A British Medical Journal Journal article (below) points out the confusion in doctors duties regarding child protection. In Britain the welfare of the child is place highly only when a decision is governed by the Children Act statute, which has created an atmosphere of increased complaints against paediatricians. Doctors may be avoiding work related to abuse because of this.

As a guardian ad Litem in the U.S., I often found medical professionals unresponsive to the violence and dysfunction responsible for the condition of the child before them.

In the U.S. there is an organization trying to change that; The Academy on Violence and Abuse, www.avahealth.org is working diligently to better educate the medical profession about the signs of abuse and how to respond effectively.

Visit the Academy’s website and watch their videos, it is compelling.

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ScienceDaily (Sep. 4, 2008) — Better guidance is urgently needed for doctors in child protection cases to prevent them from being deterred from acting to protect children, says an editorial on the British Medical Journal website.

Writing in response to recent high profile cases such as that of Sir Roy Meadow, which have highlighted “the crisis of confidence” developing between the General Medical Council (GMC) and paediatricians, David Foreman and Juliet Williams call for better guidance to prevent doctors from being deterred from raising concerns about child abuse and to restore confidence in child protection processes.

They point out that the number of complaints against paediatricians related to child abuse work increased by more than 500% between 1995 and 2003.

In addition, since 2003, registrations of children for emotional and sexual abuse have increased while those for physical and sexual abuse have declined. This, they say, suggests that doctors may be avoiding work related to abuse for which more detailed physical examinations are needed.

According to the authors, part of the problem is that there is a basic confusion in doctors’ duties regarding child protection. Medical law still states that doctors have a duty of care to both the parent and the child, but current paediatric professional guidance incorrectly applies the Children Act principle that the welfare of the child must be placed over all other considerations. In fact, this only applies to the courts, when they make a decision governed by that Act.

Therefore, in child protection cases, doctors have conflicting duties both to the child and to the parents who may not feel that doctors are acting in their best interests, particularly if they are suspects and if retrospectively no abuse is detected. This situation worsens if the doctor is later required to act as an expert witness in court.

Recent hostile media campaigns have added to the pressure on doctors by making it less likely that the GMC will dismiss high profile cases because its duty is to protect the public and also the reputation of medicine while maintaining public confidence in the profession, say the authors.

So what can be done to reinstate confidence in child protection processes and prevent a reduction in child protection?

The authors call on the GMC and other professional bodies to issue more specific guidance for doctors on how to manage these conflicting duties of care in child protection cases.

They also suggest that complaints against professionals in child protection cases should be subject to independent scrutiny before they are referred to their professional bodies.

To avoid unwarranted public criticism the public also need to be better educated about child protection work, so that the dual role of doctors in these cases is better understood, they conclude.

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by BMJ-British Medical Journal, via EurekAlert!, a service of AAAS.

BMJ-British Medical Journal (2008, September 4). Better Guidance Urgently Needed For Doctors In Child Protection Cases, Say Experts. ScienceDaily. Retrieved June 26, 2010, from http://www.sciencedaily.com /releases/2008/09/080904215617.htm

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