All Australian states and territories have legislation that requires medical practitioners to report cases of child abuse to the appropriate child protection service. This article outlines the obligations of medical practitioners to report child abuse and highlights the differences that exist in the legislative requirements in each state and territory.
On 1 August 2007, a 17 month old child was seen by a paediatrician at St Ann's Hospital, London. The presenting problems were listed as aggressive behaviour, including biting and hitting other people, easy bruising and a fungal scalp infection. The paediatrician noted three bruises on the left side of the child's face and 10–15 bruises on his back. The paediatrician provided a referral for investigation of possible metabolic disease and discharged the patient home with his mother.
Two days later the patient was dead. A postmortem examination revealed multiple injuries, including eight fractured ribs, an area of bleeding around the spine at the cervical level and numerous bruises, cuts and abrasions.
In November 2008, the child's mother, her boyfriend, and his brother were convicted of causing or allowing the child's death.
An expert review of the case concluded that the bruising the patient presented with on 1 August 2007 was typical of child abuse, and should have been recognised as such by the paediatrician.
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