When expert witnesses play judge and jury

Yesterday we came across a fascinating article by Sarah Phillimore on the Transparency Project Blog, discussing the problems which can ensue in Family Court when expert medical evidence is not based on reliable clinical practice.

For those of us who’ve grown used to the shrieks and howls of the Hoaxtead mob regarding Dr Deborah Hodes’ examinations of RD’s children during the police investigation in September 2014, it’s a familiar issue.

While the case Sarah describes is quite different from the Hampstead SRA hoax, the point in common is a physician who is seemingly so enamoured of her own ability to discern child abuse (emotional in one case, sexual in the other) that she delivers what seems more like a judgment than an expert opinion. Fortunately, in both cases the judges were experienced enough to discern the problem, but things could quite easily have swung in the other direction, ultimately causing irreparable harm.

In the more recent case, a local authority believed that a one-year-old boy should be placed for adoption. The expert witnesses, Dr Rees a psychologist and Ms Hall a social worker, provided their evidence, had produced a joint report and gave their evidence in tandem:

Dr Rees had carried out a CARE Index assessment (CIA) described as a clinical tool deployed by specially trained psychologists to assess the emotional relationship between a baby and parent. The CIA enables the psychologist to assess a very short period of care and by using codes identify the interactions by both parent and child and then to analyse them.  Having repeated the CIA over time, Dr Rees concluded the child was at high risk of emotional harm in his interactions with his mother.

She was challenged about why the other professionals had all commented on the warmth of the relationship between mother and son. The Judge was satisfied by Dr Rees’ ‘very robust’ response that she had been specifically trained to deploy the CIA as a clinical tool and she was best able to give the court expert evidence on the interactions and their significance. The other professionals were mistaken in their more positive ‘general observations’ and had missed what she had seen because ‘she had used the tool that was needed to see it’.

We were instantly reminded of Mrs Justice Pauffley’s observation in her 19 March 2015 judgment:

132. Overall, I feel impelled to observe that the level of Dr Hodes’ involvement in this case was unusual. I remind myself of the several cautionary considerations when a court is considering the contributions made by experts as comprised within Re U; Re B [2004] EWCA Civ 567 – i) The cause of an injury or an episode that cannot be explained scientifically remains equivocal. … iv) The court must always be on guard against the over-dogmatic expert, the expert whose reputation or amour propre is at stake, or the expert who has developed a scientific prejudice.

Why did Dr Hodes perform two anal exams?

The first examinations Dr Hodes performed conformed to the recommendations of the Royal College of Paediatrics and Child Health Review of 2008—they were done in the left lateral position. During examination, Dr Hodes found the following:

  • Child P: Three linear scars extended almost to the anal verge, and after 10 seconds of gentle traction there was anal laxity. There was no reflex anal dilatation.
  • Child Q: One anal fissure scar was identified, and there was no reflex anal dilatation.

The second examinations occurred on 16 September, and were done in the knee-chest position. This time, the results were different:

  • Child P: Persistent reflex anal dilatation was found during buttock separation;
  • Child Q: No reflex anal dilatation was found, but the anal fissure scar was confirmed.

In her report on Q, Dr Hodes stated that this scar was “consistent with inflicted injury from a blunt penetrating force that he has alleged”.

In her evidence during the fact-finding hearing, Dr Hodes described more of her rationale for asking to re-examine the children’s genital areas.

She said, “I’ve got this allegation which has been made to several people…” Dr Hodes had thought about it over the weekend and, “on reflection believed (she) should have examined the children in the ‘knee chest’ position”. She added, “it’s not what you do it’s how you do it”.

In her 22 September report, Dr Hodes ventured an opinion on the frequency and validity of recantation amongst child sexual abuse victims—not part of her remit, which was physical examination of the two children, but an issue about which she apparently believed she was professionally qualified to comment.

Subsequently, Dr Hodes took this case to a peer review meeting.

