that these relatively small samples capture the variation sufficiently to demonstrate efficacy across devices, treatments. These are then extrapolated to the US and wider populations. Do you believe that this is rigorously true?
The rationale underpinning this is simply practicality. You cannot get thousands (or hundreds of thousands) of patients/doctors/etc to get a strong signal and confidence. For drugs, it's super hard, but for devices and software interventions, it way easier to get data.
That brings us to the second big problem: the data structure is completely highly varied and denormalized.
1) From a pure structure point of view, it's basically free text fields that doctors sporadically fill.
2) From a underlying truth point of view, each hospital across the world has different protocols for care delivery. A histopathological FNA procedure might have a completely different meaning in CA, NY, or EU. This might simply be because of workflow, timeline, or just people using the words wrong.
What I mean with AI+Sensors:
AI doesn't need to solve the problem of intuition around medical problems. The biggest impact will likely come from the relatively mundane task of simply structuring and normalizing the data. Sensors simply help to generate more data
To be more concrete, you don't want (and shouldn't trust) this:
Prompt: "Please diagnose this person"
You want this:
Prompt: "Here is 100 TB of data from 100 different hospitals each with different workflows and patients for histopathology. For each patient, synthesize a CSV with the following schema "AnonPatientID, AnonCaseID, Pathology Result, Pathology stage, Incidenctal findings, ..."
Then I can do the analysis myself.
Hope this makes more sense.
(I work in healthtech and med device and I promise you: Demoralization at the state of medicine is a rite of passage after which you can begin to address practical problems)
No. This is misunderstanding due to my lack of clarity. Apologizes.
The biggest problems with Medical data is that 1) incredibly small scale data is collected to make assertions, 2) the data is horrendously de-normalized
In Radiology, a common validation approach is have radiologists review cases on the order of 250 studies to make assessments about a radiology product. This is considered the gold standard for FDA. Look into it more, vaccines, treatments. The sample sizes are fucking tiny.
The statistical assertion is that these relatively small samples capture the variation sufficiently to demonstrate efficacy across devices, treatments. These are then extrapolated to the US and wider populations. Do you believe that this is rigorously true?
The rationale underpinning this is simply practicality. You cannot get thousands (or hundreds of thousands) of patients/doctors/etc to get a strong signal and confidence. For drugs, it's super hard, but for devices and software interventions, it way easier to get data.
That brings us to the second big problem: the data structure is completely highly varied and denormalized.
1) From a pure structure point of view, it's basically free text fields that doctors sporadically fill.
2) From a underlying truth point of view, each hospital across the world has different protocols for care delivery. A histopathological FNA procedure might have a completely different meaning in CA, NY, or EU. This might simply be because of workflow, timeline, or just people using the words wrong.
What I mean with AI+Sensors:
AI doesn't need to solve the problem of intuition around medical problems. The biggest impact will likely come from the relatively mundane task of simply structuring and normalizing the data. Sensors simply help to generate more data
To be more concrete, you don't want (and shouldn't trust) this:
Prompt: "Please diagnose this person"
You want this:
Prompt: "Here is 100 TB of data from 100 different hospitals each with different workflows and patients for histopathology. For each patient, synthesize a CSV with the following schema "AnonPatientID, AnonCaseID, Pathology Result, Pathology stage, Incidenctal findings, ..."
Then I can do the analysis myself.
Hope this makes more sense.
(I work in healthtech and med device and I promise you: Demoralization at the state of medicine is a rite of passage after which you can begin to address practical problems)
Current AI is deeply rooted in probability and statistics, so it would actually increase the use of statistics.
I'm not saying a false positive or a false negative cannot happen. I am saying that we would have better estimates of both, according to probability theory.
Also: false positives and false negatives are basically impossible to prevent, for a sufficient small margin of error. And that's science.
I'm not saying a false positive or a false negative cannot happen. I am saying that we would have better estimates of both, according to probability theory.
Also: false positives and false negatives are basically impossible to prevent, for a sufficient small margin of error. And that's science.
I'm starting to see AI studies on the medical detection of child abuse, which unfortunately reproduce the same biases as the low-quality clinical data they are based on. An AI that would detect subdural and retinal hemorrhage without external signs of trauma with 99% accuracy would detect "child abuse with 99% accuracy" and would impress law enforcement and courts. However, it wouldn't be more reliable than an expert witness confidently asserting that these signs are almost always due to child abuse.
Reminds me of the bias towards long sleeves and stethoscopes for detecting doctors in photos.
> - Medical science handles variation by simply assuming that large enough samples will average out variation. This loses a ton of information as the “average person” is a construct that almost certainly doesn’t exist.
Well, this wouldn't even be that bad, if sample size were actually large enough.
Well, this wouldn't even be that bad, if sample size were actually large enough.
No I think the point that was being made is that the "average person" idea is not that great if you have huge variance. If I have a uniform distribution from 0 to 1, average is '0.5', but its just as likely to get 0. or 1.
Yes, I know.
My point goes beyond that one: yes, variance is a problem. But _even_ _just_ getting good averages, for all their faults, requires a bigger n than many studies have. Especially observational studies.
My point goes beyond that one: yes, variance is a problem. But _even_ _just_ getting good averages, for all their faults, requires a bigger n than many studies have. Especially observational studies.
The average family with 2.3 children :D
That's part of it. The sample size is usually super small.
Furthermore, there's the opportunity. With large amounts of data (from software, medical devices, sensors) we can actually tackle this problem at scale.
Furthermore, there's the opportunity. With large amounts of data (from software, medical devices, sensors) we can actually tackle this problem at scale.
[deleted]
Your narrative reverses the roles a bit. The lawyers appear as the heroes in this particular story and the villains are all associated with the hospital -- either in the form of people or bureaucratic red tape, depending on how generous you want to be in your analysis.
> The doctors at the hospital were absolutely, unconditionally 100% certain that no other cause than violent shaking could ever explain blood around the brain and at the back of the eyes.
> As a precautionary measure, the hospital followed mandatory reporting statutes and my wife and I temporarily lost custody of David.
> I disturbingly realized that what I had been told at the hospital, namely that subdural and retinal hemorrhage in infants are almost always caused by violent shaking even in the absence of external evidence of trauma, was an assertion based on very weak scientific foundations.
> Thanks to our incredibly effective defense lawyer, we were cleared of all charges within two months, during which we stayed at the hospital 24/7 with David until we sorted out the legal procedures.
> Every case requires years of intense, dedicated efforts by an entire team of specialized lawyers and medical experts, but there are tens of thousands of cases and few experts willing to defend them.
Hospitals are definitely the weak link in this system. Just looking at the way the story is laid out, the solution is more lawyers and fewer, less expansive hospitals.
> The doctors at the hospital were absolutely, unconditionally 100% certain that no other cause than violent shaking could ever explain blood around the brain and at the back of the eyes.
> As a precautionary measure, the hospital followed mandatory reporting statutes and my wife and I temporarily lost custody of David.
> I disturbingly realized that what I had been told at the hospital, namely that subdural and retinal hemorrhage in infants are almost always caused by violent shaking even in the absence of external evidence of trauma, was an assertion based on very weak scientific foundations.
> Thanks to our incredibly effective defense lawyer, we were cleared of all charges within two months, during which we stayed at the hospital 24/7 with David until we sorted out the legal procedures.
> Every case requires years of intense, dedicated efforts by an entire team of specialized lawyers and medical experts, but there are tens of thousands of cases and few experts willing to defend them.
Hospitals are definitely the weak link in this system. Just looking at the way the story is laid out, the solution is more lawyers and fewer, less expansive hospitals.
Oh the good old, violent Easter European bias mixed into crap science.
Seems like the bias is on your part… Which is ironic, given the articles content….
Or do you have _evidence_?
Or do you have _evidence_?
No, I don't have any bias, it's everybody else having biases. To be sure, I just checked how many times before I was biased (it's zero times), so I can't be now.
The username kinda suggests an Eastern European (https://en.wikipedia.org/wiki/Ilya_Muromets) so I read the post as a personal opinion that the bias exists.
Not everything comes with evidence, nor is everything a court case. If you have experienced racism again and again though, you can often tell when you see it, or you can quite safely deduce it in a case or wrong treatment, even without hard proof.
jauzj(4)
And yet they are wrong, so clearly evidence was needed.
> If you have experienced racism again and again though, you can often tell when you see it, or you can quite safely deduce it in a case or wrong treatment, even without hard proof.
There may be some overlap between systemic racial mistreatment and child abuse - however the nuances seem to set them far apart. I believe conflating the two makes it harder to get the full measure of each.
It's not that they can't be compared. It's that they ought to be fully considered in isolation first.
There may be some overlap between systemic racial mistreatment and child abuse - however the nuances seem to set them far apart. I believe conflating the two makes it harder to get the full measure of each.
It's not that they can't be compared. It's that they ought to be fully considered in isolation first.
Wait, are there Europeans who don't acknowledge that this bias exists? In my experience with European colleagues and those who've traveled a lot there it's so universally-acknowledged that this would surprise me.
It could be, but communication issues could also be at play, plus overeager doctors/social workers.
In Romania they go at great lengths not to pull children out of family environments, in Denmark and other more developed countries it could be the opposite.
Implying ripping children out of their families willy-nilly is "more developed."
Development past a certain point is not universally a good thing.
The term is used to describe the stages a country has been through, and there’s plenty of evidence that as countries develop further, the nature of those developments may or may not be beneficial.
Brexit, online safety and other forms of “progress” come to mind.
The term is used to describe the stages a country has been through, and there’s plenty of evidence that as countries develop further, the nature of those developments may or may not be beneficial.
Brexit, online safety and other forms of “progress” come to mind.
Its tongue in cheek. Germany is developed, but you will get arrested if you try to homeschool your children.
It’s very important your children be taught whatever it is the government wants them to be taught! Which went very well for Germany in the 1930s…
b/c it's seen as a basic right, and issue of equality to have access to the same level of state education. The concept of "your" children is something of the problem.
It could be a problem, but usually isn’t.
The (darkly) funny thing in the case of Germany is that this lack of diversity in education has created a generation with the fertility rate of South Korea (ie dying).
In this case, the state creating a monoculture that results in the ‘destruction’ of the existing state goes to show why evolution values diversity far more than monocultures.
