STEVE INSKEEP, host:

Let's go from questions of money to questions of justice. Yesterday, we brought you stories of people in the U.S. and Canada who had been wrongly accused of the death of a child. Today, we look at a common diagnosis in child deaths -Shaken Baby Syndrome - and we meet the doctor who first observed it. That syndrome is frequently used to build a case in court against alleged child abusers. But there's still disagreement among doctors, lawyers and other experts about whether Shaken Baby Syndrome is a diagnosis that's used too freely, sometimes landing innocent people in prison.

Joseph Shapiro of NPR's investigative unit has more.

JOSEPH SHAPIRO: Dr. Norman Guthkelch gets credited with first connecting head injuries in young children to violent shaking. It's now called Shaken Baby Syndrome. He's 95, a retired pediatric neurosurgeon, and he's speaking out for the first time about the syndrome and the legal system.

Dr. NORMAN GUTHKELCH (Retired Pediatric Neurosurgeon): If you get the diagnosis of fatal Shaken Baby Syndrome wrong, potentially, someone's life will be terminated.

SHAPIRO: Recently, a defense attorney asked Guthkelch to look at the records of an Arizona man who's been in prison for 10 years, convicted of killing his baby boy. Guthkelch was horrified by what he read.

Dr. GUTHKELCH: I think I used the expression in my report: I wouldn't hang a cat on the evidence of shaking as presented.

SHAPIRO: A medical examiner's autopsy report said the child died of Shaken Baby Syndrome, but discounted other possible causes, like the fact that the five-month-old had severe seizures and other medical problems.

Guthkelch worries that there are too many cases like this one.

Dr. GUTHKELCH: You may, in your heart, believe that this is a case of shaking. But you've got to prove it just as carefully as any other case.

SHAPIRO: NPR's investigative unit worked with PBS "Frontline" and ProPublica. We studied nearly two dozen cases in the U.S. and Canada, some involving shaking, where people were first convicted but later acquitted or the charges dropped.

Guthkelch says it's important to educate parents about the dangers of shaking children violently. A baby's brain is soft and easily damaged.

Today, the retired surgeon lives with his wife in a house on a peak in Tucson. He's tall and gets around with a cane.

(Soundbite of paper rustling)

SHAPIRO: He reads from his ground-breaking paper, published 40 years ago this spring, in the British Medical Journal.

Dr. GUTHKELCH: It's quite short, the paper. "Infantile Subdural Hematoma and its Relationship to Whiplash Injuries."

SHAPIRO: That research was the first to explain a perplexing brain injury. Sometimes babies and other young children were brought to the hospital with bleeding on the surface of the brain. But there was no sign of the cause: No broken bones, bruises or other signs of physical abuse.

Guthkelch solved the mystery with a simple observation: Where he lived in northern England, parents sometimes punished their children by shaking them. It was socially acceptable.

Dr. GUTHKELCH: They had no motive to lie, so the parents told me the truth. Yes, I shook him.

SHAPIRO: Other scientists built on his research. Now, Shaken Baby Syndrome is diagnosed when doctors find that unexplained bleeding on the brain and two other symptoms: bleeding behind the retinas and brain swelling.

What Guthkelch worries about is that too many medical experts see that triad of symptoms and conclude a child's been shaken without considering other possibilities.

But not all experts share his desire for new caution in diagnosing Shaken Baby Syndrome.

Ms. TERI COVINGTON (Director, National Center for Child Death Review): I truly believe deaths are not being prosecuted anymore because of this.

SHAPIRO: Teri Covington says there's already too much caution, and that because of disputes over the science, there are growing numbers of cases where the abuser isn't punished at all.

Covington runs the National Center for Child Death Review. It's a research center that helps states investigate child deaths.

Ms. COVINGTON: I have heard many a discussion of reluctance from both law enforcement and prosecutors to even start moving these cases forward in the way that they would have done five, 10 years ago.

SHAPIRO: That's one reason Dr. Guthkelch says it's time to get all sides together and try to agree on what can be said with scientific certainty about Shaken Baby Syndrome. It's a difficult conversation.

Dr. GUTHKELCH: But I do think that good will come of what politicians, I think, call free and frank discussions when they mean that they're going to half kill one another across the bargaining table.

SHAPIRO: He'd like to help lead that conversation, but he's 95 years old, so he wants it to happen soon.

Joseph Shapiro, NPR News.

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INSKEEP: For more on these cases, go to npr.org. You heard this investigation on MORNING EDITION, from NPR News.

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