Child Abuse Specialists: Do They Abet the Worst Tendencies of CPS?

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February 27, 2020 by Robert Franklin, JD, Member, National Board of Directors

Last time I wrote about the scandalous case of Megan and Andy Carter and their five-year-old daughter Ellie (NBC News, 2/14/20).  Ellie had multiple health problems due to her having been born very prematurely.  Her many visits to doctors and hospitals and her difficulty combatting an infection drew the attention of Mary Bridge Hospital’s child abuse pediatrician Dr. Elizabeth Woods who seems to have believed that Megan was overtreating the child and withholding care to keep her sick. 

Woods’ intervention into Ellie’s parental care resulted in the child being taken from her mother for over a year, Megan’s being charged with child abuse and the Carters shelling out some $300,000 to defend against allegations that were not only unfounded, but contested by other experts.  To accomplish all that, Woods made numerous statements under oath that were either untrue or stretched the truth beyond recognition.  The judge in Megan’s trial laid into Woods:

Most of Woods’ testimony, the judge wrote, was “without supporting factual basis.” Amini dismissed parts of Woods’ conclusions as “not plausible” and “speculation at best.”

But Woods wasn’t finished.  Six months after all charges had been dropped and the family reunited, the Carters got a visit from Child Protective Services.  They had a report that Megan was giving Ellie unnecessary oxygen treatments.  Who made the report?  CPS officials didn’t say, but the only person fitting the description of one of the reporters was Elizabeth Woods.

But Ellie hadn’t received oxygen treatments in over a year and hadn’t been to Mary Bridge Hospital in six months.  The report to CPS was a complete fabrication made by someone who not only didn’t know the facts, but couldn’t know them.  From this far remove, it looks like an act of malice.

As I said in my last piece, the Carters’ harrowing story of abuse by Woods and CPS is more than just one about a single rogue doctor apparently bent on depriving a child of her mother at any cost.  If that were true, we could take solace in the knowledge that any such doctor can ultimately be overruled by more scrupulous ones.

But that’s not the case and the Carters’ ordeal demonstrates the fact.

Most importantly, the Carters’ case shows the degree to which CPS was willing to pay attention to the opinions of a doctor who said there was abuse and ignore other doctors who said there wasn’t.  Apparently, caseworkers were also willing to ignore the evidence of their own eyes.

“I couldn’t understand why her opinion carried so much weight,” Carter said. “It was like, whatever Dr. Woods said, everyone just accepted it as fact.”

Woods’ key piece of “evidence” against Megan Carter was a videotape that was made in Ellie’s hospital room.  Woods claimed it showed Megan throwing away medication Ellie needed instead of administering it to the child.  Astonishingly though, the recording showed no such thing.  Plus, two hospital personnel were in the room at the time.  Did anyone at CPS even view the tape?  Or did they, as Megan said just accept as fact everything Woods said?

The same holds true for the post-case proceedings.  CPS and a police officer showed up at the Carters’ door with the claim that there was ongoing abuse in the form of unneeded oxygen treatments.  Apparently, that claim came from Woods who hadn’t clapped eyes on either Ellie or Megan in six months.  And, like so much of what Woods claimed in the case, that was simply false. 

Did anyone at CPS ask Woods how she knew about the alleged treatments?  Or did they simply accept them as fact without question?

Moreover, the Carters’ is not the only case in which something similar has happened.

In four cases reviewed by reporters, child welfare workers took children from parents based on Woods’ reports — including some in which Woods misstated key facts, according to a review of records — despite contradictory opinions from other medical experts who said they saw no evidence of abuse. 

Again, in those cases, it appears that CPS caseworkers valued Woods’ conclusions that abuse had occurred over those of other doctors who said it hadn’t.  Inevitably, that led to taking children from their homes and families.

I suspect that tends to happen for a combination of three reasons.

First, it’s the tendency of CPS workers to “err on the side of caution.”  The last thing CPS wants is to be told a child is being abused, leave the child in the home and then have the child end up severely injured or dead.  That’s a headline that no caseworker wants to read, but the inverse – a child taken when there’s not abuse – is viewed as less bad.  We’ve seen caseworkers admit as much in the past, and I suspect the tendency is deeply ingrained.

Second, the above tendency stems in part due to a failure to appreciate the damage done to children and families when the kids are taken by CPS.  The idea that “erring on the side of caution” means breaking up families as a default position is dangerously wrong.  Taking kids from their parents causes trauma.  Therefore, it is incumbent on every CPS worker to balance the potential damage to kids of leaving them in the home against the damage of removing them.  If the former doesn’t significantly outweigh the latter, then the children should remain at home.

Third, I strongly suspect that calling “child abuse” a medical subspecialty strongly reinforces the above two reasons.  After all, if the doctor who’s saying there’s abuse is a “specialist” in the matter, shouldn’t CPS value her opinion over all the others who aren’t specialists, at least in that discipline?  And doesn’t the status of specialist tend to imbue the doctor with a greater than usual certainty about her conclusions?  Certainly Dr. Woods was nothing if not certain of her opinions in the Carter case, irrespective of how badly based and factually incorrect they were.

Indeed, CPS caseworkers in the Carters’ case emphasized Woods’ “training and experience” to bolster their reliance on her and rejection of other opinions.

To justify that decision [in another case], the Child Protective Services worker described Woods as “a physician with extensive training and experience in regard to child abuse and neglect,” according to a written report reviewed by reporters.

But Woods had no fellowship training in child abuse and hadn’t passed the exam to become a specialist in the field. 

Did she have experience in diagnosing abuse?  She did, many years of it.  But that raises the question of exactly what that experience consisted of.  Did she rigorously follow up her diagnoses (whether of abuse or not) to find out if she’d made the right calls?  Did she keep scrupulous records of how many cases she got right and how many she got wrong?  If she did none of that, then of what value is her experience?  How can she learn from it if she doesn’t establish a feed-back loop to teach herself?  Based on the latest act of the Carter drama, it appears that Woods still believes that she made the right call there, despite the obvious falsity of that position and the humiliating chastisement by the judge.  If Woods believes, after all that, that Megan Carter is an abusive mother, then I suspect she has little ability to police herself and learn from her mistakes.

Will CPS authorities take note?  Or will they continue to rely on Elizabeth Woods as the last word on child abuse in Pierce County, Washington?

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