The (darkly) funny thing in the case of Germany is that this lack of diversity in education has created a generation with the fertility rate of South Korea (ie dying).
In this case, the state creating a monoculture that results in the ‘destruction’ of the existing state goes to show why evolution values diversity far more than monocultures.
> this lack of diversity in [German] education
any evidence of that?
any evidence of that?
In a lot of sci-fi, the most “developed” civilisations have their children raised by robots in crèches.
I don’t think it was supposed to be aspirational.
I don’t think it was supposed to be aspirational.
Not ripping children from actually abusive families is more developed. There are many cases of abuses families who need to lose their children, and in some those families still have children. There are other cases where good families lose their children.
Note that I carefully did not say anything about what abuse is. Unfortunately there is no agreement and I don't want to get into that debate (it is well worth having, but it would change the direction I'm trying to go here).
Note that I carefully did not say anything about what abuse is. Unfortunately there is no agreement and I don't want to get into that debate (it is well worth having, but it would change the direction I'm trying to go here).
There are debatable issues, and clear cut issues -- not providing basic care or medical care is quite clear cut.
Homeschooling is debatable, if the children are evaluated to be equal to their regular schooled peers, I don't think the child should be taken out of the family environment, but should be subject to further wellness checks by social workers.
Homeschooling is debatable, if the children are evaluated to be equal to their regular schooled peers, I don't think the child should be taken out of the family environment, but should be subject to further wellness checks by social workers.
> There are many cases of abuses families who need to lose their children, and in some those families still have children.
A challenge is where the ripped-off children wind up, a foster home system with it's own abuse issues.
A challenge is where the ripped-off children wind up, a foster home system with it's own abuse issues.
I'm not implying anything other than the fact in Romania social workers KNOW it's very, very likely the child will fare worse fate in an orphanage or foster care, EVEN in cases that would be considered abuse in the West.
Given a more developed country, I'd presume there are more people willing to adopt/do foster care for the right reasons and the social workers can regularly check upon the welfare of the child, thus there can be legitimate reasons to lower the threshold of taking a child out of a family setting vs a less developed country.
Given a more developed country, I'd presume there are more people willing to adopt/do foster care for the right reasons and the social workers can regularly check upon the welfare of the child, thus there can be legitimate reasons to lower the threshold of taking a child out of a family setting vs a less developed country.
That's not at all the implication.
> in Denmark and other more developed countries it could be the opposite.
Did you mean: richer?
Did you mean: richer?
I mean more developed, because a country like Saudi Arabia is rich but not developed imho, and there could be countries that are develope -- i.e. they have good education, infrastructure, medical care, human rights, clean environment etc etc and not that rich.
[deleted]
Sorry, I know this is an old thread, but I feel a bit like I need to share my thoughts on this matter.
> like Saudi Arabia is rich but not developed imho > good education, infrastructure, medical care, human rights, clean environment
Saudi Arabia's record on human rights is truly horrible (for example, recently they've started murdering refugees[0]), but the idea of whether a country is "developed" seems to be highly subjective, imho. I don't know for sure (never been to Saudi Arabia), but I'm guessing they check off all the boxes except for human rights[1]. (About a clean environment--I imagine they'd be as clean as Abu Dhabi or Dubai (the UAE) which were a lot cleaner imo or on par with Western cities. I guess this is a matter of subjective matter, but is human rights a dimension a country has to have in order to be considered developed? If human rights is indeed a dimension that needs to be satisfied, would that mean that the brutal treatment of black and brown minorities in the US by the police would make the U.S. a country that's not developed?
I'm asking this since Western European countries also have a track record that has historically surpassed world records for brutality. For example, Belgium[1] was chopping off the hands of African tribal people they had forced into labor (effectively enslaved), Germany murdered 6 million innocent Jewish people[2] and had a habit murdering people even before the Nazis in its colonies as well[3], the British were responsible for numerous famines in India as well as famine in Ireland as well as other atrocities[4], the French committed atrocities[5], so did the Netherlands and the Dutch with the East India Company[6], and Spain and Portugal (along with England and others) were highly culpable in the murder of millions of Native Americans[7].
Did these actions, at least temporarily, render these Western European countries as "not developed" countries?
[0][a] https://www.hrw.org/news/2023/08/21/saudi-arabia-mass-killin...
[0][b] https://www.nytimes.com/2023/08/26/world/middleeast/saudi-ki...
[1] https://en.wikipedia.org/wiki/Atrocities_in_the_Congo_Free_S...
[2] https://en.wikipedia.org/wiki/The_Holocaust
[3] https://en.wikipedia.org/wiki/Herero_and_Namaqua_genocide
[4] https://www.independent.co.uk/news/uk/home-news/worst-atroci...
[5] https://newlinesmag.com/newsletter/the-dark-legacy-of-french...
[6] https://foreignpolicy.com/2020/08/10/dutch-colonial-history-...
[7] https://en.wikipedia.org/wiki/Genocide_of_Indigenous_peoples
> like Saudi Arabia is rich but not developed imho > good education, infrastructure, medical care, human rights, clean environment
Saudi Arabia's record on human rights is truly horrible (for example, recently they've started murdering refugees[0]), but the idea of whether a country is "developed" seems to be highly subjective, imho. I don't know for sure (never been to Saudi Arabia), but I'm guessing they check off all the boxes except for human rights[1]. (About a clean environment--I imagine they'd be as clean as Abu Dhabi or Dubai (the UAE) which were a lot cleaner imo or on par with Western cities. I guess this is a matter of subjective matter, but is human rights a dimension a country has to have in order to be considered developed? If human rights is indeed a dimension that needs to be satisfied, would that mean that the brutal treatment of black and brown minorities in the US by the police would make the U.S. a country that's not developed?
I'm asking this since Western European countries also have a track record that has historically surpassed world records for brutality. For example, Belgium[1] was chopping off the hands of African tribal people they had forced into labor (effectively enslaved), Germany murdered 6 million innocent Jewish people[2] and had a habit murdering people even before the Nazis in its colonies as well[3], the British were responsible for numerous famines in India as well as famine in Ireland as well as other atrocities[4], the French committed atrocities[5], so did the Netherlands and the Dutch with the East India Company[6], and Spain and Portugal (along with England and others) were highly culpable in the murder of millions of Native Americans[7].
Did these actions, at least temporarily, render these Western European countries as "not developed" countries?
[0][a] https://www.hrw.org/news/2023/08/21/saudi-arabia-mass-killin...
[0][b] https://www.nytimes.com/2023/08/26/world/middleeast/saudi-ki...
[1] https://en.wikipedia.org/wiki/Atrocities_in_the_Congo_Free_S...
[2] https://en.wikipedia.org/wiki/The_Holocaust
[3] https://en.wikipedia.org/wiki/Herero_and_Namaqua_genocide
[4] https://www.independent.co.uk/news/uk/home-news/worst-atroci...
[5] https://newlinesmag.com/newsletter/the-dark-legacy-of-french...
[6] https://foreignpolicy.com/2020/08/10/dutch-colonial-history-...
[7] https://en.wikipedia.org/wiki/Genocide_of_Indigenous_peoples
It also because north Europe has one of the most toxic social services in the world, kidnapping kids 24/7. That's basically their job.
Whatever core truth you're trying to express, wording it in this way isn't helpful.
No.
Seen complaints/protests like this in my country. Then the adult children of the lady leading these protests spoke out against her and pointed out she was just doing it to get a house and embezzling a load of GoFundMe money.
This wasn't SBS though, she just kept adopting out her kids to devote more time to her drug habits.
This wasn't SBS though, she just kept adopting out her kids to devote more time to her drug habits.
This is a difficult question I've been pondering between the UK/USA.
Who has more authority over their children and in which domains?
Medical providers, can they ruin kids' lives in various ways? It's easy to manipulate worried parents.
Schools, do teachers have authority over their classroom, how much? Can they override parents, for example when rescuing them from anti-LGBT?
Nobody trusts churches anymore, so that's not really a problem.
Who has more authority over their children and in which domains?
Medical providers, can they ruin kids' lives in various ways? It's easy to manipulate worried parents.
Schools, do teachers have authority over their classroom, how much? Can they override parents, for example when rescuing them from anti-LGBT?
Nobody trusts churches anymore, so that's not really a problem.
> Oh the good old, violent Easter European bias mixed into crap science.
Honest question, trying to parse your statement (and bear in mind I don't live in Europe, so I'm surely missing the obvious): do you mean that in Denmark there is a bias against Eastern Europeans, such as Romanians?
Edit: excellent, got a downvote for asking an honest question and clarifying why I wrote it. Is this an example of the fine discourse we are supposed to have here? This is an honest question, I'm neither European nor a native English speaker and I have difficulty parsing the sentence I quoted. How on earth does this warrant downvotes?
Honest question, trying to parse your statement (and bear in mind I don't live in Europe, so I'm surely missing the obvious): do you mean that in Denmark there is a bias against Eastern Europeans, such as Romanians?
Edit: excellent, got a downvote for asking an honest question and clarifying why I wrote it. Is this an example of the fine discourse we are supposed to have here? This is an honest question, I'm neither European nor a native English speaker and I have difficulty parsing the sentence I quoted. How on earth does this warrant downvotes?
Yes, that's what GP meant.
Domestic violence is still common in Eastern Europe(i.e Romania) so go figure why there is a bias against Eastern Europeans.
Domestic violence is higher where poverty rates are higher. (I am not saying that poverty is the sole determinant, but it closely correlates). You will find pockets of higher domestic violence throughout the US. I don't think you can rationalize bias like this, people with ethnic prejudice will look for any apparent fact pattern to support their preconceived bias.
I could not say I ever experienced it, but I have school-aged relatives that moved to Germany and received all sorts of crap from their peers explicitly for being romanians. Not a race thing because they're whiter than most germans( blonde, white, blue eyes).
It’s not just in Denmark, most Europeans have a negative bias towards Romanian immigrants (mostly because they’re too ignorant to even know Romanians are not Roma).
> because they’re too ignorant to even know Romanians are not Roma
I don't think the term Roma has a bad association, because in my experience nobody but the most woke even know it. That is the PC term. People I've encountered just use gypsy or their local equivalent.
I don't think the term Roma has a bad association, because in my experience nobody but the most woke even know it. That is the PC term. People I've encountered just use gypsy or their local equivalent.
