Medical Ethics Concerns in Physical Child Abuse Investigations: A Critical Perspective.
Barry, George J. Redleaf, Diane L.
The Family Defense Center (Chicago, Ill.)
Published: March 6, 2014
Beginning in the fall of 2011, the Family Defense Center undertook a major research project to explore the ethical obligations of physicians who become involved in cases of suspected child abuse or neglect. Physicians typically become involved in such cases either as treating physicians or as investigative/forensic medical experts giving reports used in legal proceedings involving child protection issues. This Paper is the result of that research and contains our efforts to present the ethical concerns that have arisen in cases we have handled at the Family Defense Center. The Paper contains four parts. First, in this Introduction, Part I of the Paper, we explain our focus, our own background of involvement in medically complex cases involving children and families and generally describe the context in which these cases arise. We also provide some background to the child protection system and child abuse reporting that gives rise to some of the ethical concerns this Paper presents. In Part II, we present five Illustrative Cases which provide more detail exemplifying how medically complex child abuse cases arise and present a summary of medical ethics issues posed in each case. In Part III, we present a Discussion of the applicable ethical standards, in nine separate areas of interest, and explain how adherence to these standards in the context of a child abuse investigation could have a salutary effect in mitigating harm to families. The last section, Part IV of this Paper, sets forth our conclusions and enumerates our specific recommendations for improving medical ethical practices that this Paper critiques. (Author abstract)
ethics; medical evaluation; medical aspects of child abuse; child abuse; investigations; physicians role; pediatricians role; child abuse reporting; child protective services