Review of child care cases finds few instances that raise "serious doubt"
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《英国医生杂志》
An official review of more than 30 000 cases of children in England and Wales who were either taken from their parents and put into care or are currently involved in care proceedings has found just a handful of cases that raise serious doubts about the reliability of disputed medical evidence.
In only one case so far has a care plan for a child been changed as a result of the review.
The results show that media speculation that some 5000 care orders might be reopened on the basis of flawed medical advice was seriously wide of the mark.
The nine month investigation was ordered last January after the Court of Appeal quashed the conviction of Angela Cannings, a mother who was jailed for life for killing her two baby sons (BMJ 2004;328:183).
The court declared in the Cannings case that no prosecutions should be launched in future where reputable medical experts disagreed on the cause of death and no other cogent evidence was forthcoming.
After the ruling, ministers ordered reviews of criminal cases in which parents were convicted of killing their children—or where prosecutions were under consideration—and civil cases where care orders had been made or were currently being sought, to identify those where medical experts were in dispute.
Margaret Hodge, the children抯 minister, announced last week that of 5175 current care proceedings, disputed medical evidence featured or was expected to feature in 47 cases. Of the cases in which the impact of this was known, in only one case was the care plan changed as a result of the review.
Of a further 28 867 cases in which a care order was in place, 26 were found to involve disagreement between experts about medical evidence.
Only five of those raised "serious doubt" about the reliability of the evidence. In one of the five, plans for the child had been changed before the Cannings judgment as a result of new information.
In three cases no changes were made, and the remaining case was awaiting further consideration of medical evidence by the court.
The attorney general identified 28 possible criminal cases, but only six applications have so far been made to the criminal cases review commission, which refers possible miscarriages of justice to the court of appeal. Attempts are still being made to trace the defendants in more than a dozen cases, and "a handful" are going direct to the appeal court, according to a spokesman for the commission.
Mrs Hodge also said she would be drawing the attention of local authorities to the General Medical Council抯 ruling last March striking off an expert witness, Colin Paterson, for serious professional misconduct.
Dr Paterson, a retired chemical pathologist who has estimated that 60-70 children were returned to their parents as a result of his evidence, regularly attributed babies?fractures to "temporary brittle bone disease," while ignoring evidence pointing to deliberate injury, the GMC found.(BMJ Clare Dyer legal corr)
In only one case so far has a care plan for a child been changed as a result of the review.
The results show that media speculation that some 5000 care orders might be reopened on the basis of flawed medical advice was seriously wide of the mark.
The nine month investigation was ordered last January after the Court of Appeal quashed the conviction of Angela Cannings, a mother who was jailed for life for killing her two baby sons (BMJ 2004;328:183).
The court declared in the Cannings case that no prosecutions should be launched in future where reputable medical experts disagreed on the cause of death and no other cogent evidence was forthcoming.
After the ruling, ministers ordered reviews of criminal cases in which parents were convicted of killing their children—or where prosecutions were under consideration—and civil cases where care orders had been made or were currently being sought, to identify those where medical experts were in dispute.
Margaret Hodge, the children抯 minister, announced last week that of 5175 current care proceedings, disputed medical evidence featured or was expected to feature in 47 cases. Of the cases in which the impact of this was known, in only one case was the care plan changed as a result of the review.
Of a further 28 867 cases in which a care order was in place, 26 were found to involve disagreement between experts about medical evidence.
Only five of those raised "serious doubt" about the reliability of the evidence. In one of the five, plans for the child had been changed before the Cannings judgment as a result of new information.
In three cases no changes were made, and the remaining case was awaiting further consideration of medical evidence by the court.
The attorney general identified 28 possible criminal cases, but only six applications have so far been made to the criminal cases review commission, which refers possible miscarriages of justice to the court of appeal. Attempts are still being made to trace the defendants in more than a dozen cases, and "a handful" are going direct to the appeal court, according to a spokesman for the commission.
Mrs Hodge also said she would be drawing the attention of local authorities to the General Medical Council抯 ruling last March striking off an expert witness, Colin Paterson, for serious professional misconduct.
Dr Paterson, a retired chemical pathologist who has estimated that 60-70 children were returned to their parents as a result of his evidence, regularly attributed babies?fractures to "temporary brittle bone disease," while ignoring evidence pointing to deliberate injury, the GMC found.(BMJ Clare Dyer legal corr)