For your edit: 'honest questions' (which are in fact anything but: the person asking has no interest in the answer, and the question itself is often leading) are a common disruptive tactic used by people (normally pushing extreme right-wing ideologies) to derail a conversation.
I'm sure that you're not doing that here, but unfortunately people with genuinely honest questions have become collateral damage caused by disingenuous actors, especially among people with itchy downvote-trigger-fingers.
I'm sure that you're not doing that here, but unfortunately people with genuinely honest questions have become collateral damage caused by disingenuous actors, especially among people with itchy downvote-trigger-fingers.
Yeah, I figured, which is why my original question clarified I'm not from Europe (so no vested interest) and that I might be genuinely missing the obvious answer. Which is why I was surprised by the drive-by downvote.
Thankfully people have responded and now I both understand the sentence and the why!
Thankfully people have responded and now I both understand the sentence and the why!
this "are a common tactic" gets a bit old, good way to gatekeep certain topics.
If the same "tactic" is used, why not come up with a good counter? A point stands whether it's being asked disingenuously or not.
If the same "tactic" is used, why not come up with a good counter? A point stands whether it's being asked disingenuously or not.
Yes. Romanians probably get the worst of it from the association with Roma in general who are generally discriminated against, but there is generally a base level of anti eastern-european discrimination among western Europe (and especially the UK). Not that all or most western Europeans do this, but it's a significant enough minority that does that it's unavoidable.
There is a skin condition called Mongolian (Blue) Spot (wikipedia: https://en.wikipedia.org/wiki/Mongolian_spot ) that doctors can mistake for an infant being beaten or otherwise abused. It has led to a lot of cases of false accusations and children being forcibly removed from their parents who were then charged with child abuse.
According to Wikipedia, as to the distribution of this condition,
> The birthmark is prevalent among East, South, Southeast, North and Central Asian peoples, Indigenous Oceanians (chiefly Micronesians and Polynesians), certain populations in Africa, Amerindians, non-European Latin Americans and Caribbeans of mixed-race descent.
So you can see how, in a Western European nation, even if no-one is being biased in the sense of "hating foreigners", the false accusations would cluster in "non-indigenous" populations, for want of a better word (I originally had "immigrants" then realised that isn't the correct split I'm looking for.). Personally I believe there is no defense for doctors, courts and social workers not knowing about this and checking for it before making any accusations.
This doesn't seem to apply to Romanians / Eastern Europeans specifically, unless they have partly Asian ancestry, but it does show that there are conditions that can be mistaken for abuse that appear in some cultures more than others.
According to Wikipedia, as to the distribution of this condition,
> The birthmark is prevalent among East, South, Southeast, North and Central Asian peoples, Indigenous Oceanians (chiefly Micronesians and Polynesians), certain populations in Africa, Amerindians, non-European Latin Americans and Caribbeans of mixed-race descent.
So you can see how, in a Western European nation, even if no-one is being biased in the sense of "hating foreigners", the false accusations would cluster in "non-indigenous" populations, for want of a better word (I originally had "immigrants" then realised that isn't the correct split I'm looking for.). Personally I believe there is no defense for doctors, courts and social workers not knowing about this and checking for it before making any accusations.
This doesn't seem to apply to Romanians / Eastern Europeans specifically, unless they have partly Asian ancestry, but it does show that there are conditions that can be mistaken for abuse that appear in some cultures more than others.
Damn that hits home. I’ve got a blue spot birthmark that was seen at elementary school which then led to child services showing up at home. This happened in the US and everyone involved was “non Indigenous.”
Sorry to hear that happened to you - and I realise that "indigenous" in the U.S. means the opposite to some of Europe, sorry!
I'm guessing if some kind of Commanche social worker turned up to look at a case of blue spot, they'd go "Yeah that's a birthmark, about half our children have it, our nation even has legends about it. Have a nice day!".
I'm guessing if some kind of Commanche social worker turned up to look at a case of blue spot, they'd go "Yeah that's a birthmark, about half our children have it, our nation even has legends about it. Have a nice day!".
We detached this subthread from https://news.ycombinator.com/item?id=37670664.
This article reminded me of another local story about a doctor who provides assessment beyond the knee jerk child protection industrial complex -
https://www.seattletimes.com/seattle-news/child-abuse-or-med...
This also reminds me a lot of the indoctrination we went through at the hospital when my daughter was born.
Despite being a high risk pregnancy we were railroaded into a natural birth. After nearly 24 hours of horrific labor she spiked an extremely high fever and they had to do a c-section, making us feel like failures. They found that our daughter wouldn’t have made it otherwise.
We were castigated because my wife took medicines that entered her milk and were made to feel like failures for considering not breast feeding. She had to pump milk at five AM before she took any medicine to minimize the exposure to the extremely toxic medicine that would be present in her milk. She didn’t produce enough milk and we were at wits end. The nurses and doctors at the hospital were unhelpful and treated us like abusers. When we went to our local pediatrician he laughed and said entire generations were raised on formula and to stop killing ourselves. It was the best advice we were ever given.
Likewise my daughter couldn’t sleep on her back. She wailed every night. I read everything I could find on SIDS and I realized the correlation for back sleeping was very weak - almost statistically irrelevant - and even then the prevalence of SIDS was very low. Yet I knew for 100% my daughter wasn’t sleeping. I knew if I told anyone I would be lectured, and I worried might even be reported. The after nearly a week of not sleeping I flipped her over one night with my heart pounding. She fell asleep immediately. She didn’t die.
She’s nine now and an incredible athlete and has a sharp and brilliant mind. None of the doomsday stuff occurred. No autism, no weak immune system, no weight problems, intellectual deficiency, or all the other warnings we were given about c-section, formula, or belly sleeping. Over the years I continued to read the research and there’s basically nothing compelling about any of this advice, at least not at the level of stridency parents experience.
https://www.seattletimes.com/seattle-news/child-abuse-or-med...
This also reminds me a lot of the indoctrination we went through at the hospital when my daughter was born.
Despite being a high risk pregnancy we were railroaded into a natural birth. After nearly 24 hours of horrific labor she spiked an extremely high fever and they had to do a c-section, making us feel like failures. They found that our daughter wouldn’t have made it otherwise.
We were castigated because my wife took medicines that entered her milk and were made to feel like failures for considering not breast feeding. She had to pump milk at five AM before she took any medicine to minimize the exposure to the extremely toxic medicine that would be present in her milk. She didn’t produce enough milk and we were at wits end. The nurses and doctors at the hospital were unhelpful and treated us like abusers. When we went to our local pediatrician he laughed and said entire generations were raised on formula and to stop killing ourselves. It was the best advice we were ever given.
Likewise my daughter couldn’t sleep on her back. She wailed every night. I read everything I could find on SIDS and I realized the correlation for back sleeping was very weak - almost statistically irrelevant - and even then the prevalence of SIDS was very low. Yet I knew for 100% my daughter wasn’t sleeping. I knew if I told anyone I would be lectured, and I worried might even be reported. The after nearly a week of not sleeping I flipped her over one night with my heart pounding. She fell asleep immediately. She didn’t die.
She’s nine now and an incredible athlete and has a sharp and brilliant mind. None of the doomsday stuff occurred. No autism, no weak immune system, no weight problems, intellectual deficiency, or all the other warnings we were given about c-section, formula, or belly sleeping. Over the years I continued to read the research and there’s basically nothing compelling about any of this advice, at least not at the level of stridency parents experience.
I didn't know that about sids. What a bullshit diagnosis.
Our children mostly slept tummy down on mum's chest, skin-to-skin, because that reduced sids chance (and we were terrified). But like yours, they couldn't sleep tummy up
AIUI tummy down on a (wakeful) person is generally not a concern nor what the "back is best" crowd is referring to
Obviously a parent who is spending nearly all their time with a newborn knows them best and is likely able to make the best judgement about what works for the child, but the purpose of the advice is to avoid a class of scenario that occur most often. due to issues that are very difficult to detect and often go completely undiagnosed, as they pertain to early development and often improve naturally over time.
The technical report by AAP the other year does an excellent job of presenting the current evidence in an as objective way as possible, I highly recommend it:
https://publications.aap.org/pediatrics/article/150/1/e20220...
You will note that efforts are being made to disentangle diagnoses from the broad SIDS label and that while SIDS cases are trending downwards, it's likely due to both proper classification and education.
The point of preventative measures is to avoid the issue entirely. Sure, tummy sleeping might not be a problem for you (or maybe it was and you just got lucky!) but by generally recommending back sleeping, a class of issues is avoided.
So all in all, I really don't see this as bullshit at all. Caveat that you gotta do what you gotta do, but I'd rather this advice persist than not. We should hope that no one ever has to endure the loss of a child.
Obviously a parent who is spending nearly all their time with a newborn knows them best and is likely able to make the best judgement about what works for the child, but the purpose of the advice is to avoid a class of scenario that occur most often. due to issues that are very difficult to detect and often go completely undiagnosed, as they pertain to early development and often improve naturally over time.
The technical report by AAP the other year does an excellent job of presenting the current evidence in an as objective way as possible, I highly recommend it:
https://publications.aap.org/pediatrics/article/150/1/e20220...
You will note that efforts are being made to disentangle diagnoses from the broad SIDS label and that while SIDS cases are trending downwards, it's likely due to both proper classification and education.
The point of preventative measures is to avoid the issue entirely. Sure, tummy sleeping might not be a problem for you (or maybe it was and you just got lucky!) but by generally recommending back sleeping, a class of issues is avoided.
So all in all, I really don't see this as bullshit at all. Caveat that you gotta do what you gotta do, but I'd rather this advice persist than not. We should hope that no one ever has to endure the loss of a child.
Even in reading that despite the hyperbolic phrasing I find it unconvincing. We are talking about something that happens to less than 0.04% of babies. The odds ratio quoted is 2 - so for belly sleeping it’s 0.08%. They give hyperbolic advice (it’s critical they sleep supine every time they sleep, etc), and while I don’t dismiss an observed odds ratio in a single study of 2, I also hold that it’s not critical in the least. What’s critical is sleep, milk, love, and intimate closeness. The energy spent on back sleeping would be better applied to emphasizing the need for intimacy as failure to thrive is much more likely than sids.
And people wonder why the fertility rate is falling.
