Contents:
But how is a jury to approach conflicting expert evidence? We suggest that it can only do so if that evidence is properly marshalled and controlled before it is presented to the jury. He should be in a position to identify whether the expert evidence which either side wishes to adduce is admissible. It recommends a checklist of matters to be established by the trial judge before expert evidence is admitted, including: Their continuing observation, their experience of both the forseen and unforeseen, the recognised and unrecognised, form a powerful basis for their opinion.
Forensic Aspects of Pediatric Fractures. Differentiating Accidental Trauma from Child Abuse. Authors: Bilo, Rob A. C., Robben, Simon G. F., van Rijn, Rick R. Forensic Aspects of Pediatric Fractures: Differentiating Accidental Trauma from Child Abuse: Medicine & Health Science Books.
First, a realistic possibility of an unknown cause must not be overlooked. Radiological assessment plays a major role in the detection, and diagnosis, of non-accidental injuries in children. Read more about this topic at the excellent Radiology Assistant article by Simon Robben. All of the above images come from this article.
Not all fractures are caused by non-accidental trauma - some may be caused by 'trivial trauma' on a background of natural disease This xray of a left femur shows bowing, an incomplete fracture, cupping and fraying of metaphyses, delay in ossification of the femoral capital epiphysis, and widening of the physes, findings typical of rickets. Of all the questioned forensic theories and practices, this is the one I would put at the top of the list for the threshold examination. Of all the currently questioned practices, this is the only one asserted by a respectable minority of specialists to be completely invalid.
While a vitreolic dispute continues between the pro and con groups, defendents continue to be sentenced to exceedingly long prison terms based on the theory. While the thoery's supporters accuse the doubters of profiting from defending baby-killers, the doubters label the supporters as zealots lacking any knowledge of physics or of the scientific method. It is long past time that an authoritative body outside the adversarial system examined the underpinnings of the theory and published its results.
The child protection practice manual. Is the proposed expert still in practice? To what extent is he an expert in the subject to which he testifies?
When did he last see a case in his own clinical practice? To what extent is his view widely held?
It's a chilling thought that when we think we are doing good, we may actually be doing harm, but it is one we must always be alive to, even in the most innocuous situations. The paediatrician Dr Benjamin Spock wrote a record-breaking best-seller called Baby and Child Care, first published in , which was hugely influential and largely sensible.
In it, he confidently recommended that babies should sleep on their tummies. With young children in particular, the question may arise if this is related to child abuse. The aim of this book is to help physicians involved in child abuse cases to interpret radiological findings in light of the forensic circumstances under which they occurred. The authors present up-to-date literature related to the mechanisms underlying non-accidental cases of trauma.
In this book not only the radiological findings in child-abuse are discussed, but more importantly, these findings are analyzed from a forensic perspective. Careful attention is paid to evidence regarding reported trauma mechanisms and their clinical outcome; for example, can a fall from a couch result in a femoral fracture, and if not, where is the supporting evidence? Inhoudsopgave Fractures in child abuse. Incidence of pediatric fractures.
Differences between pediatric and adult fractures. Differential diagnosis of pediatric fractures.
Kaldewaij P, Vos PE. Fall from a High Chair In particular children of less than 1 year of age seem to fall regularly with or from high chairs. In the acute phase, the externally visible signs are abrasions of the eye lid, haematomas and oedema []. In , forensic paediatrics was added. There is no consensus regarding gender as a risk factor for NAT, although several studies have suggested that male children may be more likely to sustain fractures 14 - Three lectures on some points relating to injuries to the head. Support Center Support Center.
Fractures and child abuse. The radiologist's role in child abuse. Ethical dilemmas in child abuse. Signs, symptoms and complications. Biomechanical aspects of skull fractures. Skull fractures and intra-cranial pathology. Differential diagnosis of accidental and non-accidental skull fractures.
Craniofacial fractures and dental trauma. Biomechanical aspects of rib fractures. Rib fractures and child abuse. Differential diagnosis of accidental and non-accidental causes of rib fractures. Anatomy and physiology of long bones. Epiphyseal and metaphyseal fractures. Shaft fractures of the lower extremities. Fall from low height. Falls from bunk beds.
Falls out of shopping carts. Radiological differential diagnosis in the absence of fractures. Temporary brittle bone disease.