Advanced search

Read PDF version

Reporting child abuse: An important responsibility of doctors
An article for physicians by physicians
Originally published Fall 1996 / Revised May 2008
IL9640-2-E

Of interest to physicians dealing with children

The parents of an eight month old brought their child to the emergency department of a small community hospital for evaluation at 2315 h. The father stated that the child had a history of whooping cough for the last five weeks and he had brought the child in for persistent crying. He admitted he had "spanked the child around the head". The family physician on call performed an examination, and made arrangements for the child to be transferred to a tertiary Children’s Hospital for a CT scan and additional evaluation. The family physician on call discussed the case with the receiving physician at the tertiary care centre, and the receiving physician was aware that the Children’s Aid Society (CAS) at the transferring community had not been notified yet.

The ambulance picked up the child from the community hospital around 0100 h and the ambulance attendants allowed the father to accompany the child. During the transport the ambulance attendants realized that it was the father who had admitted to "slapping" the child. While en route they notified the police at the receiving area. The child reached the tertiary care centre at approximately 0300 h, where the receiving physician notified the receiving area Children’s Aid Society. At approximately 1100 h a nurse, on behalf of the family physician on call, notified the referring area Children’s Aid Society.

The family physician on call at the community hospital was charged with failure to report child abuse contrary to the Child and Family Services Act.

The court stated that, in consideration of the purpose, intent and clear direction set out by the Act, once abuse is suspected or believed to have occurred, there should be no hesitation with respect to:

1. when is a good time to make the call to the CAS,
2. who would be best to make the call or,
3. where the call should be made from.

The court concluded that physicians must "simply place the call"! In consideration of all the evidence, the judge found that the family physician did not exercise due diligence in fulfilling his obligation to report.

This decision was appealed and the judgment was reversed. The appeal court stated that it is acceptable to delegate the task of reporting, but the physician who delegates the responsibility of reporting child abuse remains at risk if the case is not reported in accordance with the Act.

The appeal court also stated that, while a 3-4 hour delay may not be appropriate in some circumstances, for example, when the child has been released to the potentially abusive parents, in this case the delay was acceptable. The family physician had weighed the situation, satisfied himself as to the health and safety of the child and had taken the appropriate steps. The appeal court concluded that there is no evidence that the appellant had acted in an arbitrary, capricious or improper manner.

To report the possibility of child abuse to the appropriate child protection agency in a timely and effective manner is an obligation which physicians have by law, and which society expects them to fulfill. The exact wording of the legislation may vary from one jurisdiction to another, and the name of the agency or government department to which reports must be made may also vary, but the obligation remains the same.

The bottom line:

• If a physician has reason to believe a child is in need of protection, he/she is responsible for seeing that the appropriate authority is informed in a timely manner.
• The child should not be put at risk by any delay or delegation of the act of reporting.