Part Twenty-One: Think Dirty; Meadow's Legacy; (2)

THE DISCOURSE OF MUNCHAUSEN SYNDROME BY PROXY/ FABRICATED AND INDUCED ILLNESS IS AT THE CENTRE OF CONTENTION. IN PARTICULAR, CONCERN HAS ARISEN THAT CHILDREN’S MEDICAL NEEDS ARE BEING NEGLECTED WHEN THEIR CONDITIONS ARE MISDIAGNOSED AS CHILD ABUSE.

FROM "MISDIAGNOSIS OF CHILD ABUSE RELATED TO DELAY IN DIAGNOSING A PAEDIATRIC BRAIN TUMOUR," BY LYNNE WRENNALL;

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One of the dangers of theories that are not backed by science is that their application tends to cause unfortunate results.

An abstract posted on May 19, 2008, on an Internet site called "Libertas Acadmica," discusses this phenomenon in the context of Munchausen Syndrome By Proxy/fabricated and induced illness.

The study, by Lynne Wrennall, is called "Misdiagnosis of Child Abuse Related to Delay in Diagnosing a Paediatric Brain Tumor."

Wrennall is said to be connected with the Public Health Research Group, Criminology Programme, at School of Social Science, Liverpool John Moores University, Clarence Street, Liverpool, United Kingdom

"Conflicting opinion regarding the relative weight that should be allocated to the investigation of organic causes of child illness, compared to the pursuit of suspicions of child abuse, has generated considerable public debate," the abstract begins.

"The discourse of Munchausen Syndrome by Proxy/ Fabricated and Induced Illness is at the centre of contention," it continues.

"In particular, concern has arisen that children’s medical needs are being neglected when their conditions are misdiagnosed as child abuse.

This paper documents a case study in which the use of Child Protection procedures was linked to the belief that the child’s illness had “no organic cause.”

The case study is contextualised in a review of literature relevant to the diagnostic process.

The deployment of the Child Protection perspective resulted in significant delay in the diagnosis of the child’s brain tumour.

The child was ultimately found to be suffering from an optic chasm mass lesion involving the hypothalamus and the medial temporal regions, resulting in Diencephalic Syndrome.

The evidence in this case is that erring on the side of suspecting Munchausen Syndrome by Proxy/ Fabricated and Induced Illness, was not “erring on the side of the child.”

Several lessons need to be learned from the case.

The importance of ensuring that the Child Protection perspective does not displace adequate assessment of alternative explanations for the child’s condition is emphasised, as is the need for good communication in medical relationships.

Strategies involving empathy, mediation, negotiation and conflict resolution may provide a more appropriate and therapeutic alternative to the use of Child Protection procedures in cases where the diagnosis is contentious."

Harold Levy...hlevy15@gmail.com;

Part Twenty: Think Dirty: Munchausen Syndrome By Proxy: Dr. Roy Meadow's Legacy; (1);

“THE PARENTS ARE REFUSED THE OPPORTUNITY TO OBTAIN A SECOND MEDICAL OPINION AS THIS IS LABELLED ‘DOCTOR SHOPPING’, PART OF THE MSBP CHILD ABUSE PROFILE - EVEN THOUGH DOCTORS ARE ETHICALLY OBLIGED TO ALLOW IT AND IT IS A PATIENT'S RIGHT TO OBTAIN A SECOND MEDICAL OPINION. A MOTHER COULD BE DOING NOTHING WRONG, OTHER THAN SHOWING ANXIETY AND CARE FOR HER CHILD AND QUESTIONING DOCTORS ON THE CARE OF HER VERY SICK CHILD,” SHE SAID. “BEFORE LONG, SHE COULD BE ACCUSED OF CHILD ABUSE AND FACE CRIMINAL CHARGES. IT IS JUST LIKE THE WITCH HUNTS OF CENTURIES AGO THAT WERE BASED ON GUESSWORK.”

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"TO THIS WRITER, THE AUTHORITIES IN MUNCHAUSEN SYNDROME BY PROXY CASES HAVE A PUNITIVE APPROACH TOWARDS PARENTS AND THEIR CHILDREN, WHO NEED SUPPORT RATHER THAN PUNISHMENT AND SUSPICION.

COMPASSION IS SADLY LACKING.

WE NEED TO REVERSE THE WITCH-HUNT TREND AND STOP PERSECUTING ANXIOUS MOTHERS FOR CHALLENGING PROFESSIONAL OPINIONS, WHICH IN MEDICAL EYES, IS SO OFTEN SEEN AS CHALLENGING THEIR PROFESSIONAL STANDING."

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MICHAEL NOTT: AUTHOR OF THE MUNCHAUSEN SYNDROME BY PROXY WITCH HUNT;
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Writer Michael Nott demonstrates how the Munchausen Syndrome by Proxy developed by Sir Roy Meadow - and still heralded by many professionals throughout the world - has left some parents afraid to take their children to the doctor.

As is demonstrated by the following article , published on May 24, 2005, in "On-Line Opinion" - an Australian e-journal of social and political debate, Nott is an unabashed advocate for mothers accused of Munchausen Syndrome (factitious illness) by proxy.

"Consider this," the article entitled "The Munchausen Syndrome by Proxy Witch Hunt" begins.

"If you are a mother with a young child who has a very difficult-to-diagnose illness, you could find yourself looking down the aggressive barrel of a child protection agency," it continues;

"They could take your child into foster care, and the courts could allow you only very limited supervised contact with your child again, if at all.

There is no evidence that you have caused the child's illness.

Often the children at risk are very sick but a parent may have challenged a doctor's medical treatment.

Such a scene is happening in a number of countries, including Australia, Germany, New Zealand, UK and the US.

In some cases it is happening without evidence, driven by the speculative, circumstantial and prejudicial, much the same way as the witch hunts of old.

It follows on from the Munchausen Syndrome by Proxy (MSBP) theory introduced by British pediatrician, Professor Sir Roy Meadow (Lancet in 1977), also known as "factitious illness", "pediatric falsification disorder" and similar terms.

Named after the 18th century German figure Baron von Münchhausen, famous for his "tall stories", Munchausen Syndrome is where one is alleged to be causing problems in oneself, e.g., self harm, or presenting oneself at hospital too many times.

Munchausen Syndrome by Proxy is where one is alleged to be causing problems in another person, usually one's child.

In most cases, the mother - as the usual care-giver - is accused. I write as an advocate for mothers accused of Munchausen Syndrome by Proxy.

The MSBP theory has found favour in powerful sections of the medical profession, child protection, academia, law enforcement and the judiciary.

According to medical sociologist Dr Helen Hayward-Brown it has become a nightmare waiting on the doorstep of every family with a sick child.

Hayward-Brown was awarded her doctorate for investigating false allegations of MSPB, when many of her case studies were based in Australia.

“Ordinary mothers and fathers are being accused of child abuse because their children have an illness that some pediatricians cannot diagnose, or (because) the parents strongly question the doctor over the child's treatment,” she said.

“The parents are refused the opportunity to obtain a second medical opinion as this is labelled ‘doctor shopping’, part of the MSBP child abuse profile - even though doctors are ethically obliged to allow it and it is a patient's right to obtain a second medical opinion. A mother could be doing nothing wrong, other than showing anxiety and care for her child and questioning doctors on the care of her very sick child,” she said. “Before long, she could be accused of child abuse and face criminal charges. It is just like the witch hunts of centuries ago that were based on guesswork.”

MSBP is based on a "profile" or label that allegedly indicates the mother's behaviour.

Such a profile includes the mother who shows too much interest in medical procedures, paradoxically taking no interest in the child's medical care, and the mother who passively accepts everything but also seeks attention by going to the media.

Hayward-Brown said that generally an accused mother will be told she has little hope of her children being returned unless she confesses to MSBP.

Charles Pragnell, an expert British defence witness in child protection, now based in Melbourne, Australia, said that the labelling of a carer, usually the mother, with child abuse prevents proper investigation.

Bringing legal action or making a complaint against a doctor is thereby effectively stopped.

Hayward-Brown said, “The MSBP profile used by doctors contains paradoxes that make it very difficult, almost impossible, for mothers to prove their innocence. For example, being an over-protective parent is part of the MSBP profile, but so is being a negligent parent."

Child protection agencies often took the view that a mother must be guilty and failed to undertake appropriate investigations.

"It does not matter if it is called a disorder, behaviour or syndrome. It does not matter if it is seen to be psychiatric or pediatric. The outcome is the same," she said.

The legitimacy of the MSBP theory is now undergoing intense scrutiny worldwide.

Challengers allege a lack of scientific integrity with highly questionable support literature in medical journals; there is concern that a minority of influential members of the medical profession continue its use.

Pragnell made the point that Meadow’s MSBP research had not been subject to peer review.

Meadow is facing professional misconduct charges (June 2005) being brought by the British General Medical Council, concerning alleged misleading and contradictory evidence.

The Royal Statistical Society publicly condemned (October 23, 2001) his statistical methodology, relating to his evidence in the Sally Clark case.

A supporter, Professor David Southall, has also been found guilty of serious professional misconduct regarding a child abuse case.

The UK Government has ordered official reviews of both criminal and civil cases involving Meadow's MSBP and cot death theories.

The Opposition has called for a public inquiry.

In the US, Howard Fishman, a former education director at the Harvard Medical School's psychiatry department, commented, “The child abuse industry has devoted itself to the removal of children from their homes based on spectral evidence, phantom disorders and fanciful modes of purported abuse that should be assigned to the trash bin of junk science”.

