By Judge Susan D. Reed, Bexar County District Attorney
From grandparents slowly starving a child to a mother killing her two children and hiding them under her house, we see the stories in the media and think, “How was it that no one noticed the abuse of this child?”
However, after an investigation into their death, we discover that most children who die at the hands of their caregivers have suffered from repeated abuse. There are many compelling reasons for reporting suspected child abuse or neglect but clearly the most important one is to protect children from further abuse.
During fiscal year 2006, more than 239,100 reports of alleged abuse or neglect involving children were made to Child Protective Services (CPS). These reports generated 196,302 investigations of child abuse or neglect. Of the 196,302 investigations, only 31,127 (15.9 percent) were reported by medical professionals.
Common sense, however, would dictate that medical professionals are generally on the front line detecting child abuse, and therefore play a critical role in the early identification of this abuse.
Texas law requires child abuse and neglect be reported. In fact, failure to do so is against the law. The standard used to determine under what circumstances a physician must report abuse of a minor is when the physician “has reason to believe that a minor has been or may be physically or sexually abused by a person responsible for the minor’s care, custody or welfare.” The standard is not that the physician “knows” that the minor has been abused, but that the physician has reason to believe.
Because immediate investigation by law enforcement or Child Protective Services may save a child from repeated abuse, physicians are required by law to report suspected abuse or neglect of a child within 48 hours of the time they suspect the child has been abused or neglected.
The physician’s duty is to report and not to investigate child abuse.
The investigation is done by others. Additionally, if a physician believes a child has been abused or neglected, he or she may examine the child without the consent of the child or his or her parents or legal guardian. However, if the child is 16 years or older, he or she can refuse the examination.
Although the law requires physicians to report child abuse, morally, the safety of our children demands it. Children are not able to change their situation and in most cases it is the person who they trust the most who is abusing them. These unfortunate children need the intervention of others to save them.
It is too late to help the children who have died as a result of child abuse, but early reporting of suspected abuse can prevent future deaths. Physicians are, in many instances, the first line of defense for a child. Please report what you suspect.
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