Should Waney Squier have been struck off over shaken baby syndrome?
A doctor who disputed the existence of shaken baby syndrome has said she was struck off because her views challenged the establishment. Now she is appealing against the decision, as John Sweeney explains.
Shaken baby syndrome, also known as SBS, is a controversial diagnosis that causes about 250 criminal and family court cases a year.
The three British pathologists who are openly critical of shaken baby syndrome no longer give evidence in court.
Pathologist Dr Waney Squier can't give evidence because she was struck off seven months ago after a General Medical Council (GMC) panel called her evidence "dishonest" and "deliberately misleading". Her appeal against the decision begins on Monday.
Her two most high-profile fellow sceptics, Dr Irene Scheimberg and Dr Marta Cohen, also no longer give evidence in such cases in the criminal and family courts.
Asked why she doesn't give evidence in shaken baby syndrome cases any more, Dr Scheimberg told BBC Newsnight: "Because I'm afraid of the possible consequences."
Supporters of the SBS diagnosis such as Prof Tony Risdon and Prof Colin Smith, both of whom gave evidence against Dr Squier at her panel, assert that a triad of symptoms including blood over the brain, blood in the eyes and brain damage, must have been caused by an infant being violently shaken.
Both the professors also told the panel that they do not give evidence for the defence in SBS cases.
SBS 'is rubbish'
But Dr Squier, Dr Cohen and Dr Scheimberg argue that evidence which supports the theory just isn't there.
Dr Scheimberg said: "The problem is that in 40 years we have not been able to demonstrate the traditional theory of shaken baby syndrome."
Dr Squier is less diplomatic: "Shaken baby syndrome is rubbish. There is no evidence to support this hypothesis of SBS, and yet it is still being used every day in our courts as the basis on which some very important decisions are made about whether people may be sent to prison, or babies taken away from their families.
"There is no scientific evidence to support it - there never has been. It is not right that it is still being used in the court if it has no validity."
Dr Squier has been buoyed by a letter to the British Medical Journal from 350 doctors, scientists and lawyers questioning the decision to strike her off.
Her supporters believe it is unprecedented to have so many distinguished scientists writing to the BMJ in support of a struck-off doctor.
Signatories include Prof Peter Fleming, the doctor who cut cot deaths; Sir Iain Chalmers, the pioneer of evidence-based medicine; and Prof Liliane Boccon-Gibod, an internationally renowned paediatric pathologist.
'Honesty and integrity'
It is hard to asses the impact of silencing the scientists willing to cast doubt on SBS orthodoxy.
But critics of the GMC panel - which is made up of a retired police officer, a retired Wing Commander and a community psychiatrist - fear that it could lead to multiple miscarriages of justice in the criminal courts and also in the family courts.
In 2005, the Appeal Court looked at SBS through four cases. The judges ruled that the syndrome was a hypothesis which remained valid, but with limitations.
The Crown Prosecution Service said the judgement sent "a clear signal validating the approach used by the CPS in prosecuting shaken baby syndrome cases".
After Dr Squier was struck off in March this year GMC chief executive Niall Dickson said: "This case was not about the science - it was about Dr Squier's conduct as a doctor acting as an expert witness.
"It was brought following criticism of her evidence by no fewer than four senior judges, presiding over some of the most serious matters the courts have to deal with.
"A doctor giving evidence in court is bound by the same standards as a doctor in clinical practice, and by additional rules set down by the courts.
"They have a duty to act with honesty and integrity at all times. Their work should be rigorous and their opinion presented objectively and fairly."
'No improper influence'
The original complaint against Dr Squier came not from a fellow scientist, but the Metropolitan Police.
In 2010 Detective Inspector Colin Welsh, who has since retired, told an SBS conference in the United States that defence witness testimony was at the "top of the list" as a reason for the police losing "child abuse" cases in Britain.
In his address to the conference held in the US state of Georgia, DI Welsh reportedly suggested some tactics to question everything about the defence experts.
These included questions about qualifications, employment history, testimony, research papers presented by these experts, and even going to their professional expert bodies "to see if we turn up anything".
A spokesman for the Metropolitan Police confirmed that the then DI Welsh had given the speech, but said it was "completely committed to the judicial process and would never seek to improperly influence it".
If it was the police's strategy to improve its conviction rate in SBS cases, it may have succeeded.
But now Dr Squier is calling for a public inquiry into SBS, and her battle to save her good name is shining a light on a hotly disputed area of medical science.