Evidence involving the label or profile of MSBP has been rejected by Australian courts.

For example, the Queensland Court of Appeal (R v LM [2004] QCA 192), ruled it prejudicial and inadmissible.

The South Australian Supreme Court (S4118, 1993) ruled that, although a pediatrician, Professor David Southall's MSBP testimony could only be regarded as a lay person's opinion.

Meadow's cot death theory - that one child death in the same family is a tragedy, two suspicious and three murder - has been rejected by the UK Court of Appeal (R v Angela Cannings [2004] EWCA Crim. 01) and in Tennessee, US, (2003, no. 99-D-2836).

Judicial comments in the UK Clark case (R v Sally Clark [2003] 200203824 Y3) were that Meadow's medical and statistical evidence on cot deaths in the case was "wrong" and "grossly overstated".

The Queensland Court of Appeal (R v LM [2004] QCA 192), in a unanimous judgment, stated MSBP (or factitious disorder by proxy) was not a recognised psychiatric disorder or mental illness in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM IV).

The court went on to say that MSBP had no agreed sets of symptoms or signs that allowed it to be classified into a recognised psychiatric diagnostic system, it was not a recognised medical condition, disorder or syndrome, and the court excluded evidence from a psychiatrist as "extremely prejudicial".

Justice Holmes noted that the MSBP argument was inherently circular and did nothing to prove criminal conduct.

The Australian Capital Territory's Director of Public Prosecutions, Richard Refshauge, said the QCA decision on MSBP made “clear that if a woman is to be prosecuted for harming her children, it is not enough to put a label on it; facts are required to justify the case”.

"By labelling the woman in this way with MSBP or factitious illness by proxy you are saying the woman is guilty, as the label creates the guilt … People are not convicted for having a syndrome or a particular behaviour; they are convicted for the illegal acts that they do."

The QCA decision resulted from a case in a criminal court, where guilt must be established beyond reasonable doubt, but Munchausen Syndrome by Proxy is frequently used in care proceedings in the children's court where a decision rests on the degree of probability and does not necessarily abide by the rules of evidence.

According to Pragnell, this is the heart of the problem.

He said that in care proceedings, hearsay evidence was admissible, while such evidence would be inadmissible in criminal matters.

Therefore, in care cases, the cards were heavily stacked against mothers when added to any balance-of-probability decision.

He suggested care courts should be inquisitorial, aimed at establishing what has happened and what the outcome should be.

As Hayward-Brown pointed out, parents had limited finances and were often denied government legal aid and support as opposed to the authorities, which appeared to have unlimited funds.

The NSW child protection agency, Department of Community Services (DOCS), has confirmed it is "precluded" by law from using allegations of MSBP as the basis for the removal of a child.

Yet, the writer believes it has used MSBP allegations for many years as the central allegation in child protection proceedings.

Written statements to this writer from DOCS (September 10, 2003 and September 24, 2003) suggest that DOCS was in breach of its own legislation when it stated the “Children and Young Persons (Care and Protection) Act 1998 (Section 71, Subsection 2) precludes DOCS from taking any medical condition of a parent or carer into account when making a child protection decision”.

The Director-General of DOCS, Dr Neil Shepherd, declined to be interviewed for this article.

Pragnell claims some medical authorities show scant regard for legal requirements.

"This is causing immense harm to the status of the medical profession and public trust in physicians, as relatives and friends of affected families are alarmed and angered by the needless and unwarranted removal of children and, in some cases, the imprisonment of innocent mothers," he said.

Earl Howe reported although the UK Government was looking at a restricted group of court cases where the verdict may have gone the wrong way, “It is disappointing that the Government is not addressing the MSBP or factitious illness by proxy diagnosis that is the core of the problem”.

In NSW, Victoria and Queensland, MSBP allegations are still being made against mothers. According to Hayward-Brown, there is no indication of any body in NSW or Australia showing concern about the need to review current and previous cases involving Meadow's evidence, diagnoses and theories.

Australia's Federal Government, through its Institute of Family Studies and its Child Protection Clearing House, still recognises MSBP as a valid "diagnosis".

Similarly, the Royal Australasian College of Physicians has made use of Meadow's theories on its website.

Hayward-Brown stated that medical professionals were afraid to speak out publicly against their colleagues for fear of marginalisation and persecution in a small medical community. "This problem is not going to go away,” she said.

Legal firms and lawyers had refused to take on MSBP cases as they were too controversial and, "legal aid has been refused to MSBP cases by legal aid bodies in both NSW and Victoria on the grounds that they will not succeed," she said.

This had also occurred in the UK. Cases were often long, complex and involved expensive medical witnesses.

Such a denial of legal representation had been found by the European Court of Human Rights to be a breach of human rights in an MSBP case (P, C & S v the UK; no. 56547/00; 2002) where the UK Government was found guilty and fined.

This same court found that it was a breach of human rights to remove a child at birth due to a previous allegation of MSBP.

"No one seems to want to take responsibility over MSBP allegations: the doctors and hospitals, DOCS and the health department keep blaming each other,”Hayward-Brown said.

Ministers’offices and opposition health spokespeople were quiet on the issues.

In a statement to this writer (July 26, 2004), the NSW Commissioner for Children and Young People, Gillian Calvert, said there was no consensus among the professionals on MSBP.

Calvert described MSBP as "a complicated and difficult diagnosis with significant differences of opinion among medical and legal professionals: there are some medical experts who support and diagnose the syndrome and those who dispute its existence".

It appears the commission has decided not to take any firm action or use its legislative power to order an inquiry.

The commission has also declined to answer questions on whether it is "irresponsible and careless" to allow the current situation to continue.

The commission's parliamentary committee head, Barbara Perry, declined to be interviewed.

NSW Police has also declined to release information on its use of Meadow, Southall and a US MSBP proponent.

The NSW Solicitor-General's office also refused to respond.

Hayward-Brown said she was concerned that the diagnosis of MSBP was not being properly addressed in Australia: “No one wants to change the status quo and upset the careers of many doctors and social workers.”

She thought authorities could also be reluctant to review cases because of the possibility of negligence claims.

Pragnell maintains that child protection systems are deeply flawed, erratic and dysfunctional: “There is now a worldwide storm brewing regarding child protection injustices,” he said. "And governments across the globe should take notice as the current situation will no longer be tolerated."

To this writer, the authorities in Munchausen Syndrome by Proxy cases have a punitive approach towards parents and their children, who need support rather than punishment and suspicion.

Compassion is sadly lacking.

We need to reverse the witch-hunt trend and stop persecuting anxious mothers for challenging professional opinions, which in medical eyes, is so often seen as challenging their professional standing."

Harold Levy...hlevy15@gmail.com;

Part Eighteen: Think Dirty: Ian And Angela Gay Speak Out Through An On-Line Publication;

"THE ORIGINAL TRIAL WAS BASED ON CONFLICTING MEDICAL OPINION AND CHARACTER ASSASSINATION.

THE RETRIAL PRESENTED FRESH MEDICAL EVIDENCE WHICH THE JURY ACCEPTED - THIS NEW EVIDENCE (A RARE BUT NATURALLY OCCURRING CONDITION) CERTAINLY MADE MORE SENSE THAN FORCE FEEDING A 3 YEAR OLD CHILD WITH SALT WITHOUT LEAVING ANY MARKS OR BRUISES."

IAN AND ANGELA GAY TO AN ON-LINE PUBLICATION;

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Ian and Angela Gay turned to the Internet to explain to the public what went wrong in their case;

Their account is not lengthy.

It does, however, get to the heart of what happened through their eyes.

"This case was so very complex that, to make any rash judgements based on the limited media coverage would be foolhardy," the couple explained.

"It was presented before a jury who heard the full facts - and based on that evidence found us not guilty," they continued.

" The original trial was based on conflicting medical opinion and character assassination.

The retrial presented fresh medical evidence which the jury accepted - this new evidence (a rare but naturally occurring condition) certainly made more sense than force feeding a 3 year old child with salt without leaving any marks or bruises.

Christian was diagnosed with "water on the brain" as a baby - a factor which cannot be ignored.

Then there were the subscalp bruises which were dated as less than 2 days old, whilst Christian was in hospital for 4 days!!

And of course we have the treating doctor who became a self proclaimed expert following some Internet research - surely a conflict of interest!

This prosecution was engineered by "hired guns" who got it wrong!"

Angela & Ian Gay, West Midlands,

Part Sixteen: Think Dirty; Another Way To Convict Parents: Say They tried To Poison Their Children With Salt; Sir Roy's Research;

"MOST OF THE CHILDREN SUFFERED REPETITIVE POISONING BEFORE DETECTION.

THE PERPETRATOR WAS BELIEVED TO THE MOTHER FOR 10 CHILDREN, THE FATHER FOR ONE, AND EITHER PARENT FOR ONE.

FOUR CHILDREN HAD SERUM SODIUM CONCENTRATIONS ABOVE 200 MMOL/L."

DR. ROY MEADOW; FORM ABSTRACT FOR PAPER "NON-ACCIDENTAL SALT POISONING;
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It could almost be a scenario for a science fiction movie;

Three-year-old boy inexplicably dies.

The bewildered couple that were planning to adopt him theorize that the part of the brain that controls the salt-water balance in the body has malfunctioned;

However public officials decide the couple has murdered the child by feeding him an overdose of salt.

They rely on the writings of a famed physician whose research indicates that there have been multiple cases of murder in which the murder weapon is salt.

