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PED-EM-L  February 2014

PED-EM-L February 2014

Subject:

Re: Questioning a minor

From:

Christopher Kelly <[log in to unmask]>

Reply-To:

Christopher Kelly <[log in to unmask]>

Date:

Mon, 24 Feb 2014 16:03:02 -0500

Content-Type:

text/plain

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Parts/Attachments

text/plain (73 lines)

Sorry if my initial post was not clear, but Dr. Ethan's response was not my question.  My question is whether or not it is legal to question a 9 yr old about the possibilities of abuse by a parent without telling said parent you are about to question the child about abuse (ok so thats probably not any clearer.)  I do it all the time with 12 and 13 yr olds, however its usually a discussion about sexual activity or drug use.  I don't tell the parent the nature of the discussion, I just ask them to leave for a few moments. I'm more concerned about the legalities of it.  And no, a comprehensive forensic interview was not performed, it was simply a "hey do you feel safe at home?  Is anyone hurting you?"
Thanks again, 
Chris



> Date: Mon, 24 Feb 2014 05:36:28 +0000
> From: [log in to unmask]
> Subject: Re: Questioning a minor
> To: [log in to unmask]
> 
> It seems to me that the question here is who should do the interview rather than if it should be done.  The problem is that you are basically asking to do a forensic interview which many people are not particularly good at and which could considerably hamper both a real investigation or action if such is warranted.  I am certain that the laws which regulate and mandate reporting to child protective services in each of our states (this is where we get very USA-centric; although the laws may be similar elsewhere I am not so familiar how broadly this is true) would require that the healthcare provider that has any suspicion of abuse must report in order for a "proper" investigation to ensue (I place proper in quotations because of the high degree of variability with which these investigations take place based on jurisdiction, local bias, etc and so our confidence in the veracity and reliability of its findings may be similarly highly variable).  This is, no doubt, one of those tricky situations with which we are faced and needs to be handled expertly.  The question often arises by house-staff about whether the parents should be notified about the report prior to making it or if that in and of itself would bias the results (by the way, I believe in full disclosure).  It certainly changes the tenor of the visit quite a bit.  It also then raises a multitude of other questions.  Clearly you would perform a thorough physical exam to look for other evidence of abuse (which admittedly we may not all have done for a simple hand or foot complaint, for example).  If you find evidence of "real" physical abuse, you would not let that child leave the hospital without proper reporting for fear of ongoing abuse as well as potential harm to siblings in the home.  Is the same true in this circumstance?  Is all abuse treated equally?  Is it all just as injurious to the child?  As in so many situations (and as we all entirely too familiar), the answer is never so simple. 
> Very clearly yours,
> Ethan
> 
> Ethan Wiener, MD
> PUGSOM
> Kuala Lumpur, Malaysia
> and
> Goryeb Children's Hospital
> Morristown, NJ
> 
> ________________________________________
> From: Pediatric Emergency Medicine Discussion List [[log in to unmask]] on behalf of Christopher Kelly [[log in to unmask]]
> Sent: Saturday, February 22, 2014 11:41 AM
> To: [log in to unmask]
> Subject: Re: Questioning a minor
> 
> Yes the child is brought in as a patient for an unrelated complaint, and while in the hospital, a hospital employee witnesses the child be "verbally abused" by a parent, to the point where she is concerned for the child. It is brought to your attention. What do you do?
> 
> 
> Chris
> 
> > On Feb 22, 2014, at 4:28 AM, Doc Holiday <[log in to unmask]> wrote:
> >
> > This will be an interesting thread.
> > Before it begins, could I ask whether we are stating for the sake of it that the minor to whom you refer is the patient who's in your care?
> > I am 99% certain that this is what you meant, as this is a PEM list, but my practice is only about 25% PEM and I am quite certain the answer would be different if the child is not the patient, only in the company of the patient.
> > So please confirm.
> > Thanks.
> >
> >
> >> Date: Fri, 21 Feb 2014 16:26:04 -0500
> >> From: [log in to unmask]
> >> Subject: Questioning a minor
> >> To: [log in to unmask]
> >>
> >> Question for the groupů
> >> Does anyone know about the legalities of questioning a minor (lets say a 9 yr old) about the possibilities of parental abuse without that parent's consent to question them?
> >> If someone witnessed potentially abusive behavior of a child in your hospital and notified you, could you question the child without the parents permission?
> >> Thanks
> >
> > For more information, send mail to [log in to unmask] with the message: info PED-EM-L
> > The URL for the PED-EM-L Web Page is:
> >                 http://listserv.brown.edu/ped-em-l.html
> >
> 
> For more information, send mail to [log in to unmask] with the message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
>                  http://listserv.brown.edu/ped-em-l.html
> 
> 
> 
> The information contained in this email is intended only for the use of the person(s) identified above. This communication may contain work product which is privileged and confidential, and may contain content which is regulated by Federal law. If you are not an intended recipient or the employee or agent responsible to deliver this to the intended recipient, you have received this message in error and any review, distribution or copying of it by you is prohibited. If you have received this message in error, please notify the sender immediately, and delete the message. E-mail and communication system messages generated by members of the Atlantic Health System workforce may not necessarily reflect the views of Atlantic Health System, its officers, directors or management.
> 
> For more information, send mail to [log in to unmask] with the message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
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For more information, send mail to [log in to unmask] with the message: info PED-EM-L
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