The evidence base in child protection litigation

In this week's BMJ Gornall points out some of the problems associated with the presentation of medical evidence of child abuse in the United Kingdom. He focuses on the omission from the Royal College of Paediatrics and Child Health's new handbook, Child Protection Companion, of research evidence gathered by two controversial paediatricians—David Southall and Sir Roy Meadow.1

A well developed evidence base exists for child abuse medicine that is suitable for use in litigation for child protection. The published evidence on the abuse and neglect of children begins with a descriptive article by Tardieu (the father of forensic medicine) in 1860.2 He pointed out how medical conditions that he had observed in 32 children defined the abusive nature of the events that had occurred. In 1962 Kempe and colleagues reiterated that doctors could and should infer abuse on the basis of certain medical findings of injury. The “battered child syndrome” that they defined is still a valid concept based on observational …