Thanks to his brilliance society can convict such treacherous parents and avert the perfect crime.

The parents are then arrested and charged with murder - and..........

Science fiction?

Sadly, no.

This happened to an English couple named Ian and Angela Gay.

The physician is Dr Roy Meadow whose research has led to other innocent parents and caregivers being charged with killing children.

By way of brief background, consider the following account in Wikipedia;

"In the 2005 trial of Ian and Angela Gay over the death of their adopted son Christian, the prosecution relied heavily upon Meadow's 1993 paper "Non-accidental salt poisoning"[15], citing it many times throughout the trial," the account begins.

"The judge also referred to the paper citing it five times during his summing up" it continues.

"Ian and Angela Gay were found guilty of manslaughter and spent 15 months in prison before their convictions were quashed.

In interviews for BBC Radio 4's File on 4 programme[16], Professor Jean Golding and Professor Ashley Grossman both questioned the reliability of the Meadow paper.

The naturally occurring condition diabetes insipidus was suggested as a more likely cause of an elevated salt level than deliberate salt poisoning."

Also consider the following abstract of an article by Dr. Meadow of the Department of Pediatrics and Child Health, St. James University Hospital, Leeds, entitled ""Non-accidental salt poisoning;"

"The clinical features of 12 children who incurred non-accidental salt poisoning are reported," the abstract, published in Archives of Disease in Childhood, Volume 68, begins.

"The children usually presented to hospital in the first six months of life with unexplained hypernatraemia and associated illness," it continues;

"Most of the children suffered repetitive poisoning before detection.

The perpetrator was believed to the mother for 10 children, the father for one, and either parent for one.

Four children had serum sodium concentrations above 200 mmol/l.

Seven children had incurred other fabricated illness, drug ingestion, physical abuse, or failure to thrive/neglect.

Two children died; the other 10 remained healthy in alternative care.

Features are described that should lead to earlier detection of salt poisoning; the importance of checking urine sodium excretion, whenever hypernatraemia occurs, is stressed."

Harold Levy...hlevy15@gmail.com;

Part Fourteen: Think Dirty; Donna Anthony; The Consequences; Even Her Husband Believed She was Guilty;

"I NEVER CONVICTED DONNA ORIGINALLY. I ONLY THOUGHT THAT SHE HAD KILLED THE CHILDREN BECAUSE SHE WAS PROVEN GUILTY.

DEAN ANTHONY (DONNA ANTHONY'S HUSBAND) IN EXCLUSIVE INTERVIEW WITH THE WESTERN DAILY PRESS)";
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"YOU GET THESE POLICE OFFICERS, THESE DOCTORS SAYING THAT SHE HAD BEEN MOLESTED, SHE HAD BEEN STRANGLED. THEY'RE SUPPOSED TO BE THE PROTECTORS OF SOCIETY AND ALL THIS STUFF. SO, YES, I BELIEVE SHE WAS. BUT I KNEW IT WASN'T ME."

WILLIAM MULLINS-JOHNSON TO THE ONTARIO COURT OF APPEAL;
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I was horrified to read, in this exclusive interview, that Donna Anthony's husband actually believed his wife must be guilty of killing their two sons because the jury had found her guilty. (See previous posts: Think Dirty: Donna Anthony) Parts Thirteen and Fourteen;)

I immediately thought of William Mullins-Johnson's testimony at the Ontario Court of Appeal to the effect that he believed Valin had been molested and then strangled - when we now know, years later - that his niece had died a natural death.

Asked by his lawyer (James Lockyer) if he thought that Valin had been molested and murdered, Mullins-Johnson replied: "You get these police officers, these doctors saying that she had been molested, she had been strangled. They're supposed to be the protectors of society and all this stuff. So, yes, I believe she was. But I knew it wasn't me."



Worse, Mullins Johnson told the Court that the murder charge had disastrous implications within his family - as it turned brother against brother.

"It split my family," he testified. "It had my brother thinking that I had killed his little girl. It had me thinking that my brother had killed his little girl."

As will be seen from the interview, these cases are graphic examples of the hellish implications of "thinking dirty" when investigating the deaths of infants.

"The former husband of convicted child-killer Donna Anthony last night said that the pain of losing his two little angels had never ended," the story began.

"As Anthony, who has always insisted she was innocent, won the right to appeal against her conviction, her former husband spoke exclusively to the Western Daily Press," it continued.

"Last night, Dean Anthony, 36, said his thoughts were always with his "two little angels", daughter Jordan, who died aged 11-and-a-half months, on February 1, 1996, and son Michael, who died aged four-and-a-half months the following March.

Donna Anthony, 31, of Yeovil, Somerset, was jailed for life in 1998 at Bristol Crown Court for murdering Jordan and Michael.

The case against her relied on evidence from the now-discredited paediatrician Professor Sir Roy Meadow.

Anthony always claimed both children were victims of cot death, but her original appeal in June 2000 was dismissed.

However, the Criminal Cases Review Commission (CCRC) yesterday gave her cause for hope.

It said it was sending her case back to the Court of Appeal after considering "new expert medical evidence".

Sir Roy Meadow had argued that one sudden infant death in a family is a tragedy, two are suspicious and three are murder unless proved otherwise.

His theory was that some mothers killed their babies to draw attention to themselves, a condition dubbed Munchausen's Syndrome by Proxy.

But in January last year appeal judges dismissed his evidence in the case of Angela Cannings, from Wiltshire, who was jailed for life in 2002 for murdering her two baby sons.

Mrs Cannings, a shop assistant from Salisbury, saw her conviction quashed and, in the wake of her ruling, 297 other files were reviewed. Anthony's was among those given top priority.

Mr Anthony said: "There's not a moment I don't think about the children. You are always brought up to think your children will bury you. When you lose two, you think 'what's the point of living?'.

I never convicted Donna originally. I only thought that she had killed the children because she was proven guilty.

"Now if it is proven that the evidence that was given is incorrect then she has as much right as Angela Cannings to be released and to start a new life.

"Donna was like any other mum. Admittedly she suffered from the baby blues, but so do countless others.

"As far as I am concerned she took good care of the children, they were never without anything. I was away working a lot and I was not there when it happened.

"We were separated when Michael died, but I was shocked when Donna was arrested.

"At the beginning I would have liked to have asked her why, but all the way through Donna has insisted that she is innocent.

"They are saying now that Michael may have died of a chest infection -which would make one question whether Yeovil Hospital was negligent.

"Jordan was just at the stage of crawling and saying a couple of words when she died. I haven't experienced life with children more than a year old."

Mr Anthony, who is now single, added: "I would like to have more children, but that's in God's hands. It is a question of finding someone that I can tell about this and who will stand by me no matter what happens.

"The anniversary of Jordan's death was just yesterday. You can tell people what you are going through but you can't get comfort from that when you are crying in the night."

He said that if Donna wins the appeal he would only be in contact over family matters. "I was not allowed to contact her and I have no feelings for her," he added.

Anthony's solicitor George Hawks said: "I am very pleased for Donna, although it is only the beginning of the process, not the end.

"I don't expect she will be going overboard - I am sure she will be as relieved as I am, but she will recognise that we still have a major hurdle coming up with the appeal."

Anthony will be eligible to apply for bail, but last night no firm decision had been made on the matter."

Harold Levy...hlevy15@gmail.com;

Part Thirteen: Think Dirty; Donna Anthony; A Moving Post-Script: "Look St All The Suffering Since Then."

”SHE WAS CONDEMNED BY THEORY BASED ON SUSPICION MASQUERADING AS MEDICAL OPINION, WHICH WAS COMPLETELY WRONG”, HE ADDED.

FELICITY MCCALL; FROM POST-SCRIPT PUBLISHED ON WEB-SITE DEDICATED TO FREEING DONNA ANTHONY;

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This moving "post-script" - described as a "Conviction Quashed Addendum - appeared on a Web-Site dedicated to freeing Donna Anthony under the heading: "Look at all the suffering since then."

It describes the horrific consequences caused to innocent parents, caregivers and their families when societies abandon reason, go on crusades, and rely on so-called experts like Drs. Charles Smith, Roy Meadow, and David Southall to achieve their misguided ends.

"On Monday, April 11, 2004, Donna Anthony finally walked free after the Appeal Court quashed her “guilty” verdict as unsafe and unsound," the post-script begins.

"The legal ruling was something of a formality; the crucial breakthrough had come 18 months earlier when the same court had cleared Angela Cannings of murdering her two babies," it continues.

"It had taken six years and sends the 31 year old out into a world where she is effectively homeless and has no family.

Her mother died when she was in prison.

Her husband, from whom she is divorced, had originally said he believed she had smothered her 11 month old daughter Jordan and a year later four month old Michael.

Throughout her questioning, trial and imprisonment Ms Anthony had maintained they were victims of cot death.

Her former husband now says he “accepts the appeal court’s judgement.”

Outside the Appeal Court, it was left to Donna Anthony’s solicitor, George Hawkes, to speak for her.

She was, he said “overwhelmed by her freedom”.

”She was condemned by theory based on suspicion masquerading as medical opinion, which was completely wrong”, he added.

Mr Hawkes said the whole episode” had completely shattered her life”.

“There are immense problems facing her out there which she has got to cope with, and she is going to need a lot of help and assistance” he added, as Ms Anthony, a silent, shadowy figure, was ushered into a waiting car.

The smiling young mother in the baby photographs reproduced at her trial seems a lifetime away. No amount of compensation can buy her back.

