[HN Gopher] A journey into the shaken baby syndrome/abusive head...
       ___________________________________________________________________
        
       A journey into the shaken baby syndrome/abusive head trauma
       controversy
        
       Author : rossant
       Score  : 853 points
       Date   : 2023-09-25 20:49 UTC (2 days ago)
        
 (HTM) web link (www.cambridgeblog.org)
 (TXT) w3m dump (www.cambridgeblog.org)
        
       | e40 wrote:
       | No mention of the Texas death row inmate's fate to be decided by
       | SCOTUS in mere days.
       | 
       | https://www.theguardian.com/world/2023/sep/24/texas-death-ro...
        
       | Racing0461 wrote:
       | [flagged]
        
       | TeeMassive wrote:
       | "What happened is that during my literature review, I
       | disturbingly realized that what I had been told at the hospital,
       | namely that subdural and retinal hemorrhage in infants are almost
       | always caused by violent shaking even in the absence of external
       | evidence of trauma, was an assertion based on very weak
       | scientific foundations. And yet, this "shaking hypothesis"
       | (sometimes referred to as the theory of the "triad", since
       | encephalopathy is frequently associated with the other two signs,
       | subdural and retinal hemorrhage) has been taught as though it was
       | a proven fact to generations of physicians all over the world.
       | Every year, thousands of children are removed from their parents,
       | and thousands are prosecuted, convicted, and even incarcerated,
       | on the basis of this assertion. Law professor Deborah Tuerkheimer
       | qualifies SBS/AHT as a "medical diagnosis of murder". The very
       | least we should expect for an assertion this powerful is that it
       | should be based on reliable scientific foundations."
       | 
       | This is why using experts for advice is great but everyone should
       | still be encouraged to do their own research.
        
         | xpe wrote:
         | We need so much more than some combination of (1) trusting
         | experts and (2) doing your own research.
         | 
         | The first is practically necessary but unsatisfying given well-
         | known concerns about scientific replication, knowledge
         | dissemination, and industry incentives.
         | 
         | The second isn't practical for most people.
         | 
         | I don't have detailed interventions to suggest right now, but
         | it seems clear that we need better _systems_ that result in
         | less dogmatic behavior among experts and legal systems.
        
         | scott_w wrote:
         | How would doing your own research prevent the state from taking
         | your child away and putting you in prison for murder?
        
         | kwhitefoot wrote:
         | > using experts for advice is great
         | 
         | If they are experts. The problem lies in distinguishing those
         | who actually do have expertise in the field in question from
         | those who merely think that they do and can persuade others
         | that they do.
         | 
         | In many medical contexts there is no such thing as an expert
         | because the data simply doesn't exist, they are sometimes
         | simply more capable than the general public.
        
           | TeeMassive wrote:
           | Actual experts I talked too can tell you easily _why_ the
           | opinion they have are true and the evidence it is based on.
           | They are also very good at vulgarization.
        
         | kergonath wrote:
         | > This is why using experts for advice is great but everyone
         | should still be encouraged to do their own research.
         | 
         | Not everyone is equipped to do this kind of literature review
         | (that's not research), or have access to all these papers.
         | Everyone needs to be critical and skeptical to a reasonable
         | extent, but this kind of "do your own research" attitude is
         | damaging. People just end up trusting dodgy but authoritative-
         | sounding YouTube videos and blog posts because they cannot read
         | scientific articles.
        
           | TeeMassive wrote:
           | YouTube videos are just letting other people do research ;)
        
       | babuloseo wrote:
       | Wow, makes me wanna get a ph.d.
        
       | [deleted]
        
       | drug-freedom wrote:
       | [flagged]
        
       | sandworm101 wrote:
       | >> how many people are in jail or lost their kids due to
       | something that didn't actually happen.
       | 
       | Thousands upon thousands. By some estimates upwards of 10% of
       | incarcerated individuals. The situation is just accepted. The
       | general consensus is always that locking up too many people is
       | better than than too few. It is on defense attorneys to check on
       | the system.
        
         | dang wrote:
         | We detached this subthread from
         | https://news.ycombinator.com/item?id=37667150.
        
         | lqet wrote:
         | Are you saying that 10% of incarcerated individuals are
         | innocent (which I do not find an unrealistic number), or are
         | you saying that 10% of incarcerated individuals are wrongly in
         | prison for crimes against their children?
        
           | sandworm101 wrote:
           | 10% of people are innocent of the crimes _for which they have
           | been convicted_. Whole innocence is another thing. But yes,
           | there are a huge number of people wrongfully convicted.
           | Things like DNA evidence is showing us that a great many
           | mistakes are made. For those crimes convicted without things
           | like DNA evidence, one must presume an equal rate of wrongful
           | convictions. Courts are not FAA crash investigations, or any
           | other sort of investigation. They are not about truth. They
           | are about rights and laws. There is no right to a truthful
           | outcome, only a lawful one.
        
             | rossant wrote:
             | Yes. I suggest everyone to look into the fantastic work
             | done by the Innocence Project [1] and the Innocence Network
             | [2].
             | 
             | Also, the Innocence Files is a must-watch on Netflix [3].
             | 
             | [1] https://innocenceproject.org/
             | 
             | [2] https://innocencenetwork.org/
             | 
             | [3] https://www.netflix.com/title/80214563
        
             | lqet wrote:
             | I agree, but I think OP referred to crimes involving
             | violence against their own children.
        
         | Dah00n wrote:
         | Not everywhere is the US.
        
           | dcow wrote:
           | This isn't even true for the US. In the US we believe it's
           | better to let a criminal run free than deprive an innocent of
           | their liberty.
        
             | kmkemp wrote:
             | That seems to be the sentiment based on our founding
             | origins or if you talk to an individual, but the fact is
             | that we imprison more people per capita than anyone else.
             | It's hard for me to believe that all of the criminals just
             | live in the USA.
        
               | nemo44x wrote:
               | About 70% of convicts in prison are there for violent
               | offenses and should be there. The remaining 30% is mainly
               | drug and property crimes.
               | 
               | Now it's important to understand what is meant when
               | people reference incarceration numbers. A lot of these
               | are people awaiting trial on charges they will be found
               | guilty of but receive minimal sentences via plea
               | bargaining. Another large portion are illegal immigrants
               | that are awaiting processing for either integration or
               | deportation.
               | 
               | So if you erase those 2 groups it's mainly violent
               | people. There's an abundance of violent people in the USA
               | compared to Western Europe and certainly Asia I'd say.
        
             | MacsHeadroom wrote:
             | "It is better to let 100 criminals go free than to imprison
             | 1 innocent man." -- Benjamin Franklin
        
               | sandworm101 wrote:
               | A quote I have never heard from anyone running to be a
               | DA, judge, sheriff, magistrate, or any other participant
               | beyond defense attorneys. Such sayings do not reflect
               | reality.
        
               | rossant wrote:
               | I've seen police officers say the exact opposite: "It's
               | better to imprison 100 innocent people than risking
               | letting 1 criminal go free and harm children".
               | 
               | Sigh.
        
             | bell-cot wrote:
             | > In the US we believe...
             | 
             | Sadly, that varies enormously with the social status and
             | wealth of the accused.
        
         | eecc wrote:
         | Imagine when it's not just locking up, but spills over to state
         | homicide: https://amp.theguardian.com/world/2023/sep/24/texas-
         | death-ro...
        
       | tru1ock wrote:
       | This made me think of Handmaid's Tale. Scary to know how easily
       | we will trade away liberty to an illusion of safety for the sake
       | of the children.
        
         | nonethewiser wrote:
         | I would say it's for the sake of safety. Children may be the
         | topic here, but it applies much more widely to safety in
         | general.
        
       | charles_f wrote:
       | Once my kid cut his butt cheek falling off his bike (to this day
       | I don't know how). I brought him to the hospital for sutures, and
       | was asked to live the room while he was questioned. I felt very
       | uncomfortable, and almost guilty, while this lasted for all of 5
       | minutes.
       | 
       | I _cannot_ imagine losing custody of your child _while he 's in
       | an emergency situation_ for a couple months. This must be a
       | nightmare.
        
         | stef25 wrote:
         | > was asked to live the room while he was questioned
         | 
         | Is that even legal ?
         | 
         | Anyone trying to get between my kids and I is going to have a
         | very bad day.
        
           | cool_dude85 wrote:
           | Sorry, you think in a case where the doctor suspects abuse,
           | they should have to ask the kid while the potential abuser
           | stands there next to her?
        
             | DrThunder wrote:
             | Underage kids can't consult to really anything legally on
             | their own. You cannot have a system where in certain cases
             | they're treated as adults. I get what you're saying but I
             | cannot believe that any good parent thinks this is ok.
             | 
             | This country has weird culture that's started happening in
             | the last decade where the parents take a back seat and the
             | government/institutions are taking their place. Suddenly,
             | you're hearing schools, doctor's, etc. telling kids they
             | should come to them and not trust their parents. It's
             | terrifying as a parent. Parents should never have to give
             | up their rights in the name of "safety".
        
               | cool_dude85 wrote:
               | >Parents should never have to give up their rights in the
               | name of "safety".
               | 
               | You can be forgiven with this opinion if you have not met
               | or spent time around the types of parents whose children
               | genuinely need to be taken away: neglectful, abusive, and
               | extremely harmful to their kids.
        
           | rightbyte wrote:
           | It might be a bad idea persoannly to become angry in such a
           | situation if the local social service is authoritarian.
           | 
           | But as an altruistic move for the greater good it is good.
        
             | logicchains wrote:
             | >But as an altruistic move for the greater good it is good.
             | 
             | That's only the case if overall children taken away from
             | their parents end up with better outcomes than in societies
             | where children aren't taken away from their parents, have
             | you seen any data showing this is the case? Children in
             | foster care tend to have horrifically bad outcomes,
             | statistically speaking.
        
               | bluGill wrote:
               | Children in foster care start off in a much worse
               | situation than average. Or at least that is the normal
               | case, there are exceptions like the article.
               | 
               | Many parents of 'mentally disabled' kids put the kids in
               | foster care because the parents need a break from the
               | constant care of a kid who isn't normal. Many other kids
               | end up in foster care because they have been abused. Both
               | of those will make the kids much worse than normal and
               | thus much harder to care for.
               | 
               | Kids that are close to normal but end up in foster care
               | often end up adopted fairly quick - there are plenty of
               | families who want a kid but not their own (I personally
               | know several people with genetics they don't want to pass
               | on - there are other good reasons to not want someone
               | else's kids) - but they will try to select a kid who is
               | going to be easy to raise thus kids who will end up
               | normal don't spend much time in foster care.
        
               | rightbyte wrote:
               | I meant that protesting the bad process, increasing risk
               | of having your child taken away, is good for everyone
               | else except you and your child. I.e. altruistic.
        
           | charles_f wrote:
           | I am thinking it's even mandated from the medical personnel
        
         | rightbyte wrote:
         | The scary thing in such situations is that if the doctor asks
         | "did your daddy hit you?" the child might randomly say yes.
        
           | fusslo wrote:
           | Shane koyczan has a fantastic poem about a cute thing between
           | him and his grandmother that turned into an abuse
           | investigation. And then he was bullied because of it!
           | 
           | https://genius.com/Shane-koyczan-to-this-day-annotated
        
       | pcblues wrote:
       | There is a problem with responsibility. Do you want to never let
       | a perp go (i.e. jail innocent people in order to catch every
       | guilty person) versus let some baddies slip through the net while
       | not imprisoning innocent people. My own life found itself on the
       | nexus, where I lost loved ones with a false accusation, but
       | wasn't charged for it from (obvious) lack of evidence. Although
       | the legal system worked somewhat, it was too late for me and my
       | loved ones. The liars got away with it, and mission accomplished
       | in removing me from the family.
        
         | nonethewiser wrote:
         | > Do you want to never let a perp go (i.e. jail innocent people
         | in order to catch every guilty person) versus let some baddies
         | slip through the net while not imprisoning innocent people
         | 
         | Isn't the latter the official standard most places? Innocent
         | until proven guilty. It's just not really a dilemma if you ask
         | me. If you have authority to do something based on some event,
         | then you have to prove that event happened.
        
         | P_I_Staker wrote:
         | Okay, what happened? You can't leave these half stories here,
         | lol
        
       | londons_explore wrote:
       | I do wonder how many cases of 'shaken babies' are because the
       | baby has stopped responding for some other reason, and a
       | desperate mother tries to revive them by shaking?
       | 
       | I'm pretty sure I have seen such things in nature documentaries,
       | where a mother shakes a stillborn/dead child as a last ditch
       | attempt to bring them back to life.
       | 
       | If that really was what happened, I would struggle to convict the
       | mother for murder if I was on the the jury...
        
         | rossant wrote:
         | That's a very interesting and relevant comment. Maybe that
         | happens in a few cases. However, the reality in my experience
         | is much more complex (and interesting). This is basically an
         | instance of a coerced internalized false confession, according
         | to the classification by Saul Kassin [1].
         | 
         | Let's imagine a mother seeing her baby who suddenly stops
         | breathing. Panicked, she gently takes her baby under the
         | armpits: "Please wake up!". The baby is brought to the
         | hospital, doctors find subdural and retinal hemorrhage, she is
         | accused of shaking her baby.
         | 
         | At the police station, investigators are told by doctors that
         | SBS is 100% certain, that the baby was shaken just before
         | collapsing. They keep pressuring the mother, who swears there
         | was no shaking, no trauma, no accident, no short fall,
         | absolutely nothing. The baby _just collapsed_ with no
         | triggering event. This is a story that is repeated again and
         | again by most parents and caregivers who are living this
         | situation.
         | 
         | This is such a dramatic and emotional situation for parents and
         | caregivers that many will actually doubt their own memory (that
         | actually happened to me, briefly, and yet I never went through
         | a tough police interrogation in custody). Anyway, innocent and
         | sincere persons will actually try to find rational
         | explanations. They will retrospectively try to find any sort of
         | mild movement of the baby's head that could resemble shaking.
         | Police officers will say what they're told (which is actually
         | true): mild shaking will not cause this, only extremely violent
         | ones will.
         | 
         | At one point during the interrogation, the idea will be brought
         | up that, perhaps, the mother accidentally shook the baby
         | _after_ the collapse as a resuscitation attempt. In the end, it
         | may well be the only rational explanation? The mother may even
         | end up believing that she involuntarily harmed her own child
         | while trying to save him, and that will be the charge brought
         | by the prosecution that leads the mother to trial.
         | 
         | In reality, this gesture was likely to be far too mild to do
         | any serious injury to the child. However, in this particular
         | context, it may well be the only explanation that could be
         | accepted by both the investigators and the defendant. In these
         | cases, it's more likely that the child collapsed due to some
         | undetected medical condition leading to a respiratory arrest
         | (akin to what happens in SIDS).
         | 
         | I've seen this pattern over and over again. It has actually be
         | well studied by psychologists in slightly more general
         | contexts. The book contains 2 chapters (by Keith Findley,
         | Richard Leo, Deborah Davis) on the extremely important issue of
         | SBS confessions, as this is basically the main evidence of the
         | diagnosis today.
         | 
         | [1]
         | https://en.wikipedia.org/wiki/False_confession#Coerced_inter...
        
       | [deleted]
        
       | hprotagonist wrote:
       | whoof. what an ugly trip!
       | 
       | i've interacted with the author, who wrote a very nice spike
       | sorting package called `phy` that i used several years back (and
       | iirc turned me off using hdf5 as a result), and came away very
       | impressed with what was so obviously a sharp mind. very odd to
       | recognize the name in a totally other context. Not very pleasant
       | to hear about such a rough time either!
        
         | bombcar wrote:
         | And if he hadn't, that nanny would probably be in jail.
        
           | hprotagonist wrote:
           | i'm unsurprised by his level of meticulous detail. and mostly
           | horrified by those sorts of repercussions being possible.
           | 
           | the whole thing just gives one the serious heebie jeebies
        
       | Jecintaworld wrote:
       | [flagged]
        
       | p-e-w wrote:
       | > It is the perfect combination of crap.
       | 
       | I think that's being way too charitable.
       | 
       | In a world where people are incarcerated on a scale unprecedented
       | in all of human history, and where prosecutorial success is
       | measured by number of scalps taken, the assumption that this is
       | plain malice designed to let the state rob a few more individuals
       | of their freedom makes much more sense than it all being just a
       | big pile of incompetence and misunderstandings.
        
         | suckitsam wrote:
         | "Sufficiently advanced ignorance/apathy is indistinguishable
         | from malice"
        
         | dang wrote:
         | We detached this subthread from
         | https://news.ycombinator.com/item?id=37667150.
        
         | bbarnett wrote:
         | _In a world where people are incarcerated on a scale
         | unprecedented in all of human history,_
         | 
         | This is only true, because prior to these times, people were
         | killed instead. Or beaten to within an inch of their lives.
         | Local "justice", lynching, mob action, used to be far, far more
         | common.
         | 
         | And of course, many people used to be worked to death. Or sold
         | into slavery. Or die from horrid conditions in jail. Or forced
         | into the foreign legion.
         | 
         | While I agree that something may be wrong in the US, there are
         | many regions in the world where the above still happens.
        
           | the_af wrote:
           | > _This is only true, because prior to these times, people
           | were killed instead. Or beaten to within an inch of their
           | lives. Local "justice", lynching, mob action, used to be far,
           | far more common._
           | 
           | Hm, sounds like an assertion that ought to be checked by a
           | historian, possibly ACoUP's blog? (Yes, the one who writes
           | about Rome, he is sometimes featured in HN). He specializes
           | in demolishing misconceptions people/Hollywood have about
           | history.
           | 
           | For example, many historians have been writing, recently,
           | about how medieval society was far less brutish and cruel
           | than portrayed in pop culture. There were laws, rights the
           | monarch gave their subjects, culture, etc. Lots of what we
           | "know" about the middle ages from Hollywood is simply wrong.
        
             | Dah00n wrote:
             | Lots of what we "know" about from Hollywood is simply wrong
             | :)
        
           | NordSteve wrote:
           | If you're interested in how criminal punishment changed from
           | medieval times, Medieval Crime Museum is outstanding.
           | https://www.germany.travel/en/cities-culture/medieval-
           | crime-...
        
         | helsinkiandrew wrote:
         | > the assumption that this is plain malice designed to let the
         | state rob a few more individuals of their freedom makes much
         | more sense.
         | 
         | Of course it makes much more sense that there was a massive
         | conspiracy across the medical, legal, prison industry, and
         | press to put more people in prison. Rather than some doctors
         | and legal professionals assuming SIDs was a simple explanation
         | for a not very well understood medical phenomenon probably with
         | many causes.
        
           | zackees wrote:
           | [dead]
        
           | bondarchuk wrote:
           | >Of course it makes much more sense that there was a massive
           | conspiracy across the medical, legal, prison industry, and
           | press to put more people in prison.
           | 
           | Not like it hasn't happened before. And you're overestimating
           | the required massiveness of the conspiracy IMO.
           | 
           | https://en.wikipedia.org/wiki/Kids_for_cash_scandal
        
           | [deleted]
        
         | lm28469 wrote:
         | > the assumption that this is plain malice designed to let the
         | state rob a few more individuals of their freedom makes much
         | more sense
         | 
         | That's a lot of work, a lot of malice, a lot of hate, from a
         | lot of people, for a very meagre result.
         | 
         | If that's how you view your government you must live a really
         | painful existence
        
           | p-e-w wrote:
           | > for a very meagre result
           | 
           | Power is not a meagre result. For those people who live by
           | it, it is the ultimate goal, and they will use any means to
           | obtain and expand it, no matter the cost to others.
        
           | heavyset_go wrote:
           | It's just people "doing their jobs" and trying to get ahead.
           | 
           | That's the banality of evil.
        
             | samtho wrote:
             | Lest we forget the very systems enabling this behavior of
             | banal evil were created and maintained by perhaps the most
             | evil of them all.
        
               | [deleted]
        
               | smolder wrote:
               | The word "lest" is meant to come after something else. It
               | means "for fear that" or "or else" or something similar.
               | So it's not clear what you're trying to say. I don't know
               | what "very systems" built by "the most evil" you mean
               | either. Is it supposed to be obvious what you're
               | referring to?
        
               | Clubber wrote:
               | It's from a poem in 1897.
               | 
               | https://en.wikipedia.org/wiki/Recessional_(poem)
        
               | smolder wrote:
               | Oh, okay.
        
               | smolder wrote:
               | I clicked the link and remain confused. The poem does
               | have in common the term "lest we forget", but apparently
               | nothing else. It's also used in a grammatically correct
               | way in the poem, but not in your post, since it's not
               | following anything.
        
         | circlefavshape wrote:
         | https://en.wikipedia.org/wiki/Hanlon%27s_razor
        
         | WA wrote:
         | Source? Incarceration rate seems to be going down in western
         | countries: https://news.un.org/en/story/2021/07/1096042
        
           | p-e-w wrote:
           | The _scale_ of incarceration is still unprecedented. A
           | reduction by 27 percent doesn 't change that. Imprisonment
           | was an extremely rare phenomenon for much of history (as was
           | police, for that matter). Today's incarceration rates would
           | have to be reduced by 99+% in order to reach pre-modern
           | levels, where large cities often had only a handful of cells
           | in total, and rural areas had none at all.
        
             | lm28469 wrote:
             | > Imprisonment was an extremely rare phenomenon for much of
             | history (as was police, for that matter).
             | 
             | And crimes weren't solved, people not prosecuted, criminals
             | not punished
             | 
             | For much of history life didn't even exist, that's not an
             | argument for or against anything
        
               | bbarnett wrote:
               | Mob justice existed too. And execution for minor crime,
               | with king's justice.
               | 
               | Modern western police forces, with all their foibles, are
               | far, far, far better than mob justice.
               | 
               | Are people even aware of history, and how absolutely
               | bloody it was, with an immense lack of personal rights?
               | 
               | Fixing what's broken now is good. Trying to pretend it is
               | worse than what was before, is absolutely absurd and
               | laughable.
        
               | the_af wrote:
               | It's not so clear cut. At least admit that a lot of
               | thought has been given to this, none the least by
               | Foucalt's famous essay on this topic, _Discipline and
               | Punish_.
               | 
               | Foucalt has his critics, but it's not _immediately_
               | obvious that the massive incarceration problem in some
               | Western nations is better than public execution at the
               | whim of monarchs. And some forms of torture, Foucalt
               | argued, have changed from the theatrical and public to
               | the more subdued torture of everyday lives of prison
               | inmates.
        
               | Dah00n wrote:
               | Remove the US from the list of western countries and it
               | must be better today, yes?
        
               | watwut wrote:
               | Murder clearance rates went DOWN last decades in USA.
               | Less of major crime is solved.
               | 
               | Plus majority of it never went through tria, because
               | trial is just too much risk. So, there are not all that
               | many actual checks and balances
        
               | lm28469 wrote:
               | That's a multi faceted problem. Murder rates also were
               | halves since the 80s in the US, it's not necessarily the
               | same type of criminality
               | 
               | In other countries the clearance rates are as high as
               | ever. The US is an exception in many aspects in the West,
               | closer to third world countries depending on what metric
               | you look at
               | 
               | > overall, findings showed that the clearance rate in
               | Finland and Switzerland in the years of analysis was very
               | high, in some years of the analysis even reaching 100
               | percent. Internationally, these rates are extraordinary
               | high, even in comparison with other European countries
               | such as Italy (67 percent and, later, 78 percent) ,
               | Estonia (80 percent), England & Wales (85 percent) and
               | France (80 percent)
               | 
               | https://journals.sagepub.com/doi/full/10.1177/14773708187
               | 648...
        
             | verinus wrote:
             | well, you were beaten or killed for a lot of crimes- some
             | only perceived.
             | 
             | So, one may perceive incarceration as an improvement.
        
             | moffkalast wrote:
             | To be fair, for much of history there weren't enough
             | resources for everyone, much less for keeping people fed
             | for free in a prison for decades. For serious crimes you
             | just got executed as soon as possible.
        
               | saalweachter wrote:
               | We also no longer have exile as a punishment.
        
           | yawpitch wrote:
           | Their source could be your source, which you seem to be very
           | seriously misreading.
           | 
           | > As the global population grew 21 per cent, between 2000 and
           | 2019, the number of prisoners worldwide jumped by more than
           | 25 per cent, according to the UNODC data.
           | 
           | So, worldwide trend is upward.
           | 
           | > While Northern America, Sub-Saharan Africa and Eastern
           | Europe have experienced a long-term decrease in imprisonment
           | rates of up to 27 per cent, other regions and countries, such
           | as Latin America, Australia and New Zealand, have seen up to
           | 68 per cent growth over the last two decades, the study
           | revealed.
           | 
           | So apparently your definition of "western countries" includes
           | sub-Saharan Africa but excludes most of Europe and all of
           | Australia and New Zealand?
           | 
           | Overall your own source supports their point and contradicts
           | your own.
        
             | seszett wrote:
             | > _So apparently your definition of "western countries"
             | includes sub-Saharan Africa but excludes most of Europe and
             | all of Australia and New Zealand?_
             | 
             | To be honest the text you are quoting doesn't talk about
             | Western Europe at all, and I think if you exclude Western
             | Europe, then "Northern America + Eastern Europe" is most of
             | what remains of "western countries". Australia and New
             | Zealand, while part of western countries, are so small that
             | they are basically insignificant for statistics.
             | 
             | The data in the source[0], though, says the number of
             | prisoners in Europe as a whole (as well as Northern
             | America) has decreased (Figures 10, 12, and 13) confirming
             | what GP said. Eastern Europe is quoted specifically because
             | the decrease has been much more important (basically, the
             | numbers are becoming similar to Western Europe).
             | 
             | There's no question that the trend in the West has been a
             | decrease in incarceration rate, with Australia and New
             | Zealand clear outliers.
             | 
             | [0]https://www.unodc.org/documents/data-and-
             | analysis/statistics...
        
               | yawpitch wrote:
               | If you exclude Western Europe and simply ignore Australia
               | and New Zealand you've abandoned any reasonable
               | conception of "the West" altogether.
               | 
               | Regardless, cherry-picking even such an incredibly
               | gerrymandered "West" ignores the entire point of the
               | source: the human population in prison has risen faster
               | than the human population itself... pointing to minor
               | improvements in the world's largest prison state and what
               | remains of the ex-Soviet gulag system states while
               | ignoring considerably larger regressions in, for example,
               | a nation colonized specifically to be a prison does
               | nothing to contradict that fact.
        
               | seszett wrote:
               | The data (linked in my comment) shows that incarceration
               | rates have decreased in _all of Europe_ as well as _all
               | of Northern America_ and increased in Australia and New
               | Zealand.
               | 
               | If you consider "the West" to be (as is commonly
               | admitted) Europe, Northern America, Australia and New
               | Zealand (with maybe Japan included) then incarceration
               | rates have decreased in the West. Even if they have
               | increased in minor countries (AU + NZ).
               | 
               | You're getting stuck on a sentence of the summary that
               | talks about a subset of the data, but I'm not sure why. I
               | also have no idea what you mean about a "nation colonized
               | to be a prison", but honestly this looks to me as if
               | you're just trying to push some idea without vocalizing
               | it, which is a bit off-putting. If you're talking about
               | the US, then yes it does have a much higher incarceration
               | rate than anywhere else in the West, but it's a clear
               | exception within the West and it is still decreasing.
        
