The Use of Medical Evidence in Child Protection Cases


In Family and Criminal court proceedings medical evidence is often crucial. If it is alleged that a child has been injured by a parent, for example, medical evidence is necessary to show that the child has in fact been injured by their parent. Where there are concerns about child abuse Social Services intervene in the interests of the child. On the basis of the medical evidence, therefore, children are taken away from their parents, for the children’s own good, and those children become ‘Looked After Children’, and the state’s responsibility.

There are concerns, however, about the interaction between medical diagnoses and evidence used in court. Judges are not often medical experts, and are thus reliant upon medical diagnoses. In an excellent article "Sounds of Silence: Wrongful Diagnosis of Child Abuse: A Master Theory" James Le Fanu sets out a pithy explanation of how the current concerns about wrongful diagnosis of child abuse have come about. He says they “…centre around a trio of very different clinical situations whose defining characteristic might be described rather as one of uncertainty or ambiguity:

  1. Sudden Infant Death Syndrome: SIDS remains much the commonest cause of unexpected death in childhood whose primary aetiology, despite much research, has proved elusive.

    2. Sally Clark, Angela Cannings and others were convicted of murder following the cot deaths of their children. At the time medical expertise suggested that cot deaths were random occurrences, and thus that it is highly unlikely for there to be more than one in any family. It has since been proven that there is a link between genetics and cot deaths. For news coverage of the fall out from this please see http://news.bbc.co.uk/1/hi/health/4685511.stm

  2. Medically unexplained symptoms: Doctors are not as yet omniscient. They all have puzzling patients whose signs and symptoms can be difficult to explain.”

    3. Marianne Williams was accused of poisoning her child with salt. It was later shown that the high levels of sodium found in the child’s body could have been caused naturally. For news coverage of the fall out from this please see http://news.bbc.co.uk/1/hi/england/hampshire/6088686.stm

  3. Childhood injuries: Children, by definition, are accident-prone but sometimes the severity of their injuries might seem disproportionate to the explanation provided.

    4. Shaken Baby Syndrome is a diagnosis of parents shaking their babies excessively and causing serious external damage, and sometimes brain damage. An important part of the diagnosis is the existence of Metaphyseal Fractures, but too often the existence of such fractures is used as proof.

    There is now considerable evidence to suggest that such fractures are not proof. For more on the medical science click here.
In each of these sets of cases the ambiguity means that there is vast potential for misdiagnosis. Unfortunately courts sometimes appear to give too much weight to this medical evidence, even to the extent of treating it as fact. For example:

John Hemming is campaigning for changes in the way medical evidence is used in courts, to ensure that parents are given a fair trial.

Relevant Articles

Sounds of Silence: Wrongful Diagnosis of Child Abuse: A Master Theory – James Le Fanu