Mum slams advice from expert Jul 6 2003 By Sunday Sun

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    Mum slams advice from expert Jul 6 2003




    By Sunday Sun


    A North mum has revealed how her family was torn apart when her two kids were taken away following advice by the protege of discredited expert Professor Roy Meadow.

    She has not seen them for three years and her only contact is through the four letters a year she is allowed to send them.

    Her tragic tale began in 1998 when she became concerned about the treatment of her son - who suffers from cerebral palsy and autism - by a North hospital.

    She was referred to Professor David Southall, a paediatric specialist in Staffordshire.

    Professor Southall studied under Professor Meadow and both were seen as experts in Munchausen syndrome by proxy, MSBP, a condition where mothers harm their children to get attention for themselves.

    So-called "Meadow's Law" in relation to cot death - one is a tragedy, two is suspicious and three is murder - has come under fire following the Trupti Patel and Sally Clark murder cases.

    The North mum claimed: "I only met Southall for 15 minutes but I later discovered he was accusing me of MSBP."

    At another assessment she said he became very interested when told her mum had lost three children to cystic fibrosis 33-years earlier.

    Later that year two social workers appeared at the family's home in Tyne and Wear. Her son was assessed then placed on the At Risk register and taken into care.

    "The day he was taken away was the day I died inside. Being autistic he couldn't understand what was happening.

    "He was constantly crying and asking to come home. It was terrible."

    In early 1999, after they were told their daughter had to go before a Family Proceedings Court, the family went on the run before being tracked down by police to a house in Scotland.

    The girl was taken into care, while her mum and gran were jailed for nine months for abduction.

    The mum claimed: "The final hearing in the Family Proceedings Court was told that my mum was the major Munchausen person in the family.

    "There was talk of the Crown Prosecution Service bringing murder charges against her."

    Genetic tests have revealed the family have a faulty gene associated with cystic fibrosis.

    The distraught mum added: "I haven't seen my children since. All I'm allowed is four censored letters a year.

    "I will never stop fighting until I get my kids back."

    A spokesman for Professor Southall said: "The duty of patient confidentiality prevents any doctor from commenting on the details of individual cases.

    "Decisions in child protection cases aren't taken by any one individual.

    "Cases are dealt with through Area Child Protection Committees who have representation and opinion from doctors, social workers, the police and other professionals."

    Page 2: Mums treated 'like witches'



    Mums treated 'like witches'

    North MP and human rights expert Vera Baird has slammed court rulings that have led to hundreds of children being taken off their parents as "ducking-stool justice".

    Professor Roy Meadow, of North Yorkshire, has often been called on to back up cases against mums accused of harming their kids by claiming they were seeking attention for themselves.

    Their behaviour has been attributed to the controversial condition Munchausen's syndrome by proxy, known as MSBP for short.

    Ms Baird said: "One of Meadow's criteria for MSBP states if a mother says she didn't do it then she is in denial. MSBP is ducking-stool justice.

    "Just as a woman accused of witchcraft centuries ago was only pronounced innocent if she drowned and was guilty if she survived, those mothers accused of abusing their children are assumed to be guilty if they deny the charges."

    Redcar MP and former lawyer Ms Baird added: "I cross-examined Meadow as a young barrister and I was extremely worried then by the evidence that he was giving about MSBP.

    "In light of this I have written to the Prime Minister asking for a judicial inquiry into all MSBP cases so they can be reviewed."

    Prosecutors are now contacting all defence teams involved in cases in which Meadow gave evidence as his testimony is no longer seen as reliable. We were unable to contact Mr Meadow, now retired, for comment.



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    Chance remark cost me my kids Aug 3 2003




    By Sunday Sun


    A devastated North dad has revealed how a chance remark by a relative led to his wife being branded a baby killer and the eventual break-up of his family.

    The man, who can't be named for legal reasons, has been inspired to speak out by the recent Sunday Sun expos of people who have suffered because of controversial child abuse expert Professor Roy Meadow and his followers.

    He instigated "Meadow's Law" about cot death which said, "one was a tragedy, two were suspicious and three is murder".