As the ruling was announced, newspapers were already reporting that the discredited paediatrician Sir Roy Meadow whose evidence had effectively sealed her conviction, has been paid £50,000 to testify in court.

The head of the Royal College of Paediatricians, Sir Alan Craft, says “lessons are being learned” from what he called “these difficult cases.”

Harold Levy...hlevy15@gmail.com;

Part Twelve; Think Dirty; Dr. Charles Smith's Notoriety Spreads to England; Alongside Meadow and Southall; Powerful Telegraph Story;

"SIR ROY AND SOUTHALL ARE UNREPENTANT BUT, IN CANADA, THERE HAS BEEN AN INQUIRY INTO THE ACTIONS OF DR CHARLES SMITH WHO WAS FOR TWO DECADES ONE OF CANADA'S TOP FORENSIC PATHOLOGISTS. HE TESTIFIED IN 45 CASES DATING BACK TO 1991, TO CHILDREN BEING SUFFOCATED, SODOMISED AND SHAKEN. MANY OF THOSE PARENTS HAVE SINCE BEEN EXONERATED. 'I BELIEVE I HEARD WHAT I WANTED TO HEAR,' HE ADMITTED AT THE INQUIRY IN JANUARY."

CASSANDRA JARDINE: THE TELEGRAPH;

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In 2003 Sally Clark was released from jail after being falsely accused of murdering her two sons.

She never recovered from the trauma and died a year ago, effectively of a broken heart.

Cassandra Jardine looks at how such a gross miscarriage of justice could occur, asks whether lessons have been learnt, and places Dr. Charles Smith in the ranks of notorious British "expert witnesses" such as Drs. Roy Meadow and David Southall;

Jardine has written many times exposing the madness which has led to innocent British parents and caregivers being wrongly convicted of killing children.

This moving story ran in the Telegraph on March 16 of this year, under the heading, "Has Sally Clark's case changed attitudes to infant death?"

"Exactly a year ago Sally Clark died, aged 42, while her solicitor husband, Steve, was on a business trip," Jardine's article begins.

"At an inquest her death was ascribed to acute alcohol poisoning resulting from her grief and 'enduring personality change after a catastrophic experience," it continues;

"In other words she never recovered from the nightmare that began on December 13, 1996, when her first son, 11-week-old Christopher, stopped breathing.



Sally and Stephen Clark outside the Court of Appeal in January 2003. Sally was released from prison after serving more than three years for killing her two baby sons;

Mothers never get over the death of a baby, though they may move on.

For Sally - once a bright and capable solicitor - even that was not possible.

Two years later her second child, Harry, who was eight weeks old, also died suddenly.

From that moment Sally received not sympathy but condemnation.

Paediatricians decided - in line with what was then current thinking on child abuse - that two deaths in a family was suspicious and a Crown Court jury found her guilty of murdering both of her sons.

'Die, woman, die,' other prisoners shouted out as she climbed into the prison van.

What happened next made legal history.

In January 2003, after serving three and a half years of a life sentence, Sally was freed.

The defence at her second appeal revealed that Harry's body had been riddled with the bacterium staphylococcus aureus, which would have caused a form of meningitis - information that the prosecution pathologist Dr Alan Williams had not shared with Sally's defence at her trial.

As she left the High Court, Sally declared, 'There are no winners here.'

Others charged with similar crimes, however, hoped that lessons would be learnt from what was called in the Court of Appeal 'one of the worst miscarriages of justice in recent years'.

The way the medical evidence was presented to court was 'shoddy', said Dr Sam Gullino, a forensic pathologist from Florida, who prepared a report for Sally's second appeal.

'Sound medical principles were abandoned in favour of over-simplifications, over-interpretations, exclusion of relevant data and the imagining of non-existent findings.'

For a short while it looked as if the tide had turned.

Inherited disorders were found to explain other babies' deaths: three other mothers, Trupti Patel, Angela Cannings and Donna Anthony, accused of shaking or smothering their own children, were found not guilty or had their convictions quashed.

Meadow's Law - named after Prof Sir Roy Meadow - was discredited: no longer were two cot deaths in a family to be deemed suspicious and three murder unless proved otherwise.

Summing up at Cannings' appeal in December 2004, Lord Justice Judge said that courts should not convict on disputed medical evidence alone: 'It is better for some of the guilty to go unpunished than for innocent women to be jailed.'

But, the cheers were short-lived.

Fast-forward three years to last November.

Once again the scene is a courtroom.

This time the woman on trial is mother-of-two Keran Henderson, a childminder who was looking after 11-month-old Maeve Sheppard at her home in Iver Heath, Buckinghamshire, in March 2005 when - according to Keran - the child suddenly went floppy.

Maeve died in hospital two days later, and Keran was accused of having caused Maeve's death by shaking her violently, having lost her temper over a dirty nappy.

As the verdict of guilty was delivered, Keran let out a piteous wail.

'If you could hear, as we did, the sound of that woman's grief you too might think her honest,' Mike Seckerson, the foreman of the jury, said.

But it wasn't this alone that caused him to reveal his 'disgust' at the way the trial was conducted.

He and the other medically unqualified jurors were bombarded by information from a dozen medical experts.

The majority of the jury 'listened to expert opinion and thought it evidence', leaving Seckerson with the unhappy task of delivering a majority verdict with which he disagreed.

Seckerson is not alone in fearing that yet another terrible miscarriage of justice has occurred.

Jack Straw, the minister for justice, has been inquiring solicitously about Keran's comfort in prison, says her husband Iain, who is campaigning to bring his wife home to their nine- and 14-year-old sons.

Neighbours have rallied around in support of a woman who had been a respected childminder for seven years, ran the local Beaver Scout group, helped elderly neighbours and was always up for any charity event.

Neither of her own children has ever suffered at her hand.

Significantly, Maeve had been in and out of hospital during her short life, yet none of this counted.

Someone had shaken the child, medical experts concluded, on the basis of certain signs.

'As an ex-policeman, I can't get my head around the fact that people are found guilty without any real evidence,' Iain says.

'There's no CCTV footage, no witness statement or weapon with fingerprints or blood. I think doctors are scared of saying, I don't know what happened.'

He is shocked that no one from the police or the CPS that he encountered was medically trained.

'I know the pressure is on the police to get results, to find someone guilty, but I wasn't even asked for my statement. Nor did they question the other children who were in the house that afternoon, who went home calm and happy. Would they have behaved like that if Keran had flown into a rage?'

Keran is not the only person in prison for a crime that might never have occurred.

Suzanne Holdsworth, another childminder, is three years into a life sentence for causing the death of two-year-old Kyle Fisher who also, she says, went floppy.

Doctors have compared the bleeding in his brain with injuries that would occur as the result of being thrown from a car at 60mph, yet he was not bruised and the banisters against which she supposedly battered him bear no traces of DNA.

Chaha'Oh-Niyol Kai-Whitewind is in prison for suffocating her son, though her appeal may reveal natural causes as an alternative explanation for his nosebleed and blood found in the lungs.

Criminal convictions for harming children are just the visible tip of the iceberg.

A far greater number of cases, where the evidence is insufficient for a criminal trial, are heard in the family courts, where on the 'balance of probabilities' parents are deemed to have harmed or (yet more vaguely because of 'personality disorders') be capable of harming children who are then removed from them, often at birth.

Information about family court cases is hard to obtain.

Proceedings are secret so no one knows which experts are saying what, though observers note clusters of similar cases involving certain consultants.

Parents claim that they are being accused of emotional and physical abuse on the basis of theories or syndromes that are not as foolproof as is claimed.



Angela Cannings, with her husband Terry. She was jailed for life for murdering her two baby sons, but had her conviction overturned in 2003

In the year since Sally Clark died, those facing family court proceedings have at last acquired a champion in the form of the Liberal Democrat MP John Hemming who set up Justice for Families after his girlfriend's baby was nearly taken from her because she had once failed to report a stillbirth.

His office at the House of Commons contains files on more than 200 individual cases, which he uses to identify patterns and lobby for changes in the law.

'I hear of a new case almost every day,' he says.

'Smothering' has gone out of fashion as an accusation.

So has 'salt poisoning', which Ian and Angela Gay were accused of.

The couple were released from prison in 2006 when it was shown, at appeal, that their foster son Christian Blewitt suffered from a faulty osmostat, which allowed his body to accumulate fatally high levels of sodium.

They had not, as was claimed, force-fed him teaspoons of salt.

There remain, however, two controversial medical diagnoses: shaken baby syndrome (SBS), a cluster of symptoms deemed to indicate shaking; and metaphyseal fractures, which are fractures at the ends of the long arm and leg bones, believed to denote that a child's limbs have been wrenched.

Events usually start with a paediatrician or radiologist who flags up the possibility of non-accidental injury (NAI).

Social workers and police officers then look for evidence, sometimes ignoring information about good character or happy family life.

And often solicitors acting for the defence are 'supine', says Bill Bache, who having successfully represented Angela Cannings and the Gays is now working on Keran Henderson's appeal.

Bache, like Hemming, has many suggestions for improving the system: a thorough multi-disciplinary discussion of possible causes of injuries or illness before cases proceed being one of them.

At the heart of the problem, he says, lies 'angled dogmatism' on the signs and symptoms of abuse and a willingness by some doctors to give opinions outside of their areas of expertise.

'I am handling 35 cases of parents accused of child abuse at the moment,' he says. 'All medical conundrums.'

The drive to hold parents accountable for abusing children began in 1962 when a Colorado paediatrician, Dr Henry Kempe, published his research into 'battered child syndrome'.

