You are a resident in the emergency department. An irate Parent comes to you furious
because the social worker has been asking him about striking his child. The child is r.
5-year-old boy who has been in the emergency departnent four timcs this year witl
several episodes of trauma that did not seem related. Today, the child is brought in
with a child complaint of “slipping into a hot bathtub” with a burn wound on hit
legs. The parent threatens to sue you and says “How tlare you think that about m€? I
love my son!”
What should you do?
a. Give reassurance to the Parents and trcat the patient’s iniury approPriately,
b. Ask risk management to evaluate the case.
c. Admit the child to remove him from the possibly dalgerous environment.
d. Call the police.
e. Ask the father yourself if there has been any abuse.
f. Speak to the wife privately about possible episodes of abuse.
g. Explain to the parents that the nexl time this happens you will have to call chiid
prolectrve serYlces.
h. Report the family to child protective services.
i. Give the parents a referral to a family theraPist they can see with the child the
following week
(h) Report the family to child protective services.
Although, in general, it is better to address issues directly with patients and their
families, this is not the case when you strongly suspect child abuse. Reporting ofchiid
abuse is manclatory even based on suspicion alone. Although it is frightening to be
confrontational with the family, the caregiver is legally protected even if there turns
out to be no abuse as long as thc report was made honestly and without malice. You
do not have the authority to remove the child from the custody of the parents. Only
child protective services or the courts can do that. The police would be appropriate
for an assault happening at that exact moment, but the police are not appropriate to
investigate child abuse. When you have a suspicion of child abuse, it doesn’t matter
what the parents say. That is why talking directly to the mother or father is incorrect.
When you suspect abuse, even if the family denies it, you must still report.