Abuse can be presented in many forms including, physical, emotional, sexual, and neglect. In Ireland, guidelines are set by the Medical Council to ensure the safety and well being of the child and to make sure that situations of abuse get reported. In addition to these guidelines, the Children First Guidelines have been implemented to ensure that child abuse and neglect is reported on by medial professionals (Spain, 2017). When identifying abuse and neglect, three things must be considered: the possibility of abuse, signs of abuse, and the doctors collection of information about the abuse (Spain, 2017).
Under the Children First Act of 2015, if a doctor suspects upon reasonable grounds that the child is being harmed or abused in any way (physical, sexual, neglect, or emotional abuse), they are obligated to report these findings to authorities and to The Child and Family Agency (Spain, 2017). If the child has told the doctor they are being harmed, this must also be reported (Spain, 2017). The doctor should only report when there are reasonable grounds to believe the child is being abused, it may not be a suspected hunch or a gut feeling, and should be supported by evidence as documented in a medical record. Under the Children First Act, the doctor must act in the best interest for the child. However, there is no criminal penalty against the doctor when they fail to report a case of child abuse or neglect to authorities (Spain, 2017).
Along with the Children First Act of 2015, the Criminal Justice Act of 2012 states that doctors must report offences of child abuse (Spain, 2017). The law states that a doctor is guilty if they do not report to the Gardia against an offender if they know an offence was committed against a vulnerable person (Spain, 2017). However, in defense of the child, a doctor can also choose to withhold information on the basis that they are protecting the vulnerable person (Spain, 2017).
When reporting instances of abuse, the doctor must take into consideration the confidentiality of the patient. The patient has the right to trust the doctor that what they say will be held in confidence. On the other hand, the obligation of the doctor is to protect both the individual and the public from harm (Spain, 2017). The doctor should tell the parents of the child that the case is going to be reported to the authorities (Spain, 2017). In situations such as these, the breach of patient confidentiality is justified to protect vulnerable populations (Spain, 2017).
Reflect upon the challenges posed to doctors in reporting
Reporting situations of abuse may be challenging for the doctor dealing with the situation. Reporting becomes a difficult decision for the doctor when factors come into play that make an abuse case difficult to tease apart. These situations include not knowing if the child has been abused or if the family cannot provide enough for the child, such as unemployment, mental illness or addiction of the parents, or poor housing conditions (Spain, 2017). Some doctors may also find it hard to believe that a child is being abused or neglected and may dismiss signs of abuse to some other cause (Spain, 2017).
Many doctors find reporting on abuse difficult as they are unsure what the outcome of reporting will be. The doctor might not want to report the case as the parents might lose trust in their doctor and disengage in the health care system. The parents may take the child away so that they cannot be found by authorities. This might put the child at an even greater risk for further abuse or neglect. A doctor might be afraid to act on this basis as this would only cause more harm and no benefit to the child at risk.
In addition to thinking about the safety of the child and the public, the doctor is also challenged with the consequences of reporting a case and being wrong. Several questions may be asked. Will the community lose trust in the capability of the individual doctor? Of the profession as a whole? Will other colleagues lose respect for making a wrong call? Will there be personal consequences, and will they be sued? Could they have their licence taken away from them? Will I have to go to court? If a doctor breaches patient confidentiality and is wrong, the accused may challenge them in court. To avoid this confrontation, doctors are protected if they have acted in good faith under the Protection for Persons Reporting Child Abuse Act, 1998 (Spain, 2017). This Act indicates that this breach of confidentiality can be justified if the doctor was acting in good interest of the public. These are just some examples of challenges professionals may face when deciding to report on suspected child abuse or neglect.