           | NotSuspicious wrote:
           | Unfortunate. It frankly needs to go up in Western countries
           | to get to half-decent crime rates.
        
         | akoboldfrying wrote:
         | >designed to let the state rob a few more individuals of their
         | freedom
         | 
         | "The state" doesn't benefit in any way from locking people up.
         | In fact, it costs them money (both directly and in lost taxes
         | from the lost salaries and wages of those incarcerated).
         | 
         | An argument could be made that prosecutors benefit from higher
         | incarceration rates through the incentives you described. And
         | an argument could definitely be made that private corporations
         | paying well-below-market rates for prison labour benefit.
        
           | tikhonj wrote:
           | _Politicians_ benefit from locking people up because it gives
           | them an easily measurable way to look  "tough on crime".
        
             | akoboldfrying wrote:
             | Good point.
        
           | SamPatt wrote:
           | You think states don't benefit from spending more money?
           | They're just like other organizations who try to expand their
           | budgets year over year.
           | 
           | Except they can force people to pay them more, all they need
           | is plausible justification (like combating crime, or
           | terrorists, or drugs, or viruses, or whatever the current
           | societal scare happens to be about).
        
           | NoZebra120vClip wrote:
           | I hate to break it to you, but the prison system has been the
           | premiere, essential job-creation program for these United
           | States ever since Appomattox 1865.
           | 
           | https://en.wikipedia.org/wiki/Thirteenth_Amendment_to_the_Un.
           | ..
           | 
           | https://www.aclu.org/news/human-rights/captive-labor-
           | exploit...
           | 
           | We got 800,000 or so right now. Fight unemployment? Lock more
           | people up.
        
             | JTbane wrote:
             | Yep and there are some specific product that rely heavily
             | on prison labor- license plates come to mind.
        
           | Clubber wrote:
           | Also, keep in mind, it costs the _taxpayers_ money, not the
           | people running the criminal justice system. They 're
           | motivated by climbing the ladder and scorekeeping.
        
       | DoreenMichele wrote:
       | My oldest son has special needs. He's 2e -- gifted and learning
       | disabled -- and has a serious medical condition associated with
       | being very underweight.
       | 
       | I put him in preschool to get him to talk. He could use sentences
       | but wasn't.
       | 
       | At the start of kindergarten, first, second and third grade, I
       | spoke with the teacher, explained he was difficult, let them know
       | I welcomed communication on any issue. They were thrilled and
       | relieved. Parents are often part of the problem.
       | 
       | By fourth grade, my son was no longer obviously "the weird kid."
       | That teacher reported me to the social worker for letting him
       | know up front my child was difficult and please don't hesitate to
       | discuss things with me.
       | 
       | The social worker called me, we talked for a bit. She knew both
       | my kids. Laughed it off as a silly misunderstanding. Months
       | later, his teacher let me know he did eventually get the memo
       | that my child had quirky interpretations of social things.
       | 
       | After my son finally got a proper diagnosis for his medical
       | issue, he gained twenty pounds in one year and this did wonders
       | for his social skills. Then he lost five pounds.
       | 
       | He still felt better than he ever had and neither of us were
       | concerned. His medical team implied I was in danger of being
       | reported to children's services as an abusive mother.
       | 
       | Because his condition predisposes people to being very
       | underweight, pediatric clinics for the condition routinely
       | include a dietitian and yet the standard recommended diet is
       | "junk food" because it's high salt, high fat, high calorie and
       | cheap.
       | 
       | I had not been feeding him junk food, but I dutifully put a big
       | bowl of snacks in the middle of the coffee table. He regained 2.5
       | pounds, they decided that was adequate and didn't need more
       | follow up visits.
       | 
       | We got home and, with no longer being under threat of being
       | turned in as a neglectful or abusive parent, the first thing he
       | did was hand me the bowl and tell me "We are _never_ doing this
       | again. I feel terrible! "
       | 
       | We resumed feeding him a high quality diet in line with the high
       | fat, high salt, high calorie recommendations.
       | 
       | It's awful to be so protective of your children and be accused of
       | abusing them based on no real evidence. I wish this project well.
        
         | raducu wrote:
         | What was the medical issue for your child being underweight, if
         | you could please share that?
        
           | DoreenMichele wrote:
           | He has a form of cystic fibrosis.
        
         | 12345hn6789 wrote:
         | [flagged]
        
           | dang wrote:
           | I'm not sure if this is personal attack, trolling, or both,
           | but posting this way will get you banned here, so please
           | don't do it again.
           | 
           | If you'd please review
           | https://news.ycombinator.com/newsguidelines.html and stick to
           | the rules, we'd appreciate it.
        
         | crazygringo wrote:
         | > _Then he lost five pounds. He still felt better than he ever
         | had and neither of us were concerned. His medical team implied
         | I was in danger of being reported to children 's services as an
         | abusive mother._
         | 
         | But wasn't that valid cause for concern, especially for someone
         | who should be a growing boy? If being underweight was a serious
         | medical concern for him, losing 5 pounds seems like a big
         | flashing red warning that something could be going wrong.
         | 
         | Maybe I'm misunderstanding your story, but from what you've
         | written, it sounds to me like their intervention successfully
         | ensured he was eating enough when he wasn't before?
        
           | DoreenMichele wrote:
           | You are missing the part where I harmed his health to comply
           | with their expectations. He was fine and does better on a
           | high quality diet than on a junk food diet.
           | 
           | Weight isn't the only metric that matters.
        
             | hezralig wrote:
             | What do you consider a high quality diet? What would meals
             | for a day look like to you?
        
               | lcnPylGDnU4H9OF wrote:
               | If you haven't already: find the accusation in your
               | comment.
        
               | rendall wrote:
               | I think there is a class of internet bully that clusters
               | around stories like this, not unlike the "think of the
               | children crowd" mentioned in the article.
        
               | LastTrain wrote:
               | It's a very simple question - one that my kid's
               | pediatrician asks during almost every visit. Weird that
               | you take it as an accusation.
        
               | clipsy wrote:
               | What's weird is that you apparently don't understand the
               | difference between being asked that question by your
               | child's pediatrician vs a random stranger on the
               | internet.
        
               | Dylan16807 wrote:
               | The question is not weird in the context of telling the
               | story on a messageboard.
               | 
               | If we were applying the default "random stranger" rules,
               | the story never would have been shared in the first
               | place.
        
               | ahoka wrote:
               | The answer can make the story wildly different.
        
             | whiddershins wrote:
             | Harmed his health by what metric?
        
           | jrochkind1 wrote:
           | The problem is that the phrase "a valid concern" would lead
           | me to think "something doctors and parents should consult on
           | (also with the child themself!) and determine if there is
           | cause for alarm, and if so decide collaboratively what the
           | proper course of action is." Sure! Of course! That's what you
           | do with valid health concerns, right?
           | 
           | What it actually means is "something for which social workers
           | will decide whether to take your child away from you for".
           | That's a pretty big escalation from a "valid concern", but
           | one that happens if "the system" decides you are a target. "A
           | valid concern" is in that case a code word for "credible
           | presumptive evidence of child abuse". A child being
           | underweight is a valid thing to be concerned about, it is not
           | on it's own credible presumptive evidence of abusive
           | parenting, no.
        
             | ceejayoz wrote:
             | Abusers sometimes take their victims elsewhere - new doc,
             | new town, new state - when people start getting suspicious.
             | The victim may also be retaliated against; accused of
             | trying to get help. There's a risk to consulting someone
             | you suspect might be the perpetrator.
        
               | jrochkind1 wrote:
               | There's also a pretty big risk to assuming abuse when _it
               | isn 't present_, removing a child from their parents is
               | an action causing great trauma to the child. Even just
               | putting the family through an adversarial process where
               | removal is threatened can be very traumatic to all
               | involved. If there is a challenging health issue going on
               | too, adding all that on top is actually adding barriers
               | to addressing the challenging health issue, and is
               | harmful.
               | 
               | The solution to reducing risk and harm is not to always
               | err on the side of assuming abuse and making families
               | prove otherwise.
        
               | ceejayoz wrote:
               | There's no perfect answer; there will _always_ be
               | judgement calls that turn out to be wrong, even when made
               | in good faith. You 're correct that false accusations of
               | abuse can be devastating to families; missing _real_
               | abuse is similiarly devastating.
               | 
               | As I've said elsewhere in this thread, I'm glad I don't
               | have to make these calls.
        
               | DoreenMichele wrote:
               | If the parent is abusive, trying to get their cooperation
               | in fixing the problem may be an effective means to out
               | them.
               | 
               | They had absolutely no reason to believe I was abusing
               | him. Most likely, they were just trying to cover their
               | own butts and err in that direction rather than in the
               | direction of "what's best for this child?"
               | 
               | That's without getting into larger concerns of "What on
               | earth is wrong with the world that a junk food diet is
               | the medically recommended diet for a serious medical
               | condition?"
        
               | ceejayoz wrote:
               | I'm speaking more generally than your specific case.
        
               | DoreenMichele wrote:
               | I know. I'm trying to engage you in good faith.
               | 
               | I was molested as a child. I know a fair amount about
               | abuse.
               | 
               | There isn't always a clear bright line between ignorance
               | and abuse. Assuming the worst can make the problem worse.
               | 
               | People tend to not be paragons of virtue who have all the
               | answers for everything they run into. Some people can be
               | helped to become better parents.
               | 
               | I thought long and hard about that while sending care
               | packages to a couple of welfare moms. Declaring them
               | unfit moms and having their kids taken and placed in
               | foster care wasn't some magic solution that guaranteed a
               | fabulous outcome, so I chose to try to help them succeed
               | to whatever degree I could, on a limited budget and from
               | a distance.
        
               | germinalphrase wrote:
               | I'm not questioning anything about your story. I'm just
               | curious: what types of "junk food" were they
               | recommending?
        
               | DoreenMichele wrote:
               | They routinely recommend pro inflammatory foods like
               | peanut butter. It's an inflammatory condition.
               | 
               | They recommend sugary foods. It's a condition that puts
               | one at high risk of diabetes.
               | 
               | They recommend ice cream as a high fat, high calorie
               | food. It's a condition that predisposes people to having
               | trouble tolerating milk and milk products, especially
               | from cows.
        
               | germinalphrase wrote:
               | Thank you for the additional details.
        
               | User23 wrote:
               | Is this condition so rare that naming it will doxx your
               | child? If not why not name it so others can add it to
               | their mental toolbox in case it affects them or those
               | they love?
        
               | ivalm wrote:
               | Sounds like Nephropathic Cystinosis, but honestly
               | provided info isn't enough to diagnose in its own.
        
               | lcnPylGDnU4H9OF wrote:
               | I doubt the proper answer to this risk is to assume
               | abuse. I don't mean to say the answer is easy but the
               | described behavior towards this person for how they try
               | to help their child is sickening.
        
               | ceejayoz wrote:
               | Any approach here will have bad results on a population-
               | level; there's no perfect answer. I'm very glad I'm not
               | personally responsible for decisions that could destroy
               | families or doom kids to torture if the wrong judgement
               | call is made.
        
       | fusslo wrote:
       | since everyone else is sharing an anecdote:
       | 
       | When I was 14 or so I fell off my dirt bike and broke my arm,
       | both bones in my forearm.
       | 
       | Went to the hospital. About 5 people asked me how it happened
       | taking about an hour, while I was WRITHING in pain.
       | 
       | Finally, I complained to the right nurse and she got me something
       | for the pain. It was just enough to stop crying, not enough to
       | stop feeling it.
       | 
       | I later found out that the intake nurse was concerned about
       | abuse.
       | 
       | I was dressed head to toe in dirtbike gear. I was a 150lb 14 yr
       | old. my mother was 110 lbs.
       | 
       | They delayed treatment so multiple people, nurses, doctors, and
       | hospital staff could all ask me what happened and compare if I
       | told them the same thing.
        
         | aidenn0 wrote:
         | They may delay treatment for reasons other than just asking; my
         | son was in the ER for 4 hours with a significant laceration (it
         | resulted in two layers of over 2 dozen sutures each) before he
         | was given anything as the nurses were not allowed to administer
         | an analgesic (much less pain killers) until a doctor had
         | examined him, and it took 4 hours for the doctor to get to him.
         | 
         | At no point was there any sign of the staff acting like there
         | might be abuse or neglect involved.
        
         | bell-cot wrote:
         | THIS. It very often seems as if the medical/social system has
         | "barricaded itself" inside it own ideological/psychiatric
         | obsessions with the _idea_ of child abuse, and is blind to
         | reality. Let alone the actual welfare of the child.
        
         | volkl48 wrote:
         | While I certainly don't agree with delaying your
         | treatment....your size/weight vs your mother's is irrelevant -
         | just because she's who brought you in doesn't mean that she's
         | the only person who could have abused you.
         | 
         | For all they know you've got a father or uncle or whoever
         | that's huge and has anger problems who broke it.
         | 
         | One abusive family member and a partner who's covering
         | for/trying to make up for their behavior (and may be being
         | abused themselves) is a pretty common type of abusive
         | situation.
        
       | losthobbies wrote:
       | There was a infamous case in the UK around SBS:
       | 
       | https://3dc.org.uk/press-release-preliminary-study-of-uk-sha...
       | 
       | Louise Woodward was the nanny involved and the court case was
       | televised. Was huge at the time I remember.
        
         | rossant wrote:
         | Yes, Innocence Project cofounder Barry Scheck was the defense
         | attorney in the Woodward case and he wrote a long foreword to
         | our book about it. It starts like this:
         | 
         | "After a Quarter of a Century, Have Any Lessons Been Learned
         | from the Trial of Louise Woodward?
         | 
         | Twenty-five years ago, the Louise Woodward trial in Boston (the
         | 'nanny murder case') thrust shaken baby syndrome (SBS) into
         | headlines across the globe, raising worldwide consciousness
         | about the hypothesis that infants and toddlers could be
         | seriously brain injured, even killed, by violent shaking.
         | Although the case was tried in the early days of SBS
         | prosecutions, the underlying science was fiercely disputed and
         | litigated at trial. A quarter of a century later, although
         | science has advanced, the issues remain just as hotly disputed
         | and poorly understood, and yet parents and caregivers continue
         | to be prosecuted and families torn apart based on the
         | hypothesis."
        
       | Justsignedup wrote:
       | The worst part here is: He spent months researching 500 medical
       | papers to even realize this was a problem. No way in hell will a
       | single defense lawyer get someone to be able to research enough
       | to figure this out. As stated, how many people are in jail or
       | lost their kids due to something that didn't actually happen. And
       | how many people don't know that a minor bump in the head for a
       | baby could be life threatening, but we just mark it as SIDS. And
       | even worse, no medical doctor will go this hard trying to figure
       | out how to defend a person they believe murdered a baby.
       | 
       | It is the perfect combination of crap.
       | 
       | Cyrille Rossant may save a lot of lives, in both parents and
       | children, if this becomes common knowledge.
        
         | raducu wrote:
         | Similar case in Denmark/Romania where a baby was taken from his
         | romanian parents because of the shaken baby syndrome, parents
         | spent time in jail, but the hemorage continued over time so
         | they had to concede it wasn't the shaken baby syndromd.
        
           | tokai wrote:
           | Even if the kids hemorrhaging continued, it was brought to
           | the ER initially with fractures in the right side of the
           | skull.
        
             | raducu wrote:
             | I did not know this detail, I know the Danish state offered
             | apologies, the charges were dropped and the child was
             | returned to the parents.
        
               | tokai wrote:
               | Yeah, nobody know the exact parts of the case. As its
               | semi-secret (to protect the child and parents I guess).
               | While the parents were cleared, this case is definitely
               | not appropriate to this discussion as it was definitely
               | not only hemorrhaging that started it. If a hospital gets
               | a toddler with fractures on their skull, society should
               | damn well figure out how it got them and stop it from
               | happening again.
        
               | grog454 wrote:
               | > If a hospital gets a toddler with fractures on their
               | skull, society should damn well figure out how it got
               | them and stop it from happening again.
               | 
               | What a leap (the kind the article is calling out by the
               | way). Do you really think all causes for toddler skull
               | fractures are a societal problem?
        
               | ameister14 wrote:
               | I do.
               | 
               | If a child has a serious injury the circumstances should
               | be examined, as it should be quite rare for children to
               | have serious injuries.
               | 
               | That's why places have Child Death and Serious Injury
               | Review Committees.
        
               | aidenn0 wrote:
               | As a toddler, my daughter fell out of her bed from a
               | height of less than 18 inches and broke her collar-bone.
               | It seems plausible to me that if she had landed on her
               | head rather than her shoulder, she could have fractured
               | her skull. I'm not sure that society needs to be in the
               | business of preventing all falls from such a small
               | height!
        
               | paradox242 wrote:
               | I fully understand where you are coming from, but have
               | you had a toddler?
        
             | WarOnPrivacy wrote:
             | > it was brought to the ER initially with fractures in the
             | right side of the skull.
             | 
             | Just to defuse this a bit. My #4 used to collect skull
             | fractures. He'd slip away in a nanosecond and would be 50'
             | above us two heartbeats later. We put him in a padded
             | helmet for a year or so. It stayed on sometimes.
             | 
             | As an adult he can still disappear in an empty room.
        
           | cornholio wrote:
           | The trouble is: shaken baby syndrome is real and well
           | documented. Because the crime is so abhorrent, people
           | strongly want to believe the diagnostic tools to be much more
           | sensitive and accurate than they really seem to be.
           | 
           | It's the classic "N guilty men" problem, aka Blackstone's
           | ratio: if you risk putting one innocent person in jail, how
           | many guilty people you need to catch to make it morally
           | justifiable? 5, 10? 100?
           | 
           | You have to pick a number, or else no kind of criminal
           | justice can exist.
        
             | Fire-Dragon-DoL wrote:
             | In the article it clearly states that shaking does not
             | cause the hemorrhage that's currently considered "shaken
             | baby syndrome". It literally says there aren't documented
             | cases where the shaking was captured on tape/testified and
             | the symptoms present at the same time.
             | 
             | It's more likely that a fall (or being thrown) would cause
             | the symptoms.
        
               | hoseja wrote:
               | I read it as no cases where shaking caused ONLY the
               | retinal/subdural haemorrhage, without any other trauma.
        
               | rossant wrote:
               | That's indeed what I said, but I was cautious. I'd have
               | to dig into the latest literature to be sure, but I don't
               | remember seeing even 1 case where shaking _with no
               | impact_ was independently witnessed or videotaped, and
               | was shown to cause retinal /subdural haemorrhage, with or
               | without any other form of trauma.
               | 
               | In any case, these situations are extremely rare, much
               | more than those involving any kind of head impact.
        
               | robbiep wrote:
               | You need to work on your comprehension
        
               | dang wrote:
               | Please don't cross into personal attack. You can make
               | your substantive points without that.
               | 
               | https://news.ycombinator.com/newsguidelines.html
        
             | Justsignedup wrote:
             | The better way to think of what you said is:
             | 
             | If toyota cars unintentionally accelerate and kill people,
             | but sometimes people mistakenly accelerate and kill people.
             | If I am driving a toyota and accelerate and kill a person,
             | if 100% of all cops/investigators believe the first case
             | doesn't exist, and the second case is the only possible
             | answer, I will be thrown in jail without a second thought;
             | my life is destroyed, and it wasn't even my fault.
             | 
             | But more than that, we don't even know what the ratios are,
             | is it 90% / 10%? is it 10% / 90%? is it 50/50? Because
             | everyone believes it is 0%/100% we can't make the "N guilty
             | men" decision at all, so we need a hard stop, evidence, and
             | re-start.
             | 
             | I know you were downvoted, but I think your thoughts are
             | exactly the problem I am trying to point out. So thank you
             | for commenting on it.
        
         | nelox wrote:
         | Try that in a court which doesn't recognise the reliability of
         | evidence provided by an "expert" witness.
        
           | aaron695 wrote:
           | [dead]
        
         | bombcar wrote:
         | I've heard credible rumors that SIDS is the "parent
         | accidentally killed their child but we won't tell them that"
         | polite fiction.
        
           | ncallaway wrote:
           | Who have you heard these rumors from?
           | 
           | How did you determine them to be credible?
           | 
           | My assumption is that any citation to a rumor should be
           | totally dismissed if these questions can't be answered.
        
             | SpicyLemonZest wrote:
             | It seems to me that this rumor is just an alternate framing
             | of the original commenter's assertion that "a minor bump in
             | the head for a baby could be life threatening, but we just
             | mark it as SIDS". I think it's fair to be skeptical of
             | both, but it's worth reflecting on how the same factual
             | assertions can come across as either "science-informed
             | speculation" or "crazy unsubstantiated rumor" depending on
             | how you say them.
        
               | bombcar wrote:
               | Exactly. And imagine you're a doctor, and you have a dead
               | child in front of you, crying parents, and a form to fill
               | out. No possible way of filling out the form brings the
               | child back to life, and one way makes it as easy as
               | possible for everyone, and another results in potentially
               | up to jail time.
               | 
               | Now do this repeatedly during your long and illustrious
               | career.
        
               | sarchertech wrote:
               | My wife is a pediatric ER doctor. That's not how that
               | works. If suspected SIDS case/unexplained death comes in,
               | it would be handed over to the child abuse team and the
               | medical examiner would determine cause of death. The
               | medical examiner is detached from crying parents.
               | 
               | What you're talking about would require a lot more than
               | just one well meaning doctor.
        
               | ncallaway wrote:
               | > or "crazy unsubstantiated rumor" depending on how you
               | say them.
               | 
               | "How it was said" was literally presented as
               | unsubstantiated rumor. It's not worth reflecting that
               | when someone says "I heard a rumor that X..." it sounds
               | like an unsubstantiated rumor. It's just the basic
               | structure of English language.
        
               | [deleted]
        
           | crazygringo wrote:
           | This article is entirely about _debunking_ rumors and looking
           | at actual scientific evidence to correct people 's
           | misconceptions -- misconceptions among doctors and law
           | enforcement that have ruined people's lives.
           | 
           | So please don't bring "rumors" into a discussion here. That's
           | exactly the kind of harmful behavior the article is trying to
           | fight against.
        
           | slashdev wrote:
           | Don't say horrible things like that unless you can really
           | back them up. Think of how a grief stricken parent might feel
           | after reading that.
        
             | colechristensen wrote:
             | SIDS most likely does not exist. "Unknown cause of death"
             | should be preferred.[1] If you review the literature, there
             | has been a definite increase in pushback against "SIDS"
             | instead trying to assign causes of death with known
             | mechanisms. I can't find a great reference but there is one
             | out there that proposes with evidence that the most
             | prevalent actual cause of death labeled "SIDS" is
             | accidental suffocation.
             | 
             | It is so emotionally charged though that there is and has
             | been great hesitation to assign this cause of death because
             | of the emotional effect on the parents.
             | 
             | [1] https://pubmed.ncbi.nlm.nih.gov/10571752/
        
               | jacquesm wrote:
               | One of my children had a serious problem right after
               | birth with breathing (central apnea). He'd stop breathing
               | suddenly while sleeping. If this had happened at home he
               | likely would not have made it, but the hospital was very
               | alert to it and after two weeks with many such episodes
               | it suddenly clicked and then it never happened again.
               | 
               | If we had taken him home without knowing about the
               | condition I'm pretty sure a 'SIDS' cause of death would
               | have been one of the possible outcomes regardless of the
               | actual cause (which would have been very hard to
               | determine after the fact).
        
               | slashdev wrote:
               | Thank god the hospital caught it!
        
               | jacquesm wrote:
               | They were really caught out by it themselves if not for
               | an unrelated issue they would have sent us home. So luck
               | played a huge part here. That's also two weeks that aged
               | me a couple of years. But compared to what I saw some of
               | the other parents there deal with we were the lucky ones
               | in more ways than one.
        
           | jacquesm wrote:
           | That's the whole point here, isn't it: that 'what you've
           | heard' isn't credible at all. There is no 'polite fiction'
           | here, what there is is people looking for culprits when there
           | are none. Does that meant that all such cases are accidents?
           | No, because we know for a fact that some people really do
           | hurt infants for whatever reason. But the evidence is
           | apparently such that a large fraction of the cases that were
           | thought to be criminal in actuality were not. So don't go on
           | rumors or polite fictions when lives are at stake. Do the
           | legwork before ruining people's lives.
        
         | eitally wrote:
         | The ironic thing here is that these sorts of innocuous bumps
         | and minor traumas regularly lead to severe medical
         | complications and deaths in older children & adults, too. The
         | only difference here is that babies & toddlers are too young to
         | be able to verbalize and advocate for themselves in ways that
         | most adults recognize & respect.
        
         | singleshot_ wrote:
         | > No way in hell will a single defense lawyer get someone to be
         | able to research enough to figure this out.
         | 
         | Why would we have to? We can just hire M. Rossant.
        
           | rossant wrote:
           | I wish, unfortunately I'm not a criminal defense lawyer nor a
           | medical doctor! And I don't intend to be one anytime soon. ;)
           | 
           | I think the most productive thing I can at least try to do is
           | to raise awareness among lawyers, doctors, and all
           | professionals involved. No one has the time to dig into it as
           | much as I did, but perhaps I can organize and present our
           | current knowledge as clearly as possible. The book is one
           | little step in this direction.
        
             | singleshot_ wrote:
             | First: I'm very sad about your son and also about your
             | experiences afterward.
             | 
             | If you have the requisite "knowledge, skill, experience,
             | training, or education" you can testify as an expert. No
             | need to be a lawyer, don't need to be a doctor.
             | 
             | You gave yourself that knowledge and your knowledge exceeds
             | that of the typical "they shook the baby" expert. I'd go
             | with you any day.
        
               | rossant wrote:
               | I had no idea that was possible. Thank you.
        
               | [deleted]
        
             | rainbowzootsuit wrote:
             | It seems highly likely that you and your co authors are the
             | some of the most expert people on the planet about this
             | subject.
        
       | Muromec wrote:
       | Oh the good old, violent Easter European bias mixed into crap
       | science.
        
         | dang wrote:
         | We detached this subthread from
         | https://news.ycombinator.com/item?id=37670664.
        
         | the_af wrote:
         | > _Oh the good old, violent Easter European bias mixed into
         | crap science._
         | 
         | Honest question, trying to parse your statement (and bear in
         | mind I don't live in Europe, so I'm surely missing the
         | obvious): do you mean that in Denmark there is a bias against
         | Eastern Europeans, such as Romanians?
         | 
         | Edit: excellent, got a downvote for asking an honest question
         | and clarifying why I wrote it. Is this an example of the fine
         | discourse we are supposed to have here? This is _an honest
         | question_ , I'm neither European nor a native English speaker
         | and I have difficulty parsing the sentence I quoted. How on
         | earth does this warrant downvotes?
        