    Two of the North man's first three children died of cot death syndrome in 1993 and 1997 aged eight months and four weeks respectively.

    No finger of suspicion was pointed at the family until 2000 when social services in the region were investigating a separate case of two cot deaths.

    When the parents were quizzed about that double tragedy, they told the authorities how the North man's family - who they were related to - suffered the same fate.

    The father alleged that, at a meeting about the other family, Professor Meadow suggested the social services look at his family.

    And he says that, as a result of this meeting their surviving child - a daughter - was placed on the Child Protection List.

    He also claimed that in 2000, after they had a son, social services tried to stop them taking their new baby home.

    Then when his wife missed a routine anti-natal appointment, they were ordered back to the hospital and were told their son would be kept in overnight.

    However, the dad alleged: "Social services got an emergency protection order and they kept him for 70 days at the hospital doing tests.

    "The doctors' report said there was nothing wrong with him. But the report's final summary said `considering the family's past history (we are) concerned about his safety'."

    His wife's mum, who lived in Birmingham, offered to look after their children while a Family Proceedings hearing was arranged at the High Court in Newcastle in December 2000.

    "The High Court judge made a finding against my wife stating that under the laws of probability she had suffocated one of the girls," he said.

    "Yet there hasn't been a criminal case brought against her."

    He claimed: "The police told us there isn't any evidence of foul play.

    "My crime in social services' eyes was to stand by my wife, who I still believe to be innocent to this day."

    At a final High Court hearing at Leeds in October 2001, the judge ordered the children to be sent to live with the wife's mum at her Midlands home.

    Contact was reduced to one visit per child a month. Then in July last year the couple's marriage broke up.

    Because it was his wife who had been accused of murder, the North dad hoped this opened the way for him to get his children back.

    But he was to be bitterly disappointed.

    "The only thing I could do, I was told, was take the case to court myself. I tried to get Legal Aid but I earned too much.

    "I was told it would cost me 100,000 to fight the case.

    "When I spoke to social services last week they told me I should just accept life as it is. I will never do that."

    We were unable to contact Professor Meadow for a comment.
    •  
  2. 4 Comments

  3. by   kittya
    Oh my word, this is tragic!
  4. by   gwenith
    It was on four corners last night here in Australia. Here is the link http://www.abc.net.au/4corners/default.htm
    That professor - words fail me but what I would like to do to him well they say "If you get caught don't let them give you to the women"
  5. by   Julee Oakley
    BMJ 2003;327:299-300 (9 August)


    Editorial
    Suspected child abuse: the potential for justice to miscarry
    Poor process causes more injustice than poor professional practice

    Two years ago the chief medical officer, Sir Liam Donaldson, in the course of a letter to every doctor in England and Wales, said that he doubted whether the public realised the extent to which "when things go wrong, the true cause lies in weakness within the system rather than the culpable actions of an individual."1

    One area where the British public sense that things have gone badly wrong is in the field of suspected child abuse. The quashing of Sally Clark's conviction for the murder of two of her children in January,w1 and the collapse of the Crown Prosecution case against Trupti Patel in June,w2 have shaken public confidence. In each case the issue at stake was whether it could be shown--beyond reasonable doubt--that a death originally certified as due to natural causes had, in retrospect, been caused by a parent. In each case suspicion only arose after a second child died. The Attorney General has now set up a review of these and other related cases,w3 and the actions of individuals are under scrutiny. A landmark ruling in the Court of Appeal in the last week has also brought much needed clarity to the issue of whether children have a right to legal redress if decisions about their care are taken negligently.2

    Sir Roy Meadow, a senior paediatrician with a life-time's experience of investigating cases of suspected abuse, was an expert witness in both the murder trials. A comment about the likelihood of unexplained sudden death claiming two young children in a single family formed part of his testimony in the first case. It went unchallenged at the time,w4 but has since attracted strong criticism.w5 What has not been asked is why it (or its relevance) went unchallenged at the time. Had it been a civil case, cross scrutiny of expert testimony would have resolved the relevance of these figures before they were ever put before a jury. The experts' duty is to provide informed, balanced, and impartial evidence, uninfluenced by the law's adversarial approach. But that does not mean that experts will always come to a common view. The use of expert testimony in criminal cases needs the reform that has now been instigated in civil cases.

