Tag Archives: Dr. Waney Squier

GMC Sanction Triggers Public Debate


Dr. Waney Squier

Last week’s decision by the General Medical Council (GMC) to remove pediatric neuropathologist Waney Squier from the medical register has triggered ongoing media coverage in the UK, including a number of voices speaking in her defense.

The GMC’s sanction followed a declaration earlier in the month by a tribunal that Dr. Squier was guilty of unprofessional conduct. Now she will no longer be allowed to practice or to testify as an expert witness.

Days after the tribunal announced its findings, human rights attorney Clive Stafford Smith published an opinion piece in The Guardian that likened the move to the papal inquisition of Galileo in 1615, a thought echoed a week later in the same forum, in a  letter to the editor signed by 25 medical and legal professionals in response to the GMC’s decision to strike her from the register.

Then The Guardian published a defense of the GMC process by Chief Executive Niall Dickson, who said critics had missed the point:

[T]he GMC is not and has no intention of being the arbiter of scientific opinion – the allegations we brought against Dr Squier did not rest on the validity of her scientific theory but upon her competence and conduct in presenting her evidence to the courts.

That same page contains more letters on both sides, including one by Susan Goldsmith, writer and co-producer of the film about shaking theory, The Syndrome. In another letter today, Clive Stafford Smith says that the charges were, in fact, about her opinion, not her behavior, and argues:

If we are right, then the people who mislead the court (albeit perhaps unintentionally) are those who purvey an unproven theory as fact.

Protecting Innocent Families (PIF), a non-profit that speaks on  behalf of wrongfully accused families, submitted a letter to the GMC in support of Dr. Squier, including an angle that I had not taken the time to address in my post about the decision earlier in the month:

The declaration also scolds Dr. Squier unfairly for her citations of the medical research. In one example, she cited the early biomechanical research of Dr. Anne-Christine Duhaime and colleagues (“The shaken baby syndrome: A clinical, pathological, and biomechanical study,” Journal of Neurosurgery 1987 66:409–415) to support her observation that shaking without impact has not been shown to generate sufficient forces to cause brain injury. The panel wrote that Dr. Squier had “completely misinterpreted what Duhaime had actually said,” a conclusion that baffles us. The Duhaime paper was a landmark in the field, because it was the first attempt to test shaking theory scientifically, and the results surprised even the authors, who wrote:

“It was concluded that severe head injuries commonly diagnosed as shaking injuries require impact to occur and that shaking alone in an otherwise normal baby is unlikely to cause the shaken baby syndrome.”

WindowLogoPIF also released their letter to the press, which led to some confusion, as one resulting story opened with the miscue that the PIF petition is in support of Dr. Squier: “Campaign group defends ‘dishonest’ doctor struck off medical register for ‘shaken baby’ evidence.” Christina England at Health Impact News also quoted generously, and more accurately, from the PIF materials in her treatment, “Shaken baby syndrome expert and world renowned pathologist banned from practicing medicine.” PIF has published the full text of its letter on its web site.

Both the BBC treatment of the decision against Dr. Squier and the coverage in New Scientist presented both sides of the debate, although some articles reported the GMC’s position without mentioning her supporters.

March 29 update: Columnist James Le Fanu at The Telegraph has posted an insightful item criticizing the GMC.

If you are not familiar with the debate surrounding shaken baby syndrome, please see the home page of this blog and web site.

copyright 2016 Sue Luttner


Filed under abusive head trauma, AHT, SBS, shaken baby, shaken baby syndrome, Uncategorized

Guilty of Intellectual Honesty

Pediatric Neuropathologist Dr. Waney Squier At the Evidence-Based Medicine Symposium in Denver in 2009In a 96-page decision packed with irony, the Medical Practitioners Tribunal Service (MPTS) in Britain has declared pediatric neuropathologist Waney Squier guilty of practicing outside her area of expertise, ignoring the opinions of her peers, and tarnishing the reputation of the medical profession with her testimony and written opinions in a series of shaken baby cases between 2007 and 2010.

“The tribunal is in no doubt you have been a person of good character and have not acted dishonestly in the past,” the statement offers, but it characterizes her opinions about shaken baby syndrome as “dogmatic, inflexible and unreceptive to any other view” and declares her work in the arena “misleading,” “irresponsible,” and even “dishonest.”