Drawing on 302 cases of abuse of children under three, he concluded that 'beating of children is not confined to people with a psychopathic personality or of borderline socioeconomic status'; parents often denied causing the injuries but 'to the informed physician, the bones tell a story the child is too young or frightened to tell'.

This information was shocking.

It had always been accepted that psychopaths, addicts, sociopaths or even women suffering from post-natal depression could harm children.

Kempe was saying that apparently normal, loving people could be abusers.

His research changed the role of paediatricians; it became their task to spot hidden abuse.

Identifying the signs provided a useful career opportunity for ambitious doctors in the 1970s and 80s.

Dr John Caffey in the US wrote the first influential paper establishing SBS in 1973.

In Britain, Prof Sir Roy Meadow, author of the ABC of Child Abuse, rose to fame on the strength of his 1977 academic paper on Munchausen's Syndrome by Proxy (MSbP) - children made ill by attention-seeking adults - based on the behaviour of two mothers, one of whom had (Sir Roy claimed) poisoned her toddler with salt, while the other had contaminated her child's urine sample with her own blood.

Knighted in 1996, Sir Roy was soon lecturing on the hidden epidemic of abuse and appearing as an expert witness.

By the time he gave evidence at Sally Clark's trial, Sir Roy claimed to have found 81 cot deaths which were in fact murder though, unfortunately, he destroyed the data.

He told the court that he could think of no natural explanation for either of the Clarks' children's deaths and quoted the case-clinching statistic that the chances of two cot deaths in one family was one in 73 million - a figure arrived at by multiplying the incidence of one death (1:8543) by itself.

It later emerged that the chance of a second death was more like one in 120 because there could be an underlying defect.

Though struck off by the General Medical Council in 2005 for 'gross professional misconduct', he was reinstated the following year.

The other leading light in the drive to unearth hidden abuse in Britain was Prof David Southall.

Working on aspects of MSbP in the late 1980s and early 90s, he videoed parents whom he suspected of suffocating children.

Thirty-three parents or step-parents were prosecuted, though the evidence may have been unreliable: clasping a child to the chest could, for example, indicate feeding rather than smothering.

The Clark case was also his undoing when, having merely seen Steve on tele?vision, he stated to police that it was 'beyond reasonable doubt' that Steve had murdered his sons.

A three-year ban from child protection work followed in 2004; in December 2007 he was struck off for, among other charges, concealing the medical records of some 4,500 children.

Sir Roy and Southall are unrepentant but, in Canada, there has been an inquiry into the actions of Dr Charles Smith who was for two decades one of Canada's top forensic pathologists. He testified in 45 cases dating back to 1991, to children being suffocated, sodomised and shaken. Many of those parents have since been exonerated. 'I believe I heard what I wanted to hear,' he admitted at the inquiry in January.

But the fall from grace of some of the theorists of abuse has not made as much difference as expected.

The term 'noble cause corruption' has entered the language.

The tainted term MSbP has fallen into disuse, only to be replaced by another set of initials, FII - Factitious or Induced Illness.

Real abuse is still being missed, as in the case of Victoria Climbié, partly because social services are busy investigating false allegations.

Change is slow, says Penny Mellor, who campaigns against non-scientific medical syndromes such as MSbP, because a small coterie of expert medical witnesses are sticking to theories that have been undermined by subsequent research.

'We have pathologists who don't have adequate training and experts who are so busy being experts that they have little time to keep up to date.'

Sir Roy's portrait still hangs in the London offices of the Royal College of Paediatrics and Child Health.

'Why not? He is a past president,' says Prof Terence Stephenson, the dean of the medical school at Nottingham University and the college's vice-president for science and research.

He is one of the doctors who has adopted attack as the best form of defence in response to the fall of Sir Roy and Southall.

Speaking as Professionals Against Child Abuse, they argue that doctors are being victimised by parents and the media who deny the reality of child abuse.

'Protect doctors to protect children,' he wrote to the Prime Minister in February, following a report on the case of Jessica Randall, whose abuse at the hands of her father was missed by 30 professionals.

False allegations campaigners consider Prof Stephenson a 'hawk' who has appeared in 50 cases: he prefers, he says, civil cases where a single expert witness is jointly appointed.

'In criminal cases you have to be willing to be countermanded and cross-examined' - although later he says that 'an expert is only tested by being challenged by another expert'.

Stephenson comes across as a pleasant man, driven by a passionate belief in his cause.

'I have two children. If someone were to accuse me of harming them I would be heartbroken. But our role at the Royal College is to do what's best for children. Child abuse is still under-diagnosed.'

I want to question him about evidence that casts doubt on current orthodox thinking.

Diagnosis of SBS is based on a triad of symptoms: subdural haemorrhages, retinal haemorrhages and cerebral edema (swelling of the brain).

The triad is important because regardless of other evidence, such as the absence or presence of bruises, these symptoms - particularly retinal haemorrhages - are used to diagnose abuse.

Sally Clark would never have been put on trial had Harry not been found (erroneously it transpired) to have bleeding behind the eyes.

Equally, Jessica Randall was never put on the 'at risk' register because MRI and eye scans showed no retinal haemorrhages.



Jay and Trupti Patel after Trupti was found not guilty of murdering her three children;

Dr Jennian Geddes, a neuropathologist, has suggested in the Court of Appeal that the triad need not arise from shaking.

Choking could be an alternative.

'She admitted in court that it was only a hypothesis,' Prof Stephenson says dismissively.

(The same could be said of the theory that the triad always denotes shaking.)

There is research, too, which shows that the triad can result from a fall from only 3ft, as from a bed.

'Fewer than three per cent would get retinal and subdural haemorrhages,' he replies.

But are children who fall from beds always tested?

We move on to the other contentious area - meta?physeal fractures. Stephenson appears equally dismissive about possible alternatives to a diagnosis of abuse.

'I've seen hundreds. They are extra?ordinarily rare in real, witnessed accidents.'

Yes, but they are also hard to see and radiologists won't look for them unless the possibility of abuse has been flagged.

When I suggest that paediatricians, especially those appearing regularly as expert witnesses, appear to have fixed minds, he counters by making a derisive comment about Dr Colin Paterson, a pathologist struck off by the GMC (General Medical Council) for suggesting for the defence in 30 cases that children could suffer from temporary brittle bones, resulting in multiple fractures.

Some pathologists believe he had a viable theory, but the wrong causation. Stephenson says, 'There's no evidence to back up temporary brittle bones.'

Isn't there?

Infants are being diagnosed with rickets resulting from vitamin D deficiency due to insufficient exposure to sunlight. 'Only in ethnic minorities.' Not according to research from Birmingham University, which states that one in eight Caucasian children has rickets.

'No doubt there are grey areas,' he concludes. 'If we only reported cases where we were absolutely right we would miss lots of cases. Society wants us to err on the side of caution. If society wants us to, we could go back to the situation pre-1962 and turn a blind eye.'

The problem with grey areas is their tendency to become black and white.

The doctors who see a child in hospital believe absolutely in what their colleagues have published - that what they are seeing is child abuse - and alert social workers and police.

They in turn hire expert witnesses who believe in the abuse diagnosis.

The result is costly.

'Money is certainly wasted pursuing these cases, but I'm more concerned about the human cost,' says Bill Bache, who speaks of distraught parents not allowed to be left alone with their dying child in hospital because they have fallen under suspicion; couples often forced to live separately and encouraged to blame one another; and children denied the comfort of family life.

Yet some children do die of natural but unidentified causes.

Cot deaths, for example, dropped from 30 to seven per week after 1990, when parents were advised not to put babies to sleep on their fronts.

Though they may not acknowledge it, doctors can also cause harm by giving inappropriate treatment.

The routine practice of resuscitating children by putting them on a drip is one that worries Penny Mellor, who campaigns on behalf of parents who claim to be wrongly accused of child abuse.

'If they aren't dehydrated, putting more fluids into them can cause swelling of the brain and bleeding,' she claims.

More information is needed to protect the innocent - children, parents and, indeed, doctors.

Slowly it is emerging.

When the history of false allegations is written there will be a roll-call of honour for those who have taken a fresh look at the medical conundrums and questioned orthodox thinking.

Some Americans will feature:

0: The forensic pathologist Dr John Plunkett, an expert in childhood head injuries;

0: Dr Patrick Lantz, who has been looking at retinal haemorrhages;

0: the biomechanics expert Dr Kirk Thibault, who has looked at the resulting impact when a child has a fall or is shaken;

0: and Dr Chuck Hyman, who has investigated a link between short umbilical cords and weak bones.

British experts will be on that list, too:

0: The chemical pathologist Dr Glyn Walters, who gave evidence about alternative causes of death in the Clark and Gay cases;

0: the neuropathologists Dr Waney Squier, Dr Jennian Geddes and Dr Helen Whitwell, who have found that oxygen deprivation, possibly from choking, can cause brain swelling and bleeding;

0: the geneticist Prof Michael Patton, who has looked at defects that can cause cot death;

0: the ophthalmologist Gillian Adams, who was has raised doubts about retinal haemorrhages being solely indicative of shaking;

0: Prof Nick Bishop, who is investigating why some children fracture easily;

0: and Dr Paul Johnson, who has asked courts to take obstetric history into account.

It is not easy standing against the tide, says Dr Squier, a prosecution witness at the trial of Keran Henderson.

She identified brain damage but said there was no evidence that the child had been shaken, which led to tense discussions among the medical experts.

