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Child Abuse

Whenever a physician or other care provider suspects that a child has been abused or neglected, that suspicion should be reported to the child protective agency immediately. Child abuse is not a diagnosis; it is a legal finding. Medical personnel who try to investigate this crime may confuse the evidence to the point that the law enforcement agency cannot protect the child. Physicians should defer to experts in child abuse and neglect rather than attempt to make an independent determination of abuse. These experts will act as consultants to the courts and protective services.

As with other reporting laws, neither the patient nor the parents nor the physician have the right to stop the reporting or to withhold information from the law enforcement agency. A parent may refuse to answer an investigator's questions under the Fifth Amendment protections against self-incrimination. This part of the process should not involve the physician. The physician should provide all the known information in as objective a manner as possible.

Health care providers should be very careful about vouching for the character of parents. It is not possible to know that parents are not abusive based on their behavior during office visits. Particularly with sexual abuse cases, the physician who has trouble dealing with the reality of child abuse may suffer from denial when dealing with an individual case. Keep in mind that the child is the patient and all the duties of the physician are to the patient, not the parents.

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