Provider ambivalence about using forensic medical evaluation to respond to child abuse: A content and discourse analysis

Morris, Marian; Rivaux, Stephanie L.; Faulkner, Monica

doi:10.1016/j.chiabu.2017.01.016

Cited by 5 publications

(4 citation statements)

References 27 publications

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“…In a recent qualitative study, Morris, Rivaux, and Faulkner found that healthcare providers at child advocacy centers noted their concerns for all children they evaluate, not just the cases that go to trial, while emphasizing that the well‐being of the child and family is the top priority of clinicians (26). The study included child abuse pediatricians as well as other healthcare providers (26). This is also reflected in the practice of each child abuse pediatrician at the current study’s location.…”

Section: Discussionmentioning

confidence: 99%

“…Occasionally, the close proximity of child abuse pediatricians and district attorneys in multidisciplinary teams sparks a perception that a child abuse pediatrician’s primary focus is to only diagnose maltreatment. In a recent qualitative study, Morris, Rivaux, and Faulkner found that healthcare providers at child advocacy centers noted their concerns for all children they evaluate, not just the cases that go to trial, while emphasizing that the well‐being of the child and family is the top priority of clinicians (26). The study included child abuse pediatricians as well as other healthcare providers (26).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Legal Outcomes of Suspected Maltreatment Cases Evaluated by a Child Abuse Pediatrician as Part of a Multidisciplinary Team Investigation

Hendrix

Conway

Baxter

2020

Journal of Forensic Sciences

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Child abuse pediatricians often carry the stigma that their sole role is to diagnose maltreatment. In reality, child abuse pediatricians use their clinical experience and current evidence‐based medicine to make the best medical diagnoses for the children they evaluate. To better understand the legal conclusion of suspected maltreatment cases with medical examinations, this study sought to: (i) evaluate the percentage of children seen for suspected maltreatment that led to a clinical diagnosis of maltreatment, (ii) determine the number and type of criminal charges associated, and (iii) analyze the legal outcomes of cases as they proceeded through the judicial system. This study retrospectively reviewed the legal outcomes of 1698 children medically evaluated in 2013–2014 as part of an investigation by a multidisciplinary team at a children’s advocacy center in a mid‐sized city in Oklahoma. Data were collected from electronic medical records, the district attorney’s office, and a public court docket. Of the original cohort, 477 (28.09%) children yielded a medical diagnosis of at least one type of maltreatment. Further analysis yielded 115 unique court cases involving 138 defendants and 151 children. A total of 286 charges were filed resulting in 190 convictions. While maltreatment allegations yield a high number of children that must be evaluated, a comprehensive medical evaluation helps determine which cases do not have sufficient medical findings for a diagnosis of maltreatment. The findings in this study indicate that a majority of suspected maltreatment cases seen by child abuse pediatricians did not result in criminal court outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Legal Outcomes of Suspected Maltreatment Cases Evaluated by a Child Abuse Pediatrician as Part of a Multidisciplinary Team Investigation

Hendrix

Conway

Baxter

2020

Journal of Forensic Sciences

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“…Such findings align with previous research indicating that jurors expect some form of physical evidence in cases of child sexual abuse (Shelton, Kim, & Barak, ). However, health care providers have reported ambivalence about conducting a forensic medical evaluation in response to reported child sexual abuse (Morris, Rivaux, & Faulkner, ), a phenomenon that could negatively impact victim believability and reporting.…”

Section: Discussionmentioning

confidence: 99%

Simulated judicial decision‐making for African and European American adolescents with illegal sexual behavior: The impact of medical data and victim race/ethnicity

Fix

Falligant

Alexander

2019

Behavioral Sci & The Law

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The perceived importance of victim and defendant race/ethnicity and medical evidence in child sexual abuse cases has been recognized separately in the literature. However, few studies have considered these factors simultaneously. Within a sample of 880 college students, an interaction effect was tested between the presence of medical evidence and the race/ethnicity of a juvenile defendant and victim using child sexual abuse case vignettes. The main effects of medical evidence and the race of the defendant were observed. Medical evidence and race of victim influenced victim believability such that medical evidence was more impactful for cases with African American victims. Further, there were interactions between the race of the defendant and the race of the victim in adult versus juvenile court decisions, sex offender registration and notification requirements, and length of sex offender registration and notification. Interracial sexual offending was associated with substantially higher punishment than intraracial sexual offending. Accordingly, several important implications for court‐level decision‐making processes are explored.

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“…Concerns have been raised that such examinations contribute to children's and adolescents' distress and emotional trauma (Dubowitz, 1998; Rachamim & Hodes, 2011) and may be traumatising for the child or young person (Guertin et al, 2019). This has resulted in ambivalence to refer children for such examinations (Al‐Jilaihawi et al, 2017; Morris et al, 2017). However, very little contemporary research exists to validate or refute such concerns.…”

Section: Introductionmentioning

confidence: 99%

Forensic medical examinations: The body as gateway to healing after child sexual abuse

Keeffe

McElvaney

2022

Child Abuse Review

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Despite consensus that the forensic medical examination is an integral component to a comprehensive response to child sexual abuse (CSA), concerns have been expressed about the impact of these examinations on children and young people. A small-scale survey was conducted with a group of CSA professionals (n = 19), followed by semi-structured interviews with six adolescents, accessed through CSA specialist units in Ireland. While concerns were expressed about the examination, overall, professionals were in favour of it as part of a holistic therapeutic response to CSA. Five themes were identified from the interviews with adolescents: the experience of the examination as an imposition, the unknown nature of the examination, the focus on the body itself, feeling exposed and having a say. Findings highlight how a trauma-informed approach, with emphasis on information sharing and supporting the autonomy of the young person's voice and choice throughout the process, could provide a transformative experience for young people, helping them integrate their psychological and physical sense of themselves. The forensic medical examination can facilitate the healing and recovery process by bringing into awareness many of the anxieties that, due to shame or inability to tolerate associated emotional pain, remain unspoken and unspeakable following CSA.

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Provider ambivalence about using forensic medical evaluation to respond to child abuse: A content and discourse analysis

Cited by 5 publications

References 27 publications

Legal Outcomes of Suspected Maltreatment Cases Evaluated by a Child Abuse Pediatrician as Part of a Multidisciplinary Team Investigation

Legal Outcomes of Suspected Maltreatment Cases Evaluated by a Child Abuse Pediatrician as Part of a Multidisciplinary Team Investigation

Simulated judicial decision‐making for African and European American adolescents with illegal sexual behavior: The impact of medical data and victim race/ethnicity

Forensic medical examinations: The body as gateway to healing after child sexual abuse

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