           | Macha wrote:
           | Yes. Romanians probably get the worst of it from the
           | association with Roma in general who are generally
           | discriminated against, but there is generally a base level of
           | anti eastern-european discrimination among western Europe
           | (and especially the UK). Not that all or most western
           | Europeans do this, but it's a significant enough minority
           | that does that it's unavoidable.
        
           | semanticist wrote:
           | For your edit: 'honest questions' (which are in fact anything
           | but: the person asking has no interest in the answer, and the
           | question itself is often leading) are a common disruptive
           | tactic used by people (normally pushing extreme right-wing
           | ideologies) to derail a conversation.
           | 
           | I'm sure that you're not doing that here, but unfortunately
           | people with genuinely honest questions have become collateral
           | damage caused by disingenuous actors, especially among people
           | with itchy downvote-trigger-fingers.
        
             | Chris2048 wrote:
             | this "are a common tactic" gets a bit old, good way to
             | gatekeep certain topics.
             | 
             | If the same "tactic" is used, why not come up with a good
             | counter? A point stands whether it's being asked
             | disingenuously or not.
        
             | the_af wrote:
             | Yeah, I figured, which is why my original question
             | clarified I'm not from Europe (so no vested interest) and
             | that I might be genuinely missing the obvious answer. Which
             | is why I was surprised by the drive-by downvote.
             | 
             | Thankfully people have responded and now I both understand
             | the sentence and the why!
        
           | verteu wrote:
           | Yes, that's what GP meant.
        
           | thefounder wrote:
           | Domestic violence is still common in Eastern Europe(i.e
           | Romania) so go figure why there is a bias against Eastern
           | Europeans.
        
             | benregenspan wrote:
             | Domestic violence is higher where poverty rates are higher.
             | (I am not saying that poverty is the sole determinant, but
             | it closely correlates). You will find pockets of higher
             | domestic violence throughout the US. I don't think you can
             | rationalize bias like this, people with ethnic prejudice
             | will look for any apparent fact pattern to support their
             | preconceived bias.
        
           | raducu wrote:
           | I could not say I ever experienced it, but I have school-aged
           | relatives that moved to Germany and received all sorts of
           | crap from their peers explicitly for being romanians. Not a
           | race thing because they're whiter than most germans( blonde,
           | white, blue eyes).
        
           | thatfrenchguy wrote:
           | It's not just in Denmark, most Europeans have a negative bias
           | towards Romanian immigrants (mostly because they're too
           | ignorant to even know Romanians are not Roma).
        
             | Strom wrote:
             | > _because they're too ignorant to even know Romanians are
             | not Roma_
             | 
             | I don't think the term Roma has a bad association, because
             | in my experience nobody but the most woke even know it.
             | That is the PC term. People I've encountered just use gypsy
             | or their local equivalent.
        
         | red_admiral wrote:
         | There is a skin condition called Mongolian (Blue) Spot
         | (wikipedia: https://en.wikipedia.org/wiki/Mongolian_spot ) that
         | doctors can mistake for an infant being beaten or otherwise
         | abused. It has led to a lot of cases of false accusations and
         | children being forcibly removed from their parents who were
         | then charged with child abuse.
         | 
         | According to Wikipedia, as to the distribution of this
         | condition,
         | 
         | > The birthmark is prevalent among East, South, Southeast,
         | North and Central Asian peoples, Indigenous Oceanians (chiefly
         | Micronesians and Polynesians), certain populations in Africa,
         | Amerindians, non-European Latin Americans and Caribbeans of
         | mixed-race descent.
         | 
         | So you can see how, in a Western European nation, even if no-
         | one is being biased in the sense of "hating foreigners", the
         | false accusations would cluster in "non-indigenous"
         | populations, for want of a better word (I originally had
         | "immigrants" then realised that isn't the correct split I'm
         | looking for.). Personally I believe there is no defense for
         | doctors, courts and social workers not knowing about this and
         | checking for it before making any accusations.
         | 
         | This doesn't seem to apply to Romanians / Eastern Europeans
         | specifically, unless they have partly Asian ancestry, but it
         | does show that there are conditions that can be mistaken for
         | abuse that appear in some cultures more than others.
        
           | bitxbitxbitcoin wrote:
           | Damn that hits home. I've got a blue spot birthmark that was
           | seen at elementary school which then led to child services
           | showing up at home. This happened in the US and everyone
           | involved was "non Indigenous."
        
             | red_admiral wrote:
             | Sorry to hear that happened to you - and I realise that
             | "indigenous" in the U.S. means the opposite to some of
             | Europe, sorry!
             | 
             | I'm guessing if some kind of Commanche social worker turned
             | up to look at a case of blue spot, they'd go "Yeah that's a
             | birthmark, about half our children have it, our nation even
             | has legends about it. Have a nice day!".
        
         | woof wrote:
         | Seems like the bias is on your part... Which is ironic, given
         | the articles content....
         | 
         | Or do you have _evidence_?
        
           | fishnchips wrote:
           | The username kinda suggests an Eastern European
           | (https://en.wikipedia.org/wiki/Ilya_Muromets) so I read the
           | post as a personal opinion that the bias exists.
        
           | coldtea wrote:
           | Not everything comes with evidence, nor is everything a court
           | case. If you have experienced racism again and again though,
           | you can often tell when you see it, or you can quite safely
           | deduce it in a case or wrong treatment, even without hard
           | proof.
        
             | Dah00n wrote:
             | And yet they are wrong, so clearly evidence was needed.
        
             | jauzj wrote:
             | [flagged]
        
               | achenet wrote:
               | If you happen to get a bit into the whole Nazi
               | classification of races (don't, you almost certainly have
               | something better to learn), you'll find that they made a
               | distinction between Germanic "Aryan" types and Slavs.
        
               | TRiG_Ireland wrote:
               | Well, now you've learned something.
        
               | krapp wrote:
               | >Conflating racial prejudice with cultural prejudice is a
               | cheap trick.
               | 
               | Race is culture. There is no scientific or biological
               | basis for the racial classifications we use. That whole
               | framework was invented by European slave traders and
               | imperialists to justify white supremacist ideology. At
               | one point, Irish and Italian immigrants to the US weren't
               | considered white. Whether Jews are white or not depends
               | on one's opinion of them (they tend to become less white
               | the more paranoid people become of them.) Greeks wouldn't
               | be considered white by many people yet many white people
               | also hold up ancient Greece as the bedrock of "white
               | culture," which as a concept doesn't even really make
               | sense. "Asian" defines half the human population, so
               | broad as to be nearly useless. "Black" is a whole can of
               | worms. None of it is scientific or objective, all of it
               | is a social construct.
        
               | coldtea wrote:
               | > _Racism? I didn 't know Romanians and Danes were of
               | different races._
               | 
               | Now you do. In the ideology of racism (from the 19th
               | century to the Nazis and beyond) not only Romanians and
               | Danes are of different races, but also
               | Nordic/Germanic/Anglosaxon are of different race to
               | Italians, Bulgarians, Greeks, and so on, including of
               | course the Irish. With a long history of those (and more)
               | not considerd "white" in the US, and being persecuted by
               | the KKK and others.
               | 
               | > _Conflating racial prejudice with cultural prejudice is
               | a cheap trick._
               | 
               | Yes, god forbid we condemn prejudice as racial when in
               | fact it's just prejudice because of their "inferior"
               | culture.
               | 
               | Of course, though, those two go hand-in-hand
               | historically. For example, according to Nazi racism, Jews
               | had a "damaging influence" on German culture, they
               | promoted various forms of decadence and so on. And of
               | course every modern racist would say they don't hate
               | blacks as a race, just black culture and crime and so on.
        
               | jauzj wrote:
               | [flagged]
        
             | WarOnPrivacy wrote:
             | > If you have experienced racism again and again though,
             | you can often tell when you see it, or you can quite safely
             | deduce it in a case or wrong treatment, even without hard
             | proof.
             | 
             | There may be some overlap between systemic racial
             | mistreatment and child abuse - however the nuances seem to
             | set them far apart. I believe conflating the two makes it
             | harder to get the full measure of each.
             | 
             | It's not that they can't be compared. It's that they ought
             | to be fully considered in isolation first.
        
           | Muromec wrote:
           | No, I don't have any bias, it's everybody else having biases.
           | To be sure, I just checked how many times before I was biased
           | (it's zero times), so I can't be now.
        
           | Matticus_Rex wrote:
           | Wait, are there Europeans who don't acknowledge that this
           | bias exists? In my experience with European colleagues and
           | those who've traveled a lot there it's so universally-
           | acknowledged that this would surprise me.
        
         | RektBoy wrote:
         | It also because north Europe has one of the most toxic social
         | services in the world, kidnapping kids 24/7. That's basically
         | their job.
        
           | andybak wrote:
           | Whatever core truth you're trying to express, wording it in
           | this way isn't helpful.
        
           | Dah00n wrote:
           | No.
        
           | lawlessone wrote:
           | Seen complaints/protests like this in my country. Then the
           | adult children of the lady leading these protests spoke out
           | against her and pointed out she was just doing it to get a
           | house and embezzling a load of GoFundMe money.
           | 
           | This wasn't SBS though, she just kept adopting out her kids
           | to devote more time to her drug habits.
        
         | raducu wrote:
         | It could be, but communication issues could also be at play,
         | plus overeager doctors/social workers. In Romania they go at
         | great lengths not to pull children out of family environments,
         | in Denmark and other more developed countries it could be the
         | opposite.
        
           | mike_hock wrote:
           | Implying ripping children out of their families willy-nilly
           | is "more developed."
        
             | haswell wrote:
             | Development past a certain point is not universally a good
             | thing.
             | 
             | The term is used to describe the stages a country has been
             | through, and there's plenty of evidence that as countries
             | develop further, the nature of those developments may or
             | may not be beneficial.
             | 
             | Brexit, online safety and other forms of "progress" come to
             | mind.
        
               | Dah00n wrote:
               | Late stage capitalism.
        
             | mensetmanusman wrote:
             | Its tongue in cheek. Germany is developed, but you will get
             | arrested if you try to homeschool your children.
        
               | wincy wrote:
               | It's very important your children be taught whatever it
               | is the government wants them to be taught! Which went
               | very well for Germany in the 1930s...
        
               | Chris2048 wrote:
               | b/c it's seen as a basic right, and issue of equality to
               | have access to the same level of state education. The
               | concept of "your" children is something of the problem.
        
               | mensetmanusman wrote:
               | It could be a problem, but usually isn't.
               | 
               | The (darkly) funny thing in the case of Germany is that
               | this lack of diversity in education has created a
               | generation with the fertility rate of South Korea (ie
               | dying).
               | 
               | In this case, the state creating a monoculture that
               | results in the 'destruction' of the existing state goes
               | to show why evolution values diversity far more than
               | monocultures.
        
             | madaxe_again wrote:
             | In a lot of sci-fi, the most "developed" civilisations have
             | their children raised by robots in creches.
             | 
             | I don't think it was supposed to be aspirational.
        
             | bluGill wrote:
             | Not ripping children from actually abusive families is more
             | developed. There are many cases of abuses families who need
             | to lose their children, and in some those families still
             | have children. There are other cases where good families
             | lose their children.
             | 
             | Note that I carefully did not say anything about what abuse
             | is. Unfortunately there is no agreement and I don't want to
             | get into that debate (it is well worth having, but it would
             | change the direction I'm trying to go here).
        
               | WarOnPrivacy wrote:
               | > There are many cases of abuses families who need to
               | lose their children, and in some those families still
               | have children.
               | 
               | A challenge is where the ripped-off children wind up, a
               | foster home system with it's own abuse issues.
        
               | raducu wrote:
               | There are debatable issues, and clear cut issues -- not
               | providing basic care or medical care is quite clear cut.
               | 
               | Homeschooling is debatable, if the children are evaluated
               | to be equal to their regular schooled peers, I don't
               | think the child should be taken out of the family
               | environment, but should be subject to further wellness
               | checks by social workers.
        
             | raducu wrote:
             | I'm not implying anything other than the fact in Romania
             | social workers KNOW it's very, very likely the child will
             | fare worse fate in an orphanage or foster care, EVEN in
             | cases that would be considered abuse in the West.
             | 
             | Given a more developed country, I'd presume there are more
             | people willing to adopt/do foster care for the right
             | reasons and the social workers can regularly check upon the
             | welfare of the child, thus there can be legitimate reasons
             | to lower the threshold of taking a child out of a family
             | setting vs a less developed country.
        
             | Matticus_Rex wrote:
             | That's not at all the implication.
        
           | pyrale wrote:
           | > in Denmark and other more developed countries it could be
           | the opposite.
           | 
           | Did you mean: richer?
        
             | raducu wrote:
             | I mean more developed, because a country like Saudi Arabia
             | is rich but not developed imho, and there could be
             | countries that are develope -- i.e. they have good
             | education, infrastructure, medical care, human rights,
             | clean environment etc etc and not that rich.
        
               | [deleted]
        
       | red75prime wrote:
       | Oh. And I thought that reddit outrage over the video of a father
       | throwing his son in the air was just your standard modern
       | hyperprotectiveness. Actually, the father risked lawsuit as it
       | stands. The lack of common sense (and knowledge of physics) is
       | off-putting.
        
         | mlindner wrote:
         | Did you read the article? The article claims the reverse. That
         | this is not a real problem.
        
       | katzenversteher wrote:
       | This always scared me because I don't even know what counts as
       | shaking.
       | 
       | Can you accidentally shake a baby? Can my 2 year old daughter get
       | shaken baby syndrome when older children on an inflatable castle
       | with her jump and bounce too wild around her (she can't jump yet
       | but loves the bouncing)? I've also often seen parents throw their
       | children a bit in the air and then catch them. The children like
       | it and laugh.
       | 
       | I'm not even speaking of law and police but medically. Can this
       | seriously hurt my daughter?
        
         | rossant wrote:
         | I don't think you should worry too much. Abusive shaking really
         | involves extreme forces. "Routine shaking" occurring during
         | play is not expected to be harmful to healthy children. Games
         | should be adapted to the age of children according to common
         | sense.
         | 
         | The takeaway of biomechanics studies is basically that you
         | should be much more careful about accidental head impacts on
         | hard surfaces.
        
         | eep_social wrote:
         | A) No, but no one can tell that you're a dog on the internet.
         | Further, dogs do not dispense reliable medical advice. The op
         | is a press release for a textbook covering this topic in what
         | looks like excruciating detail from a wide variety of angles. I
         | doubt a superior citation exists.
         | 
         | B) Beyond that, my understanding is that once a child is past
         | the infant phase where they cannot support their own head,
         | they're fine. Humans are not all that delicate. Bumps and falls
         | are inevitable, I don't see how we would have seen success as a
         | species if the risk were outsized. And I guess we've been
         | around for a while by now.
         | 
         | C) TFA does mention this a little but it is split across a wide
         | gap and is not the focus. I pulled the two quotes I think are
         | relevant below.
         | 
         | > And yet, although subdural and retinal hemorrhage may be
         | caused by non-accidental trauma, especially when impact is
         | involved, they simply are not specific for it: indeed, it has
         | been demonstrated that a wide range of accidental events and
         | medical conditions are plausible alternative causes.
         | Particularly fragile infants may sustain severe head injuries
         | following minor household falls. Others may suffer from genetic
         | conditions, metabolic disorders, blood clotting abnormalities,
         | or infections.
         | 
         | > On the other hand, there exist dozens of documented cases of
         | witness reports of shaking, videotaped shakings, and
         | spontaneous admissions of shaking, but without subdural and
         | retinal hemorrhage. In fact, there is virtually no known case
         | of a reliably-documented event of violent shaking without
         | impact of a healthy baby resulting in isolated subdural and
         | retinal hemorrhage (additional markers of trauma would be
         | expected in such cases). In contrast, there have been numerous
         | cases of videotaped or witnessed short falls resulting in these
         | very medical findings, considered "impossible" by the shaking
         | hypothesis.
         | 
         | So it's like they say: it's not the fall that gets you, it's
         | when you land.
        
         | DoingIsLearning wrote:
         | Generally throwing kids around (within reason) is absolutely
         | safe, specially at +2yrs. Rough play is very much part of
         | development for all mammals including us.
         | 
         | Perhaps something to help you cope with this is that our brain
         | although fragile has a lot of redundancy around it.
         | 
         | On a fall or bounce our neck will decelerate our fall/bounce,
         | there is no need to be an athlete, our muscles have a
         | contraction reflex if they are violently streched (myotatic
         | reflex), less so for very young babies with weak neck muscles
         | (think less than 6/9 months).
         | 
         | Then our skull is filled with fluid which has inertia so the
         | force on the skull is not directly transmitted to the brain.
         | You have to slush the liquid around quite a bit before your
         | brain experiences any meaningful force.
         | 
         | Effectively it is only with some extreme force or internal
         | bleeding compressing the brain that brain damage would occur.
        
           | stef25 wrote:
           | My kids love it when they come running toward me and I pick
           | them up and in one swoop throw them on to my (big) bed. I'm
           | always holding back because I see their head snap back to
           | land on the mattress, it's that "violent" head-moving-back
           | thing that gives me the fear, so I stopped.
        
             | TecoAndJix wrote:
             | a core part of my son and i's relationship is me yeeting
             | him on soft pieces of furniture (he's 3)! He is very
             | physical and likes to roughhouse - he injuries himself a
             | lot! Little kids really are made of rubber
        
         | Fire-Dragon-DoL wrote:
         | The article as I interpreted says that there is no recorded
         | case where you can get shaken baby syndrome and the sharking
         | was recorded on tape or declared in front of the police, that
         | being said, if your child has some pathology, they might be at
         | risk with even a minor fall
        
           | barsonme wrote:
           | You misread the article. The article states that there aren't
           | any SBS cases with _only_ "isolated subdural and retinal
           | hemorrhage."
        
         | amluto wrote:
         | re: the bouncy houses and such. Other than kids banging into
         | each other, this never seemed like much of a head or brain
         | injury risk. But watch out for knees! Trampolines with more
         | than one person on them are incredibly dangerous, and bouncy
         | houses seem likely to be pretty dangerous with occupants of
         | widely varying sizes. The specific issue is that the floor may
         | move abruptly and unexpectedly when someone is trying to land,
         | causing a potentially severe knee injury.
         | 
         | If you're in a bouncy house with kids, consider avoiding any
         | bouncing yourself.
        
         | CMCDragonkai wrote:
         | To protect against all possible harm against your child,
         | perhaps consider wrapping them in a giant balloon so they are
         | isolated from all possible outside influences.
         | 
         | We either accept the randomness of fate or we live in self-made
         | prisons.
        
           | gardenmud wrote:
           | I don't think this person is asking to protect against all
           | possible harm. I find it strange that you seem to think it is
           | unreasonable to not want your baby shaken so hard they die,
           | and to want to clearly know how much force that is.
        
       | Fire-Dragon-DoL wrote:
       | When I was getting ready to turn dad for the first time, I read a
       | few books on pregnancy, children and parenting. My trust on
       | medicine dropped substantially when I discovered that doctors
       | have poor notion of statistics, so they take for granted improper
       | studies results.
       | 
       | I remember one classic one is the "no coffee when pregnant", the
       | study says this causes problems, the test was performed on rats
       | and by feeding them coffee in the amount of 3/4 of their body
       | weight. We can agree that with this amount, it's reasonable it
       | could cause problems. Very different from one cup of coffee
       | though.
       | 
       | The other study that was done is about Amniocentesis, this one is
       | more interesting the chance of miscarriage is considered 0.1% but
       | this was before the operation was performed with a live
       | ultrasound to look at the needle while performing it, which
       | (probably) makes a big difference. Before, doctors performed an
       | ultrasound and then went in blind.
       | 
       | There was also a serious bias towards a certain type of
       | population. But of course doctors don't bring this up at all.
       | 
       | Last thing is sids, it's a terrible type of diagnosis that pushes
       | parents against the instinct of sleeping with their children,
       | even though this is commonly done in non-western cultures and can
       | save a lot of pain to the parents and give a lot of security to
       | the child. Do your research though, medical community reports
       | risks and I'm no doctor, just a dad who read a few books.
       | 
       | Glad my children are healthy. Every time I read about some
       | illness for children I feel an incredible weight on my heart
        
         | cjrp wrote:
         | Has SIDS been linked to co-sleeping? I thought the risks of co-
         | sleeping were more around accidentally rolling on or
         | suffocating the baby.
        
           | lqet wrote:
           | That is also what we were told after birth.
           | 
           | My personal opinion is that the advantages of co-sleeping far
           | outweigh the risks. It is much less stressful for both the
           | parents and the baby. My wife simply slept topless, turned
           | (half-sleeping) to our baby whenever it was crying, and
           | immediately fell back asleep.
        
             | nonethewiser wrote:
             | works for dad too
        
           | lesam wrote:
           | Newer research shows a good chunk of SIDS cases actually
           | _are_ likely suffocation from various causes.
           | 
           | That's why the SIDS reduction measures are mostly 'sleep on
           | the back, in an empty crib, with nothing soft around'.
           | 
           | But it's much easier to tell a grieving parent that there's
           | nothing they could have done, than that their baby got
           | unlucky and suffocated to death.
        
             | droopyEyelids wrote:
             | You are speaking facts, but it runs into the medical
             | problem of "overdiagnosis" where the treatment can be worse
             | than the disease.
             | 
             | Swaddling the baby and forcing it to sleep on its back, may
             | have a tiny statistical benefit for SIDS, but it causes
             | tons of problems at a time when people are taxed to the
             | limit of their abilities.
             | 
             | We could reduce the incident of breast cancer by removing
             | every woman's breasts, but that would be an improper risk
             | assessment.
             | 
             | The biggest factor linked to SIDS is poverty, and after
             | that it's stuff like going to bed while under the influence
             | of drugs and smoking.
        
               | omnibrain wrote:
               | And as soon as your baby can turn itself you have no more
               | influence in which position it sleeps anyway.
        
         | seszett wrote:
         | > _I remember one classic one is the "no coffee when pregnant",
         | the study says this causes problems, the test was performed on
         | rats and by feeding them coffee in the amount of 3/4 of their
         | body weight. We can agree that with this amount, it's
         | reasonable it could cause problems. Very different from one cup
         | of coffee though._
         | 
         | Honestly I don't know which study you're talking about, and I'm
         | not trying to question what you're saying (such studies indeed
         | often use exaggerated amounts because it's more likely to show
         | effects, but it can skew the results of course) but I just
         | found it interesting that depending on what "feeding them
         | coffee in the amount of 3/4 of their body weight" means, well
         | over a pregnancy it's easy to consume 3/4 of one's body weight
         | in coffee.
         | 
         | It means about 150 mL coffee per day for a woman weighing 55
         | kg, over 9 months.
         | 
         | About SIDS and sleeping with the children in the same bed, if I
         | remember correctly (it's been some time since I had to read
         | about this) the _very large_ majority of cases happened with
         | parents who either smoke or are obese. I think I couldn 't find
         | precise stats just for non-smoking, non-obese parents but it
         | seems like SIDS basically didn't happen in this case when co-
         | sleeping. It also almost never happens with immigrant parents
         | for some reason (even though they are statistically more likely
         | to practice co-sleeping, here in Europe).
        
           | noodlenotes wrote:
           | I'm a light sleeper and I feel like I have an awareness of
           | everything nearby when I'm asleep (like I used to fall asleep
           | with an open laptop in bed during college without knocking
           | into it). I have a feeling co-sleeping wouldn't be an issue
           | for me, but with all the dire warnings I'm afraid to risk it.
        
             | nonethewiser wrote:
             | > I'm a light sleeper and I feel like I have an awareness
             | of everything nearby when I'm asleep
             | 
             | You absolutely don't have awareness of everything nearby
             | when you're asleep. You are inherently incapable of even
             | determining this because you're sleeping. I'm sure you
             | react to some stimuli but that doesn't mean you can expect
             | yourself to react to every potential stimuli that you would
             | want to.
        
           | amluto wrote:
           | SIDS has all manner of interesting and unexpected demographic
           | correlations. I'm not convinced anyone knows what to make of
           | them.
        
             | TheGeminon wrote:
             | That's the problem with anything that is defined by the
             | symptoms, rather than the cause. As soon as you find
             | definitive evidence of what causes a subset of SIDS, it's
             | no longer really SIDS but "improper bed safety" or
             | "undiagnosed genetic condition".
        
             | AbrahamParangi wrote:
             | The covariates are awkward and because they correspond so
             | strongly with parental traits, the possibility exists that
             | the kids are dying because of dysfunctional parental
             | behaviors specifically.
        
         | [deleted]
        
         | gilbetron wrote:
         | When my wife was pregnant 15 years ago, I did a lot of similar
         | reading about various things. One was home vs hospital birth,
         | and at that time at least, there was a strong vibe of "home
         | birth is best birth" going around. Many people linked to a
         | study (which I can no longer find!) in Norway maybe? It was a
         | big study that "showed" that home birth was safer than hospital
         | birth. However, if you dug into the study, you'd find one
         | particular interesting nugget: if any of the home birth
         | participants experience any negative medical event, _even
         | during delivery_ , they were _removed_ from the study. It was
         | preposterous. In the end, all the study said was,  "home births
         | that happened without incident were safer than hospital
         | births", or, in other words, "safe births are safer than non-
         | safe births".
        
           | Sanzig wrote:
           | The home birth obsession makes me so angry. My wife had a
           | really bad postpartum hemorrhage when our daughter was born.
           | Thankfully, we were in the hospital, so the obstetrics team
           | was able to stop the bleeding and get her stabilized. She'd
           | have likely died if it was a home birth.
           | 
           | What's even crazier is that in most of the US, midwives only
           | need a high school diploma and a midwifery certificate - or
           | in many states, no education is required at all as the title
           | "midwife" is not protected. The vast majority of the rest of
           | the developed world requires midwives to either be
           | professional nurses with additional training in midwifery, or
           | to have a special four year midwifery degree (eg: here in
           | Canada, midwifery is a bachelor's degree). Many parents in
           | the US who opt for a home birth are likely unaware of how
           | underqualified many American midwives are compared to their
           | international counterparts to respond to an obstetric
           | emergency.
        
         | madaxe_again wrote:
         | You should see how the second hand smoke studies upon which all
         | other second hand smoke studies were based were done - very
         | similar methodology - cotton swabs were saturated with
         | combustion residues from hundreds of cigarettes, making them
         | into tarry masses, which were then applied to 100% of the
         | bodies of infant rats, every day for several weeks - and they
         | were then observed for developmental abnormalities. The
         | discussion then explicitly states that this should not be taken
         | as a human analogue, as the rats were seen to lick the residue
         | off their bodies, thus consuming all of it, and that further
         | research would be needed.
         | 
         | Further research was of course done - on rats - with much the
         | same methodology.
         | 
         | Medicine is really prone to falling for this sort of thing -
         | and it's honestly no great shock, recalling the calibre of
         | people at school who went on to become doctors. I studied
         | physics, for Christ's sake, and knew more about metabolic
         | pathways than third year med students who I would help cram.
        
