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The Champion

November 2018 , Page 38 

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Law, Child Abuse, and the Retina

By Evan Matshes, M.D. and Randy Papetti, Esq.

There is a longstanding, widespread belief in pediatric medicine that a finding of retinal hemorrhages in an infant or young child is strong evidence of child abuse. This belief originated decades ago as a cornerstone of a now-controversial diagnosis known as Shaken Baby Syndrome (“SBS”) or as Abusive Head Trauma (“AHT”). Decades of medical students have been taught that retinal hemorrhages in an infant or young child mean child abuse until proven otherwise.1 This dogma has had and continues to have enormous legal implications: expert testimony about retinal hemorrhages is powerful courtroom evidence, which prosecutors and child protection agencies have offered in thousands of criminal and family court cases.

This article urges that the beliefs about retinal hemorrhages are unreliable for legal purposes and, it seems, altogether wrong, yet they are key to the SBS/AHT diagnosis. Most debate in the case law about the forensic reliability of retinal hemorrhages is embedded in a broader dis

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