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Skakad bortom rimligt tvivel? - Svenska domstolars bevisvärdering av medicinsk sakkunnigbevisning gällande diagnosen skakvåld

Axelsson, Cecilia LU (2015) LAGM01 20151
Department of Law
Abstract (Swedish)
Den senaste tiden har ifrågasättandet av diagnosen skakvåld fått mycket uppmärksamhet, bl.a. eftersom HD i NJA 2014 s. 699, just på grund av ovan nämnda ifrågasättande, friade den tilltalade från anklagelserna om skakvåld. I ett annat fall beviljade HD resning för en man som tidigare dömts för skakvåld. Syftet med denna uppsats är att granska diagnosen skakvåld ur ett juridiskt perspektiv. Det sker genom en undersökning av vilken betydelse diagnosen har, och har haft, för den straffrättsliga bedömningen av om en åtalad har begått en viss gärning och särskilt hur domstolarna granskar och har granskat, medicinsk sakkunnigbevisning om densamma. Jag har valt att tillämpa rättssäkerhet som teoretisk utgångspunkt, och då främst i avseendena... (More)
Den senaste tiden har ifrågasättandet av diagnosen skakvåld fått mycket uppmärksamhet, bl.a. eftersom HD i NJA 2014 s. 699, just på grund av ovan nämnda ifrågasättande, friade den tilltalade från anklagelserna om skakvåld. I ett annat fall beviljade HD resning för en man som tidigare dömts för skakvåld. Syftet med denna uppsats är att granska diagnosen skakvåld ur ett juridiskt perspektiv. Det sker genom en undersökning av vilken betydelse diagnosen har, och har haft, för den straffrättsliga bedömningen av om en åtalad har begått en viss gärning och särskilt hur domstolarna granskar och har granskat, medicinsk sakkunnigbevisning om densamma. Jag har valt att tillämpa rättssäkerhet som teoretisk utgångspunkt, och då främst i avseendena förutsebarhet och strävan efter materiellt korrekta domar.

Framställningen beträffande skakvåldsdiagnosen visar att det är en omstridd diagnos. Kontroversen rör främst med vilken säkerhet man utifrån tre symptom (triaden) kan diagnosticera skakvåld. I dagsläget råder det ingen enighet om detta. Min slutsats av rättsfallsstudien, där tio rättsfall om skakvåld behandlas, blir att domstolarna i allmänhet förefaller vara i stor utsträckning beroende av de sakkunnigas utlåtanden och att de sällan verkar undersöka underlaget för deras bedömningar eller det vetenskapliga stödet för slutsatserna. Det innebär också att diagnosen inledningsvis, ibland som enda och därmed avgörande bevisning, orsakade ett antal fällande domar. Sedan den har kommit att ifrågasättas av forskare i medicin, har också HD i NJA 2014 s. 699 meddelat att diagnosen ensam, dvs. skadebilden i triaden, inte är tillräcklig för en fällande dom. Det kvarstår dock oklarheter om bl.a. vilken betydelse annan bevisning har.

Min slutsats är att domstolarna har tillmätt sakkunnigbevisningen ett mycket högt värde vid bevisvärderingen och i allmänhet har domstolarna också förlitat sig på innehållet i de sakkunnigas utlåtanden, till synes utan att kritiskt ha granskat dem eller efterfrågat det vetenskapliga stödet för utlåtandena. Det har också bidragit till en bristande prövning av alternativa hypoteser. Som en följd har rättssäkerheten varit bristande. Dels i avseendet förutsebarhet då domstolarnas bevisvärdering inte har varit enhetlig och eftersom det är osäkert vilken betydelse annan bevisning har, dels eftersom det, på grund av osäkerheterna kring diagnosen, kan finnas materiellt oriktiga fällande domar. Det kan vara oundvikligt att rättsliga bedömningar som grundade sig på tidigare accepterad kunskap senare visar sig vara materiellt oriktiga om kunskapen ifrågasätts. Det är också förståeligt att rätten i hög grad förlitar sig på den sakkunniges utlåtanden, eftersom den själv saknar relevant sakkunskap. Rättssystemet måste dock vara bättre rustat för att upptäcka sådana osäkerheter som beträffande skakvåldsdiagnosen och självständigt bedöma hur medicinsk bevisning förhåller sig till det straffrättsliga beviskravet. (Less)
Abstract
Recently the questioning of the diagnosis ’shaken baby syndrome’ has received attention, partly because the Supreme Court in a judgment, because of the poor scientific evidence base for the diagnosis, acquitted the defendant from the accusations of shaking his baby. In another case the Supreme Court granted a man, who had been sentenced to prison for killing his daughter by violent shaking, a new trial. The aim of this essay is to examine the medical diagnosis shaken baby syndrome from a legal perspective, by an investigation of how the diagnosis is being and has been used in criminal judgments and how the courts examine and have examined medical and forensic expert evidence regarding the diagnosis.

Shaken baby syndrome is a... (More)
Recently the questioning of the diagnosis ’shaken baby syndrome’ has received attention, partly because the Supreme Court in a judgment, because of the poor scientific evidence base for the diagnosis, acquitted the defendant from the accusations of shaking his baby. In another case the Supreme Court granted a man, who had been sentenced to prison for killing his daughter by violent shaking, a new trial. The aim of this essay is to examine the medical diagnosis shaken baby syndrome from a legal perspective, by an investigation of how the diagnosis is being and has been used in criminal judgments and how the courts examine and have examined medical and forensic expert evidence regarding the diagnosis.

