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LETTERS: Patrick E Lantz The evidence base for shaken baby syndrome: Response to Reece et al from 41 physicians and scientists BMJ 2004; 329: 741-c-742-c [Full text]

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Theories must be verified and validated

Charles Pragnell   (28 September 2004)

Theories must be verified and validated 28 September 2004
Charles Pragnell, Expert Defence Witness Child Protection and Child/Family Advocate U.K./Australasia Send response to journal: Re: Theories must be verified and validated	The criteria for evidence based medicine as defined by Lantz et al seems to be an appropriate starting point for the verification and validation of all theories of child abuse i.e. “Evidence based medicine is the conscientious, explicit, and judicious use of scientific evidence in making medical decisions and cautions against unsystematic, untested reasoning and institution-based clinical applications”. With further refinement and development to include para-medical child abuse theories, these criteria could be the basis of a system for verifying and validating new theories of child abuse or for revising existing theories. Too much harm has been caused to children and their families in the past because of the absence of a system to verify and validate medical evidence and the consequent reliance of Courts on medical opinions which have been little more than conjecture, supposition, and fanciful speculation. The currently promoted theories of child abuse such as Fabricated and/or Induced Illness (Munchausen Syndrome By Proxy and its many variants), Sudden Infant Death Syndrome, Shaken Baby Syndrome, Anal Dilatation Test, Repressed Memory Syndrome, Somatic Disorder, Dissociative Disorder, Satanic Ritual Abuse, which have all been variously used in child protection proceedings, should have been subjected to such a verification and validation procedure before they were introduced into child protection practice. If they had been, then a great many children and parents would have been saved the horrors and devastating effects of child protection investigations and prosecutions based on false allegations arising from unsound and unsafe theories. It would be necessary to establish a national body to undertake the verification and validation processing of new theories of child abuse using the agreed criteria and Courts could be advised to only accept medical evidence which had been validated by such a body. No doubt if such a body were created it would have representatives of the medical, legal, and social work professions, and the police but most importantly would be membership of the body from organizations representing falsely accused individuals and families who have suffered in the past because of the absence of a validation process. Organisations such as the British False Memory Society, Mothers Against Munchausen Allegations, the FivePerCenters [SBS], Action Against False Accusations of Child Abuse [AAFAA], False Allegations Against Carers and Teachers [F.A.C.T.] etc, would have a vital and necessary role to play in such a validating body. If we are to learn anything from events over the last two decades, then it must be that the use of theories of child abuse which do not have a foundation in conscientious, explicit, and judicious use of scientific evidence must be prevented and Courts should be able to rely on evidence which has been subjected to careful and thorough examination by a representative and authorised national body. Competing interests: Concern to reform the Child protection System