Shaken baby syndrome: a medical, scientific, and legal controversy
Résumé
Among the various forms of violence against children, shaking is one of the most severe. It involves young infants shaken by adults, presumably overwhelmed by their crying. Identified half a century ago, this form of abuse can cause severe or fatal neurological injuries, prompting prevention campaigns in France and worldwide. While the reality and dangerous consequences of shaking are undisputed, the medical identification of shaken infants-based on various types of observations (notably radiological and anatomo-pathological)-has been debated in academic, medical, and legal circles since the 1990s. These discussions on the scientific reliability of such 'medical diagnoses of child abuse' are supported by a vast body of literature, even though some institutional actors minimize or reject them. This article presents a non-systematic review of these debates through a brief historical overview of the controversy and a concise discussion of the key medical, scientific, and legal issues. Significant developments have emerged in the understanding of shaken baby syndrome, including the nature and pathophysiology of associated injuries, the evidentiary value of available literature, and the forensic reliability of the diagnosis. The necessity of child protection explains why these academic debates are intertwined with legal, political, and societal issues. However, this same imperative calls for moving beyond polarization to achieve a more effective and reliable detection of child abuse.
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