Abusive head trauma in court: a multi-center study on criminal proceedings in Germany
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ORIGINAL ARTICLE
Abusive head trauma in court: a multi-center study on criminal proceedings in Germany Katharina Feld 1 & Dustin Feld 2 & Bernd Karger 3 & Janine Helmus 4 & Nneka Schwimmer-Okike 5 & Heidi Pfeiffer 3 & Sibylle Banaschak 1 & Daniel Wittschieber 5 Received: 24 May 2020 / Accepted: 30 September 2020 # The Author(s) 2020
Abstract The shaken baby syndrome (SBS) is a common variant of abusive head trauma (AHT) in infants and toddlers. Data on the legal outcome of such cases are still sparse. By means of a retrospective multi-center analysis, 72 cases of living children diagnosed with SBS/AHT from three German university institutes of legal medicine were identified. Forty-six of these cases with 68 accused individuals were available and could be evaluated with regard to basic data on the course of the criminal proceedings as well as the profile of the defendants (sub-divided into suspects, convicts, and confessed perpetrators). Criminal proceedings predominantly commenced with a complaint by the treating hospital (62%) and were found to be closed (without judgment) in 50% of the cases, mostly due to a “lack of sufficient suspicion.” Of the 23 cases with judgment, the court decided on acquittal in 4 cases (17%). Imprisonment was the most frequent sentence (16 out of 19 cases with conviction, 84%), whereby the sentence has been suspended on probation in 63% of the cases. Suspects and perpetrators were mostly male and derived from the close family environment of the injured children. All confessed perpetrators stated an “excessive demand” as the reason for the violent shaking of the child. The results of the present study are in line with data from other studies with other legal systems. As many criminal proceedings were closed and the 4 acquittals occurred because the perpetration could not be ascribed to a specific perpetrator, improving the forensic methods for such an unequivocal assignment would be desirable. Keywords Child abuse . Clinical forensic medicine . Perpetrator’s confessions . Perpetrator’s profile . Legal assessment
Introduction Abusive head trauma (AHT) is predominantly encountered in infants and toddlers within their first 2 years of life [1, 2]. The incidence of AHT in the western world ranges between 20 and 40 per 100,000 children under the age of 1 year [1–7]. While the
* Daniel Wittschieber [email protected] 1
Institute of Legal Medicine, University Hospital Cologne, Cologne, Germany
2
adiutaByte GmbH, Business Campus, Sankt Augustin, Germany
3
Institute of Legal Medicine, University Hospital Münster, Münster, Germany
4
Institute of Legal Medicine, University Hospital Essen, Essen, Germany
5
Institute of Legal Medicine, Jena University Hospital, Friedrich Schiller University, Am Klinikum 1, 07747 Jena, Germany
proportion of survivors with long-term damage is reported to be between 62 and 96%, lethality is described with 13–36% [8]. A common variant of AHT is the so-called shaken baby syndrome (SBS), which is still diagnosed explicitly, at least in many Eu
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