Sexual Abuse on Children

Introduction

Since doctors usually work in a surgery or hospital clinic, the diagnosis will be made following a process of history-taking and examining the child. Pediatricians see children as their patients and are therefore bound to come into contact with child sexual abuse. Some of these children may have symptoms and signs, and if they have not disclosed the abuse they depend on a doctor to initiate concern about it. Both doctors and children will benefit from medical practice that accepts and recognizes a level of medical concern expressed in terms of 'reasonable medical certainty' (Faller, 2009).

A medical diagnosis of child sexual abuse can be a reference point which can enable other agencies to make a more informed response during a multi-disciplinary assessment. This is particularly important in preventative health terms for the young child where the doctor is able to initiate concern (Group B) and may have a vital role in beginning further assessment by making a medical diagnosis. Doctors are more likely to take on this initial responsibility on behalf of children if they believe that an accurate diagnosis is possible and, that in the absence of information to corroborate the diagnosis, they will be supported and protected. Finkelhor, makes the point that 'If the necessarily strict criteria, that of beyond reasonable doubt which is required by a criminal court of law are relied upon as the only indicator that child sexual abuse has occurred, then most sexual abuse would remain unrecognized' (Finkelhor, 2006).

To be able to discharge their role in sexual abuse effectively, doctors may need first to overcome a sense of hopelessness towards their patients whose health may be suffering because of sexual abuse. The following comments by the British Pediatric Association show how similar feelings about childhood illness have been overcome by doctors in the past:

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