'As a pathologist I describe what I see,' she said. 'It's not my business to say what caused an injury if I don't know.'

Despite her caution, a dozen experts who were prepared to theorise about shaking won the day and Keran Henderson is now serving a three-year prison sentence.

I asked her husband Iain whether he thinks that, even if exonerated, she will emerge, like Sally Clark, a broken woman.

'I don't know if she'll survive,' he replied.

'She went to prison eight years after Sally Clark. Prisoners aren't stupid, so she hasn't been given such a hard time. I'm hoping that hers is the case that brings about real change.'

Harold Levy...hlevy15@gmail.com;

Part Eleven: Think Dirty; Trupti Patel And The Rotten Courts Of Salem: (Simon Jenkins);

Trupti Patel's acquittal prompted one of the most powerful pieces of journalism I have ever read.

It is written by Simon Jenkins who edited The Times from 1990-92 and then went on to contribute a twice weekly column until 2005.

Jenkins, who was knighted for his services to journalism in 2004, was formerly political editor of The Economist and Editor of The Evening Standard.

The column, under the heading " Trupti Patel and the rotten courts of Salem," ran in The Times on June 13, 2003.

"I am walking down the street when out of a sewer swirls a giant black tentacle, waving in my face," Jenkins began.

"It is the ancient Britain lurking beneath the pavement, a place of primitive prejudice which nobody has the guts to reform," he continued.

"It keeps trying to claw the 21st century back to a foetid swamp of cruelty and unfairness.

Along its ghastly surface are rows of suckers, called lawyers.

Yesterday one such tentacle wrapped itself round my brain.

It was the Trupti Patel child murder acquittal.

I realised that modern Britain is ruled by a Government that still throws mothers into jail if they are unlucky enough to have babies that die suddenly.

Civilised countries regard such incidents as personal tragedies, not cause for a state lynching.

In Sweden or Germany, even if the mother is guilty, she is given sympathy and treatment, not handled as a common murderer.

The courts of justice are the same as tried the Salem witches.

They summon juries to pass public judgment on these wretched women, calling in aid a witch-finder general, the hawkish Professor Sir Roy Meadow.

He has no time for classic jurisprudence.

To him a mother is guilty unless “proven otherwise”.

Two cot deaths are suspicious and three are murder.

To hell with any genetic propensity to multiple deaths. This is to be tabloid justice.

New Labour must stand tough on dead babies.

Mrs Patel was Sir Roy’s latest target.

She had a healthy baby and was frantic on the death of their second child.

She and her husband became cot death experts, purchasing copious monitoring equipment.

After a second cot death, the desperate Mrs Patel conceived again and had doctors constantly examine and monitor her baby girl.

When she died after just 22 days, her chest monitor failing to work, Mrs Patel’s attempts at resuscitation broke some of the baby’s ribs.

This and her subsequent acute withdrawal inclined the Crown to prosecute her, in part for “bottling up her grief”.

This mother was acquitted with little thanks to science.

Sir Roy has always been the darling of the prosecution in cot-death cases through his talent for plucking at the emotion of juries.

The case swung Mrs Patel’s way only after her grandmother flew in from India to report on her own loss of five infants to cot death, which she put down to “God’s doing”.

In 1999 Sally Clark had no such luck in her encounter with forensic medicine.

She spent more than three years in jail before winning her release on appeal.

Like Mrs Patel, Mrs Clark saved herself from life in jail only by dint of middle-class determination.

Sir Roy is said to possess the courtroom presence of Judge Danforth in Arthur Miller’s Salem witches play, The Crucible.

He can whip any jury into finding these women guilty.

His fancy theory of “Munchausen’s Syndrome by Proxy” holds that parents harm their children to draw attention to themselves.

It convinces any jury understandably eager, when asked, to find someone to blame for a child’s death.

Sir Roy is now under (leisurely) investigation by the General Medical Council for his abuse of statistics in Mrs Clark’s trial.

He claimed that her chances of being innocent were 73 million to one against, a figure considered crucial in sending her to jail.

Yet she was clearly innocent and found so on appeal.

Sir Roy’s figures were so palpably wrong that the Royal Statistical Society wrote to the Lord Chancellor to complain.

Nothing was done.

Instead the Crown has continued to use Sir Roy to convict women in such cases.

The system is rotten.

In British trials experts are paid not to help the court with impartial evidence, as is customary in most other countries.

They are paid to lend a veneer of objectivity to one side in the argument.

The hope is that 12 good citizens, the jury, can dig out the truth from this melange of professional bias and emotion.

It is theatre, not justice.

Angela Canning, an otherwise respectable woman, found herself jailed for life last year after the cot deaths of her two children, with Sir Roy appearing against her.

She is in prison awaiting an appeal which is as tardy as the GMC’s investigation of Sir Roy.

Five other mothers are known to be in jail after jury trials for multiple child deaths.

Countless more have had their surviving children taken away from them.

John Batt, a solicitor now campaigning against these imprisonments, describes cases on his books in Glasgow, Hastings, Nottingham, Worcester, Hull, Cardiff and Winchester.

“In each case,” he told The Times, “there was no previous history of abuse and all the friends and relatives say they were loving parents.”

In each case, the Crown produced the same stage army of “child abuse experts” to give evidence against them.

I do not doubt that a very few parents kill their children deliberately.

Such people are sick and need treatment.

Where they have other children, these must be protected, usually by removing them from harm. I cannot see what is achieved by sending the mother to prison for life, except her final destruction.

Even removing the children is a serious matter.

The case of William and Michelle Carter, taken up by the London Evening Standard, saw all four children taken into care after one became sick, in what appears to be a witch-hunt by Sir Roy and Wandsworth Social Services.

This was despite pleas from all who knew the couple, teachers, doctors, even the police, that they could have meant their children no harm.

Mrs Patel did not hurt her first child, whom she loves.

She and her husband were not violent criminals but respectable people enduring the appalling trauma of seeing three children die.

The prosecution case relied on the extraordinary thesis that Mrs Patel was having one child after another to satisfy a craving for murder.

It told the jury to ignore her remorse since it was “an intention to kill that came to Mrs Patel in one moment and left her the next”.

I know such lawyers claim to be only role-playing, to be putting a case, however implausible, before the mercy of the jury.

Perhaps Sir Roy is no more than playing a role too.

Perhaps the whole system is a game of seeing how much public money can be spent on putting women in jail, which Britain does more than any country in Europe.

If so, the system is inhuman and ludicrously inappropriate.

The adversarial system, the distortion of evidence, the onus to prove innocence and the hyping of juries are all medieval and barbaric.

From what I have read, all cot-death convictions involving Sir Roy’s evidence should be considered unsafe and those imprisoned released at once pending review.

Some may consider the Patel verdict a vindication of jury trial.

That is rubbish.

This was a rare case of a jury acquitting in a child murder case only because that case was utterly groundless.

Normally juries, always bound by emotion, convict in such cases.

Attempts by the Government to limit the jury system are being fought by barristers because juries are their Common Agricultural Policy, encouraging lucrative overproduction of trials.

The judicial system appears immune to reform, even by the recent, supposedly radical Lord Chancellor, Lord Irvine of Lairg.

Mrs Clark’s release in January led to pleas for a reform in the use of criminal courts for such cases.

These pleas were ignored. The release coincided with another investigation into a child tragedy.

The Climbie tribunal confronted an administrative failure, of inadequate, ill-led and frightened officials who “allowed” a girl to die at the hands of her guardians.

What happened next was instructive.

Those involved in the Climbie case were castigated and personally destroyed by the tribunal.

The Clark cot-death team were let off scot-free, living to fight another day, including the trial of Mrs Patel.

I find it hard to disagree with those who claim government operates a double standard.

Local government is treated as run by peasants who can be traduced at will.

The judiciary is run by toffs, who can commit any malpractice they like.

Cot deaths should clearly be handled by an examining magistrate in chambers, as in Scandinavia and elsewhere.

The hope is that yesterday’s apparent upheaval in the governance of the judiciary may lead to such a reform.

I doubt it. The new “Constitution” Secretary, Lord Falconer of Thoroton, and the Prime Minister are still lawyers and lawyers are powerfully attached to territory.

Their loyalty to the majesty of the courtroom is as medieval as their love of the adversarial joust.

I cannot see Britain’s judicial Establishment allowing a handful of weeping women and wrecked families to erode their precious turf.

Harold Levy...hlevy15@gmail.com;

Part Ten: Thinking Dirty; Its Role in The Decision To Charge Trupti Patel With Murdering Her Babies;

"NURSES WHO VISITED MRS PATEL AT HOME HAD REPORTED THAT SHE SEEMED DISTANT AND REFUSED HELP.

IN FACT, MRS PATEL WAS DESPERATELY TRYING NOT TO BECOME AN OVERANXIOUS MOTHER.

TO JENNY THOMAS, CHAIRMAN OF THE CHILD BEREAVEMENT TRUST, THIS WAS A PERFECTLY NORMAL PROCESS OF EMOTIONS FOR AN ASIAN FAMILY WHO HAD SUFFERED SO MANY DEATHS.

TO THE POLICE, HOWEVER, WHO CONSIDERED HER REACTIONS ABNORMAL, IT WAS A CAUSE FOR SUSPICION."