         | mdorazio wrote:
         | I think it's both funny and sad that you're doing the exact
         | same thing as the "bad" doctors in TFA and then are on here
         | commenting about it. A quick search on Google Scholar for
         | "caffeine pregnancy" reveals a number of studies that show a
         | non-trivial link _in humans_ to increased miscarriage chances,
         | at levels of consumption that realistically occur with heavy
         | coffee drinkers. I.e. your conclusion is not so clear-cut and
         | is based on one (admittedly bad science) thing you read.
         | Example [1][2]
         | 
         | [1]
         | https://www.sciencedirect.com/science/article/abs/pii/S00029...
         | 
         | [2]
         | https://academic.oup.com/nutritionreviews/article/54/7/203/1...
        
           | scythe wrote:
           | From your second link:
           | 
           | >The results of this literature review suggest that heavy
           | caffeine use (>= 300 mg per day) during pregnancy is
           | associated with small reductions in infant birth weight that
           | may be especially detrimental to premature or low-birth-
           | weight infants. Some researchers also document an increased
           | risk of spontaneous abortion associated with caffeine
           | consumption prior to and during pregnancy. _However,
           | overwhelming evidence indicates that caffeine is not a human
           | teratogen, and that caffeine appears to have no effect on
           | preterm labor and delivery._
        
           | Fire-Dragon-DoL wrote:
           | I don't think that's fair toward me: the bad doctors never
           | told me "do your research, form your opinion". They were
           | always clear cut, they looked up on us for sleeping with our
           | children and they "checked" the breastfeeding checkmark at
           | the hospital even if my wife lamented pain during it and
           | turned out my daughter had a really bad lip/tongue tie that
           | took a month to be solved (with surgery). Notice that medical
           | personnel even told her "you have to endure it, it's normal",
           | as her breasts were cracking and she couldn't breastfeed
           | anymore (had to pump).
           | 
           | I explicitly said, do your research at the end of the
           | message.
           | 
           | P. S. The book might have been one of the following, I can't
           | remember:
           | 
           | Expecting Better: Why the Conventional Pregnancy Wisdom Is
           | Wrong--and What You Really Need to Know (The ParentData
           | Series Book 1) from Emily Oyster
           | 
           | What to expect when you are expecting
           | 
           | I think it's the first one. I read many at the same time, so
           | it's hard to remember which one had the information.
        
           | derbOac wrote:
           | The problem that became very salient to me dealing with
           | miscarriage is that women who have healthy pregnancies are
           | also more likely to have problems with morning sickness, and
           | are more likely to avoid things like coffee that are likely
           | to make them feel even more nauseous. Women who have troubled
           | pregnancies that are more likely to end in miscarriage are
           | less likely to feel nauseous and therefore continue to drink
           | and eat things as before.
           | 
           | So it's possible caffeine consumption is a sign of a troubled
           | pregnancy rather than a cause of it. I'm sure there's a point
           | where caffeine becomes problematic but that could be said of
           | a lot of things.
           | 
           | There's a paper in NEJM or JAMA that pointed to this as a
           | likely explanation but it's been a few years and don't have
           | time to look for it now. I think they were looking at timing
           | of caffeine consumption and nausea symptoms?
        
       | itsmemattchung wrote:
       | > As a precautionary measure, the hospital followed mandatory
       | reporting statutes and my wife and I temporarily lost custody of
       | David. Thanks to our incredibly effective defense lawyer, we were
       | cleared of all charges within two months, during which we stayed
       | at the hospital 24/7 with David until we sorted out the legal
       | procedures.
       | 
       | Holy shit. Parents bring baby to ER ... results reveal that baby
       | was shaken (article later confirms this was not the case) ...
       | parents lose custody for 2 months. Horror story.
        
         | roughly wrote:
         | And:
         | 
         | > [O]ur nanny was eventually cleared of all charges, but it
         | took four years for the court to recognize my son's medical
         | condition (a rare occurrence in France, as I later discovered)
         | during which we were forbidden to speak to her and she was
         | forbidden to approach children, thus losing her means of
         | livelihood.
        
         | jollyllama wrote:
         | What's the outcome for the kid? Can the system even do much to
         | help with the child's medical condition? If not, it's
         | irrational for people to take their children in for
         | examination; there's no benefit and you risk being accused.
        
           | bluGill wrote:
           | Parents only know symptoms, which could be anything. Those
           | same symptoms (or small variations) can lead to a very
           | different diagnosis which is easily treatable.
        
           | rossant wrote:
           | He underwent surgery to remove the excess of fluid around the
           | brain, and his condition progressively improved. It could
           | have worsened without the operation, we'll never know. Now,
           | at almost 8, he's doing great.
           | 
           | I've seen cases where parents call the ER after a collapse of
           | their child, only to see their child wake up just fine a few
           | minutes later. The EMT tells them it's not necessary to bring
           | their child to the hospital given the child has recovered,
           | but the parents insist. At the hospital, sometimes they have
           | to insist too for a CT scan to be performed. This is where
           | doctors find subdural bleeding and the parents end up
           | accused, the child is removed for months, etc. Yet, the child
           | gets no particular medical treatment. None of this would have
           | occurred if the parents hadn't insisted!
        
         | cwmma wrote:
         | Something similar happened recently in Massachusetts with a
         | doctor seeing an injury the parents couldn't explain and the
         | kid being taken away for a while. Injury turned out to probably
         | have been done by the grandparents who never told the parents
         | because the kid didn't fuss, but the kids were taken away in
         | the middle of the night.
         | 
         | https://www.nbcboston.com/investigations/massachusetts-dcf-e...
        
           | danenania wrote:
           | My first inclination here is to blame the doctor. Per the
           | Hippocratic Oath, doctors need to understand the implications
           | of making reports like this and only do so in cases where
           | there isn't reasonable doubt or plausible explanations other
           | than abuse. Separating children from parents and making
           | accusations like this is extremely traumatic in itself, so
           | the evidence bar needs to be very high.
           | 
           | Even if the rules tell doctors that they need to make a
           | report in a given scenario, they should not be following the
           | rules when they know the bureaucracies that handle these
           | reports are dysfunctional and prone to separating children
           | without conclusive evidence. Imo they are responsible for
           | protecting their patients from the system in these cases.
        
             | ameister14 wrote:
             | So you err on the 'some children are abused and die' side
             | of things, and other people err on the 'some parents get
             | separated from their children' side.
             | 
             | I don't think the line is at doctors reporting, and I'll
             | tell you why.
             | 
             | There are many cases of MD's having patients where they
             | know the whole family and can't believe that abuse would be
             | going on, so they don't report things like spiral fractures
             | and pattern bruising in a five year old. Those are markers
             | of serious domestic violence and abuse, but since the doc
             | knows the parent, and the parent has a sorta reasonable
             | explanation, fine.
             | 
             | No. The doctor reports, then the parents get investigated.
             | Sorry it sucks, but the point to fix is the people
             | interacting with the family at the point of investigation,
             | not the report by an MD, because unfortunately the MD is
             | going to lean towards not reporting until it is too late.
        
               | danenania wrote:
               | That would be fine if the investigations were fair and
               | followed basic principles of jurisprudence like "innocent
               | until proven guilty", but it's plain to see that kids are
               | being separated based on very flimsy evidence.
               | 
               | In my book, a doctor doesn't get to absolve themselves of
               | responsibility by saying "just following orders" and that
               | it's the investigative system that needs to be fixed. If
               | they know the system is broken, it's both immoral and a
               | deep betrayal of trust for them to report people without
               | strong evidence.
               | 
               | Almost any injury can be framed as possible evidence of
               | abuse. Parents shouldn't have to be afraid that taking
               | their kids to the hospital after an injury will get them
               | taken away. The vast majority of injuries are _not_ from
               | abuse, so a system with a low bar for evidence is going
               | to end up with more false positives than cases of abuse.
               | This is exacerbated by the fact that abusers, for obvious
               | reasons, are often going to avoid getting medical care
               | for the kids they abuse.
               | 
               | If your reasoning were applied more broadly, we'd put
               | anyone accused of a crime, or of even planning a crime,
               | in prison immediately, since otherwise crimes will occur
               | (with people hurt/killed) that could have been prevented.
               | There's a reason the legal system doesn't work this way.
        
             | cool_dude85 wrote:
             | I'm not sure if it's federal, but in my state a doctor is
             | required to report anything they feel is unusual. Mandated
             | reporter, it's called.
        
               | aidenn0 wrote:
               | There's a federal act (CAPTA) that requires states to
               | adopt mandatory reporting rules, but the rules vary from
               | state-to-state. Some states, simply by being in a
               | particular profession you are required to report (even
               | when not on the job); in other states it's specifically
               | when evidence is uncovered while performing your duties;
               | in some states, _all_ people are required to report.
               | 
               | I've never encountered a state in which a medical doctor
               | encountering evidence of abuse while seeing a patient is
               | not required to report it, with the exception of some
               | states exempting mental-health professionals told things
               | in confidence (so a psychiatrist, which is also an MD,
               | might not be required to report it depending on the
               | state).
        
         | cm2012 wrote:
         | Not surprised it happened in France, they are much more of a
         | nanny state (in good and bad ways) when it comes to parenting.
         | Like the fact that paternity tests are banned unless you have a
         | court order, etc.
        
           | huytersd wrote:
           | Can't you just get a paternity test online? Otherwise that's
           | an insane situation, do they expect a dad to raise a kid that
           | is not his?
        
             | lmm wrote:
             | > Can't you just get a paternity test online?
             | 
             | You can, but it's a crime, much like buying banned drugs
             | etc.
             | 
             | > do they expect a dad to raise a kid that is not his?
             | 
             | Yes.
        
             | seszett wrote:
             | > _do they expect a dad to raise a kid that is not his?_
             | 
             | You just need a court order to do a paternity test, they're
             | not banned but regulated by law.
        
             | sneak wrote:
             | It's not insane. Genetic lineage is the least important
             | factor in whether or not a given kid is "yours".
        
               | huytersd wrote:
               | It's by far the most important factor. Who are you to say
               | it isn't?
        
               | hcrean wrote:
               | [flagged]
        
               | [deleted]
        
               | cm2012 wrote:
               | "Slighted" is doing a lot of work in this sentence, wow.
        
               | amanaplanacanal wrote:
               | I can certainly see the other side of this argument
               | though, it feels very unfair to saddle a third party with
               | the responsibility to support a child they had no part in
               | making.
        
               | AussieWog93 wrote:
               | Do you have kids?
               | 
               | I remember when my wife was pregnant with our first, I
               | kept half-joking about getting a peace of mind paternity
               | test.
               | 
               | After actually meeting the kid and getting to know our
               | love her, I couldn't think of anything more devastating
               | than finding out she's not mine.
               | 
               | Honestly wouldn't want to know, because losing my little
               | girl would be worse than misallocating resources or
               | whatever the Darwinian theory would be.
        
               | amanaplanacanal wrote:
               | Oh sure, I totally understand that. I wouldn't care a bit
               | about genetics in that case.
               | 
               | Imagine a different scenario though. Imagine you are on
               | the point of breaking up, or even already separated, and
               | she is suddenly pregnant.
        
               | huytersd wrote:
               | You may find being willfully ignorant acceptable but
               | that's really not the norm. I do have kids. If I knew
               | they were not mine I would not leave them but I would
               | have kids that were biologically mine. Either ways I want
               | to know.
        
               | goles wrote:
               | As someone else pointed out in the thread.
               | 
               | The question wasn't would you want to know. The question
               | is does a father have a right to know if they want to.
        
               | ryandrake wrote:
               | I think the importance of the "making" part greatly
               | depends on how long it's been since the making happened.
               | The more time that elapsed, the less important it is, and
               | the more important the child's existing bond to their
               | (assumed) father is. If I suddenly found out my 10 year
               | old didn't happen to biologically come from me, it's not
               | like I'd love her any less. What kind of monster says
               | "Oh, so the kid's not 'biologically mine', I'm going to
               | stop loving them!"
               | 
               | I'd have words with mom, though, obviously...
        
               | sneak wrote:
               | > _I 'd have words with mom, though, obviously..._
               | 
               | To what end?
        
               | ryandrake wrote:
               | Never gave it much thought because my kid's genetic
               | lineage has never really been called into question.
               | Obviously if something like this came up, you'd have to
               | talk to your partner about a wide variety of topics
               | ranging from trust to STDs. But "should I keep loving and
               | raising the child" would obviously not be one of them.
        
               | ecshafer wrote:
               | If the state decides that it is better for a child, of no
               | relation to you, to be taken out of foster care and you
               | are now their legal guardian: you would be happy with
               | this turn of events? You have a job presumably, surely
               | that would be better than foster care or an orphanage.
        
               | huytersd wrote:
               | The welfare of someone else's child doesn't register very
               | highly on a majority of people's radars beyond basic
               | humanitarian considerations. How about government
               | provided daycare and forcing the mother to work.
        
               | sneak wrote:
               | Possession is nine tenths of the law. It's not someone
               | else's child if it's in your house and you need a genetic
               | test to deny responsibility.
               | 
               | This idea that bloodlines are relevant is anachronistic
               | superstition. Several of my friends are not genetically
               | related to their children. It's simply not relevant.
        
               | huytersd wrote:
               | Why are you trying to play off your limited anecdotal
               | evidence as universal? It has been the most important
               | thing since the dawn of human civilization and continues
               | to be so. What if someone just dropped off a random child
               | at your doorstep and tells you you're responsible for its
               | upbringing now. I can understand people that want to
               | adopt but that's a conscious decision they made on their
               | part.
        
               | komali2 wrote:
               | > It has been the most important thing since the dawn of
               | human civilization
               | 
               | Technically this is appeal to tradition. Certainly it's
               | true that our various worldly cultures are strongly
               | influenced by this idea, but factually speaking... before
               | paternity tests, there was literally no way to know for
               | men if a child was their paternal child, especially in
               | societies with very little physical attribute variance.
               | Therefore , it's not really true that "it's the most
               | important thing," because we've never been able to tell
               | for certainty who a child's father is until very
               | recently. Even with physical attributes, our knowledge of
               | genetics is relatively recent in human history, so
               | there's probably lots of false positives / negatives
               | (with hair or eye color for example).
               | 
               | > What if someone just dropped off a random child at your
               | doorstep and tells you you're responsible for its
               | upbringing now.
               | 
               | This doesn't make sense in the context, is this a red
               | herring or a strawman or similar? I believe the
               | discussions is around situations that would normally
               | involve a paternity test, which to me all essentially
               | double checking whether a woman could have been
               | impregnated by some other person than the expectant
               | father.
        
               | kortilla wrote:
               | It's the same thing. If a man has sex with a woman and
               | the government then drops off a foster child 9 months
               | later, that's no different than being expected to raise a
               | child fathered by another man with the same woman.
        
               | dumpsterdiver wrote:
               | When it comes to "justifiable reasons for leaving your
               | partner, the person you love and trust", infidelity is
               | right up there near the top. You seem to be implying that
               | the victim whose trust was irrevocably shattered should
               | also be saddled with the financial burden which resulted
               | from the act of infidelity. If that's how you truly feel
               | then I'll just leave it at, "I disagree." There's not
               | enough common ground to argue upon constructively
               | otherwise.
        
               | barrysteve wrote:
               | Step-fathers and step-children are well known vectors of
               | abuse. The Cinderella Effect was verified to produce more
               | abuse from step-relationships up to and including lethal
               | beatings from step-fathers.
               | 
               | Legally it might not be relevant for whatever structural
               | reason, but the reality is that it matters a lot.
        
               | cm2012 wrote:
               | Adopting is no big deal. Being cuckolded is generally
               | considered one of the biggest betrayals in the human
               | experience. It's incredibly relevant to know if your
               | spouse is faithful to you!
        
               | mark_up wrote:
               | It might matter to you, but it has no bearing on the
               | welfare of a child or the greater good of the community.
        
               | Dylan16807 wrote:
               | We can prioritize the child without forcing someone
               | nearby to become the parent.
        
               | huytersd wrote:
               | [flagged]
        
               | sneak wrote:
               | You are conflating infidelity with lack of knowledge of a
               | child's paternity.
               | 
               | They are not remotely the same.
        
               | _rm wrote:
               | I think this is the most bizarre statement I've read on
               | the internet this year. And this is _the internet_.
        
           | arp242 wrote:
           | reason.com has an entire long-running series of stories like
           | this happening in the U.S. I've heard quite a few stories
           | from the Netherlands. It probably happens in other countries
           | as well.
           | 
           | It's an issue in many Western countries, where we've
           | seemingly become risk-averse to the point where it's causing
           | more harm than good.
        
             | magicalhippo wrote:
             | Here in Norway the child protection services have been
             | found guilty[1] of being too quick to remove children from
             | their parents, and not letting the parents see them.
             | 
             | This seems to have led to the pendulum swinging too much in
             | the opposite direction, where they now seemingly force
             | foster kids to meet their biological parents against the
             | kid's will[2]...
             | 
             | [1]: https://rett24.no/articles/norge-felt-i-ni-nye-
             | barnevernsake...
             | 
             | [2]: https://www.nrk.no/norge/mener-fosterbarn-presses-til-
             | skadel...
        
         | trenchgun wrote:
         | >parents lose custody for 2 months. Horror story.
         | 
         | If you read the rest of the article, you will realize that this
         | was the absolute happy path in that kind of situation. That's
         | the real horror story: that the default path involves stuff
         | like losing custody forever, incarceration, suicide, divorce
         | etc.
        
           | rossant wrote:
           | Yes, after discovering hundreds of families living much worse
           | situations, I consider myself as one of the lucky few. I'm
           | grateful for that and this is why I can spend so much energy
           | ensuring it doesn't affect too many other families in the
           | future.
        
           | cnity wrote:
           | Watch the Netflix documentary Taking Care of Maya for a
           | sobering and ongoing look into this.
        
       | arp242 wrote:
       | > Very often, abuse is diagnosed "by default", because no known
       | alternative explanation was found (or even actively sought). This
       | is extremely dangerous, as it seems to indicate that no further
       | medical discovery need ever be made in the future.
       | 
       | Well, "dangerous" for who? For a lot of people involved in "child
       | abuse" - from medical professionals to child services to the
       | police - a false positive carries basically no consequences: you
       | report it, or follow up, or do whatever your task is, "to be
       | sure", and that's it.
       | 
       | But a false negative can have a lot more consequences, including
       | losing your job, lawsuits, becoming the centre of a media circus,
       | becoming the target of an investigation yourself, etc. etc.
       | 
       | Also see: most Amber Alerts should not have been sent, and are
       | just simple cases of runaways, miscommunications, or family
       | drama. But the official "pushing the button" to send out an alert
       | has the same incentives as above.
       | 
       | The incentives are pretty obvious.
        
         | hmottestad wrote:
         | It would be dangerous for the children. In the most extreme
         | imaginable case we could discover a preventative measure for
         | the brain bleed.
         | 
         | Infants are routinely given vitamin K and vitamin D to prevent
         | bleeding and to prevent bone development issues. Imagine if
         | there was something else that could be given to prevent brain
         | bleeds. That would save a lot of children.
        
       | pmarreck wrote:
       | As a new parent of a son, this is horrifying.
       | 
       | Why is the default, to accuse the caretakers with phantom
       | (unfounded) certainty, absent any other good evidence?
        
       | fnordpiglet wrote:
       | This article reminded me of another local story about a doctor
       | who provides assessment beyond the knee jerk child protection
       | industrial complex -
       | 
       | https://www.seattletimes.com/seattle-news/child-abuse-or-med...
       | 
       | This also reminds me a lot of the indoctrination we went through
       | at the hospital when my daughter was born.
       | 
       | Despite being a high risk pregnancy we were railroaded into a
       | natural birth. After nearly 24 hours of horrific labor she spiked
       | an extremely high fever and they had to do a c-section, making us
       | feel like failures. They found that our daughter wouldn't have
       | made it otherwise.
       | 
       | We were castigated because my wife took medicines that entered
       | her milk and were made to feel like failures for considering not
       | breast feeding. She had to pump milk at five AM before she took
       | any medicine to minimize the exposure to the extremely toxic
       | medicine that would be present in her milk. She didn't produce
       | enough milk and we were at wits end. The nurses and doctors at
       | the hospital were unhelpful and treated us like abusers. When we
       | went to our local pediatrician he laughed and said entire
       | generations were raised on formula and to stop killing ourselves.
       | It was the best advice we were ever given.
       | 
       | Likewise my daughter couldn't sleep on her back. She wailed every
       | night. I read everything I could find on SIDS and I realized the
       | correlation for back sleeping was very weak - almost
       | statistically irrelevant - and even then the prevalence of SIDS
       | was very low. Yet I knew for 100% my daughter wasn't sleeping. I
       | knew if I told anyone I would be lectured, and I worried might
       | even be reported. The after nearly a week of not sleeping I
       | flipped her over one night with my heart pounding. She fell
       | asleep immediately. She didn't die.
       | 
       | She's nine now and an incredible athlete and has a sharp and
       | brilliant mind. None of the doomsday stuff occurred. No autism,
       | no weak immune system, no weight problems, intellectual
       | deficiency, or all the other warnings we were given about
       | c-section, formula, or belly sleeping. Over the years I continued
       | to read the research and there's basically nothing compelling
       | about any of this advice, at least not at the level of stridency
       | parents experience.
        
         | Fire-Dragon-DoL wrote:
         | I didn't know that about sids. What a bullshit diagnosis. Our
         | children mostly slept tummy down on mum's chest, skin-to-skin,
         | because that reduced sids chance (and we were terrified). But
         | like yours, they couldn't sleep tummy up
        
           | xyzzy_plugh wrote:
           | AIUI tummy down on a (wakeful) person is generally not a
           | concern nor what the "back is best" crowd is referring to
           | 
           | Obviously a parent who is spending nearly all their time with
           | a newborn knows them best and is likely able to make the best
           | judgement about what works for the child, but the purpose of
           | the advice is to avoid a class of scenario that occur most
           | often. due to issues that are very difficult to detect and
           | often go completely undiagnosed, as they pertain to early
           | development and often improve naturally over time.
           | 
           | The technical report by AAP the other year does an excellent
           | job of presenting the current evidence in an as objective way
           | as possible, I highly recommend it:
           | 
           | https://publications.aap.org/pediatrics/article/150/1/e20220.
           | ..
           | 
           | You will note that efforts are being made to disentangle
           | diagnoses from the broad SIDS label and that while SIDS cases
           | are trending downwards, it's likely due to both proper
           | classification and education.
           | 
           | The point of preventative measures is to avoid the issue
           | entirely. Sure, tummy sleeping might not be a problem for you
           | (or maybe it was and you just got lucky!) but by generally
           | recommending back sleeping, a class of issues is avoided.
           | 
           | So all in all, I really don't see this as bullshit at all.
           | Caveat that you gotta do what you gotta do, but I'd rather
           | this advice persist than not. We should hope that no one ever
           | has to endure the loss of a child.
        
             | fnordpiglet wrote:
             | Even in reading that despite the hyperbolic phrasing I find
             | it unconvincing. We are talking about something that
             | happens to less than 0.04% of babies. The odds ratio quoted
             | is 2 - so for belly sleeping it's 0.08%. They give
             | hyperbolic advice (it's critical they sleep supine every
             | time they sleep, etc), and while I don't dismiss an
             | observed odds ratio in a single study of 2, I also hold
             | that it's not critical in the least. What's critical is
             | sleep, milk, love, and intimate closeness. The energy spent
             | on back sleeping would be better applied to emphasizing the
             | need for intimacy as failure to thrive is much more likely
             | than sids.
        
       | firesteelrain wrote:
       | " Let there be no misunderstanding on the point that shaking is
       | an absolutely real and dramatic form of child abuse. Inflicted
       | head trauma is a devastating condition and a definite cause of
       | traumatic brain injuries, including intracranial hemorrhage. Many
       | medical determinations of SBS/AHT are made on children who have
       | effectively been victims of violent intentional trauma.
       | Prevention efforts against all forms of child abuse are totally
       | warranted."
       | 
       | A lot of the comments here are missing this key statement. While
       | there can be medical explanations for things that look like SBS,
       | it's exceedingly rare
        
         | laurent_du wrote:
         | I missed this part. Where does the author mention that other
         | medical explanations (other than SBS) are exceedingly rare
         | compared to the baby having indeed been shaken?
        
           | firesteelrain wrote:
           | I said that blaming medical reasons for SBS is exceedingly
           | rare. As indicated, trauma due to shaking is usually the
           | case. Medical reasons can't be ruled out. That's the crux of
           | the issue.
        
         | ClarityJones wrote:
         | You're assuming that medical science is capable of providing an
         | explanation in every case, when the whole point of this article
         | is to say that these symptoms are insufficient to diagnose SBS.
         | The author is saying if we have no alternative medical
         | explanations, then we have no medical explanation at all. In
         | order to diagnose SBS, the author suggests that you need
         | additional evidence suggesting trauma such as bruising, broken
         | bones, etc. Indeed, that seems to be what the SBS lobby is now
         | saying as well, they just haven't communicated that to front-
         | line providers.
        
           | firesteelrain wrote:
           | "You're assuming that medical science is capable of providing
           | an explanation in every case, when the whole point of this
           | article is to say that these symptoms are insufficient to
           | diagnose SBS"
           | 
           | I do not disagree with you. I just caution as does the author
           | that you can't rule out criminality either.
        
           | rossant wrote:
           | > In order to diagnose SBS, the author suggests that you need
           | additional evidence suggesting trauma such as bruising,
           | broken bones, etc. Indeed, that seems to be what the SBS
           | lobby is now saying as well, they just haven't communicated
           | that to front-line providers.
           | 
           | That's exactly it.
        
         | DrThunder wrote:
         | You must have skimmed the article because it said over and over
         | that it was basically impossible to definitively identify that
         | a baby was shaken. It's a diagnosis they use when they're not
         | sure.
        
           | firesteelrain wrote:
           | It does not say that.
        
       | murphyslab wrote:
       | It's interesting the instance cited about authors of a scientific
       | paper being compelled to remove a reference because a peer
       | reviewer alleged that the researcher behind it is "a lousy and
       | dishonest researcher". What's more interesting is that PLOS ONE
       | repeated the allegation. I am curious whether there is a case for
       | defamation for the publication of such an allegation.
       | 
       | https://journals.plos.org/plosone/article/peerReview?id=10.1...
       | 
       | I've certainly had peer reviewers trying to get me to cite their
       | own papers in my articles, however I've never seen an instance
       | where a peer reviewer alleged that an article I've cited was by
       | someone disreputable.
        
