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In 2007 approximately 794 000 children in America suffered from a form of child abuse, out of this, it was newborn infants who suffered the most with 21.9% (per 1000 children) of abuse cases falling in the 0-1 year age bracket, (Source: US Dept. Health and Human Services Child Maltreatment 2007 report. 2009)

This figure shows the alarming number of innocent children that suffer from abuse in a country that is regarded as one of the most civilised nations in the world.

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There were a total of 3.2 million referrals for suspected child abuse in 2007 concerning 5.8 million children. Out of those referrals 57.7% were made by working professionals; members of the United States Healthcare department. (Source: US Dept. Health and Human Services Child Maltreatment 2007 report. 2009)

If the percentage is viewed on its own, one could be forgiven for thinking that the healthcare system in America is failing, however when the figures are added and we can see the number of referrals and the number of confirmed incidents, a different picture is painted.

Abuse can come in many forms, especially when dealing with children who are for the most part completely dependant on their parents for the care. Abuse doesn’t have to be something that shows on the surface like a bruise or an abrasion, but can just as easily come in the form of mntal abuse.

In 2007 59.0% of all abuses cases were as a result of neglect, while a mere 10% each was attributed to sexual of physical abuse. (US Dept. Health and Human Services Child Maltreatment 2007 report. 2009)

Making a decision such as reporting a case of suspected child abuse is a hard one, and whatever the circumstances the reporter will no doubt agonize over. However when you are talking about the safety of a child there is an ethical obligation to report anything suspicious.

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 The moral and ethical code for members of the Healthcare systems states among other things:

"We shall be familiar with the symptoms of child abuse, including physical, sexual, verbal, and emotional abuse, and neglect. We shall know and follow State laws and community procedures that protect children against abuse and neglect." (http://www.childwelfare.gov/pubs/usermanuals/childcare/chapterthree.cfm. 2009.)

By following this code, any employees within the healthcare system are duty bound to report all of their suspicions. With there being on average 1760 deaths per year as a result of child abuse it should be views that every one of those fatalities being a direct result of a personal failure somewhere within the system. (Source: US Dept. Health and Human Services Child Maltreatment 2007 report. 2009)

The healthcare system itself demands that all of its employees be vigilant of abuse not just because of the possibly legal ramifications but simply because children are often easily subdued by threats or bribes.

Abuse in any form is a terrible thing that must be reported simply because in a majority of cases the victims either can’t or won’t speak up for themselves. Judgement must always be used, as not every child with a bruise or underweight is an abuse victim.

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There will always be mistakes human error is unavoidable. Doctors can see more than family members or teachers. Bruises and broken bones heal within a relatively short period of time. However, doctors can tell from x-ray results if a certain bone has been broken in the past and also the specific manner of the break. There is a clear difference between an accidental break and an intentional one.

The main area of concern surrounding this issue to the broad terms defined by the mandatory reporting laws surrounding child abuse, the one recurring statement being “Reasonable cause to suspect” and the wide range in definitions from place to place as to what the precise terms of abuse are. If these laws could be more clearly defined then maybe there is a large chance of lowering the risks out there that children are expose to. (Source: Stephen h. Behnke, Jd, Phd and Robert Kinscherff, Phd, Jd 2002.)

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