There is a problem with responsibility. Do you want to never let a perp go (i.e. jail innocent people in order to catch every guilty person) versus let some baddies slip through the net while not imprisoning innocent people. My own life found itself on the nexus, where I lost loved ones with a false accusation, but wasn't charged for it from (obvious) lack of evidence. Although the legal system worked somewhat, it was too late for me and my loved ones. The liars got away with it, and mission accomplished in removing me from the family.
Okay, what happened? You can't leave these half stories here, lol
> Do you want to never let a perp go (i.e. jail innocent people in order to catch every guilty person) versus let some baddies slip through the net while not imprisoning innocent people
Isn't the latter the official standard most places? Innocent until proven guilty. It's just not really a dilemma if you ask me. If you have authority to do something based on some event, then you have to prove that event happened.
Isn't the latter the official standard most places? Innocent until proven guilty. It's just not really a dilemma if you ask me. If you have authority to do something based on some event, then you have to prove that event happened.
Here in Sweden I had to watch a video warning against baby shaking when my wife was pregnant with my first child. After seeing this horrible video, I waited a few hours to tell my wife that this entire thing was total bunk, and we've known it's been bunk for many years.
Here in Sweden this child abduction idiocy is upheld by three doctors who all refer to each other as the experts proving baby shaking is real. It's a disgrace.
Here in Sweden this child abduction idiocy is upheld by three doctors who all refer to each other as the experts proving baby shaking is real. It's a disgrace.
I've been made to watch a similar video here in The Netherlands. It's not bunk though. Violently shaking a baby will lead to trauma which can cause death. What this book is about is that there are other causes that can lead to the same symptoms. The video is right. Shaking a baby leads to AHT. But the reverse isn't. AHT does not mean that the baby has been shaken. There are many other causes for AHT.
Didn't the article state that is actually unlikely it leads to AHT?
I think the article says that shaking a baby will give you lots of different symptoms, including bruises etc. And you can't really get AHT from shaking without also getting bruises etc.
That means if you see 'AHT' without bruises (etc) it was probably not actual shaking.
That means if you see 'AHT' without bruises (etc) it was probably not actual shaking.
Yeah, it's hard to say for sure what kind of injuries you'll get from violent shaking, as we obviously can't reproduce it on actual babies, and there are so few well-described cases. Studies have been made on animal models, showing a constellation of traumatic injuries, but no clear, obvious, and reproducible pattern so far. Strikingly, the isolated "triad" of subdural and retinal hemorrhage with brain edema hasn't really been reproduced in any animal model so far [1].
Anyway, we don't need this level of scientific detail and knowledge to say that no one should ever shake a baby. All brutal gestures are obviously harmful and dangerous.
[1] https://link.springer.com/article/10.1007/s00381-022-05577-6
Anyway, we don't need this level of scientific detail and knowledge to say that no one should ever shake a baby. All brutal gestures are obviously harmful and dangerous.
[1] https://link.springer.com/article/10.1007/s00381-022-05577-6
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I mean.. sure. But if you shoot a baby it will also harmed. Or stomp on it, or set fire to it.
So, why is this video specifically about shaking? Because of this very specific and narrow conspiracy theory that takes children away from their parents.
So, why is this video specifically about shaking? Because of this very specific and narrow conspiracy theory that takes children away from their parents.
When I was getting ready to turn dad for the first time, I read a few books on pregnancy, children and parenting. My trust on medicine dropped substantially when I discovered that doctors have poor notion of statistics, so they take for granted improper studies results.
I remember one classic one is the "no coffee when pregnant", the study says this causes problems, the test was performed on rats and by feeding them coffee in the amount of 3/4 of their body weight. We can agree that with this amount, it's reasonable it could cause problems. Very different from one cup of coffee though.
The other study that was done is about Amniocentesis, this one is more interesting the chance of miscarriage is considered 0.1% but this was before the operation was performed with a live ultrasound to look at the needle while performing it, which (probably) makes a big difference. Before, doctors performed an ultrasound and then went in blind.
There was also a serious bias towards a certain type of population. But of course doctors don't bring this up at all.
Last thing is sids, it's a terrible type of diagnosis that pushes parents against the instinct of sleeping with their children, even though this is commonly done in non-western cultures and can save a lot of pain to the parents and give a lot of security to the child. Do your research though, medical community reports risks and I'm no doctor, just a dad who read a few books.
Glad my children are healthy. Every time I read about some illness for children I feel an incredible weight on my heart
I remember one classic one is the "no coffee when pregnant", the study says this causes problems, the test was performed on rats and by feeding them coffee in the amount of 3/4 of their body weight. We can agree that with this amount, it's reasonable it could cause problems. Very different from one cup of coffee though.
The other study that was done is about Amniocentesis, this one is more interesting the chance of miscarriage is considered 0.1% but this was before the operation was performed with a live ultrasound to look at the needle while performing it, which (probably) makes a big difference. Before, doctors performed an ultrasound and then went in blind.
There was also a serious bias towards a certain type of population. But of course doctors don't bring this up at all.
Last thing is sids, it's a terrible type of diagnosis that pushes parents against the instinct of sleeping with their children, even though this is commonly done in non-western cultures and can save a lot of pain to the parents and give a lot of security to the child. Do your research though, medical community reports risks and I'm no doctor, just a dad who read a few books.
Glad my children are healthy. Every time I read about some illness for children I feel an incredible weight on my heart
[deleted]
Has SIDS been linked to co-sleeping? I thought the risks of co-sleeping were more around accidentally rolling on or suffocating the baby.
That is also what we were told after birth.
My personal opinion is that the advantages of co-sleeping far outweigh the risks. It is much less stressful for both the parents and the baby. My wife simply slept topless, turned (half-sleeping) to our baby whenever it was crying, and immediately fell back asleep.
My personal opinion is that the advantages of co-sleeping far outweigh the risks. It is much less stressful for both the parents and the baby. My wife simply slept topless, turned (half-sleeping) to our baby whenever it was crying, and immediately fell back asleep.
works for dad too
Yeah, we coslept as well. We don't drink or do drugs, so we weren't in that risk group. Neither of us has been the type to fall out of bed (which would indicate lack of physical awareness during sleep). We put the baby between us, so she wouldn't roll off. We kept the room warm so there wouldn't be a risk of heavy quilts suffocating her.
And it was fantastic. No crying, no separation anxiety. Feeding was easy, so we all slept well.
And it was fantastic. No crying, no separation anxiety. Feeding was easy, so we all slept well.
Same experience. We made sure the room temperature was warm enough to not use blankets (no risk of suffocation), but not too hot for the baby.
We went from sleeping 2 hours per WEEK (I cannot describe to you how it felt), to getting 8 hours on the first co-sleep.
Never looked back.
We went from sleeping 2 hours per WEEK (I cannot describe to you how it felt), to getting 8 hours on the first co-sleep.
Never looked back.
Newer research shows a good chunk of SIDS cases actually _are_ likely suffocation from various causes.
That’s why the SIDS reduction measures are mostly ‘sleep on the back, in an empty crib, with nothing soft around’.
But it’s much easier to tell a grieving parent that there’s nothing they could have done, than that their baby got unlucky and suffocated to death.
That’s why the SIDS reduction measures are mostly ‘sleep on the back, in an empty crib, with nothing soft around’.
But it’s much easier to tell a grieving parent that there’s nothing they could have done, than that their baby got unlucky and suffocated to death.
You are speaking facts, but it runs into the medical problem of “overdiagnosis” where the treatment can be worse than the disease.
Swaddling the baby and forcing it to sleep on its back, may have a tiny statistical benefit for SIDS, but it causes tons of problems at a time when people are taxed to the limit of their abilities.
We could reduce the incident of breast cancer by removing every woman’s breasts, but that would be an improper risk assessment.
The biggest factor linked to SIDS is poverty, and after that it’s stuff like going to bed while under the influence of drugs and smoking.
Swaddling the baby and forcing it to sleep on its back, may have a tiny statistical benefit for SIDS, but it causes tons of problems at a time when people are taxed to the limit of their abilities.
We could reduce the incident of breast cancer by removing every woman’s breasts, but that would be an improper risk assessment.
The biggest factor linked to SIDS is poverty, and after that it’s stuff like going to bed while under the influence of drugs and smoking.
And as soon as your baby can turn itself you have no more influence in which position it sleeps anyway.
Well, usually the real risks for co-sleep are in the first month. There are still after, but drops heavily. Past 6 months (or was it 1 year?) I think everything goes off a cliff, you can sleep however you want
The problem is that sids is vague, sometimes is used to protect the parents from murder accusation because overly tired
> I remember one classic one is the "no coffee when pregnant", the study says this causes problems, the test was performed on rats and by feeding them coffee in the amount of 3/4 of their body weight. We can agree that with this amount, it's reasonable it could cause problems. Very different from one cup of coffee though.
Honestly I don't know which study you're talking about, and I'm not trying to question what you're saying (such studies indeed often use exaggerated amounts because it's more likely to show effects, but it can skew the results of course) but I just found it interesting that depending on what "feeding them coffee in the amount of 3/4 of their body weight" means, well over a pregnancy it's easy to consume 3/4 of one's body weight in coffee.
It means about 150 mL coffee per day for a woman weighing 55 kg, over 9 months.
About SIDS and sleeping with the children in the same bed, if I remember correctly (it's been some time since I had to read about this) the very large majority of cases happened with parents who either smoke or are obese. I think I couldn't find precise stats just for non-smoking, non-obese parents but it seems like SIDS basically didn't happen in this case when co-sleeping. It also almost never happens with immigrant parents for some reason (even though they are statistically more likely to practice co-sleeping, here in Europe).
Honestly I don't know which study you're talking about, and I'm not trying to question what you're saying (such studies indeed often use exaggerated amounts because it's more likely to show effects, but it can skew the results of course) but I just found it interesting that depending on what "feeding them coffee in the amount of 3/4 of their body weight" means, well over a pregnancy it's easy to consume 3/4 of one's body weight in coffee.
It means about 150 mL coffee per day for a woman weighing 55 kg, over 9 months.
About SIDS and sleeping with the children in the same bed, if I remember correctly (it's been some time since I had to read about this) the very large majority of cases happened with parents who either smoke or are obese. I think I couldn't find precise stats just for non-smoking, non-obese parents but it seems like SIDS basically didn't happen in this case when co-sleeping. It also almost never happens with immigrant parents for some reason (even though they are statistically more likely to practice co-sleeping, here in Europe).