As explained in her Amended Medical Report of 4 December 2014, her anogenital findings in relation to both children were then significantly amended. The previously confirmed fissures were said to be irregularities in the ruggae (folds, wrinkles or ridges) and their clinical significance was described as “possible normal variant”.

The only persisting physical sign post peer review was reflex anal dilatation in P which, so Dr Hodes maintains, is “consistent with her allegation of the blunt penetrating force to her anus i.e. sexual abuse.”

In evidence she said her colleagues had it was “abnormal and striking”; she stated that RAD is a sign which is “rarely seen”. (This is disputed in the medical literature, where estimates of the occurrence of RAD in non-abused children range from 11% to 49%.)

In her written report she also said, “There is evidence in the literature that the absence of physical signs neither supports not (sic) refutes an allegation of anal penetration. In this case it was alleged that lubrication was used which adds to the probability of abuse”.

Thus, although her interpretation of her medical findings had been trashed by her colleagues in peer review, and despite the fact that both children had originally made allegations of anal rape, but only one showed the sign Dr Hodes was looking for, she was not willing to let go of her belief that the children’s allegations were based in fact.

Did Ella contaminate Dr Hodes’ opinion?

The Pauffley judgment states, “On 26 September, Dr Hodes and a Senior House Officer met with Ms Draper “for further information regarding the children’s medical history.” A little over two pages of the four page report are devoted to the “allegations allegedly made by P and Q to their mother.”

In other words, rather than focussing on the physical findings, which were equivocal at best, Dr Hodes chose to focus on the information given to her by Ella.

In October/November 2015, we noted an online conversation on Abe and Ella’s now-defunct blog, which delves further into this issue:

Ella and Dr HodesElla and Dr Hodes 2

As “Fact and fiction” points out, Dr Hodes’ conversation with Ella should have been limited to the children’s medical history—and a history should have been taken from RD, and most important, the children’s GP. We don’t know that this did not happen, but if it did, it was not included in Dr Hodes’ reports.

Dr Hodes and reflex anal dilatation

The Hampstead hoax is far from the first instance in which Dr Hodes’ reliance upon RAD as a diagnostic tool has been questioned by the courts.

Referring to a case which was tried in 2010, Margaret Jervis pointed out that

It would appear from the judgment that there was insufficient confidence in the child’s evidence, whatever stage it was at, until April 4th when she was examined by a paediatrician, Dr Deborah Hodes. Dr Hodes examined her bottom and found no indications of past injury.

She did make a finding of ‘anal dilatation’- the opening of the anal canal on parting the buttocks that became the centre of controversy in Cleveland in 1987.

Dr Hodes gave evidence that that such evidence ‘could be supportive’ of an allegation of anal penetration but that it occurred in 11 per cent of non-abused children. This is misleading. Studies do in fact show that the ‘sign’ can appear in up to 49 per cent of non-abused children, that it may be caused by the pressure placed on the buttocks and that it has no diagnostic value in detecting sexual abuse.

During her examination, Dr Hodes also asked the child whether anyone had hurt her bottom and she replied that [the accused person] did.

So what Dr Hodes had was, in effect, not a finding supporting an allegation, but an allegation supporting in inconsequential finding in response to a leading question.

Accepting responsibility for error

In the Hampstead case, Dr Hodes seemed unwilling to give up her opinion that RD’s children had been abused, even though she’d only found RAD in one of the children. Her insistence on playing both “expert witness” and judge—assigning meaning to her findings based on evidence provided by Ella—has enabled her findings to be used as a talking point for those who’d like to believe that Hampstead is populated by members of a “Satanic death cult”.

By contrast, Dr Rees was willing to accept that the evidence she gave in the case described by Sarah was far from exemplary. Indeed, she gave a “laudably frank” response to the judge’s critique, and acknowledged her own responsibility for the problem her evidence had created.

Ultimately, in our view this is the much more professional response: people make mistakes, even when it comes to important things such as giving evidence in a hearing which will determine the future of a child. Taking responsibility for such errors is critically important, and paves the way toward a more robust and trustworthy verdict.

