Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

A journey into the shaken baby syndrome/abusive head trauma controversy

cambridgeblog.org

Post reply on HN
Print view View original

531–540 of 639 posts

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#531

Post by ameister14 »

grog454 wrote: post #497
tokai wrote: post #405

Earlier quoted context omitted.

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?

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.

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#532

Post by gwd »

tivert wrote: post #459
gwd wrote: post #356

Earlier quoted context omitted.

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 .

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.

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#533

Post by ameister14 »

danenania wrote: post #496
cwmma wrote: post #491

Earlier quoted context omitted.

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...

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 doc…

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.

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#534

Post by kergonath »

murphyslab wrote: post #455
kergonath wrote: post #303

Earlier quoted context omitted.

> 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…

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.

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#536

Post by danenania »

ameister14 wrote: post #533
danenania wrote: post #496

Earlier quoted context omitted.

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 doc…

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…

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.

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#537

Post by firesteelrain »

DrThunder wrote: post #524
firesteelrain wrote: post #321

“ 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 chil…

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.

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#538

Post by sacnoradhq »

noobermin wrote: post #503

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 unat…

This was a sensational news trope on MSM nightly news and news magazines in the 90's in the US.

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#539

Post by dartos »

sanderjd wrote: post #384
cdogl wrote: post #204

Earlier quoted context omitted.

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.

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.

Re: A journey into the shaken baby syndrome/abusive head trauma controversy

#540

Post by omnibrain »

droopyEyelids wrote: post #428
lesam wrote: post #349

Earlier quoted context omitted.

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.

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 w…

And as soon as your baby can turn itself you have no more influence in which position it sleeps anyway.
Post reply on HN