Child Abuse: Reporting and Classification in Health Care Settings

Child Maltreatment Division
Division of Health Surveillance and Epidemiology
Centre for Healthy Human Development
Health Canada
1999

Executive Summary

It has been almost three decades since the Canadian and U.S. governments began a sweeping program to combat child abuse, which included the introduction of mandatory reporting statutes. Efforts to respond to child abuse and neglect include professional training, public education, research, efficiency and capacity enhancement of the service delivery system, central child abuse registries and computer databases. In addition, all major professional groups with a role in protecting children have contributed their energy and talents to reduce the incidence and effects of child abuse. Health care professionals, particularly physicians, remain the primary target of child abuse reporting statutes, given the high likelihood of their encountering maltreated children in a medical setting, and the expectation that they are most qualified to diagnose and treat certain types of child abuse. Unfortunately, an increasing number of leaders of the hospital/medical community have stated that they do not feel that health care professionals are adequately trained to identify child abuse and neglect.

Given the problems that exist concerning the identification, classification and reporting of child abuse by physicians in health care settings, this report was initiated with the goal of providing an overview of the current knowledge and issues in these areas. The specific objectives of the report are as follows:

• to identify and discuss a range of issues related to the definition, scope and reporting of child abuse;
• to study Canadian legislation and case law regarding the duty to report child abuse; and
• to provide an overview of the identification, classification and reporting of child abuse in eight selected hospital sites.

In order to accomplish these objectives a three component study was conducted. The first component involved a review of the literature of issues related to child abuse in Canada and other countries. The second component involved a comprehensive review of the Canadian legislation and case law regarding the reporting of child abuse. The final component involved collecting information by telephone interviews with hospital personnel to develop "institutional profiles" of eight selected hospital-based programs that focus on the recognition, reporting and/or treatment of child abuse across Canada. The sites were pediatric hospitals in Vancouver, Calgary, Winnipeg, Toronto, Hamilton, Ottawa, Montreal and Halifax. Recommendations on the reporting and classification of child abuse by health care professionals derived from the report are outlined below.

To receive an electronic copy of the PDF version of this information, please send your request by e-mail to child.maltreatment@phac-aspc.gc.ca

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