As a doctor, there is a legal obligation to report suspected physical abuse of a child under their care. This is because doctors play a critical role in protecting the health and well-being of children, and abuse can have serious and long-lasting effects on their physical and emotional health. If a doctor suspects abuse, they must document any relevant facts or signs that may have been detected, and make a report to the appropriate authority, such as child protective services (CPS). While this can be a difficult decision to make, it is important to remember that the safety and well-being of the child is the top priority. In some cases, the doctor may need to balance this obligation with the relationship of trust and transparency they have with their patient and their family, but ultimately, reporting suspected abuse is a necessary step to ensure that children receive the protection they deserve.
One of our chiropractors recently contacted us with concerns about the safety of a child in a family under wellness care. The parents are still struggling with fear of COVID and the chiropractor has noticed an increase in frustration, anger and hopelessness in this family of three.
The mother and father are both stricken with fear, still wearing masks while in public and mostly self-quarantined at home. The family unit is breaking down as the parents have now caused the fear to spread to their 7-year-old son. The mother is very controlling and does not let the child out of her sight, often hovering over him and watching his every move. The father is no longer living a healthy lifestyle and has chosen to stop exercising as he is fearful that the facility will expose him to COVID. He has become very confrontational and has taken his anger out on both his wife and son with the child advising the chiropractor that his father yells and hits him when he does something wrong. The boy has developed a facial tic over the past few months with no significant neurological findings noted by a neurologist.
The chiropractor contacted ChiroFutures about her concerns and what direction, if any, to take regarding the assurance that the child is safe. She relates the three love the care they receive and feel it is the only thing that helps and gives them hope. But the chiropractor is concerned for the child's safety and questioned if there is a need to contact an authority to investigate. The chiropractor was urged to document any relative facts or signs that may have been detected that would suggest abuse. The chiropractor relates there are no such findings evident but is concerned with the mental health of the child and its impact on his overall wellbeing and development.
There is a difficult situation for the chiropractor. When a doctor perceives that a patient, especially a child, may be in danger but there are no signs of obvious abuse, you may be taking a chance if you take the step to contact an authority like CPS to investigate. First, there is the trust and transparency that is a big part of the doctor/patient relationship. Bringing in an authority without hard facts may be the beginning of a nightmare as parents say that they were wrongfully accused and the child, due to fear of repercussions, supports their position of innocence. Board complaints, lawsuits, reputation destruction etc... are all possibilities of reaction from those accused. Just think about it - this was all because a doctor was only trying to do what he/she feels was right. Strictly speaking once the doctor suspects abuse they are legally obligated to report it.
If we step back from the situation and take some time to contemplate things, we may find that it would be better to confront the issue and help the family move through this challenge. The chiropractor could in fact advise the parents of his/her concerns and question if the parents are fully aware of what is happening right in front of their eyes. This must be done with compassion about the horrible facts surrounding the past few years of insanity. Reinforcing what she feels about the onset of the child's nervous facial tic, the negative effect of isolation and the impact of minimal social contact. Advising them to seek out a family counselor psychologist and/or social worker may be a good first step.
Please understand that this in no way guarantees that the parents will accept your position and advice and may even choose to leave the practice. It is also important to note that you have little to no control of the situation and can only provide the love and understanding someone who truly cares about them can provide and hope that the miracle of what we do supports their health and positively alters the direction their present life path is heading in.
Anthony Carrino DC, FICPA
President & Co-Founder
ChiroFutures Malpractice Program
