Thermal injury and child abuse: the medical evidence dilemma

The defense of the innocent, as well as the prosecution of the guilty, is a basic premise of American justice. This article reviews nine cases defended by the public defender system, in which the authors were involved, that illustrate some of the pitfalls in making the diagnosis of child abuse and/or neglect caused by thermal injury. The basis for the defense is also discussed, together with the biologic, engineering, and socioeconomic factors. The definition of child abuse and/or neglect is discussed, as is the devastating and long-lasting label of a false accusation, much less false imprisonment. In this regard this review concludes that professionals with thermal injury expertise must become involved in the judicial process if justice is to prevail.