Introduction
The pathology of death is an area that is taken seriously in the criminal justice system. The field is embraced by clinical and forensic pathologists to assess and examine persons who have died due to external influences. Forensic experts also analyze deaths arising from accidental fatalities and suicides. Forensic pathologists can collect samples from the targeted victims to determine if the death was caused by an injury. Suspects can also be examined to determine if they committed the targeted offense. Unfortunately, some conditions such as shaken baby syndrome might pose numerous challenges within the field of forensic pathology. The purpose of this research paper is to describe the relationship between shaken baby syndrome (SBS) and the pathology of death.
Background Information
Analysis of Shaken Baby Syndrome
Matschke et al. (2009) define “shaken baby syndrome” as a form of brain injury that occurs when a toddler is shaken viciously or brutally. Although the risk for this condition is high for babies aged between 2 and 8 months, experts acknowledge that children below the age of 6 can be affected by violent shaking. Any form of shaking is known to cause subdural or retinal hemorrhages. These conditions occur due to internal bleeding in the brain or retinas. The brain of an infant is usually myelinated and has high water content, thereby making it vulnerable to the heavy shaking. Excessive injury can also occur when a shaken infant falls or is thrown on a hard surface.
Parents and guardians are usually warned against shaking their babies because potential consequences can be damaging and life-threatening. Some of them include seizures, death, blindness, brain damage, learning or speech disorders, retardation, paralysis (when the spinal cord and neck are damaged), and hearing loss (Bartschat, Richter, Stiller, & Banschak, 2015). More often than not, caregivers of babies might think that shaking babies can encourage them to stop crying. Additionally, some guardians might decide to punish their children after they have done something unpleasing or wrong. These malpractices have been observed to result in negative developmental outcomes.
Shaking is believed to increase pressure on the brain. That being the case, the affected child will portray some signs. Some of these symptoms include vomiting, irritability, seizures, loss of appetite, tremor, coma, and unconsciousness (Bartschat et al., 2015). Since young babies are usually at risk of SBS, parents, caregivers, and guardians should be keen to prevent this kind of syndrome.
How Shaken Baby Syndrome Relates to the Pathology of Death
Deceleration-acceleration activities, known to occur when a child is shaken, can result in numerous health problems. This happens to be the case because infants have specific anatomical features that make them vulnerable. To begin with, babies have large heads in comparison with their body sizes. The big head is also supported by immature and weak neck musculature (Matschke et al., 2009). When a child is shaken violently, subdural hemorrhages (bleeding in the brain) occur and catalyze brain damage. The energy associated with the acceleration events recorded during shaking can increase the motion of fluids in the brain and eventually cause severe trauma.
The shaking has also been observed to cause focal damage (Bartschat et al., 2015). Long-lasting apnea episodes might result in cerebral edema. The increasing intracranial pressure will reduce the rate at which blood flows into the cerebral part of the brain. This development results in increased cerebral hypoxia (Matschke et al., 2009, p. 213). These complications have been observed to cause brain death. Additionally, surviving babies might have terminal complications or deficits that might affect their developmental stages negatively. Byard (2013) argues that the shaking of underdeveloped brains can catalyze the development of diffuse axonal injury (DAI). This condition is a major risk factor for cerebral edema.
Shaken baby syndrome remains a serious problem that can destroy a baby’s brain cells. This form of injury prevents the brain from receiving adequate oxygen supply. Byard (2013) indicates that this condition can result in terminal brain damage. The condition can also result in death. Studies have revealed that around 15 to 37 percent of all SBS cases result in death. The findings of many autopsies reveal symptoms such as subdural, retinal, and subarachnoid hemorrhage.
Occult fractures can also occur when infants are shaken violently. Such fractures occur on long bone metaphyses and the ribs (Bartschat et al., 2015). Biomechanical and forensic studies have revealed that angular deceleration will increase when a baby’s head strikes a hard surface. This means that serious problems or symptoms will be recorded in abused children than in those who are shaken (Grenier et al., 2015). The possibility of death, therefore, increases when a child’s head hits a hard surface. This analysis also indicates that children aged six years and below are all at risk of the shaken baby syndrome.
Case Studies
Although SBS accounts for a small fraction of all child abuse cases, recent studies have indicated that most of the deaths associated with the condition are usually underreported or unknown (Byard, 2013). The number of non-accidental and abuse-related trauma tends to go unreported. Matschke et al. (2009) acknowledge that non-accidental head injury (NAHI) has become a leading cause of death in infants. The condition also affects children aged between 4 months and 5 years. Several case studies have been reported whereby shaken baby syndrome has resulted in death. Such occurrences can be studied and analyzed within the criminal justice system to come up with better strategies to deal with the condition.
In Michigan, two men (Anthony Ball and Leo Ackley) were charged for the deaths of daughters belonging to their respective girlfriends (Byard, 2013). These individuals were believed to have abused the victims. The daughters were shaken violently, something that resulted in their deaths. The observed symptoms included brain swelling and bleeding on the brain’s surface and behind the eyes. In 2013, a Chinese immigrant name Li Hangbin was charged following the death of her daughter aged 2 months. The baby, Annie, died five days after she was abused by her father. Medical experts revealed that Annie’s death was inconsistent with abuse head trauma and shaken baby syndrome (Bowden, 2011). After her father shook her violently, it was observed that Annie’s legs were broken and her skull fractured. The act earned the man a sentence of up to 15 years.