SIDS has all manner of interesting and unexpected demographic correlations. I’m not convinced anyone knows what to make of them.
That’s the problem with anything that is defined by the symptoms, rather than the cause. As soon as you find definitive evidence of what causes a subset of SIDS, it’s no longer really SIDS but “improper bed safety” or “undiagnosed genetic condition”.
The covariates are awkward and because they correspond so strongly with parental traits, the possibility exists that the kids are dying because of dysfunctional parental behaviors specifically.
I'm a light sleeper and I feel like I have an awareness of everything nearby when I'm asleep (like I used to fall asleep with an open laptop in bed during college without knocking into it). I have a feeling co-sleeping wouldn't be an issue for me, but with all the dire warnings I'm afraid to risk it.
> I'm a light sleeper and I feel like I have an awareness of everything nearby when I'm asleep
You absolutely don't have awareness of everything nearby when you're asleep. You are inherently incapable of even determining this because you're sleeping. I'm sure you react to some stimuli but that doesn't mean you can expect yourself to react to every potential stimuli that you would want to.
You absolutely don't have awareness of everything nearby when you're asleep. You are inherently incapable of even determining this because you're sleeping. I'm sure you react to some stimuli but that doesn't mean you can expect yourself to react to every potential stimuli that you would want to.
A medical professional explained to me that your body gets accustomed to the body presence of the baby and unconsciously react to it: the body is aware. Now of course mother nature experiments with everything, so there are for sure people who don't get this "awareness" and as such, could be dangerous.
My wife did exactly that because she is a light sleeper. She actually slept near the center of the bed with the baby on her chest, so she could perceive any movement.
I got used to perceive baby movements too.
I would obviously suggest to be very honest with yourself, but if you are a light sleeper and don't roll (we didn't), the most you have to be careful of is heat. Otherwise, enjoy the cuddly night
I would obviously suggest to be very honest with yourself, but if you are a light sleeper and don't roll (we didn't), the most you have to be careful of is heat. Otherwise, enjoy the cuddly night
It was intended in a day, not over the course of the pregnancy
I think it's both funny and sad that you're doing the exact same thing as the "bad" doctors in TFA and then are on here commenting about it. A quick search on Google Scholar for "caffeine pregnancy" reveals a number of studies that show a non-trivial link in humans to increased miscarriage chances, at levels of consumption that realistically occur with heavy coffee drinkers. I.e. your conclusion is not so clear-cut and is based on one (admittedly bad science) thing you read. Example [1][2]
[1] https://www.sciencedirect.com/science/article/abs/pii/S00029...
[2] https://academic.oup.com/nutritionreviews/article/54/7/203/1...
[1] https://www.sciencedirect.com/science/article/abs/pii/S00029...
[2] https://academic.oup.com/nutritionreviews/article/54/7/203/1...
From your second link:
>The results of this literature review suggest that heavy caffeine use (≥ 300 mg per day) during pregnancy is associated with small reductions in infant birth weight that may be especially detrimental to premature or low-birth-weight infants. Some researchers also document an increased risk of spontaneous abortion associated with caffeine consumption prior to and during pregnancy. However, overwhelming evidence indicates that caffeine is not a human teratogen, and that caffeine appears to have no effect on preterm labor and delivery.
>The results of this literature review suggest that heavy caffeine use (≥ 300 mg per day) during pregnancy is associated with small reductions in infant birth weight that may be especially detrimental to premature or low-birth-weight infants. Some researchers also document an increased risk of spontaneous abortion associated with caffeine consumption prior to and during pregnancy. However, overwhelming evidence indicates that caffeine is not a human teratogen, and that caffeine appears to have no effect on preterm labor and delivery.
The problem that became very salient to me dealing with miscarriage is that women who have healthy pregnancies are also more likely to have problems with morning sickness, and are more likely to avoid things like coffee that are likely to make them feel even more nauseous. Women who have troubled pregnancies that are more likely to end in miscarriage are less likely to feel nauseous and therefore continue to drink and eat things as before.
So it's possible caffeine consumption is a sign of a troubled pregnancy rather than a cause of it. I'm sure there's a point where caffeine becomes problematic but that could be said of a lot of things.
There's a paper in NEJM or JAMA that pointed to this as a likely explanation but it's been a few years and don't have time to look for it now. I think they were looking at timing of caffeine consumption and nausea symptoms?
So it's possible caffeine consumption is a sign of a troubled pregnancy rather than a cause of it. I'm sure there's a point where caffeine becomes problematic but that could be said of a lot of things.
There's a paper in NEJM or JAMA that pointed to this as a likely explanation but it's been a few years and don't have time to look for it now. I think they were looking at timing of caffeine consumption and nausea symptoms?
I don't think that's fair toward me: the bad doctors never told me "do your research, form your opinion". They were always clear cut, they looked up on us for sleeping with our children and they "checked" the breastfeeding checkmark at the hospital even if my wife lamented pain during it and turned out my daughter had a really bad lip/tongue tie that took a month to be solved (with surgery).
Notice that medical personnel even told her "you have to endure it, it's normal", as her breasts were cracking and she couldn't breastfeed anymore (had to pump).
I explicitly said, do your research at the end of the message.
P. S. The book might have been one of the following, I can't remember:
Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong--and What You Really Need to Know (The ParentData Series Book 1) from Emily Oyster
What to expect when you are expecting
I think it's the first one. I read many at the same time, so it's hard to remember which one had the information.
I explicitly said, do your research at the end of the message.
P. S. The book might have been one of the following, I can't remember:
Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong--and What You Really Need to Know (The ParentData Series Book 1) from Emily Oyster
What to expect when you are expecting
I think it's the first one. I read many at the same time, so it's hard to remember which one had the information.
You should see how the second hand smoke studies upon which all other second hand smoke studies were based were done - very similar methodology - cotton swabs were saturated with combustion residues from hundreds of cigarettes, making them into tarry masses, which were then applied to 100% of the bodies of infant rats, every day for several weeks - and they were then observed for developmental abnormalities. The discussion then explicitly states that this should not be taken as a human analogue, as the rats were seen to lick the residue off their bodies, thus consuming all of it, and that further research would be needed.
Further research was of course done - on rats - with much the same methodology.
Medicine is really prone to falling for this sort of thing - and it’s honestly no great shock, recalling the calibre of people at school who went on to become doctors. I studied physics, for Christ’s sake, and knew more about metabolic pathways than third year med students who I would help cram.
Further research was of course done - on rats - with much the same methodology.
Medicine is really prone to falling for this sort of thing - and it’s honestly no great shock, recalling the calibre of people at school who went on to become doctors. I studied physics, for Christ’s sake, and knew more about metabolic pathways than third year med students who I would help cram.
When my wife was pregnant 15 years ago, I did a lot of similar reading about various things. One was home vs hospital birth, and at that time at least, there was a strong vibe of "home birth is best birth" going around. Many people linked to a study (which I can no longer find!) in Norway maybe? It was a big study that "showed" that home birth was safer than hospital birth. However, if you dug into the study, you'd find one particular interesting nugget: if any of the home birth participants experience any negative medical event, even during delivery, they were removed from the study. It was preposterous. In the end, all the study said was, "home births that happened without incident were safer than hospital births", or, in other words, "safe births are safer than non-safe births".
The home birth obsession makes me so angry. My wife had a really bad postpartum hemorrhage when our daughter was born. Thankfully, we were in the hospital, so the obstetrics team was able to stop the bleeding and get her stabilized. She'd have likely died if it was a home birth.
What's even crazier is that in most of the US, midwives only need a high school diploma and a midwifery certificate - or in many states, no education is required at all as the title "midwife" is not protected. The vast majority of the rest of the developed world requires midwives to either be professional nurses with additional training in midwifery, or to have a special four year midwifery degree (eg: here in Canada, midwifery is a bachelor's degree). Many parents in the US who opt for a home birth are likely unaware of how underqualified many American midwives are compared to their international counterparts to respond to an obstetric emergency.
What's even crazier is that in most of the US, midwives only need a high school diploma and a midwifery certificate - or in many states, no education is required at all as the title "midwife" is not protected. The vast majority of the rest of the developed world requires midwives to either be professional nurses with additional training in midwifery, or to have a special four year midwifery degree (eg: here in Canada, midwifery is a bachelor's degree). Many parents in the US who opt for a home birth are likely unaware of how underqualified many American midwives are compared to their international counterparts to respond to an obstetric emergency.
I'm glad we were given an option but only based on comfort level, not because of better safety. We wanted the hospital, in case you need a rushed c section.
concordDance(1)
No mention of the Texas death row inmate’s fate to be decided by SCOTUS in mere days.
https://www.theguardian.com/world/2023/sep/24/texas-death-ro...
https://www.theguardian.com/world/2023/sep/24/texas-death-ro...
"Shake it baby"
Content aside (which is both thought provoking and incredibly alarming) I’m fascinated by the author’s commitment to deeply understanding a system and the factors at play within that system. There’s something inspiring about relentless truth seeking, to the point of obsession, with some extraordinary level of meticulousness. Particularly when it challenges conventional wisdom. This is a slippery slope as it can quickly nosedive into junk science and contrarianism, despite best intentions, but when it’s done well, it’s really something.
Probably a faux pas here these days, but reminds me of Elon Musk’s First Principles.
Probably a faux pas here these days, but reminds me of Elon Musk’s First Principles.
When you are a parent it comes naturally. Because your child becomes your #1 time and energy investment, all other investments of time and energy seem trivial. Many parents of autistic children have made similar intellectual commitments. I'd go so far to say that it's commonplace in that community. All the more reason children should not be separated from their parents for flimsy scientific assertions by experts.
> has been taught as though it was a proven fact to generations of physicians all over the world.
Welcome to healthcare. For many conditions having a medical degree is straight up deleterious to a doctor's ability to accurately diagnose and treat a condition.
Welcome to healthcare. For many conditions having a medical degree is straight up deleterious to a doctor's ability to accurately diagnose and treat a condition.
“ Let there be no misunderstanding on the point that shaking is an absolutely real and dramatic form of child abuse. Inflicted head trauma is a devastating condition and a definite cause of traumatic brain injuries, including intracranial hemorrhage. Many medical determinations of SBS/AHT are made on children who have effectively been victims of violent intentional trauma. Prevention efforts against all forms of child abuse are totally warranted.”
