Letters

Disclosure of child sexual abuse

BMJ 1998; 317 doi: http://dx.doi.org/10.1136/bmj.317.7152.208 (Published 18 July 1998) Cite this as: BMJ 1998;317:208

Maintaining confidentiality is not in best interest of woman or others

  1. B Harrington, Lecturer in child health.a
  1. Department of Child Health, St Mary's Hospital, Manchester M13 OJH
  2. a Professor David is Head of the academic department to which I belong. I have not discussed the case, or this letter, with him.
  3. Dudley Priority Health NHS Trust, Department of Psychiatry, Bushey Fields Hospital, Dudley, West Midlands DY1 2LZ

    EDITORmdashIn the recent ethical debate on child sexual abuse an allegation of a serious criminal offence was made in a situation of assumed confidentiality.1 Revealed child abuse (physical or sexual) is rarely an isolated occurrence, and perpetrators tend to escalate their activities with time.2 Sexual abuse of children is a personality disorder which does not spontaneously resolve and is refractory to intervention.3If these allegations are true, other children may have been or may still be being abused.

    Medical training inculcates an ability to make decisions. This can create an expectation of making a decision when it may be inappropriate for the decision to be made by an individual doctor. A fundamental tenet of child abuse work is to share information. Indeed, the Children Act makes this a duty.4One person …

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