The-Royal-Courts-of-Justice

64 thoughts on “When expert witnesses play judge and jury

  1. I’m so glad the Medical Reports and Doctor Hodes are being mentioned in a post again.. and an excellent one at that! It was good to be reminded of that 2015 online chat too.

    It’s the one thing the deluded idiots who comment on illegal videos featuring the children on YouTube still mention and cling to.. well, that and the non-existent tattoos.

    Liked by 1 person

  2. As usual, they’ve twisted the tale to claim that both children were found to have RAD, when only one did, and only then in a non-recommended position. And even at that, it’s been dismissed by most experts as a sole sign of sexual abuse.

    Like

  3. Nicely analysed, Your Howlness

    The serious damage done by incompetent expert witnesses or charlatans in court cases has often been covered in Private Eye and they’ve argued that there a several innocent people who have done time as a result. Not to knock genuine, competent expert witnesses, of course, who are invaluable to such cases, but clearly there’s an issue around the dodgier ones and courts’ over-reliance on them and the way their submissions are taken as gospel and often not sufficiently challenged.

    Liked by 1 person

  4. I’m so glad she introduces herself as Ved Chaudhari before announcing that her name is Neelu Kumari. Nothing confusing or contradictory about that.

    Liked by 1 person

  5. LOL @ ‘John Smith’, who runs that common law website and charges gullible twats £7 a pop to download a template 😂

    Like

  6. 26:38 / -5:29 – “Our public servants are on £200,000 a year. That’s £2,000 a week!”

    Another one for the ‘Number Crunching with the Fruitloops’ collection, I reckon 😂

    Liked by 1 person

  7. Oh goody, Neil Douglas-Streatham, badger-shagger par excellence, is back from his latest Facebook suspension and has wasted no time in getting back to imparting his (cough cough) ‘wisdom’…

    Like

  8. The ignorance of the Hamphoaxers whose prejudice and preconceived weird beliefs who seek confirmation of their sickness is dangerous & deadly and the sad case of Sally Clark and the discredited Dr Roy meadows amply demonstrates this. In the end Clark was the real victim. I wonder how many of Clark’s attackers were also Hoaxers?.
    https://www.telegraph.co.uk/news/uknews/1510798/Sir-Roy-Meadow-the-flawed-witness-wins-GMC-appeal.html
    This Mob © are dangerous and vicious and relentlessly nasty the way they continue to attack innocent people. And yet their shallowness is always on display as evidenced with EC’s article that the so-called RAD feature only ever involved one child but that means nothing to these creeps.

    And as always we must ask what deep repressed darkness & desires drives these people who cherry-pick the bits of any case to bolster their beliefs while discarding real evidence. Their obsession with pedophilia is worrying.

    Liked by 1 person

  9. Blimey, that was quick!

    Thanks for stopping by, Dougy. See you after your new suspension 😀

    Like

  10. Yet more evidence that we should be circumspect when one claims to have been in one of the Armed Services or Police who is then presented as, for some bizarre reason, carrying more credibility than say, a judge or even a civilian. I mention no names although for some reason I think of Brian Gerrish, Gordon Bowden, Roy Savage and now we hear this Formaldehyde was in the navy?

    # for the record- I have a relative who was an Industrial Chemist who during WW2 worked with other scientists to successful refine formaldehyde so it can be manufactured in bulk in order to bring home the bodies of those who fought for our freedoms and that of the anti-Semite Douglas Formaldehyde.(He was Jewish !)
    ## for the record -around 13 coppers a month are “encouraged” to resign from Surrey Police over various matters. And that’s just one county.

    So the Indians, Chinese , Russian, Brits, Yanks etc are all involved in a plot to pretend they send rockets into Space or even land on Mars as the Chinese also have. How do these plonkers think they receive communications via Satellites?. And why am I even asking questions of the paid up members of Cretins R Us?