A lot of the comments here are missing this key statement. While there can be medical explanations for things that look like SBS, it’s exceedingly rare
A lot of the comments here are missing this key statement. While there can be medical explanations for things that look like SBS, it’s exceedingly rare
I missed this part. Where does the author mention that other medical explanations (other than SBS) are exceedingly rare compared to the baby having indeed been shaken?
I said that blaming medical reasons for SBS is exceedingly rare. As indicated, trauma due to shaking is usually the case. Medical reasons can't be ruled out. That's the crux of the issue.
You're assuming that medical science is capable of providing an explanation in every case, when the whole point of this article is to say that these symptoms are insufficient to diagnose SBS. The author is saying if we have no alternative medical explanations, then we have no medical explanation at all. In order to diagnose SBS, the author suggests that you need additional evidence suggesting trauma such as bruising, broken bones, etc. Indeed, that seems to be what the SBS lobby is now saying as well, they just haven't communicated that to front-line providers.
"You're assuming that medical science is capable of providing an explanation in every case, when the whole point of this article is to say that these symptoms are insufficient to diagnose SBS"
I do not disagree with you. I just caution as does the author that you can't rule out criminality either.
I do not disagree with you. I just caution as does the author that you can't rule out criminality either.
> In order to diagnose SBS, the author suggests that you need additional evidence suggesting trauma such as bruising, broken bones, etc. Indeed, that seems to be what the SBS lobby is now saying as well, they just haven't communicated that to front-line providers.
That's exactly it.
That's exactly it.
You must have skimmed the article because it said over and over that it was basically impossible to definitively identify that a baby was shaken. It's a diagnosis they use when they're not sure.
It does not say that.
I think that is a reasonable gloss on the following:
> And yet, although subdural and retinal hemorrhage may be caused by non-accidental trauma, especially when impact is involved, they simply are not specific for it: indeed, it has been demonstrated that a wide range of accidental events and medical conditions are plausible alternative causes. Particularly fragile infants may sustain severe head injuries following minor household falls. Others may suffer from genetic conditions, metabolic disorders, blood clotting abnormalities, or infections.
> But in practice, extremely few medical conditions are checked for and “excluded” before concluding a diagnosis of abuse – the great majority are not checked for at all. Very often, abuse is diagnosed “by default”, because no known alternative explanation was found (or even actively sought). This is extremely dangerous, as it seems to indicate that no further medical discovery need ever be made in the future.
> Overall, the clinical literature supporting the shaking hypothesis suffers from a number of severe methodological shortcomings. The main issue is circular reasoning. It is only in a small minority of “shaken baby” cases that actual shaking has been observed by independent witnesses, videotaped, or spontaneously confessed before police interrogation. Far more often, shaking is “inferred” after the observation of subdural and retinal hemorrhage in infants who are brought to the hospital by parents or caregivers. Physicians interpret these types of bleeding as markers of violent trauma. When asked about these findings, parents and caregivers generally do not provide “acceptable explanations” – but the only “acceptable explanations” today apart from shaking are multistory falls and high speed motor vehicle accidents. This being so, it is considered that parents and caregivers must be lying when they report non-traumatic events such as a sudden collapse, an unexplained respiratory arrest, or a minor fall – even though this happens in case after case
> And yet, although subdural and retinal hemorrhage may be caused by non-accidental trauma, especially when impact is involved, they simply are not specific for it: indeed, it has been demonstrated that a wide range of accidental events and medical conditions are plausible alternative causes. Particularly fragile infants may sustain severe head injuries following minor household falls. Others may suffer from genetic conditions, metabolic disorders, blood clotting abnormalities, or infections.
> But in practice, extremely few medical conditions are checked for and “excluded” before concluding a diagnosis of abuse – the great majority are not checked for at all. Very often, abuse is diagnosed “by default”, because no known alternative explanation was found (or even actively sought). This is extremely dangerous, as it seems to indicate that no further medical discovery need ever be made in the future.
> Overall, the clinical literature supporting the shaking hypothesis suffers from a number of severe methodological shortcomings. The main issue is circular reasoning. It is only in a small minority of “shaken baby” cases that actual shaking has been observed by independent witnesses, videotaped, or spontaneously confessed before police interrogation. Far more often, shaking is “inferred” after the observation of subdural and retinal hemorrhage in infants who are brought to the hospital by parents or caregivers. Physicians interpret these types of bleeding as markers of violent trauma. When asked about these findings, parents and caregivers generally do not provide “acceptable explanations” – but the only “acceptable explanations” today apart from shaking are multistory falls and high speed motor vehicle accidents. This being so, it is considered that parents and caregivers must be lying when they report non-traumatic events such as a sudden collapse, an unexplained respiratory arrest, or a minor fall – even though this happens in case after case
> A lot of the comments here are missing this key statement. While there can be medical explanations for things that look like SBS, it’s exceedingly rare
The article seems to be dedicated to precisely the opposite conclusion. The author's contention would seem to be that in cases of shaking there is other trauma that doesn't fit the "shaken baby syndrome" theory.
The article seems to be dedicated to precisely the opposite conclusion. The author's contention would seem to be that in cases of shaking there is other trauma that doesn't fit the "shaken baby syndrome" theory.
This made me think of Handmaid's Tale. Scary to know how easily we will trade away liberty to an illusion of safety for the sake of the children.
I would say it's for the sake of safety. Children may be the topic here, but it applies much more widely to safety in general.
Imagine your child taken away from you just on the basis of some assumptions. This makes my blood boil. I have never had murderous thoughts even when I have been wronged really bad. I just forget and move on with life. But I don't think I can do that if my child is taken from me for something I didn't do. I'll definitely go postal. Land of "Freedom".
Not just a US thing. Europe is even more prevalent.
There are additional factors to take into account beyond simply labeling it as a rare condition. This includes the food or baby formula itself and the quality of water used. Given the frequency of formula recalls, there's a potential risk of obtaining a defective batch that could harm the baby.
>> how many people are in jail or lost their kids due to something that didn't actually happen.
Thousands upon thousands. By some estimates upwards of 10% of incarcerated individuals. The situation is just accepted. The general consensus is always that locking up too many people is better than than too few. It is on defense attorneys to check on the system.
Thousands upon thousands. By some estimates upwards of 10% of incarcerated individuals. The situation is just accepted. The general consensus is always that locking up too many people is better than than too few. It is on defense attorneys to check on the system.
Are you saying that 10% of incarcerated individuals are innocent (which I do not find an unrealistic number), or are you saying that 10% of incarcerated individuals are wrongly in prison for crimes against their children?
10% of people are innocent of the crimes for which they have been convicted. Whole innocence is another thing. But yes, there are a huge number of people wrongfully convicted. Things like DNA evidence is showing us that a great many mistakes are made. For those crimes convicted without things like DNA evidence, one must presume an equal rate of wrongful convictions. Courts are not FAA crash investigations, or any other sort of investigation. They are not about truth. They are about rights and laws. There is no right to a truthful outcome, only a lawful one.
I agree, but I think OP referred to crimes involving violence against their own children.
Yes. I suggest everyone to look into the fantastic work done by the Innocence Project [1] and the Innocence Network [2].
Also, the Innocence Files is a must-watch on Netflix [3].
[1] https://innocenceproject.org/
[2] https://innocencenetwork.org/
[3] https://www.netflix.com/title/80214563
Also, the Innocence Files is a must-watch on Netflix [3].
[1] https://innocenceproject.org/
[2] https://innocencenetwork.org/
[3] https://www.netflix.com/title/80214563
Not everywhere is the US.
This isn’t even true for the US. In the US we believe it’s better to let a criminal run free than deprive an innocent of their liberty.
> In the US we believe...
Sadly, that varies enormously with the social status and wealth of the accused.
Sadly, that varies enormously with the social status and wealth of the accused.
"It is better to let 100 criminals go free than to imprison 1 innocent man." — Benjamin Franklin
A quote I have never heard from anyone running to be a DA, judge, sheriff, magistrate, or any other participant beyond defense attorneys. Such sayings do not reflect reality.
I've seen police officers say the exact opposite: "It's better to imprison 100 innocent people than risking letting 1 criminal go free and harm children".
Sigh.
Sigh.
That seems to be the sentiment based on our founding origins or if you talk to an individual, but the fact is that we imprison more people per capita than anyone else. It's hard for me to believe that all of the criminals just live in the USA.
About 70% of convicts in prison are there for violent offenses and should be there. The remaining 30% is mainly drug and property crimes.
Now it’s important to understand what is meant when people reference incarceration numbers. A lot of these are people awaiting trial on charges they will be found guilty of but receive minimal sentences via plea bargaining. Another large portion are illegal immigrants that are awaiting processing for either integration or deportation.
So if you erase those 2 groups it’s mainly violent people. There’s an abundance of violent people in the USA compared to Western Europe and certainly Asia I’d say.
Now it’s important to understand what is meant when people reference incarceration numbers. A lot of these are people awaiting trial on charges they will be found guilty of but receive minimal sentences via plea bargaining. Another large portion are illegal immigrants that are awaiting processing for either integration or deportation.
So if you erase those 2 groups it’s mainly violent people. There’s an abundance of violent people in the USA compared to Western Europe and certainly Asia I’d say.
Imagine when it’s not just locking up, but spills over to state homicide: https://amp.theguardian.com/world/2023/sep/24/texas-death-ro...
We detached this subthread from https://news.ycombinator.com/item?id=37667150.
since everyone else is sharing an anecdote:
When I was 14 or so I fell off my dirt bike and broke my arm, both bones in my forearm.
Went to the hospital. About 5 people asked me how it happened taking about an hour, while I was WRITHING in pain.
Finally, I complained to the right nurse and she got me something for the pain. It was just enough to stop crying, not enough to stop feeling it.
I later found out that the intake nurse was concerned about abuse.
I was dressed head to toe in dirtbike gear. I was a 150lb 14 yr old. my mother was 110 lbs.
They delayed treatment so multiple people, nurses, doctors, and hospital staff could all ask me what happened and compare if I told them the same thing.
When I was 14 or so I fell off my dirt bike and broke my arm, both bones in my forearm.
Went to the hospital. About 5 people asked me how it happened taking about an hour, while I was WRITHING in pain.
Finally, I complained to the right nurse and she got me something for the pain. It was just enough to stop crying, not enough to stop feeling it.
