Prometheus told debate can go on only if everyone agrees in advance

A journal’s attempt to debate Shaken Baby Syndrome is thwarted by timidity and lawyers’ fears of libel.

A woman holds a child shaken by his dad.

Mid-last year, the editors of Prometheus. Critical Studies in Innovation told their publisher they were organising a debate on shaken baby syndrome. The journal often organises debates on contentious issues with a bearing on innovation.

The shaken baby syndrome hypothesis is that certain signs in a dead baby’s brain reveal the baby has been shaken. Their presence allows the conclusion that shaking caused the baby’s death and that the person last in charge of the baby was responsible.

The SBS hypothesis can be traced back a half-century to an age when the divide between the medical literature and a popular press demonising muscular, foreign nannies was not always clear. Some of this fervour endures in the National Centre on Shaken Baby Syndrome in the US, an influential organisation promoting the hypothesis, and intolerant of criticism. In 2010 a serving Metropolitan Police officer gave a presentation at its annual conference, arguing that SBS conviction rates could be increased by digging the dirt on nonconforming expert witnesses.

Though SBS remains an untested hypothesis, it is sufficiently venerable to be accepted as orthodox in medicine and in court. When Waney Squier, a leading pediatric neuropathologist based in Oxford, Britain, questioned the hypothesis as an expert witness, she was struck off — not for her opposition but for the way she expressed it. Her fate has done nothing to boost the supply of expert witnesses challenging SBS. Squier is the author of the proposition paper in the Prometheus debate.

If the justification for SBS is flimsy, resistance to an alternative is anything but. Expert witnesses supporting SBS have only to assert their conformity: dissenters have a mountain to climb. The court, unlike the academic literature, has no time for nuance. It permits no digression from core expertise (so a shaking expert may consider the consequences of shaking but not of falling). Yet the innovation literature is redolent with the benefits of crossing disciplinary boundaries.

Only expert witnesses opposing SBS need find support in the literature, all the while refraining from criticising majority thinking — and especially majority thinkers. Moreover, the failure of these maverick experts to restrict themselves to the conclusions section of cited papers attracts accusations of misrepresentation and cherrypicking. Yet social scientists question the whole of academic papers and expect particularly little from their conclusions. Definitely material aplenty for a decent Prometheus debate.

In seeking respondents worthy of Squier’s paper, we became aware of just how intemperate medical opinion on SBS can be: “I don’t think I would have anything to add by way of comment to Waney’s paper … Waney is dogmatic, inflexible, inconsistent, evasive, inaccurate, unreceptive to the opinions of other experts and misleading, although not dishonest.”

We were advised, in the nicest possible way, not to proceed. We proceeded.

Squier’s draft went to the Prometheus publishers, Taylor & Francis, in October last year for legal review. We heard nothing for months. Then, in February, T&F managers demanded all 11 debate papers. T&F lawyers somehow had formed the opinion that, even if her own paper was not libellous, Squier herself was unreasonable and would sue the other debate authors for libelling her.

“Any responses which are critical/potentially defamatory of Squier (must be) run past her before publication so that we can get her comments on those allegations/criticisms, for potential incorporation into the responses so that they are balanced.”

They wanted a debate where everyone agreed in advance.

By late March, it seemed that T&F’s internal lawyers were at last satisfied. Publication could go ahead — but not before external lawyers had been consulted. This second legal opinion, not delivered until June, was that the 11 debate papers were all likely to be libellous. Changes were required to the lot, but what changes? The lawyers refused to go into detail and T&F managers, anxious to avoid accusations of censorship, deferred entirely to the lawyers.

We asked for the lawyers’ annotations on the papers. There were none: “This is not an issue that can be resolved by changing some sentences, which is why our libel lawyer has not gone through each article line by line.”

Knowing next to nothing about SBS, the lawyers failed to appreciate that two papers likely to be libellous had been written by lawyers, one by a senior Metropolitan Police officer and another by the chairman of the General Medical Council. The lawyers made plain that any mention of the GMC, the body that brought charges against Squier, was unacceptable.

In mindlessly following mindless legal advice, T&F managers set new standards for its authors, adopting wording and logic strangely similar to the constraints on expert witnesses in court: “The main issue is that the debate goes well beyond discussion and criticism of the science, which is relatively safe ground in libel terms … (papers must be written) … without making specific allegations about named individuals or organisations, unless we are able to completely verify the facts.”

So discussion must not go beyond the science of a subject and there must be no criticism of identified individuals or organisations unless the publisher verifies the facts.

Just about every paper Prometheus has ever published would fail these criteria, as would many papers in many other journals.

On July 13, T&F managers announced a “suitable resolution” to the SBS debate problem. Without warning and with immediate effect, they declared that T&F would rid itself of Prometheus altogether. Prometheus now seeks a new publisher, one that respects academic values. The search may take some time.

Stuart Macdonald is the general editor of Prometheus.