HOUSTON (AP)—A Texas man This week could mark the first person executed in the US for a murder conviction linked to a diagnosis of shaken baby syndrome.

The Texas Board of Parole voted 6-0 on Wednesday against recommending clemency for Robert Robersonwho will receive a lethal injection on Thursday. The board also denied him a 180-day reprieve.

Republican Gov. Greg Abbott can grant clemency only after receiving a recommendation from the administration, which has faced public pressure from both parties in recent weeks to spare Roberson’s life.

Roberson57, will be executed for the 2002 murder of his 2-year-old daughter, Nikki Curtis. His lawyers have asked the U.S. Supreme Court to stay the execution.

Roberson has long proclaimed his innocence. His lawyers and a bipartisan group of Texas lawmakers, medical experts and others do not deny that head and other injuries from child abuse are real. But they argue his conviction was based on flawed and now outdated scientific evidence, and say new evidence has shown Curtis died of complications related to severe pneumonia.

But prosecutors argue that Roberson’s new evidence does not disprove their claim that Curtis died of injuries inflicted by her father.

Roberson’s scheduled execution renewed the debate over shaken baby syndrome. On one side of the debate are lawyers and some from the medical and scientific communities who argue that the shaken baby diagnosis is incorrect and has led to wrongful convictions. On the other side are prosecutors and medical associations from the US and around the world who say the diagnosis is valid, scientifically proven and the leading cause of fatal head injuries in children under 2 years of age.

Here’s what you need to know about Roberson’s highly scrutinized diagnosis ahead of Roberson’s scheduled execution:

What is shaken baby syndrome?

The diagnosis refers to a serious brain injury caused when a child’s head is injured by shaking or another violent impact, such as hitting a wall or being thrown to the ground, usually by an adult caregiver, said Dr. Suzanne Haney, a child molester. pediatrician and member of the American Academy of Pediatrics Council on Child Abuse and Neglect.

The term was changed in 2009 to abusive head trauma, a more inclusive diagnosis, Haney said.

According to the National Center on Shaken Baby Syndrome, approximately 1,300 cases of shaken baby syndrome/abuse head trauma are reported in the U.S. each year.

What is the shaken baby syndrome debate?

Critics claim doctors focused on diagnosing child abuse due to shaken baby syndrome when a trio of symptoms – bleeding around the brain, swelling of the brain and bleeding in the eyes – were found. Critics say doctors haven’t considered that things like falls with head injuries and naturally occurring illnesses like pneumonia could mimic an inflicted head injury.

Attorneys for Roberson and other supporters are not saying that child abuse doesn’t exist or that shaking a baby is safe, said Kate Judson, executive director of the Center for Integrity in Forensic Sciences, a Wisconsin-based nonprofit that aims to improve reliability of forensic scientific evidence.

“This is about whether someone was misdiagnosed and justice was not served,” Judson said.

Although Haney declined to comment on Roberson’s case, she said there is no dispute within a large majority of the medical community about the validity and science behind the diagnosis.

Haney said doctors don’t just focus on a trio of symptoms to diagnose child abuse, but instead look at all possible things, including any illnesses, that could have caused the injuries.

“I worry about the backlash against head trauma abuse because a diagnosis will disrupt the prevention efforts that are in place and could therefore harm more children,” Haney said.

Judson said she believes doctors in Roberson’s case did not consider all possible causes, including illness, to explain what happened to his daughter, and used the triad of symptoms to focus only on child abuse .

What are the concerns expressed by Roberson’s supporters?

Roberson’s attorneys say he was wrongfully arrested and later convicted after taking his daughter to a hospital. She had fallen out of bed in their home in the eastern Texas town of Palestine after being seriously ill for a week.

New evidence gathered since his 2003 trial shows that his daughter died of undiagnosed pneumonia that developed into sepsis and was likely precipitated by medications that should not have been prescribed to her and that made it more difficult for her to to breathe, said Gretchen Sween, Roberson’s attorney.

The Anderson County District Attorney’s Office, which prosecuted Roberson, has said in court documents that after a 2022 hearing to consider the new evidence, a judge rejected theories that pneumonia and other illnesses caused Curtis’ death.

What have courts said about shaken baby syndrome?

In recent years, courts across the country have overturned convictions or dropped charges related to shaken baby syndrome California, Ohio, Massachusetts And Michigan.

In a ruling last week in another Dallas County shaken baby syndrome case, the Texas Court of Criminal Appeals ordered a new trial after finding that scientific advances related to the diagnosis would now likely result in an acquittal in that case .

But the appeals court has repeatedly denied Roberson’s request to delay his execution, most recently on Friday.

At least eight people have been sentenced to death in the U.S. for shaken baby syndrome, said Robin Maher, executive director of the Death Penalty Information Center. Two of these eight have been acquitted and Roberson is the only one to receive execution dates.

“According to the National Registry of Exonerations, at least 30 people across the country have been exonerated based on this discredited scientific theory,” Maher said.

But Danielle Vazquez, executive director of the Utah-based National Center on Shaken Baby Syndrome, said: 2021 research article found that 97% of more than 1,400 convictions related to shaken baby syndrome/abuse head trauma were upheld between 2008 and 2018, and such convictions were rarely overturned on medical evidence.

Vazquez said her organization is concerned that doubts about the diagnosis could lead some parents or caregivers to mistakenly believe that shaking a baby is not harmful.

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