Academic journal article Australian Health Review

Predictors of Failure by Medical Practitioners to Report Suspected Child Abuse in Queensland, Australia

Academic journal article Australian Health Review

Predictors of Failure by Medical Practitioners to Report Suspected Child Abuse in Queensland, Australia

Article excerpt


Objective: The goal of this investigation was to examine the level of notification of child abuse and neglect and the perceived deterrents to reporting by medical practitioners, who are mandated to report their suspicions but might choose not to do so.

Design: A random sample of medical practitioners was surveyed. About three hundred medical practitioners were approached through the local Division of General Practice. 91 registered medical practitioners in Queensland, Australia, took part in the study.

Results: A quarter of medical practitioners admitted failing to report suspicions, though they were mostly cognisant of their responsibility to report suspected cases of abuse and neglect. Only the belief that the suspected abuse was a single incident and unlikely to happen again predicted non-reporting (χ^sup 2^ [1, N = 89] = 7.60, p<0.01). No gender, age or parent status differences were found between reporters and non-reporters.

Conclusions: Although the rate of non-reporting shows improvement from previous research, it is still at an unacceptable level. The failure to report appears to result not from judgement about the presence or absence of indicators of child abuse and neglect but a threshold that moves individuals to act on their suspicions. Professional development should focus on some of the fallacies which often influence medical practitioners' decisions.

Aust Health Rev 2006: 30(3): 298-304

CHILD ABUSE AND NEGLECT are very serious concerns, in that their consequences are substantial and have been shown to have a pernicious impact upon children in many ways.1 The impact can be evident across the individual's development, with negative factors being evident immediately, and continuing to emerge during childhood and adulthood, as well as intergenerationally. The early recognition of childhood abuse or neglect has been shown to contribute to a decrease in negative outcomes.2 As victims and perpetrators of child abuse and neglect typically do not self-report,3 key professionals play a vital role in identifying and reporting abuse or neglect and potentially reducing at least some of the negative consequences of child abuse and neglect.

Governments in Australia and throughout the world recognise the serious nature of abuse and neglect of children and the potentially serious consequences when this is not addressed. As a result, in many Western countries laws have been passed that have established mandatory reporting of suspected incidents of child abuse and neglect as one mechanism for addressing this concern. However, many mandated professionals have been shown to fail to report suspected abuse despite legal requirements to do so.4-8 For example, 43% of general practitioners and paediatric registrars in an Australian sample failed to report suspected abuse or neglect.6 In the period 2002-03, medical practitioners accounted for a relatively small percentage of notifications in Australia (2%-3% in most states).9

A number of reasons for failing to report suspected child abuse and neglect have been identified from studies examining a variety of groups of individuals, some mandated and others not, for example, nurses, teachers, community members and medical practitioners. The identified reasons for failure to report have included the lack of defined indicators of abuse and a lack of knowledge as to what might constitute child abuse and neglect;10,11 a perceived lack of evidence;6,8,12,13 uncertainty about reporting requirements and procedures in relation to child abuse and neglect;14,15 and knowledge of the family, 16 and the belief that the abuse was a single incident.10

Factors that have previously been found to influence medical practitioners' judgement include a reluctance to jeopardise the relationship with the child and the family;17 negative attitudes and beliefs about the effectiveness of interventions by child protection services;17 concern about legal ramifications if the allegations were investigated and found to be false, and the time required to attend court if subpoenaed to give evidence. …

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