The Child Abuse Pediatrician (CAP) – Just Another Term for Medical “Cop”

A new paper has recently been published by George Barry and Diane Redleaf of the Family Defense Center in Chicago.  The paper, titled  Medical Ethics Concerns in Physical Child Abuse Investigations, explores and reveals the extent of breeches of medical ethics by child abuse medical investigators (CAP’s).

This paper is a prodigious work, including five detailed case studies.

The title of Section I of Part III conveys the theme of the paper: “Physicians Have an Ethical Obligation Not to Become Law Enforcement Officers.”  And here is an excerpt from the Executive Summary:  “We submit, in this Paper, that this system of child abuse investigation and medical assessment is failing the children and families. We also submit that the failings are due at least in part to practices that are ethically questionable at best, or plainly unethical at worst. The harm of these practices occurs because, while the child may quickly recover from a toddler fracture, nursemaid’s elbow or subdural hematoma that is called in to child protection authorities as suspicious, the trauma families have experienced at the hands of the child protection system does not fade quickly or ever entirely disappear. Moreover, the Center is able to represent only a tiny fraction of the wrongly accused family members in medically complex cases and resources like the Center provides are not available to the vast majority of family members who encounter the child protection and medical care establishment in these cases. Unfortunately, we see little sign that the child protection and medical care establishment are addressing in a meaningful way the harmful impact of erroneous child abuse reports that have resulted from questionable ethical practices that this Paper documents. Indeed, for reasons this Paper documents, we believe that the medical profession has turned a blind eye to the treatment of children and families who are the victims of misplaced child abuse allegations and we are concerned about developments in the handling of medically complex allegations that make these problems worse, not better.”

Don’t get me wrong.  Child abuse is a horrific thing, but equally, if not more, horrific is when when innocent parents and care givers get thrown into prison or separated from their children for a child abuse “crime” they did not commit, and that did not ever happen.  This is a tragedy that occurs all too often when a medical diagnosis is made that does not recognize the new scientific understandings regarding symptoms that have traditionally (and wrongly) been attributed solely to abuse.

And here’s the scary part – the CAP’s, who are basically a medical cop, as part of their training, have been indoctrinated with the American Academy of Pediatrics medical dogma concerning causation of certain symptoms (the triad and long bone fractures) that they insist are pathognomonic (exclusively indicating) of abuse.  This is what the SBS Wars is all about.

“Chid Abuse Pediatrics” was established as a pediatric sub-specialty by the American Board of Medical Specialties in 2006. This definition of the discipline is from the website of the Council of Pediatric Subspecialties (ironically known as CoPS):  “Child Abuse Pediatricians are responsible for the diagnosis and treatment of children and adolescents who are suspected victims of any form of child maltreatment. This includes physical abuse, sexual abuse, factitious illness (medical child abuse), neglect, and psychological/emotional abuse. Child Abuse Pediatricians participate in multidisciplinary collaborative work within the medical, child welfare, law enforcement, and judicial arenas as well as with a variety of community efforts. Child Abuse Pediatricians are often called to provide expert testimony in the court systems. This field offers the opportunity for involvement and leadership roles in community, regional and national advocacy, and in prevention efforts and public policy.”  (emphasis is mine).

I would contend the very existence of the child abuse pediatrician specialty becomes something of a self-fulfilling prophecy.  “I’m here to diagnose child abuse, so that’s what I’m going to do.”

This would be my advice.  If you find yourself in the situation of taking your child to the emergency room, and you find yourself talking with a child abuse pediatrician (and they probably won’t tell you they are one), consider that you are under suspicion, and you are talking to the police.  How you choose to deal with that I must leave to you.