Highlighting Violent and Repetitive Shaking

Recent court decisions in the United States, Canada, and the United Kingdom have demonstrated confusion and uncertainty by the triers of fact, whether they be judges or juries, about the evidence presented in cases of alleged abusive head trauma. It is not surprising that judges and juries have a difficult time understanding and evaluating the evidence presented by the opposing sides of these courtroom arguments. Complicated scientific discourse by “dueling experts” who offer diametrically opposite views of the medical issues at hand cloud the issues even more. Efforts to define the admissibility of expert testimony by the courts have taken place. One such effort is the Daubert hearing,1 wherein the court attempts to determine if a theory that is being presented is generally accepted, whether it can be tested, and whether the theory depends on peer-reviewed publications, among other things. However, the Daubert hearing allows for wide interpretation by the courts, and it has limited usefulness in excluding those who would give irresponsible medical testimony. One of the medicolegal arguments in cases of abusive head trauma has been whether shaking an infant, in the absence of an impact, creates sufficient forces to produce all the classic injuries associated with abusive head trauma. … Address correspondence to Robert M. Reece, MD, Box 351, 800 Washington St, Boston, MA 02111. E-mail: rmreece{at}gmail.com