In another bizarre case, a young adult (Joseph Muller) aged 18 years died because of the shaken baby syndrome. Muller’s death, according to forensic pathologists, was as a result of severe damages inflicted by his parents when he was an infant. His parents shook him heavily when he was less than three months old. Experts indicated that the abuse had resulted in brain injury, bleeding, paralysis, blindness, and a severed spinal cord. After the incident, doctors revived the infant but they did not expect him to live for many years. Due to this kind of abuse, Muller’s parents were imprisoned for harming the baby in the mid-1990s (Byard, 2013). These case studies, therefore, show clearly that shaken baby syndrome is a serious condition that continues to disorient the lives of many children (Narang, Estrada, Greenberg, & Lindberg, 2016). Those who survive are eventually forced to lead troubled lives and even fail to realize their potential.
Difficulties that Might Arise when Investigating Shaken Baby Syndrome Deaths
Forensic pathology provides timely information through a process known as postmortem examination. Skilled pathologists can identify the potential or possible cause of death. However, the issue of shaken baby syndrome continues to raise numerous questions whenever analyzed by forensic pathologists to understand the cause of death. Tursz and Cook (2014) indicate that shaken baby syndrome is a condition invoked to deal with the problem of child abuse and brings culprits into account. The above case studies indicate that SBS is capable of causing death. The bodies of young children dying from SBS undergo postmortem to identify the possible cause of death (Tursz & Cook, 2014). However, the latest observations and findings have forced analysts to raise questions regarding the nature and effectiveness of the methods used by forensic pathologists to diagnose the cause of death.
Matschke et al. (2009) argue that skeptics are usually concerned about the connection between shaking an infant and death arising from brain injury. Growing evidence has indicated that it impossible for a shaken child to die without showing crucial marks on his or her spine and neck. Analysts have gone further to acknowledge that some children might fall and suffer a severe brain injury. If such children die, pathologists might indicate that the cause was due to abuse. In such cases, law enforcers and criminologists will use these findings to prosecute individuals who might not have committed any offense. This kind of confusion is something that has led to the conviction of many innocent parents and caregivers.
New studies have also revealed that shaking of babies injures their nerve roots. Such roots are then found to knock out the child’s delicate diaphragm. These events result in brain injury. However, the cause of death in such a baby is usually as a result of the injured nerves in the neck (Bartschat et al., 2015). This kind of evidence suggests that nerves in the neck can be damaged due to several factors. This means that shaking alone might not be the only cause of death in infants.
The above findings appear to go against the current criteria used to determine whether an infant’s death is caused by shaking or not. The courts have been using three unique symptoms to identify babies whose death is as a result of SBS. The first one is swelling in the brain. This symptom is usually common in infants suffering from shaken baby syndrome (Matschke et al., 2009). The second one is bleeding in the brain. The third one is known as retinal bleeding and occurs in the eyes. These standards are combined with other observations or inferences made by forensic pathologists and witnesses in an attempt to prosecute potential wrongdoers.
Another outstanding question is whether the use of these hallmark standards can determine if the syndrome was caused intentionally or intentionally. Pathologists go a step further to monitor symptoms such as severe brain damage and blindness in babies who do not die after being shaken (Matschke et al., 2009). Whenever there are death cases, experts and pathologists raise questions regarding the effectiveness of these standards. This happens to be the case because the symptoms outlined above might not indicate any form of abuse.
In the recent past, many criminologists and attorneys have suggested that shaking alone might not cause brain injuries. They have also been keen to assert that accidents and falls can catalyze similar symptoms. It would, therefore, be inappropriate to prosecute caregivers and parents who might not have abused the targeted children (Tursz & Cook, 2014). Some undiagnosed health conditions or illnesses are capable of producing similar symptoms. When the affected child dies, chances are quite high that his or her parents and guardians might be convicted for an offense they have not committed. This analysis, therefore, shows that shaken baby syndrome is a condition whose pathology should be reexamined to ensure justice is done.
Conclusion
The diagnosis for SBS is something that requires forensic pathologists to examine every underlying aspect or condition. Although many deaths arising from shaking have been reported, it becomes impossible to come up with an accurate and unbiased forensic report. This is the case because some untreated conditions, falls, and accidents can produce SBS-related symptoms, thereby resulting in miscarriage of justice. Future scholars should be keen to come up with evidence-based ideas and frameworks to ensure that the existing complexity between shaken baby syndrome and pathology of death is addressed for once and for all.
References
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Bowden, K. A. (2011). Shaken baby prevention in Maine: The period of PURPLE crying. Journal of Obstetric, Gynecologic and Neonatal Nursing, 40(1), s81-s82. Web.
Byard, R. W. (2013). “Shaken baby syndrome” and forensic pathology: An uneasy interface. Forensic Science, Medicine, and Pathology, 10(2), 239-241. Web.
Grenier, F., Paysant, F., Durand, C., Eysseric, H., Bost-Bru, C., & Scolan, V. (2015). Child abuse: A complex case report: Association of amitriptyline intoxication and shaken baby syndrome. Journal of Clinical Case Reports, 5(10), 1-4. Web.
Matschke, J., Hermann, B., Sperhake, J., Korber, F., Bajanowski, T., & Glatzel, M. (2009). Shaken baby syndrome: A common variant of non-accidental head injury in infants. Deutsches Arzteblatt International, 106(13), 211-217. Web.
Narang, S. K., Estrada, C., Greenberg, S., & Lindberg, D. (2016). Acceptance of shaken baby syndrome and abusive head trauma as medical diagnoses. The Journal of Pediatrics, 177, 273-278. Web.
Tursz, A., & Cook, J. M. (2014). Epidemiological data on shaken baby syndrome in France using judicial sources. Pediatric Radiology, 44(4), s641-s646. Web.