Making allegations without due care is wrong

doi:10.1136/bmj.330.7506.1508

BMJ 2005;330:1508 (25 June), doi:10.1136/bmj.330.7506.1508

Letter

Making allegations without due care is wrong

The first 150 words of the full text of this article appear below.

EDITOR—Dyer reported that parents wrongfully accused ofchild abuse cannot sue doctors.¹ When doctors are required toreport abuse but are given unlimited immunity for reportinga suspicion of child abuse, over-reporting seems likely. Themost serious problem arises when suspicions become formal diagnoses.

In my practice, I regularly see charts in which the first personto raise a suspicion of abuse is considered to have made a definitiveand incontrovertible diagnosis. Subsequent consultants echoit, and it is assumed to be fact. Except when a medical studentsees the child, there is seldom the barest outline of a differentialdiagnosis anywhere in the record. Such failure to consider,and systematically exclude, alternative explanations for thechild's signs and symptoms represents tunnel vision and oftenprecludes further investigation. It is poor medicine that would,in any other setting, be ample grounds for a negligence action.

At minimum, a . . . [Full text of this article]

Peter J Stephens, forensic pathologist

100 Club Drive, Suite 135, Burnsville, NC 28714, USA pjstephens@ccvn.com