MackSquierHead2009For about the past 15 years, Dr. Squier, a consulting neuropathologist at the Oxford Radcliffe Hospitals, has been challenging the community of child abuse experts to reconsider the unproven model of shaken baby syndrome that’s been winning in court for decades. She has not only testified to her theories but also conducted research and published in the medical journals.

The charges against her were levied by the General Medical Council (GMC) at the instigation of prosecutors concerned that her testimony was impeding convictions in shaking cases, according to Dr. Michael Powers, QC, as quoted in the coverage by Robert Booth at The Guardian. The GMC will determine her penalty later in the month, possibly loss of her status as a practicing physician.

Dr. John Plunkett

Dr. John Plunkett

Dr. John Plunkett, a pathologist who has fought off charges of perjury for his testimony regarding shaken baby theory, pointed out that Dr. Squier is receiving a Champion of Justice award next month at the annual Innocence Network conference in San Antonio, Texas. “How is it that the Innocence Network can give this award to Dr. Squier if the GMC has correctly characterized her behavior as dishonest and worthy of sanction?” he asked.

Dr. Bergina Brickhouse, a psychiatrist whose husband was cleared of shaking accusations based partly on a report from Dr. Squier, wrote in an email, “If not for the strength, fortitude, and technical expertise that Dr. Squier has shown, my family would most assuredly have been ripped apart by well-meaning but ignorant medical staff.”

Developmental Medicine & Child Neurology, 2008

Developmental Medicine & Child Neurology, 2008

I would have expected adjudication of the charges to be conducted by a panel of physicians, but the MPTS set up a team of one retired psychiatrist and two lay persons—a retired Royal Air Force wing commander and a retired police officer—to evaluate the evidence against Dr. Squier. The members seem not to have read the medical literature but based their conclusions primarily on oral testimony given over several months of hearings that started in the fall. The panel’s report describes all of the prosecution’s expert witnesses as “credible” but articulates various objections to the experts called by the defense.

Forensic pathology professor Bo Erik Ingemar Thiblin of Uppsala University, for example, had explained how circular reasoning in the early shaken baby papers allowed the theory to become established without scientific proof, the same argument that convinced the Swedish Supreme Court to revisit the legal status of shaken baby theory last year. Dr. Thiblin is an expert in epidemiology, the study of patterns, causes, and effects in health conditions, a complex field that emphasizes assessment and analysis of the known facts. In a triumph for circularity, the tribunal rejected his testimony with this explanation:

“It was clear that Professor Thiblin did not believe in the concept of shaken baby syndrome, and his view of the literature was coloured by that. He was critical of the methodology of all the research literature in relation to the subject because of its perceived circularity bias. The tribunal considered that his expert opinion on non-accidental head injury lacked credibility; therefore the tribunal attached limited weight to his evidence.”

In an insightful editorial in The Guardian today, human rights attorney Clive Stafford Smith compared the tribunal to the trial of Galileo by the church for his theory that the earth orbits around the sun and not the other way around:

“I am convinced that Squier is correct, but one does not have to agree with me to see the ugly side to the GMC prosecution: the moment that we are denied the right to question a scientific theory that is held by the majority, we are not far away from Galileo’s predicament in 1615, as he appeared before the papal inquisition… It was not until 1982 that Pope John Paul II issued a formal admission that the church had got it wrong.”

Dr. Waney Squier

One of the inexplicable elements of the decision was the tribunal’s finding that Dr. Squier had erred by testifying to biomechanical issues without any expertise in biomechanics—although the prosecution experts who testified in the hearings were, like Dr. Squier, physicians with no apparent specialized training in biomechanics (Dr. Richard Bonshek, ophthalmic pathologist; Prof. Rupert A. Risdon, pediatric forensic pathologist; Dr. Neil Stoodley, neuroradiologist; and Prof. Colin Smith, neuropathologist).

Similarly, the declaration scolds her for citing the 1987 paper by Duhaime et al. to support her observation that shaking without impact has not been shown to create forces sufficient to cause the brain injury. The tribunal said she had “completely misinterpreted what Duhaime had actually said,” even though the paper’s introduction says:

“It was concluded that severe head injuries commonly diagnosed as shaking injuries require impact to occur and that shaking alone in an otherwise normal baby is unlikely to cause the shaken baby syndrome.”