I later found out that the intake nurse was concerned about abuse.
I was dressed head to toe in dirtbike gear. I was a 150lb 14 yr old. my mother was 110 lbs.
They delayed treatment so multiple people, nurses, doctors, and hospital staff could all ask me what happened and compare if I told them the same thing.
THIS. It very often seems as if the medical/social system has "barricaded itself" inside it own ideological/psychiatric obsessions with the idea of child abuse, and is blind to reality. Let alone the actual welfare of the child.
They may delay treatment for reasons other than just asking; my son was in the ER for 4 hours with a significant laceration (it resulted in two layers of over 2 dozen sutures each) before he was given anything as the nurses were not allowed to administer an analgesic (much less pain killers) until a doctor had examined him, and it took 4 hours for the doctor to get to him.
At no point was there any sign of the staff acting like there might be abuse or neglect involved.
At no point was there any sign of the staff acting like there might be abuse or neglect involved.
While I certainly don't agree with delaying your treatment....your size/weight vs your mother's is irrelevant - just because she's who brought you in doesn't mean that she's the only person who could have abused you.
For all they know you've got a father or uncle or whoever that's huge and has anger problems who broke it.
One abusive family member and a partner who's covering for/trying to make up for their behavior (and may be being abused themselves) is a pretty common type of abusive situation.
For all they know you've got a father or uncle or whoever that's huge and has anger problems who broke it.
One abusive family member and a partner who's covering for/trying to make up for their behavior (and may be being abused themselves) is a pretty common type of abusive situation.
There was a infamous case in the UK around SBS:
https://3dc.org.uk/press-release-preliminary-study-of-uk-sha...
Louise Woodward was the nanny involved and the court case was televised. Was huge at the time I remember.
https://3dc.org.uk/press-release-preliminary-study-of-uk-sha...
Louise Woodward was the nanny involved and the court case was televised. Was huge at the time I remember.
Yes, Innocence Project cofounder Barry Scheck was the defense attorney in the Woodward case and he wrote a long foreword to our book about it. It starts like this:
"After a Quarter of a Century, Have Any Lessons Been Learned from the Trial of Louise Woodward?
Twenty-five years ago, the Louise Woodward trial in Boston (the ‘nanny murder case’) thrust shaken baby syndrome (SBS) into headlines across the globe, raising worldwide consciousness about the hypothesis that infants and toddlers could be seriously brain injured, even killed, by violent shaking. Although the case was tried in the early days of SBS prosecutions, the underlying science was fiercely disputed and litigated at trial. A quarter of a century later, although science has advanced, the issues remain just as hotly disputed and poorly understood, and yet parents and caregivers continue to be prosecuted and families torn apart based on the hypothesis."
"After a Quarter of a Century, Have Any Lessons Been Learned from the Trial of Louise Woodward?
Twenty-five years ago, the Louise Woodward trial in Boston (the ‘nanny murder case’) thrust shaken baby syndrome (SBS) into headlines across the globe, raising worldwide consciousness about the hypothesis that infants and toddlers could be seriously brain injured, even killed, by violent shaking. Although the case was tried in the early days of SBS prosecutions, the underlying science was fiercely disputed and litigated at trial. A quarter of a century later, although science has advanced, the issues remain just as hotly disputed and poorly understood, and yet parents and caregivers continue to be prosecuted and families torn apart based on the hypothesis."
> What happened is that during my literature review, I disturbingly realized that what I had been told at the hospital ... was an assertion based on very weak scientific foundations. And yet ... has been taught as though it was a proven fact to generations of physicians all over the world.
This exact thing has happened to me so many times, on so many different medical topics, that it is now my going in assumption that if I review the literature, this is what I'll find. The most flabberghasting case was one in which I was able to determine the standard of care the doctors insisted on was in flat contradiction to the established science in the course of an afternoon. As a mathematician by training, I am used to checking the reasoning behind everything I believe for myself. I can understand not having taken months and months to delve into a deeply technical topic, but when the state of affairs can be determined in an afternoon? I cannot fathom spending a career giving people advice and never having looked that far.
My favorite example of obvious, silly unscientific behavior is the basic set of practices and beliefs surrounding blood pressure. Blood pressure varies a lot, second to second, minute to minute, hour to hour, and day to day, with an astonishing range, for a very long list of reasons both benign and concerning. It is an obvious fact, well known and easy to establish by anyone with a measuring device and a little statistical curiosity. The literature, the instruction books shipped with measuring devices, the procedures followed by doctors and nurses, the procedures they say they should be following, bear all the hallmarks of the behavior of the statistically unsophisticated seeking patterns and meaning in randomness. But my very favorite behavior is the sheer cognitive dissonance. I have had nurses take my blood pressure while varying the circumstance - sitting, lying, this arm, that arm - until they got the answer they wanted, reported it to a doctor, who compared it to a chart with great authority and made a claim about my health over a span of months and years. I have had a five minute conversation with a doctor about the statistical variation of the number and the fact that best practices involve taking many measurements and he opined that it wasn't really valid unless you measured it over twenty four hours... and then said, "anyway..." and proceeded in the next sentence to diagnose me and argue strenuously for a prescription based on a single measurement and no context.
One of the things I find cynically, darkly entertaining is how often the standard advice is, not just random, not just useless, but exactly wrong. The diet they insist on to manage gallstones is known to cause gallstones. The treatment traditionally insisted on for diabetes is known to kill you faster the more exactly you comply. The saline typically used in hospitals, compared to an electrolyte balanced solution, is known to kill patients. They institutionally get saline wrong!
The absolute theatrics and bureaucracy required historically to institute handwashing in hospitals indicates a cultural problem, and the current state of affairs suggests to me that it remains. I am not talking about advancing scientific knowledge here - I am talking about accounting for things that are well known and can be checked with little effort so long as one is not intimidated by basic science. The prospect of professional mathematicians behaving this way is laughable. Everyone knows the discredited results and no one would dream of using them. The prospect of cybersecurity professionals taking years to apply a patch after a security flaw is discovered beggars belief. Yet here are the doctors, insisting with great pomp and authority on easily checkable wrong things, and they have apparently been doing so in many domains, for a very long time. I know there is value in medical advice, and in many situations I seek it, but it is enough to make one want to throw in the towel and consult the aromatherapists and their healing crystals - at least they won't insist on something destructive!
The words "scientific medicine" clearly do not mean what I would think they should mean.
This exact thing has happened to me so many times, on so many different medical topics, that it is now my going in assumption that if I review the literature, this is what I'll find. The most flabberghasting case was one in which I was able to determine the standard of care the doctors insisted on was in flat contradiction to the established science in the course of an afternoon. As a mathematician by training, I am used to checking the reasoning behind everything I believe for myself. I can understand not having taken months and months to delve into a deeply technical topic, but when the state of affairs can be determined in an afternoon? I cannot fathom spending a career giving people advice and never having looked that far.
My favorite example of obvious, silly unscientific behavior is the basic set of practices and beliefs surrounding blood pressure. Blood pressure varies a lot, second to second, minute to minute, hour to hour, and day to day, with an astonishing range, for a very long list of reasons both benign and concerning. It is an obvious fact, well known and easy to establish by anyone with a measuring device and a little statistical curiosity. The literature, the instruction books shipped with measuring devices, the procedures followed by doctors and nurses, the procedures they say they should be following, bear all the hallmarks of the behavior of the statistically unsophisticated seeking patterns and meaning in randomness. But my very favorite behavior is the sheer cognitive dissonance. I have had nurses take my blood pressure while varying the circumstance - sitting, lying, this arm, that arm - until they got the answer they wanted, reported it to a doctor, who compared it to a chart with great authority and made a claim about my health over a span of months and years. I have had a five minute conversation with a doctor about the statistical variation of the number and the fact that best practices involve taking many measurements and he opined that it wasn't really valid unless you measured it over twenty four hours... and then said, "anyway..." and proceeded in the next sentence to diagnose me and argue strenuously for a prescription based on a single measurement and no context.
One of the things I find cynically, darkly entertaining is how often the standard advice is, not just random, not just useless, but exactly wrong. The diet they insist on to manage gallstones is known to cause gallstones. The treatment traditionally insisted on for diabetes is known to kill you faster the more exactly you comply. The saline typically used in hospitals, compared to an electrolyte balanced solution, is known to kill patients. They institutionally get saline wrong!
The absolute theatrics and bureaucracy required historically to institute handwashing in hospitals indicates a cultural problem, and the current state of affairs suggests to me that it remains. I am not talking about advancing scientific knowledge here - I am talking about accounting for things that are well known and can be checked with little effort so long as one is not intimidated by basic science. The prospect of professional mathematicians behaving this way is laughable. Everyone knows the discredited results and no one would dream of using them. The prospect of cybersecurity professionals taking years to apply a patch after a security flaw is discovered beggars belief. Yet here are the doctors, insisting with great pomp and authority on easily checkable wrong things, and they have apparently been doing so in many domains, for a very long time. I know there is value in medical advice, and in many situations I seek it, but it is enough to make one want to throw in the towel and consult the aromatherapists and their healing crystals - at least they won't insist on something destructive!
The words "scientific medicine" clearly do not mean what I would think they should mean.
> The prospect of cybersecurity professionals taking years to apply a patch after a security flaw is discovered beggars belief.
Not just years, but generations in some cases.
Not just years, but generations in some cases.
One particularly aggravating manifestation of the medical industry's inability to be wrong is its tendency to blame patients. It is famous for doing so in the area of obesity. But one rather entertaining incident happened to me: I was in the hospital under observation and (for medical reasons) fasting. They had me on IV saline which, apart from the medication I was getting, was all I took in. After a day or so, I was informed I had developed a potassium deficiency, and given a supplement with the air of someone who needed to fix a bad diet.
My potassium had been just fine when I came into the hospital. At this point, I stood up and read the content of the saline bag, considered how many times I'd seen it changed, did a little noodling about sodium potassium balance, and dramatically downgraded my opinion of the experts in charge of my care.
My potassium had been just fine when I came into the hospital. At this point, I stood up and read the content of the saline bag, considered how many times I'd seen it changed, did a little noodling about sodium potassium balance, and dramatically downgraded my opinion of the experts in charge of my care.