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"DURING THE TRIAL IT EMERGED THAT THE BABIES PROBABLY DIED FROM A RARE, NEWLY DISCOVERED GENE DISORDER KNOWN AS LONG QT SYNDROME, WHICH MISSES A GENERATION BEFORE STRIKING AGAIN. MRS PATEL’S 80-YEAR-OLD GRANDMOTHER TRAVELLED FROM INDIA TO REVEAL HOW SHE HAD LOST FIVE OF HER 12 CHILDREN. THREE OF THOSE DEATHS WERE LINKED TO THE DISORDER."

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HELEN STUDD: THE TIMES ON-LINE;

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As I learned more about the Patel case, I wondered how many other parents and caregivers were wrongfully charged with killing children - in the absence of concrete evidence - because a pathologist or social worker made unwarranted social assumptions about their character.

The role that false assumptions played in the Patel case is described by reporter Helen Studd in a story which appeared in the on-line version of The Times on June 12, 2003, under the heading: "Grieving mother learnt to keep her tears private."

The story appeared under the sub-heading: "Cultural differences left neighbours with the impression of a cold and heartless woman."

"The lonely tears of Trupti Patel, heard by neighbours through the walls of her house, belied her appearance as a cold, heartless mother unmoved by the deaths of three babies," the story began.

"Mrs Patel’s childhood in an Asian community had taught her to keep her grief private, even from her own mother, while her success as a career woman only reinforced her image of outward self-control," it continued.

"To a large extent, it was the cultural differences between her reserved upbringing and the more emotionally demonstrative British society that landed her in the dock at Reading Crown Court.

While those with experience of the bereavement process recognise that Hindu families grieve differently, Mrs Patel’s dearth of public tears appeared unfeeling to outsiders.

Thames Valley Police refused to believe that three cot deaths in one family could be anything other than murder.

Three ordinary cardboard boxes stacked in a wardrobe at the marital home bear the names of Amar, Jamie and Mia.

Inside are their birth and death certificates together with photographs, imprints of their feet, copies of their fingerprints and locks of hair.

Mrs Patel’s family emigrated to Britain from the Punjab in 1965 and she was born in Bolton, Lancashire, two years later.

Her childhood was a mixture of Asian and Western influences. She won a place at the town’s grammar school, developing a love of chemistry.

She studied pharmacy at King’s College London, and Greenwich Hospital.

While working towards her pre-registration qualification at Greenwich in 1990, she was introduced to Jayant Kumar Patel, a recently qualified electronics engineer, by a mutual aunt.

After seven months together the couple decided to get married.

Before the wedding she gave up her job in Greenwich and moved back to Bolton to help her parents with the preparations.

The marriage took place at a register office in Bolton, followed by a traditional Hindu ceremony, in June 1991.

After the wedding, the couple moved in with Mr Patel’s parents, whom she had met only twice before the ceremony.

For two years she lived in a house with her in-laws.

Mrs Patel soon began to find life cramped and lonely, with her husband working 200 miles away in Maidenhead, so, in 1993, the couple moved south, buying a modern three-bedroom semi-detached house, now worth £250,000, near Mr Patel’s workplace.

“It was nice to have space and privacy,” she told police. “We were very happy together.”

Mrs Patel threw herself into her career as a pharmacist at the Churchill Hospital in Oxford, soon rising to the position of dispensary manager in charge of 13 staff.

The couple began to discuss the possibility of having children.

After one last exotic holiday together to Hong Kong, Malaysia and Bali, they started trying for a family.

After Mrs Patel became pregnant, a year later, she suffered a miscarriage.

Only three months later she was pregnant again.

Her first child, who cannot be named for legal reasons, was born by emergency caesarean after a 20-hour labour in 1995.

She was disappointed to learn that she would be unable to return to work on a part-time basis.

“I have no high goals,” she told the police. “I had achieved what I always said I would achieve. I did not want to go higher up the ladder.”

As her next three children died one by one from cot death, she became increasingly unable to cope.

With each death, she became increasingly resigned, afraid to grieve too long in case she was going against divine will.

Second Part;

She was also determined to get over the babies’ deaths quickly in order to prevent her feelings of grief passing to the next child.

Publicly, she threw herself back into work, while privately she was devastated and would spend long hours in tears.

Neighbours could hear her crying after her husband had left in the mornings.

Even during her trial, she gave the jury only occasional glimpses of her real feelings, when she could no longer control her weeping.

Her son Amar was the first to die, in 1997.

Mrs Patel found he had stopped breathing when she went to wake him for his feed.

Mrs Patel, who had trained in cardio-pulmonary resuscitation at the London Hospital in Whitechapel, tried frantically to save him, helped by a 999 operator she telephoned.

But Amar was dead within the hour. The cause of his death was given as sudden infant death syndrome.

Mrs Patel became subdued, which to outsiders appeared as if she did not care.

Before she conceived again, she attended a conference in London into cot deaths and investigated monitors available to detect respiratory problems in babies.

Before her next baby, Jamie, was born in 1999, Mrs Patel changed the carpets and curtains at home, fearing that dust mites might have been responsible for Amar’s death.

Two weeks after Jamie’s birth, his father found him “lifeless” in his carrycot.

The panicking couple battled to revive him.

A helicopter took the baby to hospital, where doctors fought for 12 hours to save his life, but he died from a massive fit.

Again, the death was attributed to sudden infant death syndrome.

While Mrs Patel was pregnant with her fourth child in 2000, she began eating organic foods.

Mia was born on May 14, 2001, at Wexham Park Hospital. Mother and baby were monitored around the clock.

Mia was transferred to the John Radcliffe Hospital, Oxford, for specific heart, breathing and sleep-pattern monitoring. A week later she was allowed home.

A breathing monitor was placed under her cot mattress to signal an alarm if she developed problems.

Mrs Patel was unhappy with the device and wanted a more sophisticated version to strap to Mia’s chest.

Her fears over the performance of the device later proved well-founded.

After only a few days Mia began to vomit and Mrs Patel took her to the family GP, who said her condition would improve.

Back home Mr Patel took photographs of his wife cuddling Mia in bed.

Hours later, Mrs Patel found the baby apparently lifeless in her cot. The alarm had failed to activate.

Mrs Patel raced down stairs, clutching Mia, desperately forcing short breaths into her limp baby. The 22-day-old baby died at Great Ormond Street Hospital in London.

This time, a post-mortem examination found four broken ribs in the baby’s chest.

Nurses who visited Mrs Patel at home had reported that she seemed distant and refused help.

In fact, Mrs Patel was desperately trying not to become an overanxious mother.

To Jenny Thomas, chairman of the Child Bereavement Trust, this was a perfectly normal process of emotions for an Asian family who had suffered so many deaths.

To the police, however, who considered her reactions abnormal, it was a cause for suspicion.

During the trial it emerged that the babies probably died from a rare, newly discovered gene disorder known as long QT syndrome, which misses a generation before striking again.

Mrs Patel’s 80-year-old grandmother travelled from India to reveal how she had lost five of her 12 children.

Three of those deaths were linked to the disorder."

Harold Levy...hlevy15@gmail.com

Part Nine; Think Dirty; Trupti Patel; Another Victim Of "Meadow's Law;"

"AFTER THE TRIAL STARTED, TWO KEY PROSECUTION WITNESSES WHO HAD EXAMINED MIA'S BODY AND HAD DISPUTED MRS PATEL'S CLAIM THAT THE FRACTURED RIBS WERE CAUSED BY HER ATTEMPTS AT RESUSCITATION, SAID THAT THEY WERE NO LONGER SURE. PROFESSOR RUPERT RISDON, A PAEDIATRIC PATHOLOGIST, WROTE TO THE JUDGE SAYING THAT HE HAD FOUND EVIDENCE OF RIB FRACTURES CAUSED BY RESUSCITATION IN THREE CHILDREN THAT HE HAD EXAMINED IN THE PREVIOUS MONTH ALONE, AND NATHANIEL CAREY, A HOME OFFICE PATHOLOGIST, SAID HE COULD "NO LONGER STATE CATEGORICALLY THAT THE RIB FRACTURES WERE NOT DUE TO RESUSCITATION."

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Trupti Patel went through the hellish experience of being charged with killing three of her babies on the opinion of Sir Roy Meadow.

As the author of a note in Wikipedia pointed out: "Sir Roy's dictum that "one sudden infant death in a family is a tragedy, two is suspicious and three is murder unless proven otherwise" became known as "Meadow's Law."

"Meadow's Law" unfortunately did not take into consideration that Patel might suffer from an undiscovered genetic defect: Her maternal grandmother had lost five children in infancy,

"Trupti Patel is a qualified pharmacist from Berkshire, England, who was acquitted in 2003 of murdering three of her children," the note begins.

"The three children were Amar (5 September 1997–10 December 1997), Jamie (21 June 1999–6 July 1999), and Mia (14 May 2001–5 June 2001)," it continues.

"Trupti Patel was born into a family of Punjabis who had moved from India to England.

She spent her childhood in Lancashire, and attended grammar school.

She then went to study at King's College London, where she gained a B.Sc. in pharmacy.

Around this time, she met her future husband, Jayant, a qualified electrical engineer who later worked as a business analyst for British Telecom.

They were married within seven months, and their first child, a girl, was born in 1995.

Their second child, a boy, died unexpectedly at the age of two months, in December 1997.

Eighteen months later, another boy died aged just fifteen days.

Postmortem examinations yielded no explanations for the deaths, but a daughter who died at the age of twenty-two days in June 2001 was found to have four broken ribs.

A police investigation was started, which led to Trupti Patel's arrest in May 2002. She was charged with the murder of her three babies.