Shaken baby syndrome is a controversial diagnosis. The main issue is how reliable it is to infer the diagnosis from the mere presence of three specific symptoms (the triad). Today there is no consensus regarding this question. My conclusion from the case study, where ten cases regarding shaken baby syndrome were examined, is that the courts in general seem to be largely dependent on the statements from the forensic and/or medical experts. The courts rarely seem to question the evidence base for their judgments or the scientific support for their conclusions. As a result the diagnosis for several years and in several cases, sometimes as the only and thus crucial evidence, has caused several convictions. The medical questioning of the diagnosis did however influence the Supreme Court to announce that the diagnosis alone, i.e. the triad, is not enough to prove beyond reasonable doubt that violent shaking has caused the injuries. There are still ambiguities though, especially regarding whether the triad together with some other evidence, e.g. a confession from the defendant, can cause convictions.

My conclusion is that the courts have valued the medical and forensic expert evidence highly and in general the courts have also relied on the contents of the experts’ statements, seemingly without critically reviewing them or investigating the scientific support for those statements. That has also caused an incomplete examination of so called ’alternative hypothesises’. I also conclude that the principle of rule law, in terms of legal certainty and predictability, has been threatened and there may also, because of the questioning of the diagnosis, be materially incorrect convictions. It might be unavoidable that criminal judgments based on, at that time accepted science, later turn out to be materially incorrect if the scientific ground gets criticized or overturned. It is also understandable that the courts are highly dependent on the forensic experts’ statements, since the courts often lack sufficient knowledge regarding such complex medical issues as concerning shaken baby syndrome. The criminal justice system still has to be better prepared to detect such controversies as regarding shaken baby syndrome and it also has to improve its ability to, independently, assess how medical and forensic proof relates to the criminal standard of proof. (Less)
Please use this url to cite or link to this publication:
author
Axelsson, Cecilia LU
supervisor
organization
alternative title
Shaken beyond reasonable doubt? - Swedish courts' evaluation of forensic and medical expert evidence regarding Shaken baby syndrome
course
LAGM01 20151
year
type
H3 - Professional qualifications (4 Years - )
subject
keywords
straffrätt, criminal law
language
Swedish
id
5426277
date added to LUP
2015-06-03 13:50:24
date last changed
2015-06-03 13:50:24
@misc{5426277,
  abstract     = {Recently the questioning of the diagnosis ’shaken baby syndrome’ has received attention, partly because the Supreme Court in a judgment, because of the poor scientific evidence base for the diagnosis, acquitted the defendant from the accusations of shaking his baby. In another case the Supreme Court granted a man, who had been sentenced to prison for killing his daughter by violent shaking, a new trial. The aim of this essay is to examine the medical diagnosis shaken baby syndrome from a legal perspective, by an investigation of how the diagnosis is being and has been used in criminal judgments and how the courts examine and have examined medical and forensic expert evidence regarding the diagnosis.

Shaken baby syndrome is a controversial diagnosis. The main issue is how reliable it is to infer the diagnosis from the mere presence of three specific symptoms (the triad). Today there is no consensus regarding this question. My conclusion from the case study, where ten cases regarding shaken baby syndrome were examined, is that the courts in general seem to be largely dependent on the statements from the forensic and/or medical experts. The courts rarely seem to question the evidence base for their judgments or the scientific support for their conclusions. As a result the diagnosis for several years and in several cases, sometimes as the only and thus crucial evidence, has caused several convictions. The medical questioning of the diagnosis did however influence the Supreme Court to announce that the diagnosis alone, i.e. the triad, is not enough to prove beyond reasonable doubt that violent shaking has caused the injuries. There are still ambiguities though, especially regarding whether the triad together with some other evidence, e.g. a confession from the defendant, can cause convictions.

My conclusion is that the courts have valued the medical and forensic expert evidence highly and in general the courts have also relied on the contents of the experts’ statements, seemingly without critically reviewing them or investigating the scientific support for those statements. That has also caused an incomplete examination of so called ’alternative hypothesises’. I also conclude that the principle of rule law, in terms of legal certainty and predictability, has been threatened and there may also, because of the questioning of the diagnosis, be materially incorrect convictions. It might be unavoidable that criminal judgments based on, at that time accepted science, later turn out to be materially incorrect if the scientific ground gets criticized or overturned. It is also understandable that the courts are highly dependent on the forensic experts’ statements, since the courts often lack sufficient knowledge regarding such complex medical issues as concerning shaken baby syndrome. The criminal justice system still has to be better prepared to detect such controversies as regarding shaken baby syndrome and it also has to improve its ability to, independently, assess how medical and forensic proof relates to the criminal standard of proof.},
  author       = {Axelsson, Cecilia},
  keyword      = {straffrätt,criminal law},
  language     = {swe},
  note         = {Student Paper},
  title        = {Skakad bortom rimligt tvivel? - Svenska domstolars bevisvärdering av medicinsk sakkunnigbevisning gällande diagnosen skakvåld},
  year         = {2015},
}