    Like

  11. Wonderful! Our Koala Bear Stamp of Excellence committee is working overtime to produce said awards for so many members of Hoaxtead. Recipients will instead receive a sort of Mental award so may now include the initials KBSE after their names.

    Like

  12. Thanks, Sam 🙂

    Do you do a triple version? I appear to have scored a hat-trick 😀

    Like

  13. I dont see his issue with Belle Isle (it is actually Belle Ile with the funny slash above the I that I cant do on this keyboard) its average height above sea level is 40m, its highest point is 70m above sea level, the restaurant appears to be 5m above sea level to the deck and is 38 km from Belle Ile in a straight line.
    According to the earth curvature calculator at
    https://dizzib.github.io/earth/curve-calc/?d0=38&h0=6.8&unit=metric
    if he is standing up on the deck, and is 1.8m high (thats a guess) then anything above 64m high on the island should be visible (including the lighthouse lens flashing)

    The whole island wouldnt be visible, but certainly parts of it should be

    Like

  14. Hope this helps, mate:

    I find that feature really handy, not just for the aforementioned circumflex but for all the other accents too.

    Like

  15. It might, if I had word…

    Since the last win7 machine crashed after the unwanted win10 autoupgrade, we have a ‘windowless house’ now

    4 laptops/towers- all ubuntu except 1 mint
    3 tablets 1 puppy, 2 android
    3 phones, all droids (including my ancient sony still running gingerbread!)

    Like

  16. The Ghost describes something I see in metaphor:

    “This Mob © are dangerous and vicious and relentlessly nasty the way they continue to attack innocent people. And yet their shallowness is always on display as evidenced with EC’s article that the so-called RAD feature only ever involved one child but that means nothing to these creeps.

    And as always we must ask what deep repressed darkness & desires drives these people who cherry-pick the bits of any case to bolster their beliefs while discarding real evidence. Their obsession with pedophilia is worrying.”

    +++++++++++++

    The child in the animation represents all the children in Hampstead, and the thing hunting the child represents Angela Power Disney, Rupert Quaintance, Jake Clarke, Kris Costa, Sabine McNeill, Neelu Berry, Belinda McKenzie, and those like them. The animation captures the essence of what we are up against.

    Like

  17. it’s particularly audacious when they can’t even be arsed to upload half their shows. Still waiting to hear those Rupert & Angie episodes.

    Liked by 1 person

  18. Thanks El C for the shout out and reminding me of the excellent comment of Mrs Justice Pauffley which I have added to The Transparency Projects forthcoming guidance notes about the use of experts in cases involving children. I had steered clear of the the whole satanic panic but think I had better include some discussion about that given the serious impact that the Cleveland and Orkneys scandals had for e.g.

    Liked by 2 people

  19. Was Dr Hodes ever reprimanded about using RAD and her meddling in this case?
    Someone should really have complained to GMC about her – I would even go as far as to say Hodes bad practice was criminal – think about it: Without the fraud evidence she produced those that believed this hoax would not have felt as strongly as they did – Dr Hodes made the perfect storm in the Hampstead case.

    Another example of bad practice here – in this case the therapists interviewing children in sex abuse cases: It is old but worthy of a watch.

    Liked by 1 person

  20. I had a discussion with an old feller, not long ago, who claimed to have been a doctor in the US Navy and later a consultant forensic MD in Washington. He said, RAD was indeed an old test for anal sex, but in his experience it was entirely an entrapment ploy! The idea being, if a seaman was brought to him for RAD exam, he could produce either a positive or a negative result – depending on what the officer ordering the exam wished to prove – by the way the subject was positioned. (Just as I’ve always said).
    But the exam itself wasn’t enough. If a seaman’s superiors wanted to “drum him out” of the service as a homo, they needed a confession from him, and this was the real point of the exam. After the exam, the seaman would be told that they had “irrefutable medical evidence” he was a homosexual & a sodomite – and if that was in fact the case, they would generally confess at that point and willingly submit to discharge on those grounds.