The case, which was heard at Reading crown court, was one of a number of famous court cases in Britain in which mothers who reported more than one cot death were accused of murder.

It was also one of a number of cases in which evidence was given by Professor Sir Roy Meadow, a controversial paediatrician whose testimony helped to convict Sally Clark, Angela Cannings, and Donna Anthony of murdering their babies; all three women were cleared on appeal.

Sir Roy's dictum that "one sudden infant death in a family is a tragedy, two is suspicious and three is murder unless proven otherwise" became known as "Meadow's Law",[3] and his claim that the likelihood of two babies dying from natural causes in the same family was one in 73 million prompted the Royal Statistical Society to write a letter of complaint to the Lord Chancellor, stating that the figure had "no statistical basis";[4] other experts said that when genetic and environmental factors were taken into account, the figure was closer to one in 200.

Sir Roy Meadow, giving evidence for the prosecution, listed four indications of Mrs Patel's guilt. One was the injuries suffered by the third child to die.

Mrs Patel's explanation was that the rib fractures had resulted from her attempts at resuscitation.

The second and third points were that the children had had several medical examinations, and had been well until shortly before their deaths.

The fourth point was that three consecutive children had died, and that, according to Sir Roy, "in general, sudden and unexpected death does not run in families."

One of the defence witnesses was genetics specialist Professor Michael Patton, who testified that several cot deaths in the same family could be caused by an undiscovered genetic defect, and that the chances of experiencing more than one cot death could be as high as one in twenty.

The court heard evidence that Mrs Patel's maternal grandmother had lost five children in infancy, but that her remaining seven children were "alive and well".

By the time the case came to court, Sir Roy's claims about the likelihood of a second cot death in the same family had been largely discredited.

Sally Clark's conviction for the murder of her sons had been overturned some months earlier, and Angela Cannings's guilt was disputed by many.

After the trial started, two key prosecution witnesses who had examined Mia's body and had disputed Mrs Patel's claim that the fractured ribs were caused by her attempts at resuscitation, said that they were no longer sure.

Professor Rupert Risdon, a paediatric pathologist, wrote to the judge saying that he had found evidence of rib fractures caused by resuscitation in three children that he had examined in the previous month alone, and Nathaniel Carey, a Home Office pathologist, said he could "no longer state categorically that the rib fractures were not due to resuscitation."

On 11 June 2003, at the end of a six-and-a-half week trial, thirty-five-year-old Trupti Patel was acquitted of all charges.

She announced shortly after her acquittal that her husband would have a vasectomy, as they were unwilling to take the risk of having another child.

A court order had been imposed on her after the death of Mia in 2001,[10] forbidding her to be alone with her, or to cook for her, and that order remained in force following her acquittal."

Next Posting: "Part Nine: Think Dirty: How a misunderstanding of cultural differences led to Trupti Patel being charged with murdering her babies."

Harold Levy...hlevy15@gmail.com;

Part Eight: Think Dirty; Angela Canning's Personal Agony: Interview with The New Statesman;

It must be difficult to imagine the agony that an innocent mother must fell when convicted and imprisoned for killing a child.

Angela Cannings gives us a taste of the personal hell she experienced after being charged with murdering her two babies in an interview with reporter Viv Groskop, published in the New Statesman on Sept. 13, 2004, under the heading, ''In prison, I was lowest of the low.'' (A previous post presented the terrible price paid by Sally Clark);

The Editor tells us that, "Viv Groskop talks to Angela Cannings, one of three mothers last year cleared of multiple baby murders, and asks if she can ever repair her shattered life."

"Is it too naive to think that we may never see another innocent mother imprisoned for murdering her children?," the article containing the interview begins;

"The report published on 6 September by a working group of the Royal College of Paediatrics and Child Health and the Royal College of Pathologists, chaired by the Labour peer Helena Kennedy QC, wants future decisions to prosecute to be made only after a multi-professional review," it continues;

"It also says that post-mortem examinations of babies who have died suddenly and mysteriously should be carried out by specialist paediatric pathologists.

These are among several welcome safeguards, but they will do nothing to help the women whose cases prompted the review.

They include Angela Cannings who, like the solicitor Sally Clark and the pharmacist Trupti Patel, was released from prison last year after her conviction for multiple baby murders was overturned.

Cannings was sentenced to life imprisonment in April 2002 after she had suffered three cot deaths.

Like Clark and Patel, she finds that nobody is much interested in her now that her innocence has been established and justice done.

But you do not simply slot back into your old life, she argues.

She has tried to stay positive and enjoy being reunited with her husband, Terry, and her daughter, Jade, aged eight, but it has not been easy.

"Since Sally Clark's release," Cannings says, "we've found out that she has struggled very badly.

I can understand that, because I think I struggle with it inwardly. I don't feel I can offload all my thoughts and feelings on Terry, because he's doing [the same thing] to me, and by lunchtime most days we can end up feeling very low and depressed." However, she forces herself to be optimistic. "I have been given that chance to be back at home with my husband and daughter, and I'm grabbing every opportunity to get something back of what we had."

These women have to deal with the aftermath of months spent in prison as well as the effects on the children they left behind, and with being denied the chance to grieve for their dead babies.

For Sally Clark, recovery has been painful, public and seemingly impossible.

In June this year, the official account of her story was published (Stolen Innocence: a mother's fight for justice), but she was too upset to give interviews.

At the time, her husband, Steve, also a lawyer, said that she finds it hard to leave the house.

"Sally still isn't well, and she never will be well again. She has written all this stuff, but she doesn't want to see it. It upsets her. She would really rather this wasn't happening. She is not the happy, confident person she was before this happened to her. She is vulnerable, she has panic attacks, she gets flustered by things that most of us just deal with. She constantly feels that people are judging her, and it is a vicious circle."

Adjusting to life with the son who was taken away from her has been just as much of a struggle.

Trupti Patel has also given no interviews.

Despite the not guilty verdict, a court order prevents her from spending time alone with her surviving daughter.

Her babies Amar, Jamie and Mia all died aged less than three months between 1997 and 2001.

At her appeal, her 80-year-old grandmother travelled from India to give evidence that she herself had had five babies who died of unexplained causes.

The judge concluded that Patel's babies may have had a rare inherited predisposition to cot death. Outside the court, her solicitor said: "Few mothers will ever experience the death of a baby, let alone the death of three. Virtually no mother, however, will have to face the trauma of being accused of deliberately suffocating her children."

All three women's stories are complicated beyond imagining.

Prison and wrongful conviction are just half of it.

As Cannings points out, even before she was convicted, she had to undergo virtual house arrest for almost two years while the police gathered evidence.

During this investigation, her sister got married; social services insisted that Cannings's mother supervise all contact with Jade during the wedding, and Cannings was allowed only one drink of alcohol - the wedding toast.

All of Cannings's visits to her daughter, then a toddler, were severely restricted and monitored.

For four years, of which 21 months were spent in prison, she was not allowed to spend any time alone with Jade, and so could not live in the same house as her husband.

It is unthinkable the strain this would put on any marriage, let alone on a parent's relationship with a small child.

Since Cannings's release last December, she, Terry and Jade have left Salisbury in Wiltshire, where the three babies died, and made a new start in Plymouth.

Terry gave up his job as a bakery manager at Tesco to look after Jade while his wife was in prison, and so the family lives on state benefits.

The couple are both looking for work.

"We've lost four years of family life," Cannings says, "and we never had a chance to grieve for Matthew [the son whose death in 1999 prompted her arrest].
That's still to come for me. But we've started afresh and we are getting used to being together.

"It was a complete shock for me to be back in the family home again, getting used to doing things like housework. I'm learning more about Terry and Jade and what they had to do to cope. Jade has had to learn to dress herself, to plait her own hair. She doesn't even let me brush her hair, because she has always done it herself. She doesn't know any different."

Cannings also finds it hard to forget the press coverage at the time.

When she received her life sentence, she was vilified by the newspapers as the worst of criminals.

In prison, she received the kind of treatment reserved for paedophiles and child murderers.

"I was the lowest of the low in prison," she says, "because people who harm their babies are unthinkable. I was physically and verbally attacked. I found it strange: you are in a prison and still people judge you. It wasn't like you just get on with your sentence - it's all backchat and people judging what you are in for. The first couple of months were the worst because it was in the news, on all the front pages, with the heading 'Baby killer'. I had been labelled and there was nothing I could do. I just kept thinking, 'This isn't me.' But it's very hard to try and tell people: 'Actually, this isn't right.'"

Cannings admits that there are still days when she feels very depressed, but says it helps to know that other families have survived what her family has gone through.

That knowledge has played a significant part in helping her to pick up her life again.

She also thinks of the thousands of other families that have been affected by the theory that a high proportion of unexplained baby deaths are attributable to Munchausen's syndrome by proxy, in which parents harm their children in order to get sympathy and attention.

The theory - associated mainly with Sir Roy Meadow, a senior paediatrician whose testimony played a role in the convictions of Cannings, Clark and Patel - is now largely discredited.

As a result, up to 258 criminal cases and possibly another 5,000 civil cases, which nearly always result in children being removed from their parents' care, are under review.

"We have been involved in campaigning with families up and down the country who have had their children taken away," says Cannings. "Obviously, the authorities do have to investigate any accusations of child abuse. But you have to look at these cases: if there is no clear-cut evidence, why ruin a family's life?

"It saddens me that it took four years for us - but as a family, we hope that in time the memory will fade. Our hope for the future is that we never, ever see a case like that again.""

Harold Levy...hlevy15@gmail.com'