         | kergonath wrote:
         | > I've certainly had peer reviewers trying to get me to cite
         | their own papers in my articles, however I've never seen an
         | instance where a peer reviewer alleged that an article I've
         | cited was by someone disreputable.
         | 
         | I have recommended some citations to be removed as a reviewer.
         | It's not useful to keep citing discredited articles that should
         | have been retracted. Keeping them in new articles just makes
         | them more likely to be read uncritically and further propagate
         | bullshit.
         | 
         | OTOH, the argument is "the article is rubbish", not some kind
         | of as hominem attack because I don't like the main author.
        
           | murphyslab wrote:
           | I can see encouraging authors to remove "zombie citations",
           | but that should be rare nowadays, as many bibliographic
           | databases will automatically flag retracted articles now,
           | thanks to integration with the Retraction Watch database.
        
             | kergonath wrote:
             | Hopefully, yes. But there are a lot of articles that should
             | be retracted, but that won't be because of editorial
             | policies or the fact that nobody actually cares.
        
       | didibus wrote:
       | As a parent, I can only imagine one thing worst than someone
       | causing such head injury to my child, it is for me to be falsely
       | convicted of such abuse and losing access to my own child.
        
         | qez2 wrote:
         | [dead]
        
       | RektBoy wrote:
       | "Shake it baby"
        
       | zapdrive wrote:
       | Imagine your child taken away from you just on the basis of some
       | assumptions. This makes my blood boil. I have never had murderous
       | thoughts even when I have been wronged really bad. I just forget
       | and move on with life. But I don't think I can do that if my
       | child is taken from me for something I didn't do. I'll definitely
       | go postal. Land of "Freedom".
        
         | slackfan wrote:
         | Not just a US thing. Europe is even more prevalent.
        
       | mcguire wrote:
       | " _But in practice, extremely few medical conditions are checked
       | for and "excluded" before concluding a diagnosis ... - the great
       | majority are not checked for at all. Very often, ... is diagnosed
       | "by default", because no known alternative explanation was found
       | (or even actively sought)._ "
       | 
       | From anecdotes I hear, that is one of the major problems with the
       | medical system in a nutshell.
        
       | noobermin wrote:
       | In the anglosphere (or may be just america) "think of the
       | children" has lead to a lot of these sorts of issues. Child abuse
       | is the worst thing anyone could imagine, and so, how could anyone
       | over-react? How can any action be enough? May be some figures or
       | entities take advantage of this, but there is some sincere
       | motivation in these drives too. And now, we have issues like this
       | article, children not being allowed unattended in most public
       | places, children unallowed to walk on their own without adult
       | supervision, and it goes on and on.
       | 
       | The thing is there is no needed ill intent, all parents can be
       | sincere, and yet create a society and culture that stunts their
       | very childrens' growth and lives. In the article, as the author
       | said, how many thousands of parents have been separated from
       | their child, and the infant, now parent-less, will be shuffled
       | from foster home to foster home, all in the name of ending abuse
       | based on filmsy evidence and poor science? It's depressing.
       | 
       | The very desire to protect and love leads to hurting those we
       | intend to help.
        
         | [deleted]
        
         | sacnoradhq wrote:
         | This was a sensational news trope on MSM nightly news and news
         | magazines in the 90's in the US.
        
       | kr0bat wrote:
       | I came to realize that there was a long-standing scientific
       | controversy in the field, and I felt that I had no choice but to
       | get to the bottom of things myself. Although I am not a medical
       | doctor, I hold a PhD in neuroscience and am familiar with
       | critically reading scientific literature. I decided that I would
       | invest as much time as necessary to learn everything I possibly
       | could on the subject. At that point, there was nothing in my life
       | more important than finding out what had really happened to my
       | son.
       | 
       | This is why higher education (and academic mettle) is amazing
        
         | drt5b7j wrote:
         | [flagged]
        
           | faeriechangling wrote:
           | I'm not dismissive of education. I learn on the job. I learn
           | in my free time. I learn to further my career. I learn to
           | help myself out. I learn for fun.
           | 
           | What I resent is the absurd idea that going to a brick and
           | mortar institutions for 4, 6, maybe 10 years, following a
           | track the teacher and administration considered best, with
           | the vast majority of those being educated getting an outdated
           | curriculum, is an effective means of learning. This entire
           | attitude is portrayed as pro-education but it's really just
           | pro-institution. It's only an effective means of learning
           | insofar that the credential you get at the end can open doors
           | to opportunities to learn, a point I will readily concede.
           | 
           | I also have done amateur medical research in my spare time
           | and literally printed out some papers and taken them to my
           | doctor and said "let's do this". This ended up being very
           | successful and very productive. It's not what the OP did is
           | something people who did fancy book lernin' through a SCHOOL
           | can do only after years of toil. You can just pick up the
           | skills you need as you go and get reasonable results.
        
             | dtdynasty wrote:
             | I think you underestimate the lack of self directed
             | learning ability people have before going to a higher
             | education institutions. I know I would have failed at solo
             | learning without going to college before hand.
             | 
             | Structured education can definitely help a majority of
             | students who need to get to a point where self directed
             | learning is effective. I have my qualms with higher
             | education but its existence itself is not one of them.
        
           | dartos wrote:
           | And that's solid advice for starting a tech company. (This is
           | a y combinator website)
        
         | dartos wrote:
         | I think that speaks more towards the author than higher
         | education.
         | 
         | Definitely a tangent, but attributing that attitude to higher
         | education is like someone attributing a doctor saving their
         | life to an act of god. Like yeah if you squint I guess that's
         | true.
         | 
         | My experience with higher education has been that of
         | administrators taking advantage of my naivety for profit,
         | elitism towards those not in academia, and dismissal of any
         | ideas that wouldn't directly result in a grant or a good
         | headline.
         | 
         | I wouldn't really say that the author's "mettle" is a result of
         | the same environment.
        
           | sanderjd wrote:
           | Yeah I dunno... I mean, a lot of these things are true, and
           | they all are big problems, but also, in my experience,
           | academics (at least in the sciences) do actually know how to
           | read and understand research, which is an extremely difficult
           | and useful skill.
        
             | j16sdiz wrote:
             | Isn't that just what PhD do? I meant going through piles of
             | papers - most of them bring more new questions than answers
             | - and stay sane
        
               | sanderjd wrote:
               | Yep. That's exactly what I'm saying. This is like the
               | primary skill that people learn to get a PhD. It's true
               | that people can learn it without getting a PhD, but
               | hardly anyone does, because it kind of sucks and if
               | you're doing it you may as well do it with the guidance
               | of an advisor and get a credential at the end.
        
             | hyperthesis wrote:
             | Yeah, I think "mettle" here is like a sword and shield and
             | the ability to use them (read and understand scientific
             | literature, and able to do so, self-directed, for _years_
             | ).
             | 
             | But whether a person _does_ use them, and for what, is
             | entirely due to the person themselves.
        
             | cdogl wrote:
             | Many academics have these skills; whether the higher
             | education system is effective at teaching them and delivers
             | an experience worth the significant cost to students (or
             | here in Australia, also the publics).
        
               | sanderjd wrote:
               | I would argue that it's clearly _the most_ effective
               | system at training people to do this. It 's fine to
               | imagine (and try to create) alternative systems that
               | would work better. But there isn't one now.
               | 
               | Constructive criticism is good. But what I mostly see
               | (and often do myself) is just grousing.
        
               | dartos wrote:
               | Yeah you're not wrong at all. I'm not saying "down with
               | academia" or anything like that.
               | 
               | Just that attributing the work and work ethic of an
               | individual to the institution of academia is weird and
               | fosters and propagates elitism.
        
             | dartos wrote:
             | That's okay, I know.
             | 
             | Anyone with the wherewithal can learn to "read and
             | understand research" it's not a magical power bestowed upon
             | the few who receive recognition from some long standing
             | bloated institution.
             | 
             | Attributing the drive and work of an individual to such an
             | institution is weird and elitist.
             | 
             | I should note that if said institution paid for, assembled
             | the team, and provided resources, then that institution
             | obviously deserves credit.
        
               | sanderjd wrote:
               | I think this is a misunderstanding of how stuff works. I
               | agree that anyone (or at least a large percentage of
               | people) can learn to do it and it isn't a magical power.
               | 
               | But it's far more common for academics to be able to do
               | it because _that 's what academics learn to do_. It's a
               | large focus of the training.
               | 
               | It isn't elitist to say "car mechanics are good at
               | reading and acting on the information in car engine
               | manuals", that's just what car mechanics are trained to
               | do and get consistent practice at doing.
        
               | dartos wrote:
               | I don't think there's any misunderstanding. Your comment
               | seems in line with what I said and what I believe.
               | 
               | One can teach themselves how to be a mechanic and pass
               | the ASE. Most go through some course to learn the trade,
               | of course. It's more structured that way and many find it
               | easier.
               | 
               | I've never had my auto repair shop attribute their
               | mechanic's skill to where they learned to be a mechanic.
               | I never turned down a mechanic bc they didn't go to the
               | brown or Harvard of car repair.
               | 
               | On the other hand I'm an expert in my field, but I've
               | been turned down from at least 1 job specifically because
               | I didn't graduate from Brown university. (It was a
               | backend job for the now-defunct Delivery Dudes)
               | 
               | OP attributed the mettle of the author to higher
               | education and academia, which I think is weird and
               | elitist.
               | 
               | Attributing success or ability to an institution fosters
               | that kind of weird elitism.
        
           | autoexec wrote:
           | Lots of other parents driven to look for answers about what
           | happened to their child, but being far less educated on how
           | to read and understand academic papers, ended up "doing their
           | own research" and became antivaxxers. There's a lot to be
           | said for having an education that enables you to evaluate
           | scientific literature effectively.
        
             | cm2012 wrote:
             | The kind of people who get PhDs can also figure out how to
             | read academic papers on their own. There's a lot of
             | correlation/causation mix up on this thread.
             | 
             | For instance, people who get accepted into Harvard but
             | don't attend have the exact same life outcomes to those who
             | get accepted and do attend. The same is now true for
             | college in general once you account for opportunity costs.
        
             | faeriechangling wrote:
             | I was in a private discussion group during the pandemic
             | that "did their own research"
             | 
             | First off, this was genuinely valuable during the first few
             | months. Gigantic medical institutions were moving at a
             | glacial pace and were making proclamations literally months
             | behind the state of the research. In order to conserve
             | masks, propaganda was put out that masks were only
             | effective if you were a medical professional, and the most
             | common way I saw this rationalised was that the general
             | public was simply too stupid to wear a mask in a sanitary
             | way. So I proceeded to wear a mask in a sanitary way. Then
             | after a few months mask stocks started to pile up so
             | propagandists THEN pronounced that more science was
             | conducted and masks were actually effective for everybody!
             | 
             | That positive outcome aside, what other people saw was that
             | the younger people got, the lower the risks of COVID, and
             | the higher the risks of getting vaccinated. In fact, it
             | seemed from the numbers (This is for the earlier strains of
             | COVID), that for certain populations (young people who
             | lived like hermits, in other words, hacker news readers) it
             | could be on a selfish individual basis, be irrational to
             | get the COVID vaccine. The risk from myocarditis could
             | actually outweigh the risk of COVID itself. It was however,
             | always in the collective interest for as many people to get
             | vaccinated as possible, to reduce the transmission of
             | COVID, and reduce the consequent strain on medical
             | resources and the direct/indirect deaths this caused.
             | Public health institutions did not get into this nuance,
             | because it wasn't in the collective interest, so they just
             | told everybody the vaccine was good for you. I proceeded to
             | get vaccinated, and the main person I held discussions with
             | did not, after both drawing the exact same scientific
             | conclusion. Not every anti-vaccer was stupid, some of them
             | were just massive civil libertarians.
             | 
             | What I saw from people who DIDN'T do their own research is
             | that they were UNIFORMLY misinformed because they tended to
             | either believe institutions who would lie to them whenever
             | it served their purposes (2 weeks to flatten the curve!),
             | or believed whatever podcaster told them about Ivermectin.
        
               | linuxftw wrote:
               | We know now that the CDC and the manufacturers (and the
               | media) lied about efficacy regarding preventing
               | transmission/infection. In fact, the trials didn't even
               | attempt to measure transmission or infection, and were
               | not ever authorized for such. The only thing they were
               | authorized for was reducing the severity.
               | 
               | Do not perpetuate the myth that the vaccines slowed the
               | spread.
        
               | faeriechangling wrote:
               | No, I think I will stand by my position that the vaccines
               | did in fact slow the spread, especially early on. I think
               | there is LOTS of evidence about the vaccines effects on
               | transmission which points to them being effective.
               | 
               | Also think back to before we had good evidence on
               | transmissibility/infection. Myocarditis hit the young,
               | who were the last to be vaccinated, and consequently
               | among the last to be researched. So the evidence of the
               | vaccinations effects on transmissibility/infection led
               | the evidence about myocarditis. Before either of those
               | bits of evidence came out, the vaccines were nevertheless
               | VERY effective at reducing hospitalisations from COVID-19
               | caused by early strains in those initial trials. I've
               | also only really heard of the Pfizer trial's being
               | severely criticised after the fact.
               | 
               | So there was good cause to get vaccinated the entire
               | time, although the value of vaccination kept dropping as
               | new strains kept cropping up which were seemingly less
               | impaired by vaccination, and after omicron I saw a huge
               | amount of people start to skip vaccination.
        
               | ifyoubuildit wrote:
               | > I think there is LOTS of evidence about the vaccines
               | effects on transmission which points to them being
               | effective.
               | 
               | Can you point to some canonical sources on this?
               | Preferably things that were published in the last year or
               | so.
               | 
               | My understanding is that effects on infection and
               | transmission were overstated and very short lived anyway.
               | Didn't everybody get covid eventually, multiple times
               | even?
        
               | adgjlsfhk1 wrote:
               | Everyone getting covid and slowing transmission aren't
               | incompatible. In the no lockdown, no vaccine world,
               | everyone gets covid in ~100 days. With vaccines that
               | period is a lot longer (roughly a year?) even though
               | omicron has roughly twice as high a transmission rate.
               | The simplest proof that vaccines have an effect on
               | transmission is the number of infected people by vaccine
               | status. There have been dozens of studies of this (see
               | https://covid.cdc.gov/covid-data-tracker/#vaccine-
               | effectiven...) but this really is one where you can just
               | eyeball the effects
               | https://www.nytimes.com/interactive/2021/10/28/us/covid-
               | brea....
        
               | bluGill wrote:
               | While is was not measured directly, we can still look at
               | other data. People who don't get COVID obviously cannot
               | spread it, and so we know vaccines were effective to slow
               | the spread. They were not good enough to stop it, but
               | they did slow it.
        
               | tsimionescu wrote:
               | You can go ahead and read the trials yourself. They very
               | much found that the vaccines were _excellent_ at
               | preventing Covid-19 entirely (they did not measure if
               | they also prevented SARS-CoV-2 asymptomatic infection).
               | 
               | It just turns out that they had far too little data and
               | that in real-world conditions they weren't anywhere near
               | the 90+% claimed effectiveness.
               | 
               | Even so, the latest population-level research still
               | suggests that the vaccines were 50-60% effective at
               | preventing Covid-19 entirely, at least for some months.
        
               | linuxftw wrote:
               | First, they still haven't released all the trial data.
               | Second, the data the FDA released on their own website
               | for the Pfizer trials proved they didn't even test all of
               | the participants in the trial for COVID, nor did they
               | test all the 'suspected but unverified' cases of COVID.
               | 
               | There simply is no data to prove they ever prevented
               | transmission. The trials were the best place to prove
               | that, and they DIDN'T EVEN BOTHER TO TRY.
        
         | [deleted]
        
         | rossant wrote:
         | Yes, I met other parents with higher education/a scientific
         | background (researchers, engineers...) and living the same
         | situation with their child. They naturally question the
         | assertions by healthcare professionals, they make their own
         | research, they ask highly precise and relevant questions to
         | such a point that most doctors are simply unable to answer...
         | 
         | I remember that as I was questioning the diagnosis at the
         | hospital and trying to make sure there wasn't another medical
         | explanation, I was basically threatened by doctors who told me,
         | "Just stop asking questions and accuse your nanny as everyone
         | else, or you'll be the one in trouble". Apparently, it was very
         | unusual for a parent to refrain from accusing the nanny when
         | she was the suspect number 1!
         | 
         | I actually know one case where the parents (with a high
         | education) were "too fast" in exonerating their nanny and tried
         | to find a second medical opinion on their own to find out why
         | their child was sick. Well, the judicial system didn't like it
         | and they ended up being accused themselves. Their child was
         | taken away for 4 months. The trauma was so intense that their
         | family didn't survive and they eventually divorced (that's
         | unfortunately the fate of many, if not most families).
        
       | sneak wrote:
       | > _I couldn't live with this uncertainty any longer. But first, I
       | had to get my son back. As a precautionary measure, the hospital
       | followed mandatory reporting statutes and my wife and I
       | temporarily lost custody of David. Thanks to our incredibly
       | effective defense lawyer, we were cleared of all charges within
       | two months, during which we stayed at the hospital 24 /7 with
       | David until we sorted out the legal procedures. I would discover
       | much later that we actually had been lucky to be allowed to do
       | this, as most parents are abruptly separated from their babies
       | for months after reporting takes place._
       | 
       | This sounds very much like presumed guilt rather than presumed
       | innocence.
        
         | Seattle3503 wrote:
         | Is the criminal justice system in France based on a presumption
         | of innonce?
        
           | rossant wrote:
           | Yes, as others have said. However, this is a legitimate
           | question, because in these specific cases, the burden of
           | proof tends to be on the side of the defendant who needs to
           | prove they didn't harm their child. That's obviously
           | impossible, and probably unconstitutional.
           | 
           | When medical experts claim they're 100% confident that _this_
           | child was violently shaken at _this specific time_ , and that
           | you were the only person with the child at that time, how can
           | you defend yourself when you haven't done anything? There's
           | nothing you could ever do to convince courts that your word
           | has more value than the confidence of highly reputable
           | experts with decades of experience.
           | 
           | This is an instance where the prosecution's case relies on
           | the confidence in medical authorities, and where it is
           | extremely hard to challenge it as the subject is so difficult
           | on a scientific and technical level. In the US and other
           | adversarial jurisdictions, you see an incredible level of
           | technicality during oral debates, with extensive and long-
           | running discussions around extremely obscure points related
           | to the anatomy, physiology, and pathology of the infant
           | nervous system in highly specific pathological situations,
           | where infants frequently suffer from multiple rare medical
           | conditions or risk factors. Few people in the world have the
           | required expertise, and even fewer accept to testify in
           | courts! There's also an obvious financial imbalance between
           | the State and the defendant.
           | 
           | In inquisitorial jurisdictions like France, this is even
           | worse as there's basically no system in place to challenge
           | the views of the State's experts.
           | 
           | So, yes, litigating these cases is extraordinarily
           | challenging because the only way to prove the defendant's
           | innocence is to challenge the opinion of overly assertive
           | medical experts by digging into highly difficult (and
           | multidisciplinary) science.
        
           | armada651 wrote:
           | Is that a serious question? Yes, the French justice system is
           | based on a presumption of innocence, just like any other
           | functioning democratic nation. It is a basic human right
           | under the UN charter after all.
        
             | mlindner wrote:
             | You say that, but this doesn't seem like presumption of
             | innocence. A country with a presumption of innocence
             | doesn't take your child away from you without trial.
        
               | tsimionescu wrote:
               | A presumption of innocence doesn't mean that a trial is
               | needed before (what are supposed to be) basic safety
               | measures.
               | 
               | Judges can issue preliminary injunctions before trial in
               | all places in the world. A justice system that can't take
               | any coercive action until the end of a trial would simply
               | not function.
               | 
               | In particular though, cases like this aren't even related
               | to the presumption of innocence. The state believes that
               | the child has suffered harm, so a judge takes them in
               | protective custody. Who is harming the child remains to
               | be determined, but taking the child into custody is
               | supposed to protect the child immediately.
               | 
               | Of course, this can be, like in this case, wrongly
               | applied to disastrous effects. But it has also saved many
               | children from abusive parents, where leaving them without
               | state protection for years while the trial advances would
               | have scarred them permanently or killed them.
        
               | Muromec wrote:
               | Pre-trial detention is a thing pretty much everywhere
               | despite literally locking innocent people up before a
               | trial.
        
               | robbie-c wrote:
               | Tough to see how else you would do it - a hypothetical
               | murderer in broad daylight with a ton of reliable
               | witnesses and video evidence would still have to wait for
               | a trial, I don't think anyone would seriously say that
               | this hypothetical person should be free until the trial
               | happens.
        
               | jjgreen wrote:
               | I don't think so either
               | https://www.itv.com/news/london/2023-09-21/met-police-
               | office...
        
               | ascorbic wrote:
               | I'm willing to bet that almost all countries have a
               | different standard of proof for taking a child away than
               | for criminal trial, and none will wait for the outcome of
               | a trial to do this.
        
               | mlindner wrote:
               | I don't deny that many other countries may also be
               | missing elements of the presumption of innocence.
        
           | kergonath wrote:
           | There are complications when immediate danger needs to be
           | avoided. E.g., the system prefers to take away children
           | preventively in serious cases rather than leaving them in a
           | dangerous environment. Which is sometimes justified, and
           | sometimes not. The idea in this case is that it is easier to
           | correct a mistake by restoring custody than by reviving a
           | dead child.
           | 
           | A bit like temporary restraining orders pending trial in the
           | US.
        
       | jurgenaut23 wrote:
       | Thank you so much for investigating this matter so thoroughly and
       | fighting for justice so eagerly. As the father of a 4-month-old
       | baby, I couldn't imagine anything more devastating than having
       | him taken away by the authorities for something neither my wife
       | nor I have done. I can only imagine the despair of the families
       | to whom this happens, let alone the impact on the poor kids
       | themselves.
        
       | concordDance wrote:
       | [flagged]
        
         | jacquesm wrote:
         | You've _got_ to be kidding. This takes victim blaming to a
         | whole new level.
        
           | concordDance wrote:
           | Uh, why would I be kidding and how on earth is that victim
           | blaming?
           | 
           | There's a range of reasons people don't tend to make the full
           | case for the opposite of the thing they're passionate about.
           | Those who can actually do so are vanishingly rare.
        
             | praash wrote:
             | This is a valid point! People might feel they must put 100%
             | on arguing for their case when fighting a consensus,
             | because everyone else is already doing the opposite.
             | 
             | Steel-manning the opposing perspective could yield
             | _stronger_ insight in favor of their passion. This would
             | convince people to change their minds more effectively,
             | because most are obsessed in the case of  "true SBS" with
             | physical abuse.
             | 
             | I think your original comment just had a ring of "he's
             | selling a book, don't trust his intentions"
        
       | juanani wrote:
       | [dead]
        
       | stevev wrote:
       | There are additional factors to take into account beyond simply
       | labeling it as a rare condition. This includes the food or baby
       | formula itself and the quality of water used. Given the frequency
       | of formula recalls, there's a potential risk of obtaining a
       | defective batch that could harm the baby.
        
       | mlindner wrote:
       | > As a precautionary measure, the hospital followed mandatory
       | reporting statutes and my wife and I temporarily lost custody of
       | David.
       | 
       | Are people absolutely nuts? Is this just a thing in France or is
       | this elsewhere in Europe or even the US? You're actively
       | encouraging people to not bring their children to the ER by doing
       | this crazy nonsense.
        
         | switch007 wrote:
         | Definitely a UK thing too. If you take your kid to A&E you can
         | guarantee every person who interacts with you is required to be
         | on the lookout for abuse. You get probing questions by the
         | doctors as veiled accusations and you may get protection
         | services knocking on your door the next day.
        
         | rossant wrote:
         | This is a thing in most Western countries! _Especially_ in the
         | US. It dates back to the 1960s [1].
         | 
         | Most parents don't realize that anytime they interact with a
         | medical doctor (or another professional), they interact with
         | someone who was trained to detect "signs of abuse", which
         | basically can be anything out of the ordinary. They are
         | required by law to report any suspicion of abuse, and they can
         | be prosecuted if they fail to do so. The incentives are pretty
         | clear. Unfortunately, while this obviously protects some
         | children, there are adverse effects such as an enormous waste
         | of human and financial resources to unsubstantiated reports
         | [2].
         | 
         | To quote Wikipedia (this is more generally about hotline calls
         | but this also affects healthcare professionals):
         | 
         | "There are approximately 3.6 million calls each year nationwide
         | (..) affecting on average 1 out of 10 U.S. families with
         | children under the age of 18 each year (there are 32.2 million
         | such families). (...) Of those substantiated, over half are
         | minor situations and many are situations where the worker
         | thinks something may happen in the future.
         | 
         | Each year, approximately 85% of hotline calls either do not
         | warrant investigation or are not substantiated. Approximately
         | 78% of all investigations are unsubstantiated and approximately
         | 22% are substantiated, with around 9% where "alternative
         | responses" are offered in some states, which have a focus on
         | working with the family to address issues rather than
         | confirming maltreatment."
         | 
         | On this topic, I highly recommend "Take Care of Maya" on
         | Netflix.
         | 
         | [1]
         | https://en.wikipedia.org/wiki/Mandatory_reporting_in_the_Uni...
         | 
         | [2]
         | https://lawreview.law.ucdavis.edu/issues/50/1/Articles/50-1_...
         | 
         | [3]
         | https://en.wikipedia.org/wiki/Factitious_disorder_imposed_on...
        
       | guynamedloren wrote:
       | Content aside (which is both thought provoking and incredibly
       | alarming) I'm fascinated by the author's commitment to deeply
       | understanding a system and the factors at play within that
       | system. There's something inspiring about relentless truth
       | seeking, to the point of obsession, with some extraordinary level
       | of meticulousness. Particularly when it challenges conventional
       | wisdom. This is a slippery slope as it can quickly nosedive into
       | junk science and contrarianism, despite best intentions, but when
       | it's done well, it's really something.
       | 
       | Probably a faux pas here these days, but reminds me of Elon
       | Musk's First Principles.
        
         | tboyd47 wrote:
         | When you are a parent it comes naturally. Because your child
         | becomes your #1 time and energy investment, all other
         | investments of time and energy seem trivial. Many parents of
         | autistic children have made similar intellectual commitments.
         | I'd go so far to say that it's commonplace in that community.
         | All the more reason children should not be separated from their
         | parents for flimsy scientific assertions by experts.
        
       | hackernewds wrote:
       | > . As a precautionary measure, the hospital followed mandatory
       | reporting statutes and my wife and I temporarily lost custody of
       | David. Thanks to our incredibly effective defense lawyer, we were
       | cleared of all charges within two months, during which we stayed
       | at the hospital 24/7 with David until we sorted out the legal
       | procedures.
       | 
       | Woah
        
       | boxed wrote:
       | Here in Sweden I had to watch a video warning against baby
       | shaking when my wife was pregnant with my first child. After
       | seeing this horrible video, I waited a few hours to tell my wife
       | that this entire thing was total bunk, and we've known it's been
       | bunk for many years.
       | 
       | Here in Sweden this child abduction idiocy is upheld by three
       | doctors who all refer to each other as the experts proving baby
       | shaking is real. It's a disgrace.
        
