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December 1985

Child Abuse Reporting

Author Affiliations

Division of Educational Research Mount Sinai Hospital Medical Center Chicago, IL 60608, and Departments of Pediatrics and Preventive Medicine Rush Medical College Chicago, IL 60612
Departments of Pediatrics Mount Sinai Hospital Medical Center Chicago, IL 60608, and Rush Medical College Chicago, IL 60612

Am J Dis Child. 1985;139(12):1176-1177. doi:10.1001/archpedi.1985.02140140010001

Sir.—We read with interest the article by Saulsbury and Campbell1 entitled "Evaluation of Child Abuse Reporting by Physicians." Saulsbury and Campbell's data provide important information on physician attitudes, which should ultimately help guide the needed development of educational curricula in medical schools, residency training, and continuing education programs. Becuase of the results of a similar survey, we recently conducted in Illinois (unpublished data), several comments seem germane.

It is easy to understand our colleagues' hesitancy to report suspected cases of child abuse and neglect when the diagnoses are uncertain. In other areas of medical problem solving, a physician establishes hypotheses based on empirical suspicions and cues.2 His/her next step is to test the hypotheses using historical information in conjuction with clinical and laboratory data. Closure and therapeutic intervention usually occur only after the physician is reasonably certain of the diagnosis. In cases of child abuse and neglect, however, closure for