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Books, Journals, New Media
January 21, 2004


Author Affiliations

Books, Journals, New Media Section Editor: Harriet S. Meyer, MD, Contributing Editor, JAMA; David H. Morse, MS, University of Southern California, Norris Medical Library, Journal Review Editor.

JAMA. 2004;291(3):376-377. doi:10.1001/jama.291.3.376

Silent Injustice primarily consists of four high-profile cases in which young women were charged with killing their infants. The author, who was an expert witness during the trials, argues that the women were innocent and that the prosecutions were wrong. The cases serve as a springboard for the author's strong opinions about the injustice of how the medical and legal systems treat women whose babies die.

The first case occupies two thirds of the total pages devoted to case descriptions. A young English woman who had told no one that she was pregnant and who thought that she was no longer pregnant went on holiday with her boyfriend and several of his friends to New York City. When the men went out for a night on the town, the woman delivered a baby, which she wrapped up. She later claimed that the baby had never cried. As she was passing through the airport on the way back to England, the dead baby in her carry-on was found. Ultimately pleading guilty to manslaughter, she was placed on probation. Dr Gilbert-Barness argues that the child had an umbilical cord so twisted as to be incompatible with life and had not been born alive. She expresses scorn for the prosecutor (one of the leading child abuse prosecutors in the country) and emphasizes how nice the young woman was. The net effect is a story with little balance about how the case was viewed by others, too much emphasis on personality, and insufficient medical detail to facilitate understanding by medical readers. The critique of the medical evidence seems eclipsed by medical arguments regarding infanticide and prosecution practices (seemingly disparate issues). For example, beyond the assertion that the umbilical cord was fatally twisted, no information is added about the response of the original medical examiner to the author's conclusion nor about the mechanism of how the fetus would have died on the verge of being born.

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