         | Sander_Marechal wrote:
         | I've been made to watch a similar video here in The
         | Netherlands. It's not bunk though. Violently shaking a baby
         | will lead to trauma which can cause death. What this book is
         | about is that there are _other_ causes that can lead to the
         | same symptoms. The video is right. Shaking a baby leads to AHT.
         | But the reverse isn 't. AHT does not mean that the baby has
         | been shaken. There are many other causes for AHT.
        
           | Fire-Dragon-DoL wrote:
           | Didn't the article state that is actually unlikely it leads
           | to AHT?
        
             | eru wrote:
             | I think the article says that shaking a baby will give you
             | lots of different symptoms, including bruises etc. And you
             | can't really get AHT from shaking without also getting
             | bruises etc.
             | 
             | That means if you see 'AHT' without bruises (etc) it was
             | probably not actual shaking.
        
               | rossant wrote:
               | Yeah, it's hard to say for sure what kind of injuries
               | you'll get from violent shaking, as we obviously can't
               | reproduce it on actual babies, and there are so few well-
               | described cases. Studies have been made on animal models,
               | showing a constellation of traumatic injuries, but no
               | clear, obvious, and reproducible pattern so far.
               | Strikingly, the isolated "triad" of subdural and retinal
               | hemorrhage with brain edema hasn't really been reproduced
               | in _any_ animal model so far [1].
               | 
               | Anyway, we don't need this level of scientific detail and
               | knowledge to say that no one should ever shake a baby.
               | All brutal gestures are obviously harmful and dangerous.
               | 
               | [1] https://link.springer.com/article/10.1007/s00381-022-
               | 05577-6
        
               | [deleted]
        
       | Apocryphon wrote:
       | This is timely as the life of Robert Roberson is currently being
       | decided based on this syndrome:
       | 
       | https://news.ycombinator.com/item?id=37632122
       | 
       | https://www.themarshallproject.org/2023/09/15/texas-shaken-b...
        
         | dang wrote:
         | Yes and the current submission is a result of this subthreaed
         | from there:
         | 
         | https://news.ycombinator.com/item?id=37635094
        
         | [deleted]
        
         | suckitsam wrote:
         | From a related article on the case [1]:
         | 
         | > Evans said the syndrome remains a fair medical diagnosis and
         | also notes in the report that SBS was not the sole cause of
         | child's death.
         | 
         | There ought to be a law where lawyers deal with legal
         | interpretations and advice and medical doctors deal with
         | medical interpretation and advice.
         | 
         | In a sane world, she'd be taken off the bench until she
         | completes some remedial legal coursework and several dozen
         | hours of medical talks from this century.                 [1]
         | https://www.cbs19.tv/article/news/local/judge-denies-
         | recommending-east-texas-death-row-inmates-appeal-exoneration-
         | new-trial/501-39bfdd8e-b687-4065-9b34-25b60c320e6c
        
       | rapatel0 wrote:
       | This doesn't surprise me. We have massive systemic issues in
       | medical science and care delivery.
       | 
       | - Medical science handles variation by simply assuming that large
       | enough samples will average out variation. This loses a ton of
       | information as the "average person" is a construct that almost
       | certainly doesn't exist.
       | 
       | - news media on medical science glosses over all uncertainties in
       | the name of clickbaity sensationalism.
       | 
       | - lawyers are the incentivized by our adversarial legal system to
       | adopt aggressively hyperbolic interpretations of the science to
       | sue people and extract money.
       | 
       | - medical associations then tweak policies to protect against
       | malpractice
       | 
       | Run this loop enough times and lots of noise gets amplified.
       | 
       | My hope is the AI+sensors ushers in the era of truely
       | personalized medicine.
        
         | [deleted]
        
         | [deleted]
        
         | eru wrote:
         | > - Medical science handles variation by simply assuming that
         | large enough samples will average out variation. This loses a
         | ton of information as the "average person" is a construct that
         | almost certainly doesn't exist.
         | 
         | Well, this wouldn't even be that bad, if sample size were
         | actually large enough.
        
           | frotaur wrote:
           | No I think the point that was being made is that the "average
           | person" idea is not that great if you have huge variance. If
           | I have a uniform distribution from 0 to 1, average is '0.5',
           | but its just as likely to get 0. or 1.
        
             | eru wrote:
             | Yes, I know.
             | 
             | My point goes beyond that one: yes, variance is a problem.
             | But _even_ _just_ getting good averages, for all their
             | faults, requires a bigger n than many studies have.
             | Especially observational studies.
        
             | hmottestad wrote:
             | The average family with 2.3 children :D
        
           | rapatel0 wrote:
           | That's part of it. The sample size is usually super small.
           | 
           | Furthermore, there's the opportunity. With large amounts of
           | data (from software, medical devices, sensors) we can
           | actually tackle this problem at scale.
        
         | tboyd47 wrote:
         | Your narrative reverses the roles a bit. The lawyers appear as
         | the heroes in this particular story and the villains are all
         | associated with the hospital -- either in the form of people or
         | bureaucratic red tape, depending on how generous you want to be
         | in your analysis.
         | 
         | > The doctors at the hospital were absolutely, unconditionally
         | 100% certain that no other cause than violent shaking could
         | ever explain blood around the brain and at the back of the
         | eyes.
         | 
         | > As a precautionary measure, the hospital followed mandatory
         | reporting statutes and my wife and I temporarily lost custody
         | of David.
         | 
         | > I disturbingly realized that what I had been told at the
         | hospital, namely that subdural and retinal hemorrhage in
         | infants are almost always caused by violent shaking even in the
         | absence of external evidence of trauma, was an assertion based
         | on very weak scientific foundations.
         | 
         | > Thanks to our incredibly effective defense lawyer, we were
         | cleared of all charges within two months, during which we
         | stayed at the hospital 24/7 with David until we sorted out the
         | legal procedures.
         | 
         | > Every case requires years of intense, dedicated efforts by an
         | entire team of specialized lawyers and medical experts, but
         | there are tens of thousands of cases and few experts willing to
         | defend them.
         | 
         | Hospitals are definitely the weak link in this system. Just
         | looking at the way the story is laid out, the solution is more
         | lawyers and fewer, less expansive hospitals.
        
         | rossant wrote:
         | I'm starting to see AI studies on the medical detection of
         | child abuse, which unfortunately reproduce the same biases as
         | the low-quality clinical data they are based on. An AI that
         | would detect subdural and retinal hemorrhage without external
         | signs of trauma with 99% accuracy would detect "child abuse
         | with 99% accuracy" and would impress law enforcement and
         | courts. However, it wouldn't be more reliable than an expert
         | witness confidently asserting that these signs are almost
         | always due to child abuse.
        
           | hmottestad wrote:
           | Reminds me of the bias towards long sleeves and stethoscopes
           | for detecting doctors in photos.
        
         | idoubtit wrote:
         | Basically, you want to replace statistics ("large enough
         | samples will average out variation") with AI. I'm afraid that's
         | cargo cult instead of science.
         | 
         | AI can lie. It means a "truely personalized medicine" would
         | sometimes poison its patients. See for instance Donald Knuth
         | experiment with Chat GPT, starting with "Answer #3 is fouled up
         | beautifully!" with some totally wrong AI answers https://www-
         | cs-faculty.stanford.edu/~knuth/chatGPT20.txt
         | 
         | Of course medical science could make a better use of
         | statistics, get help from AI, and discern more profiles (e.g.
         | one US adult out of two is obese, and it's often unclear how to
         | adjust medication to person mass). But that's a long process,
         | with no obvious path, and much distinct from the magic "AI will
         | solve it all".
        
           | xpe wrote:
           | (I'll bring a conciliatory bias to this conversation. Under
           | what interpretations might the ^ and ^^ comments be saying
           | mostly the same thing?)
           | 
           | >> My hope is the AI+sensors ushers in the era of truely
           | personalized medicine.
           | 
           | > AI can lie.
           | 
           | The first hope is compatible with the second fact. It is
           | possible that carefully _designed_ AI systems (that have
           | different architectures than 'vanilla' LLMs) can serve a
           | useful purpose here.
           | 
           | There is a lot of interesting conversation to be had in 'the
           | conciliatory zone', leaving plenty of opportunities to
           | disagree when it is warranted.
           | 
           | > Basically, you want to replace statistics ("large enough
           | samples will average out variation") with AI. I'm afraid
           | that's cargo cult instead of science.
           | 
           | There is a whole lot of _assuming_ going on here, followed by
           | a mischaracterization. This is not the paragon of curious
           | conversation.
           | 
           | I don't expect perfection, but I still think we should try. I
           | don't mean to pick on any one person; I do this sometimes as
           | well. I'm just pointing it out because, well, it is right
           | here, right now.
           | 
           | Think about the impact on the system. Seeing the anti-pattern
           | above too often can drive people away. I think it does. Who
           | remains? People who somehow aren't bothered by it?
           | Downselecting in this way is self-defeating.
           | 
           | I'm probably just as frustrated as anyone here (if not more)
           | regarding (i) the state of medicine, (ii) perceptions of what
           | current AI technology can do, and (iii) many other serious
           | problems. But we shouldn't not let this frustration bleed
           | into our personal interactions.
           | 
           | It is both a waste of our time and (worse) damaging to the
           | community ethos when we take an unnecessarily pessimistic
           | view of _each other_. Some online fora are 'good enough'
           | (though flawed) to help us connect and build bridges as
           | _people_. It doesn't help when we fall into the all-too-
           | common pattern of sniping without asking questions first and
           | clarifying meaning.
           | 
           | Again, nothing personal. This is more of a rant and request.
        
           | rapatel0 wrote:
           | > Basically, you want to replace statistics ("large enough
           | samples will average out variation") with AI
           | 
           | No. This is misunderstanding due to my lack of clarity.
           | Apologizes.
           | 
           | The biggest problems with Medical data is that 1) incredibly
           | small scale data is collected to make assertions, 2) the data
           | is horrendously de-normalized
           | 
           | In Radiology, a common validation approach is have
           | radiologists review cases on the order of 250 studies to make
           | assessments about a radiology product. This is considered the
           | gold standard for FDA. Look into it more, vaccines,
           | treatments. The sample sizes are fucking tiny.
           | 
           | The statistical assertion is that these relatively small
           | samples capture the variation sufficiently to demonstrate
           | efficacy across devices, treatments. These are then
           | extrapolated to the US and wider populations. Do you believe
           | that this is rigorously true?
           | 
           | The rationale underpinning this is simply practicality. You
           | cannot get thousands (or hundreds of thousands) of
           | patients/doctors/etc to get a strong signal and confidence.
           | For drugs, it's super hard, but for devices and software
           | interventions, it way easier to get data.
           | 
           | That brings us to the second big problem: the data structure
           | is completely highly varied and denormalized.
           | 
           | 1) From a pure structure point of view, it's basically free
           | text fields that doctors sporadically fill.
           | 
           | 2) From a underlying truth point of view, each hospital
           | across the world has different protocols for care delivery. A
           | histopathological FNA procedure might have a completely
           | different meaning in CA, NY, or EU. This might simply be
           | because of workflow, timeline, or just people using the words
           | wrong.
           | 
           | What I mean with AI+Sensors:
           | 
           | AI doesn't need to solve the problem of intuition around
           | medical problems. The biggest impact will likely come from
           | the relatively mundane task of simply structuring and
           | normalizing the data. Sensors simply help to generate more
           | data
           | 
           | To be more concrete, you don't want (and shouldn't trust)
           | this:
           | 
           | Prompt: "Please diagnose this person"
           | 
           | You want this:
           | 
           | Prompt: "Here is 100 TB of data from 100 different hospitals
           | each with different workflows and patients for
           | histopathology. For each patient, synthesize a CSV with the
           | following schema "AnonPatientID, AnonCaseID, Pathology
           | Result, Pathology stage, Incidenctal findings, ..."
           | 
           | Then I can do the analysis myself.
           | 
           | Hope this makes more sense.
           | 
           | (I work in healthtech and med device and I promise you:
           | Demoralization at the state of medicine is a rite of passage
           | after which you can begin to address practical problems)
        
       | Dove wrote:
       | > What happened is that during my literature review, I
       | disturbingly realized that what I had been told at the hospital
       | ... was an assertion based on very weak scientific foundations.
       | And yet ... has been taught as though it was a proven fact to
       | generations of physicians all over the world.
       | 
       | This exact thing has happened to me so many times, on so many
       | different medical topics, that it is now my going in assumption
       | that if I review the literature, this is what I'll find. The most
       | flabberghasting case was one in which I was able to determine the
       | standard of care the doctors insisted on was in flat
       | contradiction to the established science _in the course of an
       | afternoon_. As a mathematician by training, I am used to checking
       | the reasoning behind everything I believe for myself. I can
       | understand not having taken months and months to delve into a
       | deeply technical topic, but when the state of affairs can be
       | determined in an afternoon? I cannot fathom spending a career
       | giving people advice and never having looked that far.
       | 
       | My favorite example of obvious, silly unscientific behavior is
       | the basic set of practices and beliefs surrounding blood
       | pressure. Blood pressure varies a lot, second to second, minute
       | to minute, hour to hour, and day to day, with an astonishing
       | range, for a very long list of reasons both benign and
       | concerning. It is an obvious fact, well known and easy to
       | establish by anyone with a measuring device and a little
       | statistical curiosity. The literature, the instruction books
       | shipped with measuring devices, the procedures followed by
       | doctors and nurses, the procedures they say they _should_ be
       | following, bear all the hallmarks of the behavior of the
       | statistically unsophisticated seeking patterns and meaning in
       | randomness. But my very favorite behavior is the sheer cognitive
       | dissonance. I have had nurses take my blood pressure while
       | varying the circumstance - sitting, lying, this arm, that arm -
       | until they got the answer they wanted, reported it to a doctor,
       | who compared it to a chart with great authority and made a claim
       | about my health over a span of months and years. I have had a
       | five minute conversation with a doctor about the statistical
       | variation of the number and the fact that best practices involve
       | taking many measurements and he opined that it wasn 't really
       | valid unless you measured it over twenty four hours... and then
       | said, "anyway..." and proceeded in the next sentence to diagnose
       | me and argue strenuously for a prescription based on a single
       | measurement and no context.
       | 
       | One of the things I find cynically, darkly entertaining is how
       | often the standard advice is, not just random, not just useless,
       | but _exactly wrong_. The diet they insist on to manage gallstones
       | is known to cause gallstones. The treatment traditionally
       | insisted on for diabetes is known to kill you faster the more
       | exactly you comply. The saline typically used in hospitals,
       | compared to an electrolyte balanced solution, is known to kill
       | patients. _They institutionally get saline wrong!_
       | 
       | The absolute theatrics and bureaucracy required historically to
       | institute handwashing in hospitals indicates a cultural problem,
       | and the current state of affairs suggests to me that it remains.
       | I am not talking about advancing scientific knowledge here - I am
       | talking about accounting for things that are well known and can
       | be checked with little effort so long as one is not intimidated
       | by basic science. The prospect of professional mathematicians
       | behaving this way is laughable. Everyone knows the discredited
       | results and no one would dream of using them. The prospect of
       | cybersecurity professionals taking years to apply a patch after a
       | security flaw is discovered beggars belief. Yet here are the
       | doctors, insisting with great pomp and authority on easily
       | checkable wrong things, and they have apparently been doing so in
       | many domains, for a very long time. I know there is value in
       | medical advice, and in many situations I seek it, but it is
       | enough to make one want to throw in the towel and consult the
       | aromatherapists and their healing crystals - at least they won't
       | insist on something destructive!
       | 
       | The words "scientific medicine" clearly do not mean what I would
       | think they should mean.
        
         | Dove wrote:
         | One particularly aggravating manifestation of the medical
         | industry's inability to be wrong is its tendency to blame
         | patients. It is famous for doing so in the area of obesity. But
         | one rather entertaining incident happened to me: I was in the
         | hospital under observation and (for medical reasons) fasting.
         | They had me on IV saline which, apart from the medication I was
         | getting, was all I took in. After a day or so, I was informed I
         | had developed a potassium deficiency, and given a supplement
         | with the air of someone who needed to fix a bad diet.
         | 
         | My potassium had been just fine when I came into the hospital.
         | At this point, I stood up and read the content of the saline
         | bag, considered how many times I'd seen it changed, did a
         | little noodling about sodium potassium balance, and
         | dramatically downgraded my opinion of the experts in charge of
         | my care.
        
         | J_Shelby_J wrote:
         | > The prospect of cybersecurity professionals taking years to
         | apply a patch after a security flaw is discovered beggars
         | belief.
         | 
         | Not just years, but generations in some cases.
        
       | ls612 wrote:
       | [flagged]
        
         | CodeAndCuffs wrote:
         | Are you asserting that the caution against shaking babies was
         | intentionally constructed for the sole purpose of the state
         | kidnapping children? For what motivation, to what end? How
         | orchestrated? Who is "the state"? Do they have a hand picked
         | squad of CPS investigators to kidnap children from their
         | targets, or do they just use any CPS investigator? Are the
         | investigators in on it, or are they just thinking they're
         | helping kids? Can you cite references for any of the answers to
         | any of these questions?
        
           | babuloseo wrote:
           | But the link in question does make it seem like being a nanny
           | probably could have better protections in France if uh, the
           | person lost 4 years due to this charge.
        
           | ls612 wrote:
           | [flagged]
        
       | hammock wrote:
       | TLDR:
       | 
       | There are issues with the way/how quickly we diagnose shaken baby
       | syndrome without exploring other potential diagnoses, and with
       | how severely/quickly we take kids away from their parents once we
       | "think" we have a shaken baby
        
         | pests wrote:
         | > we diagnose shaken baby syndrome without exploring other
         | potential diagnoses
         | 
         | It's more that 'shaken baby syndrome' is caused by more things
         | than just a shaken baby (and evidence that shaking does not
         | cause it even.)
         | 
         | > the more neutral and objective term of "retino-dural
         | hemorrhage of infancy" (RDHI).
        
         | boxed wrote:
         | It's much worse. There's no evidence of any baby shaking. At
         | all.
        
           | rossant wrote:
           | Well, I was very surprised to discover that shaking appears
           | to be a highly common and widespread form of child abuse in
           | the world [1]. It may affect 2-3% of all babies in the US and
           | other developed countries, and the rate may be 10x or more
           | higher in other countries.
           | 
           | I think it's reasonable to say that billions of babies may
           | have been shaken in the past, yet the vast majority (of the
           | order of 99.9% or even much more? [2]) are not diagnosed with
           | shaken baby syndrome, since this diagnosis has an incidence
           | of ~1/3,000 among children < 12 months in developed
           | countries. In the countries where the incidence of shaking
           | appears to be >50%, it is striking to note that the SBS
           | diagnosis actually does not exist, i.e. doctors are not
           | trained to diagnose it.
           | 
           | On the other hand, actual cases of severe inflicted head
           | injuries probably affect < 1/10,000 children < 12 months, and
           | I think most of them involve external evidence of trauma.
           | Those that do not probably involve extreme forms of shaking
           | far beyond what most of the billions of "shaken babies"
           | sustain.
           | 
           | In other words, I've come to the likely conclusion that the
           | intersection of babies who are effectively shaken, and babies
           | who are labelled with "shaken baby syndrome", is an abysmal
           | proportion of the first set, and a small proportion of the
           | second.
           | 
           | [1] https://www.sciencedirect.com/science/article/pii/S074937
           | 970...
           | 
           | [2] Excerpt from the paper above: "the ratio of children
           | hospitalized or dying from inflicted neurotrauma compared to
           | the numbers of reported shaken children may be estimated at 1
           | to 152."
        
         | bluSCALE4 wrote:
         | This doesn't do it justice. The damn name of the diagnosis
         | makes it sound like a crime was committed. Guy runs an
         | educational foundation on the issue that gets over 200 people a
         | year asking for help in France alone.
        
       | Llamamoe wrote:
       | > has been taught as though it was a proven fact to generations
       | of physicians all over the world.
       | 
       | Welcome to healthcare. For many conditions having a medical
       | degree is straight up deleterious to a doctor's ability to
       | accurately diagnose and treat a condition.
        
       | [deleted]
        
       | ClumsyPilot wrote:
       | trully unbelievable, i lose faith in thr justice system day by
       | day
        
         | anon291 wrote:
         | The justice system is doing what the doctors tell them. Broadly
         | speaking If a medical professional testifies that this is the
         | only way, what qualifications does a DA have to question him?
         | Medicine is a profession; thus the professional body ought to
         | be addressing this and, if the guidance changes, be advocating
         | and lobbying to Congress that people start being released.
        
           | p-e-w wrote:
           | > If a medical professional testifies that this is the only
           | way, what qualifications does a DA have to question him?
           | 
           | Questioning witnesses is literally the DA's job. That doesn't
           | magically stop being the case just because the witness is an
           | expert. The DA is indeed qualified for this. You could even
           | say it's one of the main reasons the DA exists.
        
             | anon291 wrote:
             | Got it. So the DA is supposed to not only be an expert in
             | the law, but enough of an expert in medicine such that he
             | can flaunt widely acknowledged medical standards while
             | cross-examining expert witnesses on why they're wrong.
             | 
             | The author of this post admitted that it took him countless
             | hours to discover that medicine basically has this issue
             | wrong and only after being particularly motivated to do so.
             | If the DA has so much medical expertise that they know
             | better than the doctors, then what exactly is he doing
             | being a DA?
             | 
             | The idea that the main purpose of the DA is to know better
             | than doctors is ludicrous.
        
               | p-e-w wrote:
               | The DA's job is to question the _credibility_ of
               | witnesses. If credentials conferred credibility, it
               | wouldn 't be possible to ever convict an expert of
               | anything.
               | 
               | So to be plain: No, DA's don't (and aren't supposed to)
               | just take experts by their word. They ask clarifying
               | questions, and often bring additional experts offering
               | contradicting testimony.
               | 
               | Do you seriously think courts operate by "the doctor said
               | so, case closed"? We wouldn't need courts if that were
               | the case.
        
               | anon291 wrote:
               | So the defense attorney (since it wouldn't be the da
               | anyway) is going to convince the jury that not just the
               | witness but the entire medical profession is suspect
               | because of its heretofore unanimous belief that shaken
               | baby syndrome is the only explanation of these
               | phenomenon.
               | 
               | > Do you seriously think courts operate by "the doctor
               | said so, case closed"? We wouldn't need courts if that
               | were the case.
               | 
               | For certain things.. yes. If a doctor tells a jury that
               | these injuries could only be sustained via shaking
               | trauma, most juries will believe them over a rogue doctor
               | or a non doctor. Doctors have some of the highest trust
               | ratings of all professions. Attorneys have some of the
               | lowest. That means convincing the jury the doctors are
               | wrong.
               | 
               | The blame should lay at the feet of the medical
               | professional bodies.
        
         | parl_match wrote:
         | The justice system does the best it can with the information it
         | has. It is far from perfect. It makes horrible mistakes all the
         | time. The problem, of course, is improving it without knock-on
         | effects making it worse.
         | 
         | There are huge swaths of people doing the work required to make
         | it better, every day. It's not as easy as turning a dial from
         | "bad" to "good"
        
           | razeh wrote:
           | No. When it comes to evaluating forensic evidence lawyers
           | are, by training, too process oriented to solve the problems.
           | Ask a prosecutor what the error rate is for fingerprints or
           | DNA evidence and you'll get a blank stare. They don't even
           | try to measure it.
        
             | paiute wrote:
             | A lot of doctors are process oriented as well. Which is
             | fine most of the time. But I was similarly disturbed when a
             | specialist had zero clue what the approx half life of one
             | of the primary drugs they use was. There was a situation
             | that didn't fit the book and i just looked it up for them
             | on the spot. They didn't like me.
        
             | zamadatix wrote:
             | You're telling me no defense lawyer thinks about arguing
             | the evidence is unreliable or are you just saying the
             | prosecution throws everything they can find at their side
             | of the case? The former seems extremely hard to believe
             | (lest you're about to become the greatest defense lawmaker
             | of all time due to wisdom shared in a short HN comment) and
             | the latter seems to be evidence of the system working both
             | well and as designed, not evidence it's badly faulty.
        
               | TedDoesntTalk wrote:
               | > latter seems to be evidence of the system working both
               | well and as designed
               | 
               | Prosecutors in America have one goal: close the case. At
               | any cost, close the case. They are not interested in
               | justice. They are not interested in finding the one who
               | actually committed the crime. They are interested in
               | closing the case. If that is "working as designed", then
               | we need to change the design.
        
               | bluGill wrote:
               | Sure, but the accused should have a lawyer who is
               | screaming about anything that is unreliable.
        
               | TedDoesntTalk wrote:
               | Have you seen the caseloads of public defenders?
        
               | zamadatix wrote:
               | And the opposite is true of the defense. The result is a
               | 3rd party gets to hear all of the evidence either side
               | could come up with and weight the outcome based on all of
               | that instead of 2 interested parties trying to figure it
               | out themselves.
               | 
               | There are of course ways to improve the legal system,
               | more equal access to quality representation is my
               | preferred improvement regardless of system, but you can't
               | just look at one element of the system in isolation and
               | declare the whole concept bad. That's "The CPU produces
               | waste heat so we need to remove it completely" type logic
               | where you find one thing that sounds unambiguously bad
               | and ignore that it could be a symptom of great net
               | positive function of that thing. Doesn't mean it's
               | perfect either, just means it needs more than a shallow
               | dismissal.
        
           | sneak wrote:
           | If the current functioning is it doing "the best it can", the
           | whole thing should be burnt to the ground.
        
             | goles wrote:
             | If you burnt to the ground everything doing the best it can
             | probably 75% of the public and every instution would
             | spontaneously combust.
        
             | OmarShehata wrote:
             | > A system that does not incarcerate anyone for any reason
             | would be much preferable
             | 
             | surely you don't actually believe that? I don't think the
             | result of this is just 0 false positives. The result of
             | that is a lot more crime, and a lot more injustice.
        
               | sneak wrote:
               | I think you (as is very common) vastly overestimate the
               | effect of the threat of incarceration on crime.
        
               | iteria wrote:
               | I think incarceration is very bad at deterring future
               | crimes, but it very good at delaying them. Someone in
               | jail for 10 years is at the very least not going to
               | commit a crime for 10 years. There is some merit to that
               | until we have a better system.
        
               | 10u152 wrote:
               | Forget the threat. Serial muggers/armed robbers/thugs
               | need to be off the street. This "nobody should be in
               | prison" rhetoric is painfully naive. Wait till you've had
               | elderly/defenseless parents or friends violently mugged
               | and beaten, you'll change your tune.
        
             | dylan604 wrote:
             | to be replaced with what? i'm all for making changes that
             | are an improvement, but just burning it to the ground for
             | the sake of it with no end game is not an improvement
        
               | gjsman-1000 wrote:
               | At this point, I would not be surprised if having two
               | judges per case, randomly selected from the community,
               | from parents who have successfully had at least three
               | children leave the nest while still remaining on speaking
               | terms, was a more reliable method of justice.
        