    This man is an MD, still, but I don’t have evidence to prove what he told me (told us, actually, at the club). His story fits with some other scuttlebutt of that nature I’ve come across online before, however.

    Liked by 1 person

  21. I don’t remember exactly, but wasn’t there a French doctor of some sort who wrote an incredibly homophobic book about gay men, and RAD was in there as a “sign”. A doctor at the turn of the 19th century.

    Liked by 1 person

  22. Thanks, Tracey 🙂

    Pages 23-24:

    As Louise said, social workers are very fond of throwing about the words, “These people need to work with me openly and honestly.” Well, that cuts both ways. We need to work openly and honestly with them as well. I would give two counter examples to the things that Louise has been talking about to show that things can go badly wrong. So on the social media side I’m thinking particularly of the Hoaxsted dad which, for those who don’t know, were a set of individuals in the Hampstead area were abusing their child and manipulating their child and actually feeding them juice made of cannabis and getting them to tell stories about their father which were patently not true, and then the stories expanded in the way that these things do and it involved everybody in the local community and head teachers and apparently staff at the local McDonald’s and staff at local shoe shops and babies were being sacrificed to the devil and all of this went on the internet and children were seen telling these stories on videos and shared, I think, about half a million times. There’s a judgment that says that all of this is rubbish but all of the people who were being accused of those things on the internet were having their lives ruined. People were publishing, “This person eats and kills babies. Here’s where he lives. Here’s the school he teaches at.” People were turning up at their schools ready to lynch them and it was complete drivel.

    By the way, it seems even the government can’t spell ‘Hoaxtead’! LOL

    Liked by 1 person

  23. It sounds suspiciously like she’s trying the same trick to avoid her long overdue eviction that wrecka patel tried to avoid hers….
    Filing false sales claims against the property and ‘renting’ it back to herself to try avoiding foreclosure…
    It worked for a short time as the courts tried to clean up exactly who owned the property, that little stunt probably cost the taxpayers a few hundred thousand while she lived for free in the house before they declared the ‘sale’ void and chucked her out for good.

    😦

    Liked by 2 people

  24. I have just reminded myself of the Orkneys satanic panic. I had forgotten how terrible that was. I wonder to what extent AC was aware of this history – it would have certainly allowed him to think that there was a reliable precedent for how gullible and dangerous those in authority can sometimes be.

    Liked by 1 person

  25. I’m surprised he finds time to lick Greeny’s arse in between all that Satan-worshiping.

    Like

  26. As a good Catholic owl, there is no Hell. I sadly have to announce that Malc is homeless. Please give generously.

    Up the Pontiff!

    Liked by 2 people

  27. Yo’re wrong, he is in a Hell of his own making – and he put an awful lot of effort into it.

    Like

  28. @Anowlcalledsage

    He thinks you’re Spiny Norman, lol:

    https://archive.li/8SSM2

    Don’t take it personally – he thinks everyone is Spiny (except for Steved and Sam, who he’s convinced are MQ, and Farmer Giles, who he’s certain is Maggs Shaw). One day he might guess one right! (Don’t hold your breath, though)

    Like

  29. Hehe…The way it is with us Catholics is that at some point it was decided that all that hellfire and brimstone guff was just… guff. I don’t recall if a Vatican council decided that for us or what….I just remember being informed that Hell is the furthest place you can find yourself from God….and that separation from all that is good and holy leaves us in a very lonely place without God’s love but we’re not going to burn in hell forever as a result because that sort of hell doesn’t exist and never did … Hell – Catholic Style – is being ‘sent to coventry’ for all intents and purposes….so what if Jesus Christ, the Virgin Mary, the Holy Spirit and God Almighty refuse to hear your prayers….were they ever guilty of listening in the first place?

    So yes, Pope Francis is not a proponent of the bizzare notion you will burn in hell for your sins…that accusation would be against his religion.

    Like

Comments are closed.