[deleted]
[deleted]
Thank you so much for investigating this matter so thoroughly and fighting for justice so eagerly. As the father of a 4-month-old baby, I couldn't imagine anything more devastating than having him taken away by the authorities for something neither my wife nor I have done. I can only imagine the despair of the families to whom this happens, let alone the impact on the poor kids themselves.
I do wonder how many cases of 'shaken babies' are because the baby has stopped responding for some other reason, and a desperate mother tries to revive them by shaking?
I'm pretty sure I have seen such things in nature documentaries, where a mother shakes a stillborn/dead child as a last ditch attempt to bring them back to life.
If that really was what happened, I would struggle to convict the mother for murder if I was on the the jury...
I'm pretty sure I have seen such things in nature documentaries, where a mother shakes a stillborn/dead child as a last ditch attempt to bring them back to life.
If that really was what happened, I would struggle to convict the mother for murder if I was on the the jury...
That's a very interesting and relevant comment. Maybe that happens in a few cases. However, the reality in my experience is much more complex (and interesting). This is basically an instance of a coerced internalized false confession, according to the classification by Saul Kassin [1].
Let's imagine a mother seeing her baby who suddenly stops breathing. Panicked, she gently takes her baby under the armpits: "Please wake up!". The baby is brought to the hospital, doctors find subdural and retinal hemorrhage, she is accused of shaking her baby.
At the police station, investigators are told by doctors that SBS is 100% certain, that the baby was shaken just before collapsing. They keep pressuring the mother, who swears there was no shaking, no trauma, no accident, no short fall, absolutely nothing. The baby just collapsed with no triggering event. This is a story that is repeated again and again by most parents and caregivers who are living this situation.
This is such a dramatic and emotional situation for parents and caregivers that many will actually doubt their own memory (that actually happened to me, briefly, and yet I never went through a tough police interrogation in custody). Anyway, innocent and sincere persons will actually try to find rational explanations. They will retrospectively try to find any sort of mild movement of the baby's head that could resemble shaking. Police officers will say what they're told (which is actually true): mild shaking will not cause this, only extremely violent ones will.
At one point during the interrogation, the idea will be brought up that, perhaps, the mother accidentally shook the baby after the collapse as a resuscitation attempt. In the end, it may well be the only rational explanation? The mother may even end up believing that she involuntarily harmed her own child while trying to save him, and that will be the charge brought by the prosecution that leads the mother to trial.
In reality, this gesture was likely to be far too mild to do any serious injury to the child. However, in this particular context, it may well be the only explanation that could be accepted by both the investigators and the defendant. In these cases, it's more likely that the child collapsed due to some undetected medical condition leading to a respiratory arrest (akin to what happens in SIDS).
I've seen this pattern over and over again. It has actually be well studied by psychologists in slightly more general contexts. The book contains 2 chapters (by Keith Findley, Richard Leo, Deborah Davis) on the extremely important issue of SBS confessions, as this is basically the main evidence of the diagnosis today.
[1] https://en.wikipedia.org/wiki/False_confession#Coerced_inter...
Let's imagine a mother seeing her baby who suddenly stops breathing. Panicked, she gently takes her baby under the armpits: "Please wake up!". The baby is brought to the hospital, doctors find subdural and retinal hemorrhage, she is accused of shaking her baby.
At the police station, investigators are told by doctors that SBS is 100% certain, that the baby was shaken just before collapsing. They keep pressuring the mother, who swears there was no shaking, no trauma, no accident, no short fall, absolutely nothing. The baby just collapsed with no triggering event. This is a story that is repeated again and again by most parents and caregivers who are living this situation.
This is such a dramatic and emotional situation for parents and caregivers that many will actually doubt their own memory (that actually happened to me, briefly, and yet I never went through a tough police interrogation in custody). Anyway, innocent and sincere persons will actually try to find rational explanations. They will retrospectively try to find any sort of mild movement of the baby's head that could resemble shaking. Police officers will say what they're told (which is actually true): mild shaking will not cause this, only extremely violent ones will.
At one point during the interrogation, the idea will be brought up that, perhaps, the mother accidentally shook the baby after the collapse as a resuscitation attempt. In the end, it may well be the only rational explanation? The mother may even end up believing that she involuntarily harmed her own child while trying to save him, and that will be the charge brought by the prosecution that leads the mother to trial.
In reality, this gesture was likely to be far too mild to do any serious injury to the child. However, in this particular context, it may well be the only explanation that could be accepted by both the investigators and the defendant. In these cases, it's more likely that the child collapsed due to some undetected medical condition leading to a respiratory arrest (akin to what happens in SIDS).
I've seen this pattern over and over again. It has actually be well studied by psychologists in slightly more general contexts. The book contains 2 chapters (by Keith Findley, Richard Leo, Deborah Davis) on the extremely important issue of SBS confessions, as this is basically the main evidence of the diagnosis today.
[1] https://en.wikipedia.org/wiki/False_confession#Coerced_inter...
As a new parent of a son, this is horrifying.
Why is the default, to accuse the caretakers with phantom (unfounded) certainty, absent any other good evidence?
Why is the default, to accuse the caretakers with phantom (unfounded) certainty, absent any other good evidence?
"But in practice, extremely few medical conditions are checked for and “excluded” before concluding a diagnosis ... – the great majority are not checked for at all. Very often, ... is diagnosed “by default”, because no known alternative explanation was found (or even actively sought)."
From anecdotes I hear, that is one of the major problems with the medical system in a nutshell.
From anecdotes I hear, that is one of the major problems with the medical system in a nutshell.
In the anglosphere (or may be just america) "think of the children" has lead to a lot of these sorts of issues. Child abuse is the worst thing anyone could imagine, and so, how could anyone over-react? How can any action be enough? May be some figures or entities take advantage of this, but there is some sincere motivation in these drives too. And now, we have issues like this article, children not being allowed unattended in most public places, children unallowed to walk on their own without adult supervision, and it goes on and on.
The thing is there is no needed ill intent, all parents can be sincere, and yet create a society and culture that stunts their very childrens' growth and lives. In the article, as the author said, how many thousands of parents have been separated from their child, and the infant, now parent-less, will be shuffled from foster home to foster home, all in the name of ending abuse based on filmsy evidence and poor science? It's depressing.
The very desire to protect and love leads to hurting those we intend to help.
The thing is there is no needed ill intent, all parents can be sincere, and yet create a society and culture that stunts their very childrens' growth and lives. In the article, as the author said, how many thousands of parents have been separated from their child, and the infant, now parent-less, will be shuffled from foster home to foster home, all in the name of ending abuse based on filmsy evidence and poor science? It's depressing.
The very desire to protect and love leads to hurting those we intend to help.
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This was a sensational news trope on MSM nightly news and news magazines in the 90's in the US.
The story is set in France if you were thinking this is a uniquely Anglo issue.
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While his experience is nightmarish enough it's hard not to suspect that being a well-educated professional had a lot to do with some of the special privileges he was afforded compared to other parents.
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So what I got from this article is that it's a good idea to have a 24/7 CCTV coverage of all areas where a baby might be in case there might be a need to defend oneself from fradulent accusations by government agents. Oh well.
It's actually a fairly good idea, we think about it a lot. My highest hope is that technology soon reaches a point where it's cheap and convenient and not totally socially awkward to videotape the life of a baby 24/7. I feel like we're not totally there yet. The new Ray-Ban Meta can apparently record 60 seconds of video. What we need is 24/7 continuous videotaping to ensure that the exact moment when a baby collapses (and the hours before), and the caregiver calls the ER, is filmed.
A single case where we a video would prove that there was no shaking at this exact moment might help convince many doctors (not all, unfortunately).
Relatedly, this recent medical article [1] reports a case of an alleged short fall resulting in subdural and retinal hemorrhage. As usual, doctors did not believe in the story of the short fall (they assume a short fall can almost never cause them) and they concluded that the short fall was a cover-up for unadmitted abuse. The police was called and, surprise, the whole thing was filmed by CCTV. The videotape proved that the story of the short fall was entirely correct and the caregiver was exculpated.
Interestingly, the doctors did not conclude that their belief was wrong (short falls almost never cause subdural and retinal hemorrhage), but that it was an "outlier".
[1] https://www.sciencedirect.com/science/article/abs/pii/S10918...
A single case where we a video would prove that there was no shaking at this exact moment might help convince many doctors (not all, unfortunately).
Relatedly, this recent medical article [1] reports a case of an alleged short fall resulting in subdural and retinal hemorrhage. As usual, doctors did not believe in the story of the short fall (they assume a short fall can almost never cause them) and they concluded that the short fall was a cover-up for unadmitted abuse. The police was called and, surprise, the whole thing was filmed by CCTV. The videotape proved that the story of the short fall was entirely correct and the caregiver was exculpated.
Interestingly, the doctors did not conclude that their belief was wrong (short falls almost never cause subdural and retinal hemorrhage), but that it was an "outlier".
[1] https://www.sciencedirect.com/science/article/abs/pii/S10918...
Largely agree w article. However I think it's important to mention that there are other validated ways to detect abuse and that clinical decision making is, or at least should be, based on multiple lines of evidence. Especially with abuse.
In ED and clinic I have had kids that screened positive for TEN 4 FACESp (see https://jamanetwork.com/journals/jamanetworkopen/fullarticle...). One of these babies ended up having b/l subdurals, likely abuse. In the end they may have called that "shaken baby", however there were multiple other red flags, the subdurals was only one piece, and the suspected mechanism of the subdurals was repeated drops / falls.
Agreed "shaking" may not be the mechanism but the author lists other mechanisms that can lead to subdurals and retinal hemorrhage where NAT could play role, eg hypoxia via choking, repeated falls from pushing/drops, neglect in unsafe motor vehicle situations.
In ED and clinic I have had kids that screened positive for TEN 4 FACESp (see https://jamanetwork.com/journals/jamanetworkopen/fullarticle...). One of these babies ended up having b/l subdurals, likely abuse. In the end they may have called that "shaken baby", however there were multiple other red flags, the subdurals was only one piece, and the suspected mechanism of the subdurals was repeated drops / falls.
Agreed "shaking" may not be the mechanism but the author lists other mechanisms that can lead to subdurals and retinal hemorrhage where NAT could play role, eg hypoxia via choking, repeated falls from pushing/drops, neglect in unsafe motor vehicle situations.
I cannot imagine losing custody of your child while he's in an emergency situation for a couple months. This must be a nightmare.