               | dylan604 wrote:
               | isn't an even number of judges ripe for uselessness?
        
               | sneak wrote:
               | A system that does not incarcerate anyone for any reason
               | would be much preferable to the atrocities that are the
               | current criminal justice systems in most of the global
               | west (and especially of course the United States).
        
               | epivosism wrote:
               | Have you thought about moving to Somalia?
        
               | gjsman-1000 wrote:
               | Interesting and unusual perspective - we have the one
               | person in this thread who supports wildly expanding the
               | death penalty.
               | 
               | Unless the person above is, of course, an anarchist who
               | has no answer for what to do about Richard Ramirez, Ted
               | Bundy, Jeffrey Dahmer, Phillip Garrido, or Brian
               | Mitchell. I would say that as imperfect and heavily
               | flawed as our system is, "Perfect is the enemy of good."
        
               | p-e-w wrote:
               | > what to do about Richard Ramirez, Ted Bundy, Jeffrey
               | Dahmer, Phillip Garrido, or Brian Mitchell
               | 
               | Nothing. Those people are one-in-a-million anomalies. If
               | it weren't for the media hype surrounding them, their
               | impact on society would be comparable to the impact of
               | deaths from lightning strikes. What do we do about people
               | being struck by lightning? Nothing.
        
               | singleshot_ wrote:
               | https://en.wikipedia.org/wiki/Lightning_rod
               | https://en.wikipedia.org/wiki/Static_wick
        
               | tumult wrote:
               | That's not true. We have things in place to protect
               | people and objects from lightning strikes. For example,
               | lightning protection systems on tall buildings.
        
               | p-e-w wrote:
               | Those protect the building, not individual people. Nobody
               | carries around mobile lightning rods, even though they
               | were invented centuries ago.
        
               | tumult wrote:
               | It protects the people in the building. Likewise,
               | arresting a serial killer protects anyone they would have
               | killed next.
        
               | Filligree wrote:
               | That's nuts. Even if you were correct about that, and I'm
               | not admitting any such thing, it isn't how people work.
               | If the state doesn't provide justice, then the mob will.
        
               | p-e-w wrote:
               | "Justice" is an incredibly malleable idea that is largely
               | shaped by what people are told. Until very, very
               | recently, nobody gave a fuck about serial killers, or
               | even knew they existed. If the hype stopped, there
               | wouldn't be any mobs to worry about.
        
               | gjsman-1000 wrote:
               | Define recently. There is plenty of historical hysteria
               | around them. Ever heard of Jack the Ripper?
        
           | boomboomsubban wrote:
           | There are also huge swaths of people actively trying to make
           | it worse, that's what the FBI did (does?) for years when it
           | knowingly pushed junk forensics.
           | 
           | Or what basically every prosecution does, when it knows that
           | the science behind some things isn't airtight but still
           | presents it in the best possible light to get a conviction.
        
             | TedDoesntTalk wrote:
             | > junk forensics
             | 
             | Fiber analysis (e.g. carpets)
        
           | yieldcrv wrote:
           | and none as effective as this one person
           | 
           | too many cooks in the kitchen
        
           | marcus_holmes wrote:
           | It's not a justice system, it's a Law and Order system: It's
           | not designed to deliver justice, it's designed to resolve
           | disputes relatively cheaply, while allowing for spending more
           | money to get better results.
        
         | Waterluvian wrote:
         | Nothing shook my faith in the _medical_ system more than having
         | kids.
         | 
         | Holy cow is modern medicine still as smugly wrong as it's
         | always been. Every generation laughs at all the stupid stuff
         | the previous generations believed, and then acts so confident
         | that they've got it right this time.
         | 
         | And as a result you get unworthy nurses making moms feel
         | intense shame for not "trying hard enough" to somehow magically
         | produce milk.
        
           | mberning wrote:
           | Same experience. The medical system is a reflection of pop
           | parenting culture or vice versa. Everyone was so gung ho on
           | breastfeeding, but when the milk didn't come in and our son
           | wasn't interested in a dry breast the only advice given was
           | "keep trying". Then the shock and surprise when baby is
           | losing weight. We had to demand formula, which was given
           | grudgingly, and left the hospital a day later. If we have
           | another we will do breast plus formula from the get go.
        
             | jt2190 wrote:
             | > We had to demand formula
             | 
             | I don't understand. You can't just go to the store and buy
             | infant formula?
        
               | msteffen wrote:
               | In the US (not sure about other countries), new parents
               | often stay at the hospital where the baby was delivered
               | for a few days after the birth. During this time, the
               | hospital often provides them all their food and childcare
               | supplies: diapers, swaddles, diaper cream, wipes, etc. To
               | get formula, you have to ask the hospital for it, but if
               | your nurse doesn't want to give it to you because they
               | think you should try harder at breastfeeding, you get
               | stuck. You could sneak out and buy some, but you're
               | pretty exhausted, and your partner is still stuck with a
               | screaming, hungry baby until you're back.
               | 
               | (I realize after writing this out that being at the mercy
               | of your hospital sounds draconian, but it can be really
               | really great if you have a good nurse or midwife. They
               | teach you how to bathe and swaddle the baby, how to
               | nurse, how to rock them to sleep, etc. All skills you'll
               | need once you leave)
        
               | Huggernaut wrote:
               | In the Netherlands, for the 8 days after you give birth,
               | someone comes to your house for some number of hours per
               | day (in our case 8) to teach you these things, maybe do
               | some tidying and cooking but most importantly, take the
               | baby so you can sleep! This is called kraamzorg.
               | 
               | It also has some similar pitfalls, as they are not
               | necessarily specialists and it's still hard to disagree
               | or do something else even if in your own home in the face
               | of the supposed expert.
        
               | jimbob45 wrote:
               | It's not that easy to just _know_ how parenting is going
               | to work the first time around. You can be lactating prior
               | to delivery and then dry up for no reason. Even worse,
               | your baby can decide not to latch or be tongue-tied. If
               | your husband isn't on hand to run to the store from the
               | hospital, things can get challenging.
               | 
               | We had to worry about my wife dying because they wouldn't
               | suggest a C-section and we didn't think to ask for one
               | (her induction didn't take for several days). We're quite
               | confident they'd have let her die before suggesting one.
               | Thankfully, we thought better in time.
        
               | bluGill wrote:
               | Not so easy when you are in a hospital recovering from
               | birth. They generally won't allow things from offsight
               | into the hospital either, so even if you (dad) goes to
               | get some you have to get it in without getting caught.
               | 
               | The other side is nursing is hard, and so it is easy to
               | cheat and use formula when you could with a little effort
               | nurse the baby just fine. (Nursing is generally slightly
               | better for the baby, but the difference is tiny. Nursing
               | is generally a lot better for the wallet though)
        
             | p-e-w wrote:
             | > The medical system is a reflection of pop parenting
             | culture
             | 
             | Indeed. And not just in relation to parenting. The average
             | doctor is constantly trying to emulate TV doctors, just
             | like the average police detective is influenced by what
             | they see on CSI, and every archaeologist wants to be
             | Indiana Jones or Lara Croft. It would be hilarious, if it
             | didn't have such disastrous consequences for regular people
             | every day.
        
               | matheusmoreira wrote:
               | Huh? Doctors don't base their decisions on House
               | episodes. Not even ER episodes.
        
               | p-e-w wrote:
               | No, but they base their behavior and expectations on such
               | shows. Life imitates art.
        
           | gjsman-1000 wrote:
           | My sister wouldn't sleep. The doctor constantly gave the
           | "sigh, you're an idiot, you just do X and Y and they sleep"
           | talk to my mother because nothing came up on their screening,
           | even though my mother almost wanted to scream that something
           | was clearly wrong and abnormal. Turns out, different doctor,
           | serious vitamin deficiency.
           | 
           | And medical incompetence by staff, not doctors, is also
           | awful. My brother hated reading. He got glasses, still hated
           | reading, my mother wondered why he could be so disobedient in
           | that regard. They said, well, the prescription is right, he
           | can clearly see fine. Turns out two years later that the
           | lenses were installed _on opposite sides_. Right lens on left
           | eye, left lens on right eye. A simple mistake, but the
           | consequences...
        
             | maximus-decimus wrote:
             | I do find it bizarre they don't verify you can see with
             | your actual glasses.
        
               | hackernewds wrote:
               | How would one have tested it instead?
        
               | analog31 wrote:
               | They can verify the prescription. Also in principle they
               | could use the same machine that finds the prescription,
               | to verify that your net correction is zero with your
               | glasses on.
               | 
               | I once proved that my wife got the wrong prescription by
               | just holding her old and new glasses up at arms length
               | and seeing that things looked way different through them.
               | The glasses place agreed.
        
             | SOLAR_FIELDS wrote:
             | It's especially a problem with women and minorities.
             | Doctors just don't believe them. I'm neither of those and I
             | had to convince my doctor that I had Lyme disease. I had
             | the bullseye right where the tick had bit me. It was
             | clearly Lyme disease. He assumed it couldn't be because it
             | took 8 weeks for the bullseye to show up (it's usually a
             | matter of days in America). He did not know that European
             | Lyme disease takes much longer for the bullseye to appear.
             | He at least had the tact to call me later and apologize
             | after he did more research
        
             | darkclouds wrote:
             | [dead]
        
           | irjustin wrote:
           | > unworthy nurses making moms feel intense shame for not
           | "trying hard enough" to somehow magically produce milk.
           | 
           | Stay away from mommy blogs/forums. Those are the most toxic
           | cesspools I've ever witnessed. Things are changing, some of
           | the newer ones are not nearly as bad, but man the judgement
           | is super real.
           | 
           | Nurses are one thing, but personally, the worst is family
           | members who think they know better and don't understand the
           | data and that times have changed.
           | 
           | FORMULA IS PERFECTLY FINE.
        
             | laurent_du wrote:
             | Maternal milk is better than formula in every possible way
             | and there is a perfect scientific consensus around this.
             | Formula is the least worst substitute to maternal milk but
             | going around and screaming that formula is perfectly fine,
             | as if it was as good (or even better!) than maternal milk
             | is denying some very well-established piece of science for
             | likely ideological reasons.
        
               | cperciva wrote:
               | Milk is better than formula, but formula is better than
               | starvation.
               | 
               | There are way too many instances of infants "failing to
               | thrive" because their mothers are bullied into relying on
               | breast milk which they simply aren't producing enough of.
        
               | cbsks wrote:
               | It's like saying that you should only eat organic food.
               | Sure, there is lots of science backing it up, but that's
               | besides the point. It's not always possible or easy for
               | everyone to get organic food. Any food is better than no
               | food.
        
               | xyzzyz wrote:
               | > Maternal milk is better than formula in every possible
               | way and there is a perfect scientific consensus around
               | this.
               | 
               | I have not seen result like this obtained in a
               | randomized, controlled trial, and it is almost certainly
               | false as stated: you're almost certainly exaggerating for
               | effect, but doing that in scientific context is bad
               | intellectual hygiene.
               | 
               | All results of this sort that I have seen have been
               | purely correlational, and as such suffer from selection
               | bias. This might be true, but the evidence is far from
               | conclusive, and if such consensus exists among medical
               | professionals, it only shows how susceptible they are to
               | groupthink and parroting the stuff they heard from the
               | cathedra.
        
               | irjustin wrote:
               | And this is what I'm talking about - Clearly, you've
               | never been a mother who can't produce milk for her child.
               | 
               | I've been there with my wife and I'm only the husband.
               | 
               | Everything you say is true, but by saying this and in
               | this manner, you lack empathy. You sound just like the
               | mommy blogs and their followers that I'm speaking against
               | who spout facts with no room for life's situations. My
               | wife sincerely believed she was less of a mother because
               | of people like this.
               | 
               | I say it again: Formula is _perfectly_ fine. Use it a
               | little or as a total replacement. You're not a lesser
               | mother/parent for it.
        
               | boredhedgehog wrote:
               | When you say more empathy is required, do you mean the
               | same thing should be phrased differently, or do you mean
               | it should not be said at all?
        
               | irjustin wrote:
               | Probably something that says while breast milk is ideal,
               | formula is a great alternative if it's not available.
               | 
               | Acknowledging that formula is a safe alternative and that
               | you don't need to stress.
        
             | hackernewds wrote:
             | What are some good mom blogs?
        
               | astura wrote:
               | Not a "mom blog," but covers pregnancy and childbirth
               | from a scientific viewpoint plus some parenting topics -
               | The Skeptical OB - https://www.skepticalob.com/ the
               | author was a practicing obstetrician, professor at
               | Harvard Medical School, and mom of 4.
        
             | CrHn3 wrote:
             | Formula is adequate as far as macronutrients go, but it
             | lacks sugars present (at varying levels-about 20% of the
             | population are FUT2 non-secretors and cannot produce the
             | a1,2-fucosyltransferase enzyme that is used to make human
             | milk oligosaccharides), stem cells and bacteria present in
             | breast milk. Women in the US are often deficient in the
             | strain that can metabolize the human milk oligosaccharides,
             | b. infantis, and it's not clear afaik to what extent
             | bacteria gets passed vertically in breastmilk. The microRNA
             | present in breastmilk can modulate gene expression, but the
             | extent and effects are unclear.
             | 
             | B. infantis and human milk oligosaccharides create a
             | feedback loop that encourages the formation of a robust
             | immune system during a critical period [1]. Some formulas
             | contain b. infantis, and some contain 2'FL, the HMO present
             | in breastmilk. The most robust strain is EVC001, which has
             | been shown to be present at a year after 21 days of
             | supplementation. In an observational study, it reduced the
             | diagnosis of necrotizing enterocolitis in very low birth
             | rate infants by 73% [2].
             | 
             | I wish this was common knowledge, but most formulas do not
             | contain these (often they contain other pre and probiotics)
             | and babies are missing out on the specific sugars and
             | bacteria that we know impact the development of the immune
             | system.
             | 
             | 1. https://www.cell.com/cell/fulltext/S0092-8674(21)00660-7
             | 2. https://pubmed.ncbi.nlm.nih.gov/35032555/
        
               | irjustin wrote:
               | At least this one doesn't sound as bad as the other post,
               | but it's still in the same vein - you've never been a
               | mother who can't produce milk for her child.
               | 
               | I've been as the husband there and are all your facts
               | don't allow for people's situations.
               | 
               | Formula is perfectly fine.
        
               | CrHn3 wrote:
               | > you've never been a mother who can't produce milk for
               | her child
               | 
               | That's your assumption.
               | 
               | You're missing the point, which is that you can
               | supplement formula with both 2'FL and b. infantis and get
               | immune system outcomes that are more similar to those
               | that occur while breastfeeding [1]. The fact that milk
               | typically faciliates a cascade of changes that lay the
               | foundation for a healthy immune system is not at odds
               | with formula feeding. Formula is adequate macronutrition,
               | but if we cannot be honest about the ways in which it is
               | not on par with breastmilk, we will never close the gaps.
               | 
               | 1. https://www.nutraingredients.com/Article/2023/05/18/Ab
               | bott-s...
        
               | irjustin wrote:
               | > That's your assumption.
               | 
               | Oh do correct me if I'm wrong. I'd love to hear your
               | personal experience. Anyway...
               | 
               | How can you close the gaps when the mother isn't
               | producing milk?
               | 
               | I'm actually confused because you keep telling me it's
               | better, with links and everything, but... It's simply non
               | existent for a lot of mothers. Non producing or a bad
               | latch is enough to put a newborn baby at risk after one
               | week.
               | 
               | It's like you don't believe it's possible.
               | 
               | That's why you're just like the mommy blogs. "You must
               | feed 'em breast milk. It's soooooo important"
        
               | CrHn3 wrote:
               | I've breastfed multiple children with ups and downs of it
               | being easy and hard, suffered through the struggle of
               | learning to do it the first time as postpartum mother
               | after major surgery, through teething, latch issues,
               | biting, pure physical exhaustion, and the transition of
               | going back to work that leads to decreased supply. I've
               | watched close friends that have struggled with production
               | with underweight, premature babies pump like crazy and
               | feel stressed out trying to get their supply up but
               | ultimately transition to formula on the advice of
               | doctors. My own anxiety around combination feeding and
               | not feeling like I had a clear understanding of
               | differences in the microbiome with a surgical birth or
               | formula use lead to me reading everything I could find to
               | gain a better understanding of the differences in
               | outcomes for exclusive breastfeeding, combination and
               | formula feeding.
               | 
               | We can close the gaps by subsidizing Evivo's EVC001 b.
               | infantis and making it a standard that every formula
               | contains 2'FL. Individuals can choose these formulas and
               | purchase b. infantis already. If we were to make it so
               | that all babies, not just NICU babies at hospitals aware
               | of the research, get these two things, public health
               | outcomes (especially those related to autoimmune
               | conditions) should be better than if we continue allowing
               | formula that is not as analogous with breastmilk. We can
               | have better lactation support that is current and
               | evidence based (such as that from ABM contributor Katrina
               | Mitchell https://physicianguidetobreastfeeding.org).
               | 
               | Another reason mom blogs are toxic is because people read
               | past others points when issues are really emotionally
               | charged for them. Really sorry your wife struggled.
               | Formula is fine, but there are reasons breastmilk is
               | pushed, especially since milk is supply and demand and
               | it's hard to identify those with true low supply and
               | those whose bodies just haven't ramped up production yet.
               | Hopefully as a model of immune system response and the
               | impact of b. infantis and HMOs gains more awareness,
               | there will be less pressure since we are assured babies
               | are getting many of the same benefits.
        
           | LAC-Tech wrote:
           | Older nurses are the best. They've seen it all.
        
             | doublespanner wrote:
             | The worst encounters I have had with nurses have been with
             | older ones filtering information and using out of date
             | practices because they think they have seen it all and now
             | know best.
        
           | [deleted]
        
           | froggertoaster wrote:
           | After 5 kids in 10 years, you come to realize that the
           | standards aren't agreed upon, and best
           | practices/recommendations change YEAR TO YEAR without fail.
           | 
           | Breastfeeding is one of the worst things hoisted upon mothers
           | who are told "you must try no matter what" - seemingly
           | ignoring the mental and physical health of the mother and the
           | father all the while.
        
             | cycomanic wrote:
             | My partner is a GP who has been doing early childhood
             | screening. One thing she learnt after doing a special
             | training is that advice on proper breastfeeding is very
             | difficult to find. She found that with many mothers that
             | had problems, some small adjustments could often make a
             | huge difference (often causing a kind of hallelujah moment
             | for the mothers). The issue is much of the advice given at
             | the hospital is wrong or insufficient.
             | 
             | The training the she did is the possums program from
             | Australia, if somebody wants to look it up I think some
             | resources are available for free.
        
               | anon291 wrote:
               | Completely agree. Half the lactation consultants have
               | never breastfed themselves. The advice my wife got from
               | the nurses versus what she got from her own mother and my
               | grandmother were completely at odds. Both of those women
               | told her to just keep doing it and to ignore the nurses
               | while the professionals were single mindedly focused on a
               | few days of weight loss. The milk came in (as all the
               | older women expected) and my daughter breastfed for many
               | years after.
               | 
               | Really the advice given is simply ridiculous. I honestly
               | think most men who's children have nursed can give better
               | advice than the lactation consultants. One that always
               | makes me roll my eyes is the idea that a breastfed child
               | should eat for a few minutes and then be full for an hour
               | or two. That is simply... Not how it works. Babies like
               | eating and being with mom. Breastfeeding mothers should
               | expect to be with their newborn all the time. We are
               | lucky to know many breastfeeding mothers and I don't know
               | any family where the baby is satiated after ten minutes.
               | And yet... The professionals are convinced this is how it
               | works
        
             | autoexec wrote:
             | There are a lot of really good benefits to breastfeeding
             | but it's not going to work for everybody or in every
             | situation. I wouldn't fault a doctor for recommending it,
             | but they shouldn't make someone feel bad if it isn't
             | working out.
             | 
             | I want recommendations and best practices to change as our
             | understanding of things improve though. The alternative
             | would mean that either no more research is being done, or
             | doctors are just ignoring anything they didn't learn while
             | in school.
        
               | bcrosby95 wrote:
               | Our doctor was fine with it. The nurse called formula
               | poison.
        
           | routerl wrote:
           | > Every generation laughs at all the stupid stuff the
           | previous generations believed, and then acts so confident
           | that they've got it right this time.
           | 
           | Voltaire (1694-1778) wrote a satirical account of a medieval
           | university's oral examination on medicine: the examiner asks
           | why morphine puts people to sleep, and the student
           | confidently replies that morphine has a "dormative essence".
           | This is a bit like saying that things with an essence of
           | gravity fall towards the earth, whereas things with an
           | essence of levity float towards the sky. The examiner proudly
           | accepts that answer and bestows upon the student the title of
           | doctor.
           | 
           | This was very funny to anyone educated in the time Voltaire
           | was writing, since they would have known that morphine puts
           | people to sleep because... it has round molecules with no
           | sharp edges...
           | 
           | Edit: correction below, thank you thaumasiotes.
        
             | matheusmoreira wrote:
             | I used to enjoy this blog written by a person who hated US
             | medical school:
             | 
             | https://web.archive.org/web/20101218031844/http://www.medsc
             | h...
             | 
             | People will probably find it offensive but it does explain
             | a lot about why the stuff being taught is almost always not
             | questioned.
             | 
             | This post in particular:
             | 
             | https://web.archive.org/web/20101211180021/http://www.medsc
             | h...
        
             | thaumasiotes wrote:
             | > Voltaire (1694-1778) wrote a satirical account of a
             | medieval university's oral examination on medicine: the
             | examiner asks why morphine puts people to sleep, and the
             | student confidently replies that morphine has a "dormative
             | essence".
             | 
             | It was Moliere (<1622 - 1673), who wrote a play that
             | featured an apothecary (explaining the functioning of
             | _opium_ to laymen), but no examinations.
             | 
             | https://en.wikipedia.org/wiki/The_Imaginary_Invalid
        
           | jvanderbot wrote:
           | Our twins were put into my wife's arms, and we were wheeled
           | into a room to stay for 48 hrs, being woken up every 2 hours
           | by a nurse, which would wake up our kids, making the whole
           | thing a living nightmare. I have no idea how I drove home.
           | 
           | They had no care for my wife's ability to heal, rest, or
           | anything, just subjecting us to the worst kind of
           | institutionalized checklist torture. The medical system cares
           | for nothing other than preventing lawsuits and providing a
           | place for doctors to do their 1 hr of work on their 18
           | patients a day.
        
       | stephen_g wrote:
       | Amazing that bit about child welfare organisations fighting
       | against the science, when clearly taking children away based on
       | false accusations is clearly far worse for the child's welfare,
       | not to mention the parents'!
       | 
       | It's just incredible the injustice that can be done in the name
       | of protecting children. I really do wonder if it's cultural or
       | some kind of innate psychological irrarionality that seems
       | stronger in some than others. I love kids and care deeply about
       | their welfare, but people sometimes try to make _me_ feel bad or
       | that I'm the weird one for being able to think (I believe) fairly
       | rationally about the risks and dangers that they face, instead of
       | massively over-exaggerating!
       | 
       | Or of course the opposite, keeping an appropriate eye on
       | relations and acquaintances when people assume they're totally
       | safe but it's actually somebody with that level of relation who's
       | likely to be a danger than a stranger.
        
         | fluidcruft wrote:
         | My sense is it's important to keep in back-of-mind that there
         | is a massive selection effect involved in terms of which people
         | chose to enter these fields and what sorts of personal life
         | events (trauma, abuse, witnessing of abuse etc) motives
         | choosing to make this a career. These are not well-paid careers
         | (nor are they high-status) so money and status are typically
         | not motivations (in fact a relative of an in-law works in a
         | closely-related field and we talk at Thanksgiving-type family
         | events about work and their employers often seem to me to be
         | exploiting their investment in the field). I think it's why it
         | can be so difficult to discuss it with them, it is deeply
         | personal and they feel the "system" failed in the past and they
         | want it fixed.
         | 
         | Anyway, it's not meant as an ad hom, but it helps to step back
         | and think why people are involved with certain roles.
         | 
         | To be clear: here the author only bothered look with his well-
         | trained eyes because he was sucked in after the law intruded
         | into his life. It's easy to assume that everyone is highly-
         | skilled. But... highly-skilled people don't usually choose to
         | work for peanuts without other reasons. Fields like this are
         | neglected.
        
         | cool_dude85 wrote:
         | It seems like there is still significant disagreement with this
         | guy's argument in "the science", at least as best as any
         | individual child welfare employee would understand it. There
         | are no doubt specialist doctors, general practitioners, etc.
         | telling the child welfare folks that it's as clear cut a
         | diagnosis as you could get.
         | 
         | The fact of the matter is, the article here is a brief overview
         | describing none of the actual scientific literature at a level
         | that should be convincing to a medical practitioner. But you
         | read it and are apparently convinced of the author's point. So,
         | a layperson (I assume, in your case) is presented with some
         | well-written evidence from an authoritative perspective,
         | alongside broad contours of the actual medical evidence but no
         | details, and is convinced that it's true. Is it so hard to
         | believe that a child welfare worker would be equally convinced
         | under the same circumstances when talking to a doctor,
         | neurologist, trauma surgeon, etc. who believes the opposite as
         | this author?
        
         | tivert wrote:
         | > Amazing that bit about child welfare organisations fighting
         | against the science, when clearly taking children away based on
         | false accusations is clearly far worse for the child's welfare,
         | not to mention the parents'!
         | 
         | This is just speculation, but I bet those groups (or their
         | members) aren't always _calmly and coolly_ trying to find the
         | best policies protect the welfare of children. Instead they
         | feel themselves on a kind of righteous moral crusade, and what
         | 's more heroic than swooping in to take the child away from the
         | clutches of the villain? The feelings of heroism could obscure
         | understanding the harm the "heroic act" could cause.
        
           | raducu wrote:
           | > and what's more heroic than swooping in to take the child
           | away from the clutches of the villain?
           | 
           | In a (somewhat) post-scarcity society attention from others
           | is hard currency and narcissism is at an all time high.
        
