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Showing posts with label Child Abuse. Show all posts
Showing posts with label Child Abuse. Show all posts

Thursday, August 2, 2012

Psychologist Who Wrote of Abuse Is Punished

By Timothy Williams
The New York Times
Originally published July 30, 2012

A federal health services psychologist who told superiors that an American Indian tribe was ignoring widespread child abuse on a North Dakota reservation has been reprimanded and reassigned, according to federal officials and documents.

The psychologist, Michael R. Tilus, director of behavioral health at the Spirit Lake Health Center on the Spirit Lake Indian reservation, describes himself as a whistle-blower. He wrote in an e-mail to state and federal health officials this spring about an “epidemic” of child abuse on Spirit Lake, which is in a remote area of northeastern North Dakota.

Among the recipients were officials with the Department of Health and Human Services and the Indian Health Service, which oversee most health care on Spirit Lake.  

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Dr. Tilus wrote that instead of being punished, he deserved whistle-blower protection under the Food and Drug Administration Safety and Innovation Act of 2012, which was signed into law by President Obama this month. That law extends military whistle-blower safeguards to federal Public Health Service officers.

Thursday, July 12, 2012

Child Abuse Reporting: Rethinking Child Protection

By Susan C. Kim, JD, MPH; Lawrence O. Gostin, JD; & Thomas B. Cole, MD, MPH.
Journal of the American Medical Association
JAMA. 2012;308(1):37-38. doi:10.1001/jama.2012.6414
Originally published July 4, 2012

The general public has been bewildered by the magnitude of sex abuse cases and the widespread failure by pillars of the community to notify appropriate authorities. The crime of sexually abusing children is punishable in all jurisdictions. However, what is the duty to report suspected cases by individuals in positions of trust over young people, such as in the church or university sports?

Since the mid-1980s, law enforcement has been investigating allegations of sexual crimes committed by Catholic priests against young boys and girls. These sexual abuse scandals and lawsuits have cost the Church an estimated $2 billion in settlements. A 2004 US Conference of Catholic Bishops report found that law enforcement was contacted in only 24% of cases of suspected abuse. In other cases, the church hierarchy responded internally or not at all: priests may have been counseled, evaluated, provided treatment, suspended, or limited in their priestly duties.

The entire article is here.

Thanks to Ken Pope for this lead.

Monday, July 2, 2012

Sandusky Verdict: Will Reporting Rates For Sex Abuse Improve?

A strong set of beliefs prevents reporting, but seeing the system visibly work will encourage others to come forward

by Christopher J. Ferguson
Time Magazine - Ideas
Originally published June 25, 2012

Jerry Sandusky
With the verdict in the Jerry Sandusky trial behind us, it’s worth reconsidering one of the most troubling aspects of this case: Why do many people, including professionals such as psychologists and pediatricians, fail to report child sexual abuse? It is well-known that authorities at Penn State, including head football coach Joe Paterno, did not report what they had learned to legal authorities. The incident witnessed by Mike McQueary was passed up the chain at Penn State, but no one took that crucial step of informing law enforcement officials. This failure allowed Sandusky to remain free to continue to abuse children.

It is easy to convince ourselves that we would act more decisively if we were in the same situation, and many people indeed do. But even medical and mental health professionals with a legal duty to report abuse fail to do so.

The entire story is here.

Thanks to Gary Schoener for this story.

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On a national ethics educators listserv, the following exchange took place about this article.

Sam Knapp:

This article reflects popular attitudes about mandated reporting.

However, reporting rates are highly influenced by rates of substantiation after reports of abuse are made. Pennsylvania has the lowest rate of substantiated child abuse in the country (one-seventh the national average) and a rate of substantiating child abuse, which is 14% (compared to 23% nationwide). And if you look across the country you find that the states that have low rates of child abuse reports tend to have low rates of substantiating those reports and states that have high rates of child abuse reports tend to have high rates of substantiating those reports. What happens is an informal process of education where mandated reporters learn, over time, that certain reports are not going to be founded (or even investigated), so they discontinue making those reports.

Some states have proposed legislation that would make the failure to file a mandated a report a felony (in most states it is a misdemeanor). My concern is that the fear of a felony will cause mandated reporters to adopt a very low threshold for making reports resulting in an investigation of a large number of cases where the likelihood of child abuse being founded is extremely low.

I know that we as a profession can do better at educating our own on child abuse and child abuse reporting laws. My point is that reporting rates are very much influenced by the response of the child protective system to those reports.

Gary Schoener responded:

I agree Sam that reporting is not the issue in terms of mandated reporters -- at least not the lone issue.

What was troubling about the Sandusky case was not the non-reporting as much as the inaction by the adults -- especially officials.  I have seen cases where at least there is internal disciplinary action, referral for therapy, etc.  In fact, some of the high visibility Catholic cases actually did involve taking action -- it's just that the action was ineffective.

One common problem was the failure of professionals who were sent pedophiles for treatment to know what they were doing, or to propose a return to work without any surveillance.  You may not remember, but in Boston there was a big pissing match between the Archdiocese and the Institute for Living.  The Archdiocese did not ask if the guy should be put back, and the Inst. for Living allegedly made no such warning or recommendation about safety.

Likewise, that Minnesota statute I mentioned was directed at people like us, asking that we be accountable in cases where someone has been caught and is being fired or resigning.  We have not eliminated silence agreements completely, I am sure, but they are very rare indeed here.

I certainly agree that reporting to child protection can be very ineffective, and the same can be true for reporting to the police. 

Sunday, November 20, 2011

Doctors Might Miss Some Cases of Child Abuse

By Robert Preidt
MedicineNet.com

Many cases of child abuse are not reported by primary health care providers, a new study suggests.

Primary care providers (PCPs) are usually doctors but can also be physician assistants and nurse practitioners.

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The PCPs and child abuse experts agreed about the suspicion of abuse in 81% of the cases, but PCPs did not report 21% of injuries that the experts said they would have reported to child protective services (CPS).

The story can be read here.

The research article can be found here.