Conclusion

An apparent consensus about child abuse masks profound disagreements about the proper boundaries of family privacy, the obligations of parents and health professionals, and governmental responsibility to oversee the care and nurturing of children. These disagreements are reflected in difficulties in defining child abuse, difficulties in enforcing compliance with mandatory reporting requirements, and difficulties in evaluating the effects of interventions. Thus, while the law requires that child abuse be reported if it is suspected, health professionals can create their own index of suspicion. Some providers may report ambiguous cases, while others rarely report suspected abuse at all.

Individuals who work with children must balance their legal and ethical obligations to children, to their parents or caretakers, and to society. Professionals who have a higher regard for familial privacy and parental authority may develop a stricter standard or a higher threshold for suspecting abuse, and thus may be less likely to report it. Professionals who believe more strongly in the independent rights of children may develop a lower threshold for suspecting abuse, and may thus be more likely to report it. Current legal and moral approaches, while theoretically compelling, are quite recent, and have not been thoroughly evaluated. The principle that children deserve protection and nurturance is generally accepted, but the means by which the principle is to be brought to fruition remain uncertain.

JOHN D. LANTOS (1 995) BIBLIOGRAPHY REVISED

SEE ALSO: Children: History of Childhood; Circumcision, Female; Harm; Homicide; Social Work in Healthcare; and other Abuse, Interpersonal subentries

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