           | pivot654 wrote:
           | I work in child welfare in Australia. Not sure how it
           | compares to the models in other countries, but we desperately
           | try not to remove child from their families. There is very
           | little evidence to support it improves outcomes for those
           | children, and the removing itself is highly horrific for
           | everyone involved. Even in the instances we remove children,
           | we actively attempt to work with the parents to address the
           | issue. We are also beholden to the Courts to justify our
           | decision making.
           | 
           | The harm we cause is better explained by systematic reasons
           | (workload, case complexity, red tape, worker burnout and
           | apathy, racism)
        
             | RoyalHenOil wrote:
             | What happens if the cops are called, rather than child
             | services?
             | 
             | This is how I ended up in foster care over a false
             | accusation against my parents (in the US). I'm told that if
             | the accuser had called child services directly, they would
             | have done their investigation first and only taken me if
             | they determined I was in danger (which I was not).
             | 
             | But because the accuser called the cops instead, the cops
             | took me without investigating first and handed me over to
             | child services. Thus I spent the entire investigation
             | period in foster care, until a judge ordered me to be sent
             | back to my family. Even though they failed to produce any
             | evidence of abuse, it still took many months.
             | 
             | It was an extremely traumatizing and harrowing experience
             | (honestly even harder on me and my parents than when my
             | brother got sick and died) and remains the worst thing I
             | have ever experienced. But I find it hard to even talk
             | about because people tend to assume that if a child is
             | seized from a home, the parents must have been abusive. (My
             | parents are extremely not abusive, not even in the mildest
             | sense of the word.)
             | 
             | What's fucked is that I actually know two other families
             | who went through this exact same experience: false accuser
             | calls the cops, the cops give the kid to child services,
             | child services puts the kid in foster care while
             | investigating, the investigation turns up no evidence of
             | abuse, the court forces child services to send the kid
             | home, and the kid finally returns home with lifelong
             | trauma.
        
             | cool_dude85 wrote:
             | Yeah in my dealings with child welfare workers (in America
             | at least), they are the first to understand how "the
             | system", and they as a key component, can cause harm.
        
           | conductr wrote:
           | > they feel themselves on a kind of righteous moral crusade
           | 
           | They see a lot of bad stuff which causes them to have a
           | difficult time admitting that sometimes bad stuff just
           | happens on it's own
           | 
           | Reminds me of the police/detectives that "just know he did
           | it" because they don't understand that people grieve
           | differently. I really empathize with the people that don't
           | have a meltdown and cry when they hear some horrific news. I
           | don't think I would either in many cases. I'd want the cops
           | to do their job and go find the perp so I'd talk to them in a
           | calm and concise manner telling them what I knew; even though
           | that's likely highly suspicious behavior.
        
             | rossant wrote:
             | That actually happened to me, not with the police though,
             | but with social workers. I explained the situation in a
             | very calm, concise, and perhaps emotionally detached manner
             | because this is just my personality. They wrote in their
             | report that they found it strange that "I almost did not
             | cry during the interview", which they said was the main
             | reason they would recommend to put David in foster care.
             | The guilt of knowing that I, with my personality, was
             | responsible for losing his care, was devastating.
             | 
             | I also found this argument absurd: I was suspected of
             | losing my temper on my child, and it's my calmness that was
             | interpreted as a sign of danger!
             | 
             | It reminds me the Robert Roberson Texas death penalty case
             | that John Grisham recently wrote about [1]: "He told
             | hospital staff that she had fallen out of bed, but they
             | didn't believe him. They didn't know he was autistic and
             | decided he didn't show the proper emotions given the dire
             | situation."
             | 
             | [1] https://www.wsj.com/articles/texas-may-execute-a-man-
             | based-o...
        
               | stephen_g wrote:
               | It's especially bizarre because even apart from things
               | like autism, even for more neurotypical people
               | disassociation (which as I understand in mild forms can
               | appear as emotional detachment which could come off as
               | being calm) is a well known symptom of acute stress
               | responses (i.e. psychological shock). As unreproducible
               | as a lot of psychology is, putting any merit in 'they
               | didn't respond how I think they "should" have' seems like
               | just utterly extraordinary nonsense...
        
               | conductr wrote:
               | I'm rather neurotypical but I worked in high trauma
               | environments during my college years; ER, OR, ICU,
               | various life and death situations on daily basis in a
               | healthcare environment. I pretty much saw it all.
               | 
               | That was 20+ years ago, my career was not there so I left
               | clinical work but the ability to function during high
               | stress and deal with the present mentally stuck with me.
               | I also could mostly leave it at the door and it didn't
               | weigh on me outside work (I think most healthcare workers
               | can do this, it all just becomes normal.
               | 
               | Since then, I'm the one that springs into action instead
               | of paralyzed by shock/surprise. Saved someone choking in
               | a restaurant, pulled a pregnant woman from a burning car
               | after an accident, just a few weeks ago someone had a
               | stroke at a park and I had to figure out best way to help
               | - all these had many other bystanders just watching it
               | happen and they all just were frozen until I came over
               | and took charge barking order about call an ambulance or
               | telling them exactly how to help. I've also learned that
               | when something really bad happens in my life, like bad
               | diagnoses/death of loved ones, my immediate response is
               | to help and support what ever immediate actions are
               | needed, talk about what needs to be done, help others
               | experiencing immediate and usually uncontrollable grief.
               | My grief usually starts a day or two later once all the
               | immediate concerns are addressed.
        
               | PH95VuimJjqBqy wrote:
               | When I was young my youngest brother walked across a
               | large firepit barefoot (no one realized it was still hot,
               | the neighbor had been burning wood and the like outside).
               | 
               | He experienced 3rd degree burns on his feet and my mother
               | rushed him to the hospital. My stepfather at the time was
               | basically freaking out, my mother was very calm. After it
               | was over the thing she told us is that panicking in an
               | emergency helps no one.
               | 
               | It's a lesson I've kept with me my entire life. Most of
               | the time, for me to truly process things, I need to be
               | alone. I have no doubt I would come across as detached
               | and not caring if something tramautic were to happen to
               | me.
               | 
               | OTOH, I had to put a pet down once and I was crying like
               | a baby so maybe not. I've never been in a situation where
               | I haven't had time to process before really speaking
               | about it to others so I really am not sure what my
               | response would be.
        
               | conductr wrote:
               | > I had to put a pet down once and I was crying like a
               | baby so maybe not
               | 
               | I relate with much of your comment but this was something
               | I actually considered writing before. The most drastic
               | emotional response I've ever experienced was putting a
               | pet down. I knew it was the right choice, planned it out,
               | to be done at home in the back yard, his favorite place
               | and final resting place, and even made time for one last
               | outing to his favorite lake a little while before.
               | 
               | But with all the planning and forethought, it's like I
               | started grieving before the event happened. So when it
               | did happen, I just cried and cried. Like, sobbing on the
               | floor for an hour type thing. Also, the fact he was
               | mentally still 100% but his body was failing made it a
               | wrenching decision that I was questioning even though I
               | felt like it was the humane choice.
               | 
               | I was really in a funk for about a year after. The first
               | couple months, I'd just randomly cry as some old memory
               | would pop in my head. I was really close to this dog
               | though, was like a child to me and it hit really hard. I
               | got him in my early 20s, then later married but hadn't
               | had kids yet. For some reason, the saddest thought in my
               | head was "he'll never get to meet my kids". I've had 2
               | dogs since, that have been more like pets than children
               | and I have real children too which changes the dynamic
               | entirely.
        
               | dpeckett wrote:
               | Sounds a lot like the terrible case of Lindy Chamberlain
               | "A Dingo Ate My Baby"
               | https://www.youtube.com/watch?v=quC4cbpJeaU
        
           | heavyset_go wrote:
           | I suspect that was the motivation for Apple's iPhone client-
           | side scanning and reporting of CSAM feature and the
           | subsequent hard push for it.
        
           | stephen_g wrote:
           | That is a point - and also, while I'm sure many are just
           | misguided, and I generally don't want to assume malice when
           | ignorance is a more likely cause, it is certainly interesting
           | that some high-profile people on these 'heroic moral
           | crusades' do then seem to get caught up in sexual misconduct
           | scandals of their own surprisingly frequently...
        
           | rossant wrote:
           | Exactly. I met many people like this. The notion of
           | groupthink comes to mind: "Unquestioned belief in the
           | morality of the group, causing members to ignore the
           | consequences of their actions."
           | 
           | See https://en.m.wikipedia.org/wiki/Groupthink
        
           | jvanderbot wrote:
           | This is true, but not for the reasons you might expect. Well,
           | 10% of the time this is the case, but 90% ...
           | 
           | Mostly they are operating on priors. The prior probability of
           | a separation being the right thing to do is very high,
           | because they have a _long list of mitigation before they
           | actually can take a kid away. In the case of a doctor-
           | approved immediate physical danger, they are regulated into
           | acting on behalf of the immediate safety of the child while
           | the investigation is ongoing but even that is considered
           | temporary.
           | 
           | The goal of any foster care situation is to get the kids back
           | with the biological parents, so time is on their side,
           | provided they are not living in a circumstance that disallows
           | the kind of attendance and involvement that the state would
           | require to clear a caseworker to re-unite the family. Sadly,
           | many are.
           | 
           | Source: Foster parent.
        
             | RoyalHenOil wrote:
             | Priors should never, ever factor into it like this.
             | 
             | I was a foster child who was taken from my parents wrongly.
             | A third party (not connected to child services) made a
             | false accusation to the cops, who took me and turned me
             | over to child services without any investigation. Even
             | though I insisted nothing had happened and even though
             | child services failed to produce any evidence (beyond
             | aforesaid hearsay) over the course of their investigation,
             | child services nonetheless fought extremely hard against
             | letting me go home to my family.
             | 
             | In the end, a judge had to order them to return me to my
             | family because they refused to accept that the accusation
             | had been a lie.
             | 
             | In the meantime, I went through three different foster
             | homes. I was a very difficult kid to foster (I cried and
             | screamed a lot, demanding to go home) and so I
             | unfortunately experienced abuse and neglect in two of the
             | three homes. (My first foster home was particularly severe,
             | which was strange because they were otherwise great parents
             | to their biological kids. At least the other abusive home
             | treated their real children equally poorly.)
        
           | moffkalast wrote:
           | "We need to take away your kid because um.. DEUS VULT."
        
           | gwd wrote:
           | There's another factor in this, which makes it hard to
           | change:
           | 
           | For the people in child welfare organizations, for social
           | workers, for doctors, for police, for judges to change their
           | mind about _current and future_ decisions requires them to
           | change their mind about _past_ decisions. The necessary
           | implication is that many of the people they have persecuted
           | in the past were, in fact, innocent. It requires them to
           | admit that _they personally_ have likely caused untold
           | suffering to parents, caretakers, and children.
           | 
           | This is hard for anyone; but if you've lived your life trying
           | to be the hero, feeling good about swooping in and rescuing
           | children from the clutches of evil villains, how can you face
           | the fact that _you_ are the evil villain in so many children
           | 's stories?
           | 
           | You might call this the Paradox of Judgment: If you don't say
           | that something is that bad, then lots of people don't think
           | it's a big deal and don't do anything about it. But if you
           | _do_ say that something is really bad, then there develop all
           | these pathologies of denialism around it.
        
             | P_I_Staker wrote:
             | Interestingly enough, no bigger offender then the
             | psychiatric and mental health community. There's a very
             | sophisticated system for shutting down criticism and
             | lashing out at patients that have civil rights concerns.
             | 
             | They do a lot of mental gymnastics trying to run from the
             | idea that their main function is to imprison and take away
             | peoples rights, often without due process.
             | 
             | Medical industry is rife with abuse. They routinely kill
             | people out of spite, torture dying people and their
             | families, and want to be shielded from any criticism... so
             | fuck all the patients and look for reasons they're "not
             | righteous", etc, so you can dismiss them.
             | 
             | It's quite interesting (and disturbing) to see how much
             | culture evolves around deflecting blame and victim blaming.
        
               | ryandrake wrote:
               | Your comment reminds me of the Rosenhan Experiment[1].
               | "The first part involved the use of healthy associates or
               | "pseudopatients" (three women and six men, including
               | Rosenhan himself) who briefly feigned auditory
               | hallucinations in an attempt to gain admission to 12
               | psychiatric hospitals in five states in the United
               | States. All were admitted and diagnosed with psychiatric
               | disorders. ... The second part of his study involved a
               | hospital administration challenging Rosenhan to send
               | pseudopatients to its facility, whose staff asserted that
               | they would be able to detect the pseudopatients. Rosenhan
               | agreed, and in the following weeks 41 out of 193 new
               | patients were identified as potential pseudopatients,
               | with 19 of these receiving suspicion from at least one
               | psychiatrist and one other staff member. Rosenhan sent no
               | pseudopatients to the hospital."
               | 
               | 1: https://en.wikipedia.org/wiki/Rosenhan_experiment
        
               | dekhn wrote:
               | My favorite control experiment! Tell somebody you did
               | something and ask them what the results were, but don't
               | actually do the something.
               | 
               | "Honey, I doubled the salt in the pasta this time, how
               | does it taste?" "Oh, it's really salty". "Ha-HA! I didn't
               | actually add ANY salt!"
               | 
               | (do not actually do this to people you like or who like
               | you)
        
             | oooyay wrote:
             | There's also the normalization of seeing and hearing awful
             | things. After a while of being exposed to the wretches of
             | humanity you begin to see the signals for the wretches
             | everywhere.
             | 
             | As the warrior poet Maslow put it, "if the only tool you
             | ever have is a hammer, you tend to see every problem as a
             | nail."
        
               | RoyalHenOil wrote:
               | I actually strongly suspect that this is a major issue
               | with cops. Even the most well-meaning new hire is likely
               | to become jaded and paranoid after years of interacting
               | primarily with criminals. They are probably more likely
               | to assume the worst of a given stranger, even in contexts
               | where there is no reason to suspect that stranger.
        
             | rossant wrote:
             | This is spot on. This psychological barrier is probably the
             | number one obstacle to a wider recognition of the existence
             | and extent of this problem.
             | 
             | People like me who challenge the science behind the
             | diagnoses of SBS face an absolutely unprecedented and
             | unreasonable pushback, like I've never seen in any other
             | area. Basically everyone who has worked on this side has
             | faced threats, insults, personal attacks, cancellations,
             | boycotts, and so on. The "cognitive bias" you mention (does
             | it have a name? perhaps cognitive dissonance?) is a likely
             | reason for this amount of antagonism.
        
               | mabcat wrote:
               | Closest name I can think of is "commitment and
               | consistency". People tend to behave as they have behaved
               | in the past, doing so is both a cognitive shortcut and a
               | source of positive emotion. We go to great lengths to
               | maintain consistency (see also: confirmation bias), and
               | being consistent even in the face of conflicting evidence
               | feels _better_ than being inconsistent but right.
               | 
               | From Cialdini: "Once we have made a choice or taken a
               | stand, we will encounter personal and interpersonal
               | pressures to behave consistently with that commitment.
               | Those pressures will cause us to respond in ways that
               | justify our earlier decision."
        
               | hn_version_0023 wrote:
               | In my head -- and I'm no doctor, believe you me! -- I
               | call this "emotional inertia", which is a phrase I've
               | borrowed from one of the many doctors who has treated me
               | for depression.
        
               | gwd wrote:
               | It certainly would be a form of cognitive dissonance, but
               | that's _much_ more general; I experienced cognitive
               | dissonance hearing the word  "nicht" pronounced by a
               | native German speaker yesterday evening, because it
               | wasn't at all like what I expected it to sound like.
               | 
               | "Confirmation bias", where you tend to see what you
               | expect to see, is narrower; but still I think doesn't
               | capture what we're talking about. We're specifically
               | talking about resistance to accepting the idea because
               | accepting it would mean reclassifying actions you
               | yourself had taken from "very good" to "very bad". It's
               | kind of weird that it doesn't have a name -- I'm
               | convinced it plays a pretty big part of human behavior,
               | much more than is commonly acknowledged.
        
               | rossant wrote:
               | > We're specifically talking about resistance to
               | accepting the idea because accepting it would mean
               | reclassifying actions you yourself had taken from "very
               | good" to "very bad".
               | 
               | That's _exactly_ it. I 'd love to discover scientific
               | literature about this phenomenon, and I'd also be
               | surprised if it doesn't already have a name and an
               | extensive literature. But if that's the case: I think
               | there are research carriers in psychology to make here...
               | 
               | Edit: ChatGPT found "belief perseverance" [1] but, again,
               | that's not exactly what we're talking about, which also
               | relates to a personal sense of morality and "being one of
               | the good guys".
               | 
               | [1] https://en.wikipedia.org/wiki/Belief_perseverance
        
               | gwd wrote:
               | You could call it "moral self-image maintenance bias": A
               | bias towards maintaining your self-image as an upright,
               | moral person.
        
               | tivert wrote:
               | I think it's probably just a kind of "avoidance" or
               | "denial."
               | 
               | https://en.wikipedia.org/wiki/Experiential_avoidance
               | 
               | https://en.wikipedia.org/wiki/Denial_(Freud)
               | 
               | HN and software engineers have bias to over-focus on the
               | cognitive, but I think the key experience here is
               | _emotional distress_.
        
               | rossant wrote:
               | I agree. It's kind of ironic you mention "denial". It
               | turns out this is one of the favorite attacks by "SBS
               | proponents" against those who challenge the scientific
               | reliability of the diagnosis. We are called "denialists"
               | and we're accused of "denying the existence of child
               | abuse" (?). Parents in my organization (Adikia) who face
               | false allegations of abuse are said to be in "denial" of
               | their own abusive behavior. This story line appears to be
               | quite credible and powerful within the medical and
               | judicial communities.
               | 
               | Here's one among thousands of examples, from a really
               | terrible paper by one such powerful SBS proponent here in
               | France [1] (another of his papers was actually retracted
               | this year [2]).
               | 
               | "Fake news 11: the caretakers' denial is sincere
               | 
               | Clinicians and defenders can become intoxicated by the
               | denials of parents suffering the agony of having their
               | child in dire condition, and at the same time being
               | grilled for their possible responsibility. The mental
               | mechanisms of self-denial are well-known to
               | psychiatrists. A perpetrator, after a violent burst, and
               | faced with its terrible consequences, can experience a
               | dissociation mechanism similar to witnesses of
               | catastrophes, dissociation being understood as "a break
               | between the memory, the perception, the consciousness and
               | the identity...when faced with unbearable feelings".
               | Sincere denial easily elicits compassion from the medical
               | staff as well as defenders, a natural response which is
               | enhanced by professional training. Some authors have
               | documented with functional imaging the sincerity of
               | denial in a case of convicted child abuse and concluded
               | that the sincerity of denial is not a criterion for
               | innocence."
               | 
               | [1] https://link.springer.com/article/10.1007/s00381-021-
               | 05357-8
               | 
               | [2] https://link.springer.com/article/10.1007/s00381-023-
               | 05889-1
        
               | gwd wrote:
               | You obviously have more experience than I do; but two
               | phrases I'd be tempted to try out in these discussions
               | are, "If you were wrong, would you want to know?" And at
               | some point later "How would you know if you were wrong?"
        
               | gwd wrote:
               | I phrased it that way because I think this kind of
               | influence on our judgement is pervasive: we all have our
               | "thumbs on the scale" when evaluating our own behavior.
               | That's bias. But at some point it's not a "thumb on the
               | scale" anymore -- you've just thrown the scale away;
               | that's denial.
               | 
               | Still, there are different types and sources of denial,
               | just as there are different sources of emotional bias.
               | "Self-image maintenance bias" and "self-image maintenance
               | denial" can both be about general ways in which we try to
               | maintain our self image (as strong, talented, attractive,
               | whatever). "Moral self-image maintenance bias" or "moral
               | self-image maintenance denial" can be about ways in which
               | we try to maintain our self-image as good, decent people.
        
               | alexashka wrote:
               | It's the sunk cost fallacy.
               | 
               | This is why Max Planch (German physicist) has quipped
               | that science advances one funeral at a time.
        
             | NiloCK wrote:
             | It's hard to understand something if your salary depends on
             | it being false.
             | 
             | It's much, much harder again to understand something if it
             | makes your life's work ignoble.
        
         | duxup wrote:
         | My theory is that emotionally charged issues seem like a haven
         | for people not thinking clearly and cover for hand waving or
         | opposing any thoughtful analysis.
         | 
         | I think there are people drawn to the absolutes. I can maybe
         | see how it can be comforting to have a black and white issue to
         | try to solve / help. A good side to be a part of in a world
         | that to some seems very bad or confusing.
         | 
         | Some old friends of mine are very much into these kinds of
         | children's issues. But when they talk to you about it it's all
         | emotion, it's not even clear to me that they know much at all
         | other than a sense that the bad guys are out there, maybe some
         | strange legislation they support and so on. They're not
         | interested in justice, just this absolute sorta cause.
        
           | rossant wrote:
           | I agree. This is clearly visible in trials where emotion
           | plays a big part. An innocent childminder being charged with
           | murder can't really compete with the extraordinarily charged
           | testimony of grieving, devastated and sincere parents who
           | have been made to believe in the strongest way possible that
           | she killed their baby.
        
           | [deleted]
        
         | michael1999 wrote:
         | Baby-stealing is a deep drive.
        
         | sam_goody wrote:
         | > It's just incredible the injustice that can be done in the
         | name of protecting children
         | 
         | Whatever it is:
         | 
         | - If it's in the name of protecting the children, odds are it
         | is not justice.
         | 
         | - If it is not justice, at some point the excuse will be to
         | protect the children
        
           | smolder wrote:
           | > - If it is not justice, at some point the excuse will be to
           | protect the children
           | 
           | I don't think this is a very solid maxim. It seems to imply
           | things other than justice can only occur if protecting
           | children is a claimed motive.
        
         | Red_Leaves_Flyy wrote:
         | >I really do wonder if it's cultural or some kind of innate
         | psychological irrarionality that seems stronger in some than
         | others.
         | 
         | CPS is a human organization. There are no algorithms and the
         | guidelines rarely perfectly fit the situation a case worker is
         | given. Keep this in mind. CPS is horrifically under funded
         | meaning that intelligent and competent staff readily leave the
         | field for better paying gigs.
         | 
         | The biggest problem I see with foster care at large is the
         | rampant classism, sexism, racism, and other isms. The providers
         | tend to be solidly middle class degree bearing people who have
         | no personal connection to primary instigating factors of foster
         | care involvement. Namely and typically presenting cross
         | generationally: poverty, crimes of despair or desperation, and
         | trauma whether that be internal or external to the family unit
         | or community such as neighborhood violence, caregiver assault,
         | or tragic loss.
         | 
         | It easy for providers to casually profile incoming children and
         | their families as poor uneducated violent predacious drug
         | dealing junkies. Providers are given extreme control over the
         | entire family and their extended relations and use this power
         | to coerce whatever behavior they desire out of the people. If
         | the provider dislikes the family they have a lot of tools to
         | inflict suffering on them and oppositely they have a lot of
         | tools to assist families and keep them together.
         | 
         | Honestly, the entire system is such a god damn mess that it
         | should be rebuilt with the same level of distrust of staff that
         | they can exercise against families.
         | 
         | Perhaps the most pressing single metric to focus may be the
         | foster to prison pipeline.
         | 
         | Sorry for the meandering post, bookcases could be filled with
         | anecdotes and descriptions of the flaws in these systems. In
         | general, I think the failure of child protection agencies
         | reflects the decay in America at large. I could point to stuff
         | like broken family units or loss of religions community but I'm
         | not dog whistling here. Stable healthy nurturing familial units
         | of any relation are obviously better but man in the house rules
         | and other racist/classist measures caused more harm. I'm also
         | vehemently opposed to all major organized religions that are
         | regularly used to justify war and protect child sex predators.
         | Perhaps the collapse of American industry and slow erosion of
         | social safety nets has hastened the social collapse. Perhaps
         | the internet had instigated the collapse of communal
         | organizations. Perhaps winner take all government enforced
         | monopoly capitalism is the cause. Perhaps it was the theft of
         | 50,000,000,000.00 from the bottom 99 by the 1% that lead to
         | this. Regardless, the solution is not going to be found in
         | rebuilding foster care when our social fabric is rotten.
         | 
         | 0. https://srcd.onlinelibrary.wiley.com/doi/10.1002/sop2.10
         | 
         | 1. https://www.crimlawpractitioner.org/post/the-foster-care-
         | to-....
         | 
         | 3. https://nlihc.org/resource/study-examines-man-house-rules-
         | vo...
         | 
         | 4. https://time.com/5888024/50-trillion-income-inequality-
         | ameri...
        
         | nickelcitymario wrote:
         | I have some inside information on how this plays out in
         | Ontario, Canada, at least. One of my family members was a
         | lawyer for the regional Children's Aid, and I worked for him
         | for a few years. Another family member was a child protection
         | social worker for two decades, but retired early because they
         | felt the organization didn't prioritize the welfare of children
         | (as is their mandate) but rather the needs of the organization
         | or (perhaps more realistically) the needs of their own careers.
         | 
         | MANY social workers feel this way. They got into the field out
         | of a genuine concern for the well-being of the most vulnerable
         | members of our society, and instead found themselves dealing
         | with politics (both real and office).
         | 
         | I'm not sure how it is in other countries, but in my region,
         | they actually appoint a lawyer for the child. This is great,
         | but it also tells you a lot about what everyone else's
         | priorities are that children need their own lawyers:
         | 
         | (1) Parents want their kids back, of course. Not all parents
         | are fit to get them back. But their lawyers fight for the
         | return of their kids regardless of circumstances or reasons for
         | their removal.
         | 
         | (2) Child protection agencies are under constant attack, so at
         | the executive level, they lose sight of the individual kids and
         | are instead worried about the needs of the organization and
         | public relations.
         | 
         | (3) The social workers themselves are handcuffed to do anything
         | about it and have to follow procedure, even if they can see it
         | plainly that the procedure is not in the best interests of the
         | child.
         | 
         | (4) Police want nothing to do with any of it and are quick to
         | wash their hands of these situations.
         | 
         | (5) The children's lawyer somehow has to represent the needs of
         | the child, which may place them at odds with their own clients
         | (the kids).
         | 
         | (6) Activist groups will generally support the parents blindly,
         | because by law, for the privacy of the children, the only
         | parties listed above who can publicly speak about any given
         | case are the parents themselves. So you can only ever hear one
         | side of the argument. That's right: If a father, for example,
         | sexually abuses his kids and as a result has them removed, he's
         | free to say just about anything he likes about the matter,
         | without ever acknowledging that he's a child molester. The
         | other parties can't say a thing about this.
         | 
         | As a result, it's impossible, as a member of the public, to
         | ever know whether it was appropriate or not that the children
         | were removed from the care of their parents. I happen to know,
         | from first-hand experience, that it's a mixed bag: Some parents
         | shouldn't be allowed anywhere near any child ever, much less
         | their own. Others are victims of a system gone haywire. And we,
         | the concerned public, can't have an informed discussion about
         | any of it.
         | 
         | All in all, it transforms child protection into a game of who-
         | has-the-best-lawyers rather than trying to do what's right for
         | the kids. Is it any wonder so many kids end up traumatized by
         | this system?
        
         | zdragnar wrote:
         | There's a bias in favor of action, especially among the social
         | workers that I have known. The worst possible sin is to do
         | nothing at all.
         | 
         | In cases like this, in the moment, it may be impossible to tell
         | what is actually best for the child. Since removing the child
         | is a form of remediation, it can easily seem to be less harmful
         | than leaving them in a situation that might be actively harming
         | them.
        
       ___________________________________________________________________
       (page generated 2023-09-27 23:01 UTC)