Meadow out to grass

The attorney general was right to instigate an urgent review of 258
cot death cases in which parents have been found guilty of killing
their children. Lord Goldsmith ordered the review after the Appeal
Court ruled that convictions should not be obtained on the evidence
of experts alone where there was disagreement among them because
medical science was “still at the frontiers of knowledge”.

It is almost inevitable in such cases that there will be a media
villain and this one is no exception. It is, of course, professor
Sir Roy Meadow, the paediatrician whose evidence was crucial in the
recent high-profile cases involving Angela Cannings, Trupti Patel
and Sally Clarke. All were accused of killing their children on the
doubtful basis of Meadow’s infamous “law” that one cot death is a
tragedy, two suspicious and three murder. Other experts now argue
that this is a myth and that the odds of two cot deaths are more
like 8,500 to one than the 73 million to one claimed by Meadow.
Evidence has begun to emerge of a genetic link between sibling cot
deaths, potentially shortening the odds still further. Cannings,
Patel and Clark were all exonerated and it is overwhelmingly likely
that others will follow.

But Meadow’s evidence has not always been so suspect. He was the
first to recognise Munchausen syndrome by proxy (MSP), accepted as
a condition in which parents deliberately harm their own children.
The government has also said it will review thousands of civil
cases in which children have been taken into care. It is unclear
which cases will be reviewed, but many of them may concern victims
of MSP while others may concern siblings of babies whose
unexplained deaths have given rise to suspicion. It would be a
mistake to assume that the expert evidence in these cases was
automatically dubious, especially where they involve conditions
such as MSP for which there is an established body of knowledge and
much more agreement among experts.

Nor should it be forgotten that the judicial system itself is to
blame for putting experts such as Meadow on a pedestal. Social
workers and their colleagues often have rather less exalted status
in court, yet they may have come to know the families much better
through their work with them. Meadow has a great deal to answer
for, but, for once, he is not alone.

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