In a moving one-minute interview on the BBC, Dr. Squier said she is “devastated” by the finding, which she said has “enormous implications” not just for doctors but for any experts willing to testify in court. “You can give an honestly held, well-supported opinion and find yourself out of job,” she observed.

The charges against Dr. Squier are consistent with a strategy advocated by Detective Inspector Colin Welsh of New Scotland Yard in 2010 at the 11th International Conference on Shaken Baby Syndrome for improving the conviction rate in these cases by neutralizing experts willing to testify for the defense (see “Back Door Tactics Show Through“).

Proponents of shaking theory also ridicule their critics at conferences and scorn them in print, and in 2014 they attempted to block the premiere showing of the documentary The Syndrome, which they dismissed as “a national platform for the tiny handful of well-known child abuse defense witnesses to publicize their fringe message.”

An editorial this winter in the journal Pediatric Radiology, “Child Abuse: We Have Problems” by Dr. Peter J. Strouse, declares that “child abuse denialists” now pose “a growing threat to the health care of children and the well-being of children and families,” and calls on institutional rejection of doctors who defy the common knowledge about child abuse:

The court system seems ill-equipped to properly censure the denialists in spite of their deceitful and unethical behavior. Ideally, the legal system would practice peer-review by unbiased observers, but this does not occur. Institutions that harbor denialists, whether they be private practices or esteemed academic institutions, should carefully consider their employment.

Even in this environment, Dr. Squier has been willing to say in print and in court what her own research and experience were telling her about shaken baby theory.  I am in awe of both of her intellectual honesty and her courage, and I am horrified at Friday’s decision. The only silver lining I can think of is that maybe, this time, they have gone too far. The ironically named “determination of facts” released on Friday will not hold up to the scrutiny that Dr. Squier’s own work has already survived (see, for example, “When Pie in the Sky Turns Out to Be Dawning Knowledge”).

If you are not familiar with the debate surrounding shaken baby theory, please see the home page of this blog.

Copyright 2016, Sue Luttner



Filed under abusive head trauma, AHT, SBS, shaken baby syndrome

“Back Door” Tactics Show Through

March 16, 2012, BBC One

Tensions have been mounting among the pathologists on the medico-legal drama Silent Witness, and now the doctors are finally speaking frankly. No, the head of the lab assures his young colleague, there is no conspiracy against Dr. Helen Karamides, the prominent pediatric neuropathologist whose maverick views on shaken baby syndrome have made her a lightning rod for criticism. He is double-checking Karamides’s work not because of a political witch hunt, he explains, but because the pathologist has been accused of conducting her research with illegally acquired brain tissues.

Pediatric Neuropathologist Dr. Waney Squier
At the Evidence-Based Medicine Symposium in Denver in 2009

To anyone familiar with the career of pediatric neuropathologist Dr. Waney Squier, the parallels were obvious:  Like the Karamides character, Squier has testified for the defense in infant-shaking cases, in the face of harsh criticism from her peers and even from the bench—as in the courtroom scene in the opening episode of the two-part show, titled “Paradise Lost.”

Unlike Karamides, however, Squier has published her infant-brain research in the peer-reviewed literature, and she was quickly cleared when accused of violating the human-tissue laws.

The irony is that the conclusion of “Paradise Lost” actually adds to the evidence for a conspiracy of sorts against doctors who question the prosecution model of shaken baby syndrome:  By the end of the wrap-up segment, the Karamides character has videotaped her own suicide, confessing that, “as you correctly alleged,” she had conducted her research on illegally harvested baby brains. Autopsy reveals that she was an alcoholic. The packet that I’d hoped would document her research contains only extensive interviews with a serial killer, who seems to have turned himself into a psychopath by head-banging as a lonely, unloved child.

Anyone who questions the classic model of shaken baby syndrome would be discouraged by the fictional outcome, but Waney Squier has filed a complaint, with both the BBC and Ofcom, an entity that describes itself on the web as an “independent regulator and competition authority for the UK communications industries.”

