Ilene, Sol, and Daniel discuss how to look for signs of child abuse in pediatric patients. Also, how to speak to the parents and navigating the tricky waters surrounding a potential child abuse situation.
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I just want to start by saying abuse does happen and is terrible and should be stopped. That being said we should also think about false positives which the speakers mentioned in the last 15 seconds. I had a colleague who's ex wife out of spite falsely accused him of physically abusing their children. Just in talking to him it is devastating, on par with being sued by a patient. It took him a year and a half of interviews, depression and lawyer stuff before it ended. Once that gets out into the community people at church, at work, at school will forever look at the person differently. Some of the nurses refused to work with him, some patients refused to be seen by him. You should remember that lawyers on both sides do everything they can to win a case, so they will pick apart everything the parents say and everything in their house and their past to make them look like a bad person that would abuse their child and they will bring in ridiculous expert witnesses to testify that the child was abused because the child frowned when asked a certain question, etc. The government is a blunt instrument that will leave a mark on someones life once this process is begun. On top of all of that the children have their own issues with being separated from their parents, wondering if their parents really did abuse them and having all these traumatizing interviews from the officials. For these reasons I am hesitant to begin the process haphazardly. Just like you wouldn't sue a Doctor for mild suspicion of malpractice you shouldn't sic the government on people unless the situation warrants it. Some may prefer to have high sensitivity but low specificity on the subject of child abuse, but that has consequences they will never see. I prefer to be more specific than sensitive.
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Mario P., MD - January 29, 2014 10:28 AM
I just want to start by saying abuse does happen and is terrible and should be stopped. That being said we should also think about false positives which the speakers mentioned in the last 15 seconds. I had a colleague who's ex wife out of spite falsely accused him of physically abusing their children. Just in talking to him it is devastating, on par with being sued by a patient. It took him a year and a half of interviews, depression and lawyer stuff before it ended. Once that gets out into the community people at church, at work, at school will forever look at the person differently. Some of the nurses refused to work with him, some patients refused to be seen by him. You should remember that lawyers on both sides do everything they can to win a case, so they will pick apart everything the parents say and everything in their house and their past to make them look like a bad person that would abuse their child and they will bring in ridiculous expert witnesses to testify that the child was abused because the child frowned when asked a certain question, etc. The government is a blunt instrument that will leave a mark on someones life once this process is begun. On top of all of that the children have their own issues with being separated from their parents, wondering if their parents really did abuse them and having all these traumatizing interviews from the officials. For these reasons I am hesitant to begin the process haphazardly. Just like you wouldn't sue a Doctor for mild suspicion of malpractice you shouldn't sic the government on people unless the situation warrants it. Some may prefer to have high sensitivity but low specificity on the subject of child abuse, but that has consequences they will never see. I prefer to be more specific than sensitive.