Thursday, March 13, 2008

Child Abuse Is Erroneously Diagnosed

Wednesday, March 5, 2008 9:09 AM

By: Michael Arnold Glueck and Robert J. Cihak, The Medicine Men Article Font Size

The loss of a child is one of life's most painful experiences regardless of the cause, whether illness, accident, or injury. Parents say it's almost unbearable to have a child die.

But how about having your child forcibly removed from your home on suspicion of a crime you didn't commit? Adding insult to injury, the accusations in question are based on an irrational medical diagnosis. This is a reality faced by far too many parents accused of child abuse.

Yes, some parents do abuse their children. However, the medical profession and government officials often abuse the diagnosis of child abuse.

Since our column, "Temporary Brittle Bone Disease and Infant Fractures" appeared in 2005, dozens of grandparents, attorneys, public defenders, other family members, friends and the parents themselves have contacted us about apparently false child abuse accusations. (See

These correspondents often present convincing stories of loving parents who would not abuse their children. They describe medical professionals and government officials instigating false charges, causing infants to be ripped from their mother's arms, essentially at the point of a gun.

In one such case, in January, a mother described how her youngest, a four-month-old daughter, had multiple unexplained fractures. Because of suspicion of child abuse, government agents took all three of her children out of their home. The daughter had no bruising or other signs of trauma during eight previous well-baby medical visits.

In another case, also presented in January, a man wrote us about his four-month-old grandson found to have multiple fractures with pretty much the same medical history as above. At that time, the parents had custody of the infant but government agents were threatening to take the infant away.

In our 2005 article, we briefly described the clinical observations and research leading to the temporary brittle bone disease (TBBD) hypothesis.

While in their mother's womb, babies grow and develop at astonishing rates. Dr. Colin R. Paterson of Scotland discovered that some babies were born with bones prone to fracture during the few months of life outside the womb but without anything else to suggest child abuse, such as bruises or internal injuries. Dr. Paterson hypothesized that these babies had a temporary form of brittle bone disease, different from osteogenesis imperfecta and other known causes producing weak bones and multiple fractures.

Dr. Marvin Miller, professor of Pediatrics and Obstetrics and Gynecology at Wright State School of Medicine in Dayton, Ohio, recently reported 65 infants with a similar pattern of medical findings in the journal "Medical Hypotheses" (2005 65, 880-886). He hypothesized that these babies were tightly confined in the womb and weren't getting enough exercise to produce normal bone strength. Such confinement can be due to a number of causes, such as large fibroids, twins, or a shortage of fluid around the baby.

After birth, these babies start to exercise more normally. Their bones grow even more rapidly than normal babies' bones, to catch up with the new demands of living outside the womb. This rapid growth can produce new bone in multiple layers and simulate healing fractures. In addition, some of the weak bones actually do break during normal care, such as during diapers changes.

About 50 years ago, diagnosing child abuse from X-ray images alone became popular. In medical jargon, these X-ray findings were said to be "pathognomonic" of child abuse.

But medical science hasn't yet discovered everything. It is therefore illogical to imply that infants with multiple unexplained fractures could only be due to child abuse. Medical scientists continue to discover new medical conditions, previously unknown and therefore impossible to diagnose or identify.

For example, Dr. Roy Morello of the Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, and others described a new genetic cause for brittle bones less than two years ago.

The diagnosis by excluding everything else known to science, diagnosis by exclusion, is a logically false approach simply because doctors and medical science don't know everything.

Yet this false logic is the basis for the diagnosis of child abuse by X-ray appearance alone. We expect bureaucrats to abuse us. As doctors, we're grieved when medical professionals abuse children by making diagnoses leading to false accusations of child abuse.

In addition, some government social service workers face "bounty hunter" incentives. When they take children from their parents, the government agents benefit from publicity about child abuse, even when the charges are false. The agencies then use this publicity when they ask the state legislature for more money so they can investigate, harass, and prosecute even more families. These perverse incentives also need to be corrected.

All other factors being equal, children thrive best when they grow up in their own parents' home. As Voltaire said in 1747, "It is better to risk saving a guilty person than to condemn an innocent one."

We therefore ask medical, social service, legal and law enforcement professionals to review the problem of false accusations harming children and their families. Applying scientific advances and simple logic should result in new procedures for evaluating infants with healing bones.

We doctors, and especially radiologists, must earn the trust of our patients by not making irrational diagnoses, such as the diagnosis of child abuse based on X-ray appearances alone.

Because doctors and medical science cannot be presumed to be perfect, parents and other people taking care of children must be presumed to be innocent, until proven guilty. Justice must take precedence over the rush to convict.

Robert J. Cihak, M.D., is a senior fellow and board member of the Discovery Institute and a past president of the Association of American Physicians and Surgeons. Michael Arnold Glueck, M.D., is a multiple-award-winning writer who comments on medical-legal issues. Both doctors are board-certified diagnostic radiologists.

Original Article- - Child Abuse Is Erroneously Diagnosed


Anonymous said...

So what do you do when you have no money to fight these accusations. We are going through the very same thing right now in New Mexico. We have less than stellar publically funded attorneys for respondents;Protective Services who say they are underfunded and under resourced which is impacting visitation; targeting my son and expecting someone to say they did something that they didn't so they can move their process along; reunification plan that is not implemented; investigations that don't happen. It is an empire that isn't questioned nor held accountable and yet the very children and families they are charged with supporting are being destroyed. I am the grandparent in this nightmare who also cannot be considered placement because I helped with the caregiving. They did not name me as a respondent but am considered a suspect. I am being told that I am in denial that my son hurt the baby and that is why I am looking for other possible causes for unexplained fractures. Attorneys, advocates all say not to upset the Protective Service workers because they will make it worse and they are correct. There is no place to take our concerns to that doesn't result in punishment by limiting visitation or other important reunification activity. The insanity goes on and on. This is a nightmare that doesn't end. Meanwhile we have babies in foster care and another child living with his bio dad who is confused and traumatized because he can't be with his mom or my son. There is no due process nor Justice in the Protective Services system.

Louise Uccio said...

Sad to have to say.. you are correct!

There is no justice but what we can al do and most that already know this are doing .. is LEARN THE LAW for your state.. then demand your attorney do what YOU KNOW is right and in the best interest of YOUR CHILDREN!

Become your own attorney..
it takes a huge commitment but it's the ony way!

I wish you the best of luck!!