    The media expressed much outrage at this particular lapse,w6 but the banning of a defence expert for repeatedly expressing opinions unsupported by any objective evidence went almost completely unreported.3 Many would accept that in a criminal trial it is worse for expert evidence to result in wrongful conviction than wrongful acquittal. However, when it is the safe custody of a child that is in question, it is the child's best interest that has to be paramount. For courts to be asked to believe that bone fractures in early infancy can be caused by what a single defence expert has called "temporary brittle bone disease" risked exposing children to further injury and possible death.w7 The media showed no interest in the miscarriage of justice that this might have caused.

    Sir Liam is almost certainly right. We need to look rather less critically at the people caught in the spotlight, and more at the systems failure involved. Court hearings--like diagnostic tests in medicine--sometimes get things wrong first time round. The task is to look at what has caused both false negative and false positive findings, and to see what can be done to minimise these.

    One obvious flaw in the handling of the Sally Clark case was the dearth of high quality forensic input into the initial investigation of these deaths.w7 Pathology services in the United Kingdom are now sadly stretched. As many as 400 histopathology posts may be vacant by next year.4 The way in which politicians and the media handled the outcome of the Alder Hey inquiry (caused by one pathologist retaining body parts wholesale without parental consent after autopsy) has had an even more damaging effect on paediatric and perinatal pathology.5 6 The systems failure at the heart of the current crisis is the lack of any well resourced, regionalised, forensic pathology service, staffed well enough for every coroner's autopsy to be cross checked by a second colleague.6 Audit for quality is impossible without this.

    In that respect Dame Janet Smith's proposals are to be preferred to those being proposed by the Home Office here.7 The BMJ news item on 19 July describing Dame Janet's proposals was captioned "Investigators should be trained to 'think dirty.'"8 In fact, as correspondents were quick to point out, they just need to think--to think critically and objectively. As the Foundation for Sudden Infant Death emphasised, the admonition to "think dirty" has already done untold damage. Suspicion should be the end point, not the starting point, for any investigation.9

    Only a minuscule fraction of all child abuse ends in death, but when it does it causes understandable public outrage. The government inquiry Lord Laming undertook last year following the death of Victoria Climbi was charged with identifying the lessons that needed to be learnt.w8 He heard evidence that paediatricians are increasingly reluctant to become involved in child protection work for fear that this will trigger a formal complaint, a disciplinary hearing, and even litigation. He chose not to address the reason for this in any detail, but the problem will not go away.w8 Paediatricians face a real dilemma if they find their duty of care to the child conflicts with their duty to respect parental wishes. One paediatrician who thought that his duty of care to the child came first was recently called to account before the General Medical Council on that very issue. While the council eventually found the doctor "not guilty of professional misconduct" that was hardly a ringing endorsement of the principle enshrined in the Childrens' Act of 1989 that, in any unresolvable conflict, it is the child's best interest that must prevail.10 There are those who thought that the General Medical Council should have called the doctor to account had he not taken that line. That certainly was the tenor of a landmark ruling by His Honour Judge Hale last yearw9 that was upheld on appeal, by the Master of the Rolls, in a long and nuanced judgment last week.2 Other aspects of that important judgment, limiting the immunity that a statutory body can claim if its management of a case has been deemed negligent, are reported elsewhere in this issue (p 305).

    It is not for the doctor to decide what is in the child's best interest, but it is the doctor's job to see that the court is given a chance to make that decision. Many paediatricians are becoming increasingly reluctant to become involved in such matters because a single genuine misjudgment can now trigger a heavy handed disciplinary inquiry and much adverse media publicity. If pathologists are no longer going to be expected to make decisions that may have legal repercussions single handed, neither should their paediatric colleagues. Currently they feel damned if they do and damned if they don't. There is a resultant temptation to avoid all involvement and say that these things are a matter for social services or for the police. Uncertainty as to where prime responsibility lies, however, has been at the heart of many recent disasters.w9 If that duty rests with all three agencies there is a real sense in which it rests with none. It might be clearer where it needs to rest if cases of ill treatment were categorised by motive and degree rather than, as now, by the type of injury sustained11--although, as one reader quickly pointed out, it is not always possible to be sure whether ill treatment really is involved.12 It might also help if we stopped calling neglect a form of abuse.13 Most of these families need help and support--not a pejorative label.