Dr. Squier declines to talk about the situation, saying only that she trusts the BBC will do the right thing. Her complaint was leaked to the magazine Private Eye, however, which claimed to be quoting from her letter to the two agencies:

“While the storyline portrayed my unique professional circumstances in some detail, it deviates from the truth with respect to an accusation of retaining baby brains for research without permission. Such action would be gross professional miconduct and a criminal offence.”

Squier’s complaint allegedly described the character’s suicide as “disturbing to me and my friends” and “extremely painful to my daughters and my close family.”

The coverage in Private Eye, which doesn’t seem to be posted publicly, also included this observation about the BBC’s embarrassment:

One of the many factors that make the Beeb’s position extremely dicey is that none of the dirt previously directed at Squier by her enemies has stuck, thrown as it was by parties with an obvious axe to grind.

Squier was one of the doctors deeply involved in the response to the Alder Hey organ retention scandal in Liverpool 12 years ago which, ironically, led to the Human Tissue Act three years later and the setting up of the HTA to police it. She now believes she has been depicted as in the mould of Professor Dick Van Velzen, the rogue pathologist at the centre of the Alder Hey scandal.

One of the other factors that “make the beeb’s position extremely dicey” is that Squier had received a call from Silent Witness about a year before the “Paradise Lost” show aired, in which she learned they were doing a program on shaken baby syndrome.

The London Evening Standard published this piece on the complaint, seemingly picked up from Private Eye. 

Heather Kirkwood in 2015

Heather Kirkwood in 2015

What fascinates me about this story is that the BBC faux pas illustrates the kind of “back door” campaign that attorney Heather Kirkwood alerted me to two years ago, between sessions at the Eleventh International Conference on Shaken Baby Syndrome/Abusive Head Trauma, in Atlanta, Georgia.

I happened to catch Kirkwood not long after she’d attended a talk, by Detective Inspector Colin Welsh from New Scotland Yard, with the title “A National Co-ordinated Approach to Cases of Non-Accidental Head Trauma in the UK.” Kirkwood knew complaints had been filed with the General Medical Council (GMC) against Dr. Squier and a colleague of hers, histopathologist Dr. Marta Cohen, based on their courtroom testimony in shaken baby cases. She had just learned why.

“I don’t believe this,” she said, her incredulity tinged with indignation. “Their entire coordinated plan was to keep Dr. Squier and Dr. Cohen off the stand.”

According to Kirkwood’s transcribed notes, D.I. Welsh’s talk had detailed a strategy for improving the conviction rate in shaking cases by neutralizing the “handful of experts” who testify  for the defense and whose role, according to Welsh, is to confuse the jury with the complexity of the science and provide possible alternative causes without explaining why the child died.

In a witnessed statement drafted after the conference, Kirkwood wrote that she had gone to the session expecting to hear about coordination among different arms of law enforcement but realized several minutes into the presentation that “the ‘national coordinated approach’ referenced in the title of the talk was essentially a description of the joint efforts of New Scotland Yard, prosecution counsel, and prosecution medical experts to prevent Dr. Squier and Dr. Cohen from testifying for the defense on their findings in specific cases as well as on their published and peer-reviewed research.”

Welsh’s talk also addressed the problem of “judicial inexperience,” Kirkwood’s notes report. His advice for influencing judges who’ve been listening to SBS critics was not to address the debate in argument, but to work through the “back door,” reaching judges informally outside of court and explaining the prosecution point of view without the opposition present.

Kirkwood’s notes also quote Welsh as advising police to “seek maximum publicity for convictions” and to relay to the press that “shaking undoubtedly causes injuries and in some cases death.” Welsh reported that his team had scheduled SBS training courses for police officers and first responders, and that his agency makes itself available to “offer advice to senior investigating officers.”

Squier and Cohen have so far weathered the complaints lodged against them, but the campaign is having its effect. Last year Squier told the Canadian Broadcasting Company that attacks motivated by her position on shaken baby syndrome threaten her ability to work, and she hesitates to continue testifying.

Presumably the editors at “Silent Witness” consulted one or more child-abuse experts to advise them on their story about shaken baby syndrome. I hope they take a second look at the sources who not only approved such a dismissive treatment of a real problem—the overdagnosis of infant shaking—but also planted a personal attack on one of the rare, courageous physicians willing to rely on scientific evidence instead of popular opinion.

-Sue Luttner


Filed under abusive head trauma, AHT, SBS, shaken baby syndrome