A mother brings her young daughter
to the pediatrician with a dislocated shoulder and bruising
along one side of her face. "She fell off her bike,"
her mother says ruefully, "again." True enough,
the chart shows the girl was in three months earlier for
a broken arm, also after a fall from her bike. Flipping
back, the doctor notices she was admitted with a concussion
as a toddler. Are these just normal childhood injuries
or could it be abuse?
More and more, pediatricians
are hesitating before opening up the child abuse can
of worms, according to child protection experts in Britain.
Recent high-profile cases of falsely accused parents
have pediatricians there feeling vilified. Several child
abuse theories have been debunked and the doctors who
espoused them are being investigated, all of which is
fostering a culture of fear among British doctors. The
number of children on the British child protection register
has fallen from 35,000 in 1995 to 26,600 last year,
which experts cite as evidence that fewer doctors are
reporting abuse.
Two high-profile disciplinary cases against doctors
in Britain are undoubtedly responsible for the recent
backlash. First, several cases in which a parent was
sent to jail for murdering babies who'd apparently died
of crib death were overturned or reopened. The common
feature at most of their trials was testimony from an
expert witness named Sir Roy Meadows. The eminent pediatrician
-- known for his Munchausen's Syndrome by Proxy theory
that some mothers abuse or induce illness in their children
to draw attention to themselves -- had become sought
after by prosecutors for his influential new theory.
Dubbed 'Meadow's Law,' it stated that one crib death
is a tragedy, two suspicious, three murder, and that
the chances of a second crib death in a family were
one in 73 million. Two of the mothers, Sally Clark and
Angela Canning, had their convictions overturned; Trupti
Patel, on trial at the time for triple infanticide,
was acquitted. Britain's General Medical Council (GMC)
is currently investigating Sir Meadows for professional
misconduct. Sir Meadows' colleague, Professor David
Southall, the pioneer behind the controversial idea
of covert surveillance of suspected abusive parents,
faced similar charges. Professor Southall saw Sally
Clark's husband Steve being interviewed on television
and became convinced that Mr Clark, and not his wife,
was responsible for the death of their two sons. He
promptly informed police of his suspicion; his interference
resulted in his professional misconduct case. At the
time Professor Southall was suspended from his hospital,
which had received several complaints relating to false
accusations of child abuse. The GMC panel ruled that
his actions were inappropriate and irresponsible and
will decide in August if his licence should be revoked.
Meanwhile, in Canada a recent survey of pediatrics residents
found that they feel ill-equipped to deal with child
abuse. "Ninety two percent of residents feel they
need further training in child protection, including
85% of graduating residents," said Dr Susan Bennett,
head of the Child and Youth Protection Program at the
Children's Hospital of Eastern Ontario, in a public
statement. Another survey revealed that Canadian doctors
who work in child protection have high levels of burnout.
These finding have prompted the Canadian Paediatric
Society to launch the Child and Youth Maltreatment Section
to educate and support doctors working in the field.
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