    Ultimately it is for the courts to make these difficult judgments, but they cannot do this without medical help. Doctors, being human, will sometimes give flawed advice. There needs to be a robust system in place, in all our courts, to see that this does not result in a miscarriage of justice. Because many family court decisions are, understandably, made behind closed doors, the public cannot know how robust their systems are already.

    Edmund Hey, retired paediatrician

    Newcastle (shey@easynet.co.uk)




    --------------------------------------------------------------------------------
    See News p 305

    Extra references w1-w9 appear on bmj.com

    Competing interests: None declared.

    References


    Letter from the Chief Medical Officer, 12 July 2001.
    Dyer C. Judges rule that children can sue for wrongful diagnosis of abuse. BMJ 2003;327: 305.[Free Full Text]
    Williams C. The role of the expert witness. Arch Dis Child 2002;87: 267-8.[Free Full Text]
    Burton JL, Wells M. The Alder Hey affair. J Clin Path 2001;54: 820-3.[Free Full Text]
    Cox P, Scott R. Perinatal pathology in 2001. Arch Dis Child 2001;84: 457-8.[Free Full Text]
    The future of paediatric pathology services. London: Royal College of Paediatrics and Child Health, 2002.
    Milroy CM, Whitwell HL. Reforming the coroner's service. BMJ 2003;327: 175-6.[Free Full Text]
    Dyer C. Investigators should be trained to "think dirty" about cause of death, Shipman report says. BMJ 2003;327: 123.[Free Full Text]
    Epstein J. Do not think dirty about infant deaths. [electronic response to: Dyer. Investigators should be trained to "think dirty" about cause of death]. BMJ 2003. http://www.bmj.com/cgi/eletters/327/7407/123-c#34860 (accessed 4 Aug 2003).
    Hall D. Protecting children, supporting professionals. Arch Dis Child 2003;88: 557-9.[Free Full Text]
    Southall DP, Samuels MP, Golden MH. Classification of child abuse by motive and degree rather than type of injury. Arch Dis Child 2003;88: 101-4.[Abstract/Free Full Text]
    Nelson EAS. Category D: unknown whether ill treatment is cause. Arch Dis Child 2003;88: 645.[Free Full Text]
    Golden MP, Samuels MP, Southall DP. How to distinguish between neglect and deprivational abuse. Arch Dis Child 2003;88: 105-7.[Abstract/Free Full Text]


    Other related articles in BMJ:
    NEWS
    Judges rule that children can sue for wrongful diagnosis of abuse.
    Clare Dyer
    BMJ 2003 327: 305. [Full text]

    w1 Dyer C. Sally Clark freed after appeal court quashes her conviction. BMJ 2003;326:304.

    w2 Marks N. An expert witness falls from grace. BMJ 2003;327:110.

    w3 Dyer C. Group to review babies' deaths. BMJ 2003;327:10.

    w4 Meadow R. A case of murder and the BMJ. BMJ 2002;324:41-3.

    w5 Watkins SJ. Conviction my mathematical error ? BMJ 2000;320:2-3.

    w6 Wilson R. Cot death mothers: the witch hunt. BMJ 2003;326:402.

    w7 Milroy CM. Medical experts and the criminal courts. BMJ 2003;326:294-5.

    w8 Hall D. Child protection - lessons from Victoria Climbi. BMJ 2003;326:293-4.

    w9 Dyer C. Paediatricians did not have a duty of care to patient's mother. BMJ 2002;325:1321.
  6. by   gwenith
    Very insightful look at the process that fueled that whole tragedy. Thank - you for posting this additional information.

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