Paediatrics: Good ethical and legal practice in suspected child abuse

Good ethical and legal practice in suspected child abuse

The crucial issue for doctors is the safety of the child and this overrides considerations such as confidentiality.

·  Reporting: as soon as abuse is suspected it is important to share this information with other clinicians and social services and police.

·  Parents and carers have parental responsibility for their children. Share your concerns and course of action with them as far as is safe for the child.

Criminal proceedings

·  Crown prosecution service decides whether to bring a criminal case.

·  Burden of proof needed is ‘beyond all reasonable doubt’.

·  No hearsay evidence is permissible.

·  Magistrates Court or Crown Court.

Civil proceedings

·  Burden of proof needed is ‘on balance of probability’.

·  Magistrates Court, County Court, or High Court.

·  Divorce and other civil matters included as well as child abuse.

Court orders (Children Act 1989)

Police Protection Order

·  Application: by the police in case of emergency.

·  Duration: maximum 72hr.

·  Child removed to suitable accommodation or prevention of removal from a current location of safety (e.g. hospital ward).

Emergency Protection Order

·  Duration: 8 days, but can be extended for a period of 7 days on one occasion only.

·  Application: by anyone but usually by social services.

Child Assessment Order

·  Implemented when parents are uncooperative. In practice little used and not if there are grounds for an emergency protection order.

·  Duration: 7 days.

·  Application: by an authorized person, usually the local authority.

Interim Care Order

·  Duration: maximum 8wks.

·  Application: by the local authority usually (or NSPCC).

·  Gives parental responsibility to the local authority (i.e. social services).

Supervision orders

·  Duration: 12mths in the first instance.

·  Application: by social services or NSPCC.