Child Abuse Reporting Requirements

Reporting Requirements

• Mandatory Reporting of Child Abuse
  • Anyone who witnesses or reasonably suspects child abuse (mental or physical) must report it immediately to protective services.
  • There is concurrent federal law for diagnoses made at a federal facility.
  • Physicians who diagnose or treat children 13 years old or younger for a sexually transmitted disease must report it to the Department of Health.
  • Failure to report is a criminal offense, a Class A misdemeanor.
• Reporting Child Sexual Abuse
  • Anyone who knows or has reason to believe a child has been sexually abused is obligated to report it to the Department, local law enforcement, or the local Juvenile Court judge
  • Those who report in good faith are immune from civil or criminal liability
  • Failure to report is a crime, a Class A misdemeanor
  • In child sexual abuse cases, there is no physician-patient or other privilege that can prevent someone from testifying or providing a report.
• Reporting Injuries from Violence
  • Anyone who renders aid to an individual injured by a deadly weapon, other means of violence, poison, exposure to a meth lab, or suspected mutilation of female genitalia must report it to the chief of police, sheriff, and district attorney.
  • There is an exception for injuries that are not life-threatening and are sustained by:
    • Individuals 18 years of age or older
    • Individuals who object to disclosure
    • Victims of sexual assault or domestic abuse
  • EMTs reporting to a physician are not subject to this exception.
  • Those who report in good faith are immune from civil liability.

Vulnerable Populations in Research

• Vulnerable populations require special considerations in research participation due to their potential for exploitation and difficulty in providing informed consent.
• Categories of Vulnerability:
  • Cognitive or Communicative vulnerability
  • Institutional vulnerability
  • Deferential vulnerability
  • Medical vulnerability
  • Economic vulnerability
  • Social vulnerability
• Specific Examples of Vulnerable Populations:
  • Pregnant women
  • Human fetuses
  • Neonates
  • Prisoners
  • Children
  • Individuals with physical disabilities
  • Individuals with mental disabilities or cognitive impairments
  • Economically disadvantaged individuals
  • Socially disadvantaged individuals
  • Terminally ill or very sick individuals
  • Racial or ethnic minorities
  • Institutionalized persons (correctional facilities, nursing homes, mental health facilities)

IRB’s Role in Human Subjects Research

• The Institutional Review Board (IRB) plays a critical role in reviewing research involving human subjects, especially children.
• Informed Consent and Assent Requirements
  • For research involving children, both parental consent and child assent (affirmative agreement) are required.
  • This demonstrates respect for individual autonomy and the understanding that all individuals deserve absolute, infinite worth, not relative worth.
  • Kant’s ethics grounds the outrage over using human subjects as "ends-in-themselves" in experimentation and emphasizes the importance of informed consent in research.

Bioethics Case Analysis

• A Framework for Case Analysis:
  • Medical Indications (Beneficence and Nonmaleficence):
    • Nature of the medical problem, its severity, and appropriate therapies
    • Treatment goals, probability of success, and plan if treatment fails
    • How can the patient benefit and harm be avoided?
  • Patient Preferences (Respect for Autonomy):
    • The patient's mental capacity, legal competency, and treatment preferences
    • The patient's understanding of information, their informed consent, and their possible coercion
    • Identification of appropriate surrogates if the patient lacks capacity.
• Treating Minors (Respect for Autonomy and Parental Rights):
  • Consent for minors may be required in various medical situations:
    • Situations where the minor's life is in danger or they are unable to consent.
  • Specific areas requiring parental notification or permission:
    • Contraception, pregnancy treatment, treatment of STDs
    • Substance use issues or medical situations resulting from substance use
    • Emergencies when a parent cannot be contacted in time.
  • Parents may be required to provide consent for specific procedures, like abortion.
  • Informed Consent:
    • This is a vital aspect of respecting patient autonomy.
    • It involves providing patients with clear and comprehensive information about treatment options and obtaining their permission to proceed with the plan.
    • For informed consent to be valid, patients must be given all pertinent information, understand it, express their preferences freely, and the consent must be documented.
• Treatment Decisions:
  • Patients or their surrogates have the right to reject any treatment plan at any time.
  • Patients can refuse a specific treatment option without refusing all options.
  • Patient refusal does not constitute physician abandonment, still requiring the physician to provide appropriate care, except for what the patient has refused.
  • Refusal of medical care does not automatically constitute suicide or grounds for deeming a patient incapacitated.
• Physician-Assisted Suicide:
  • It is illegal in most states and rare. Physicians cannot administer medications, and the patient must self-administer.
  • It does not include medically appropriate doses of pain medication provided the patient or designee receives information about possible side effects.
  • Patients have the right to refuse food and water and potentially die of dehydration.
  • Patients sustained on machines can refuse care and request that treatment be stopped.
  • This issue is considered wrong on COMLEX-USA and USMLE exams.

This quiz explores the mandatory reporting requirements for child abuse, including obligations for healthcare professionals and penalties for failure to report. Understand the legal responsibilities and protections for those who report suspected abuse, as well as the definition of child sexual abuse and its implications. Test your knowledge on this critical topic.